Conectar
by Qian Yue Tan, Kinda Ibrahim, Helen C. Roberts, Khaled Amar, Simon D.S. Fraser
BackgroundPeople with Parkinson’s (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes.
ObjectiveTo assess the extent of treatment burden in Parkinson’s disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden.
MethodsA mixed-methods study was conducted consisting of: 1) a UK-wide cross-sectional survey for PwP and caregivers using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden levels and associated factors and 2) focus groups with key stakeholders to discuss survey findings and develop recommendations.
Results160 PwP (mean age = 68 years) and 30 caregivers (mean age = 69 years) completed the surveys. High treatment burden was reported by 21% (N = 34) of PwP and 50% (N = 15) of caregivers using the MTBQ. Amongst PwP, higher treatment burden was significantly associated with advancing PD severity, frailty, a higher number of non-motor symptoms, and more frequent medication timings (>3 times/day). Caregivers reporting higher treatment burden were more likely to care for someone with memory issues, had lower mental well-being scores and higher caregiver burden. Three online focus groups involved 11 participants (3 PwP, 1 caregiver and 7 healthcare professionals) recruited from the South of England. Recommendations to reduce treatment burden that were discussed in the focus groups include improving communication. clear expectation setting, and better signposting from healthcare professionals, increasing education and awareness of PD complexity, flexibility of appointment structures, increasing access to healthcare professionals, and embracing the supportive role of technology.
ConclusionsTreatment burden is common amongst PwP and caregivers and could be identified in clinical practice using the MTBQ. There is a need for change at individual provider and system levels to recognise and minimise treatment burden to improve health outcomes in PD.
by Anne-Fleur Griffon, Loeïza Rault, Clément Tanvet, Etienne Simon-Lorière, Myrielle Dupont-Rouzeyrol, Catherine Inizan
BackgroundComparing the in vitro fitness of dengue virus (DENV) isolates is a pivotal approach to assess the contribution of DENV strains’ replicative fitness to epidemiological contexts, including serotype replacements. Competition assays are the gold standard to compare the in vitro replicative fitness of viral strains. Implementing competition assays between DENV serotypes requires an experimental setup and an appropriate read-out to quantify the viral progeny of strains belonging to different serotypes.
MethodsIn the current study, we optimized an existing serotyping qRT-PCR by adapting primer/probe design and multiplexing the serotype-specific qRT-PCR reactions, allowing to accurately detect and quantify all four DENV serotypes. We next developed an in vitro competition assay to compare the replicative fitness of two DENV serotypes in the human hepatic cell line HuH7.
FindingsThe qRT-PCR was specific, and had a limit of detection below 7.52, 1.19, 3.48 and 1.36 genome copies/µL, an efficiency of 1.993, 1.975, 1.902, 1.898 and a linearity (R²) of 0.99975, 0.99975, 0.99850, 0.99965 for DENV-1, −2, −3 and −4, respectively. Challenge of this multiplex serotype-specific qRT-PCR on mixes of viral supernatants containing known concentrations of strains from two serotypes evidenced an accurate quantification of the amount of genome copies of each serotype. Quantification of the viral progeny of each serotype in the inoculum and the supernatant of competition assays using the serotype-specific multiplex qRT-PCR unveiled an enrichment of the supernatant in DENV-1 genome copies, uncovering the enhanced replicative fitness of this DENV-1 isolate.
ConclusionsThis optimized qRT-PCR combined with a relevant cellular model allowed to accurately quantify the viral progeny of two DENV strains belonging to two different serotypes in a competition assay, allowing to determine which strain had a replicative advantage. This reliable experimental setup is adaptable to the comparative study of the replicative fitness of any DENV serotypes.
Chronic subdural haematoma (CSDH) is a common neurosurgical condition in older adults, with a recurrence rate of approximately 7.1–13% after burr-hole drainage. Although surgical adjuncts such as subdural drains and middle meningeal artery embolisation may reduce recurrence, these are not suitable for all patients. Pharmacological strategies, including tranexamic acid, Goreisan and carbazochrome sodium sulfonate hydrate, have shown potential, but high-level evidence remains lacking. A prior retrospective study suggested that a triple oral regimen combining these agents may reduce recurrence. This randomised controlled trial aims to evaluate its efficacy and safety.
This is a prospective, multicentre, open-label, randomised controlled trial conducted across six hospitals in Ibaraki, Japan. A total of 180 patients undergoing first-time burr-hole surgery for CSDH will be randomised 1:1 to receive either triple therapy (Goreisan 7.5 g/day, carbazochrome sodium sulfonate hydrate 90 mg/day and tranexamic acid 750 mg/day for up to 90 days) or standard postoperative care. The primary outcome is recurrence requiring reoperation within 90 days. Secondary outcomes include time to recurrence and haematoma volume reduction on serial CT imaging. All analyses will follow the intention-to-treat principle, using logistic regression, Cox proportional hazards models and mixed-effects models.
Written, informed consent will be obtained from all participants at each participating hospital by trained staff from that hospital. The trial protocol has been approved by the ethics committee of the University of Tsukuba Hospital (approval no. TCRB23-025) and the Institutional Review Boards of all participating centres. Study findings will be disseminated through presentations at scientific conferences and publications in peer-reviewed journals. A summary of the results will also be provided to participating institutions and made publicly available in accordance with the BMJ Open data sharing policy.
jRCTs031240007.
by Emily Dunlap, Yanbing Zhou, Manny M.Y. Kwok, Billy C.L. So, Hirofumi Tanaka
ObjectiveTo evaluate the effects of aquatic exercise compared with non-exercise controls and land-based exercise on arterial stiffness and endothelial function.
DesignSystematic review and meta-analyses of randomized controlled trials assessed using the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation.
Data sourcesPubMed/MEDLINE, CINAHL Plus, SPORTDiscus, and reference lists, searched from database inception to April 16, 2025.
Eligibility criteriaStudies evaluating chronic aquatic exercise (multi-session interventions) compared with land-based exercise or non-exercise comparison groups in adults, measuring arterial stiffness via pulse wave velocity (PWV) or endothelial function via flow-mediated dilation (FMD).
ResultsThis review includes 18 randomized controlled trials with 845 participants (mean age 65 ± 7 years). Studies compared aquatic exercise with non-exercise controls (8 studies), land-based exercise (6 studies), or both (4 studies). Exercise sessions averaged 50 minutes, 3 times weekly for 11 weeks. Most studies (17 out of 18) implemented moderate-to-vigorous intensity protocols. Aquatic exercise resulted in improvements in arterial stiffness compared with non-exercise controls (7 studies; SMD = –2.37, 95% CI: –4.46 to –0.29; I2 = 98%: low certainty), with most evidence reflecting systemic and peripheral PWV. Changes in arterial stiffness did not differ from those observed after land-based exercise (6 studies; SMD = –0.07, 95% CI: –0.34 to 0.20; I2 = 0%, moderate certainty). For endothelial function, aquatic exercise may improve outcomes versus non-exercise controls (6 studies; SMD = 0.91, 95% CI: 0.39 to 1.43; I2 = 68%; low certainty) and may lead to greater improvements than land-based exercise (7 studies; SMD = 0.55, 95% CI: 0.05 to 1.06; I2 = 75%; low certainty).
ConclusionAquatic exercise improves systemic and peripheral arterial stiffness as well as endothelial function compared with non-exercising controls. Changes in arterial stiffness do not differ from those observed after land-based exercise. Aquatic exercise may provide greater improvement in endothelial function than land-based exercise, though this is supported by low-certainty evidence, and substantial heterogeneity limits confidence in the generalizability of this finding.
PROSPERO registrationCRD42025642087.
by Natthakul Akarapredee, Chalirmporn Atasilp, Chonlaphat Sukasem, Pimonpan Jinda, Rattanaporn Sukprasong, Jiraporn Jensuriyarkun, Soravit Wongjitjanyong, Patompong Satapornpong, Natchaya Vanwong
IntroductionIrinotecan is a chemotherapy agent commonly prescribed for metastatic colorectal cancer but often leads to neutropenia. Variations in genes encoding drug-metabolizing enzymes and transporters may affect the toxicity and effectiveness of irinotecan. This study aimed to examine the impact of these genetic polymorphisms on irinotecan outcomes in Thai colorectal cancer patients.
MethodsThe study retrospectively analyzed 41 metastatic colorectal cancer patients treated with irinotecan-based chemotherapy. Genotyping was conducted for 23 single nucleotide polymorphisms in genes including UGT1A1, CYP3A4, CYP3A5, CES1, ABCB1, ABCC2, ABCC5, ABCG1, ABCG2, and SLCO1B1.Toxicity and efficacy were assessed, with statistical significance set at a Bonferroni-corrected P value Results
In terms of toxicity, UGT1A1*6 was significantly associated with both all-grade and severe neutropenia in the first cycle (p p p ABCC2 -24C > T variant was linked to all-grade neutropenia in the second cycle (p = 0.001). For efficacy, patients with the wild-type UGT1A1*6 had longer progression-free survival (PFS) (p SLCO1B1 521T > C variant was associated with improved PFS (p Conclusion
UGT1A1*6 and ABCC2 -24C > T variants emerge as potential predictors of irinotecan-induced neutropenia, while UGT1A1*6 and SLCO1B1 521T > C may serve as markers of prolonged PFS in Thai patients. Validation through larger prospective studies is essential to confirm and refine these genetic associations.
by Fabian Standl, Lena Senger, Heribert Stich
BackgroundSex workers are often considered at elevated risk for sexually transmitted infections (STIs). This pilot study describes the socio‑epidemiological characteristics of registered sex workers in a rural German setting, estimates the prevalence of four STIs (HIV, hepatitis B [HBV], hepatitis C [HCV], and syphilis [lues]), compares these with the local population, and assesses HBV immunization coverage.
MethodsUnder §10 of the Prostitute Protection Act (ProstSchG), annual health consultations are mandatory; voluntary serologic testing is permitted under §19 of the Infection Protection Act. We conducted a retrospective observational monocentric pilot study using routine consultation records and voluntary serologic results from the Public Health Service (PHS) of Landshut (2017–2021). In total, 523 consultations were documented; 99 blood samples from 48 registered sex workers (2019–2021) were analyzed. Primary screening assays were followed by confirmatory tests when indicated. Crude point/period prevalences and 95% confidence intervals (95% CI) were calculated. HBV immunization was defined according to Standing Committee on Vaccination (STIKO) recommendations.
ResultsThe cohort was predominantly female (n = 47; 97.9%), mean age 34.8 ± 11.2 years; 85.3% (n = 41) had a migration background (n = 27; 56.3% from Eastern EU countries). No acute HIV, HBV, or HCV infection was detected. Evidence of past HBV infection (anti‑HBc) was found in n = 7 (14.6%; 95% CI: 6.8–26.5), past HCV in n = 1 (2.1%; 95% CI: 0.2–9.3). Syphilis serology was reactive in 12.5% (n = 6), with n = 2 (4.2%; 95% CI: 0.9–12.7) meeting criteria for treatment‑requiring infection. HBV vaccine‑induced immunity was documented in 43.8%; only 29.2% achieved titers ≥100 mIU/ml. Compared with regional surveillance data, the prevalence of acute notifiable STIs among sex workers was not increased.
ConclusionsIn this rural setting, acute notifiable STIs were uncommon among registered sex workers, while past HBV infection and suboptimal HBV immunization were frequent. Public health efforts should prioritize HBV vaccination and syphilis prevention or treatment, and expand low‑threshold, trusted services tailored to this workforce.
Approximately 53 million family caregivers (FCGs) support and provide home-based care for patients with chronic and life-limiting conditions. Caregiving at the end of life is an emotionally, cognitively and physically demanding role, and FCGs are often unpaid and receive little training. FCGs in remote, rural areas experience adverse social determinants of health (SDOHs), such as limited access to healthcare services and are often financially vulnerable, affecting their healthcare coverage, placing them at higher risk for poor emotional health. Adequate health literacy, a key SDOH, may be a protective factor. The purpose is to present the protocol of an explanatory sequential mixed-method study aiming to examine rural-dwelling FCGs’ emotional health, relationships among FCG characteristics (demographics, co-morbidities) and SDOH and health literacy as a potential mediator.
With 80% power to detect a mediation effect of at least 0.11 when the two-sided alpha is 0.05, an anticipated 108 adult rural FCGs who are providing palliative end-of-life care (PEOLC) will be recruited. Rigorous remote, digital- and community-based recruitment strategies will be employed to increase access to FCGs from under-represented rural communities. Self-report surveys include demographic and health characteristics, SDOH (health literacy, education level, employment status, annual income level, healthcare access and insurance) and anxiety/depressive symptoms. Descriptive statistics will be used to characterise the sample. Correlation analysis and one-way Analysis of variance (ANOVA) will be used to study the relationships between FCG characteristics, SDOH and anxiety/depressive symptoms. Hayes’ PROCESS Macro for IBM SPSS Statistics will be used to test mediation effects of health literacy between FCG characteristics/SDOH and anxiety/depressive symptoms. Indirect effects will be tested using bootstrapped CIs. Semistructured interviews will be conducted with a representative sample to elicit FCG perceptions relative to how SDOH affect their care provision and emotional health, then analysed using content analysis. Quantitative and qualitative strands will be examined and compared for convergence and divergence, then integrated for final interpretations.
Michigan State University’s Institutional Review Board has reviewed and approved the study. Written informed consent will be obtained from each participant. Study findings will be disseminated through publications in peer-reviewed journals and presentations at academic conferences.
Study outcomes will inform the role of SDOHs, particularly health literacy, for the development of interventions to emotionally support rural FCGs.
Perioperative psychological symptoms are prevalent among patients undergoing lung surgery and can contribute to adverse clinical outcomes. Pharmacological interventions for these symptoms have inherent limitations. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising non-invasive therapeutic approach. This study aims to evaluate the efficacy of taVNS in managing perioperative psychological symptoms in patients undergoing elective thoracoscopic pneumonectomy under general anaesthesia.
This single-centre, prospective, randomised, double-blind, controlled trial will enrol 176 patients scheduled for elective thoracoscopic lung resection. Participants will be randomly allocated to either the active taVNS or the sham taVNS groups in a 1:1 ratio. Both groups will receive 30 min active or sham stimulation sessions at four time points: (1) the afternoon prior to surgery, (2) the morning of the surgery, (3) following extubation and (4) the first afternoon postsurgery. The primary outcome is the incidence of perioperative anxiety, assessed using the Hospital Anxiety and Depression Scale-Anxiety subscale. Secondary outcomes include depression scores, stress index, sleep quality, pain scores, incidence of postoperative delirium, fatigue, cough symptoms and postoperative recovery quality, all evaluated through validated assessment tools. Analyses will be conducted using intention-to-treat and per-protocol populations.
The Ethics Committee of Affiliated Hospital of Xuzhou Medical University granted approval for the study with approval number: XYFY2024-KL444-01. Dissemination will be via national anaesthesia conferences and publication in the peer-reviewed literature.
ChiCTR2400090542.
Postictal agitation (PIA) is a common adverse effect following electroconvulsive therapy (ECT). Current pharmacological treatments for PIA have undesirable side effects, and interventions to prevent PIA are unsatisfactory. The aim of this study is to assess the effect of peri-interventional music on PIA for patients undergoing ECT. Additionally, the study will assess the impact of music on pretreatment anxiety and post-treatment cognitive impairment.
This multicentre, open-label, parallel randomised controlled trial (RCT) aims to include 92 patients from two centres in Rotterdam, the Netherlands. Participants will be randomised into two groups: a music intervention group and a control group. The music group listens to recorded music 30 min before and 12 min after each of the first six ECT sessions of the full ECT course, while the control group will receive standard care. The primary outcome is the presence of PIA, measured using the Richmond Agitation-Sedation Scale (RASS). Secondary outcomes include the severity and duration of PIA, pretreatment anxiety, recovery duration, peri-treatment medication requirements, cognitive impairment and depression severity. Data will be analysed according to an intention-to-treat principle.
This study protocol has been approved by the Medical Ethical Review Committee of the Erasmus Medical Centre on 28 January 2025 (MEC-2024–0467) and subsequently received local approval at Antes Parnassia group. The trial will be carried out following the Declaration of Helsinki principles. Study results will be reported in a peer-reviewed journal according to the Consolidated Standards of Reporting Trials guidelines.
The purpose of this article is to present the Gothenland Millennium Cohort, describe the data collection process, present key measures used and summarise some of the key findings to date in order to stimulate collaboration and use of the cohort data. This research programme was originally established to study pathways to alcohol and drug use, behavioural problems, mental health issues, and the factors that promote or prevent these outcomes. The Cohort aims to support scientific research and doctoral education through a longitudinal study that tracks individuals from early adolescence through adulthood. This programme is multidisciplinary (social work, psychology, disability research) with the goal of producing high-quality research that deepens our understanding of how early-life vulnerabilities, risks and protective factors influence long-term wellbeing, including health and welfare, in diverse populations.
In 2013, all school-registered adolescents, in grades 6 and 7 (aged 12 and 13), in four municipalities in Gothenland region (ie, southern Sweden) born in year 2000 or 2001, were invited to participate. Of 2150 invited adolescents, 1885 (88%) accepted participation in the programme and 1760 (93.4%) participated in at least one of the annual data collection waves up to grade 9 (Wave 4), with participation rates ranging from 70% to 85% per wave. Wave 5 questionnaires were collected during the second year of upper secondary school (grade 11). In Wave 5, half (50.4 %; n = 949) of the adolescents participated. In Wave 6, interviews were conducted with a selection of participants in their last year of upper secondary school (grade 12). Parents were surveyed in Waves 1 and 2 by self-report questionnaires (response rate = 32%; 41%). Data were also gathered from teachers (attrition
Over 240 publications have been produced as of September 2025 in the areas of disability and everyday functioning, child-parent relationships, child welfare, substance use and criminal behaviour, mental health, trauma, harassment, and sexuality.
These include continued investigation of wellbeing and its related indicators during adolescence as well as in emerging adulthood, continued efforts to secure funding and an age 25 expansion of the cohort data.
Hypertension and depression frequently co-occur, complicating patient management and worsening outcomes. This scoping review aims to systematically map non-pharmacological interventions for managing comorbid hypertension and depression, providing insights into current practices and guiding future research.
Following the Joanna Briggs Institute guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews standards, a comprehensive search was conducted across multiple databases, including PUBMED, Embase, PsycINFO, CINAHL, Cochrane Library, Chinese Biomedical Literature Database and Chinese National Knowledge Infrastructure, covering the literature from January 2004 to December 2023. Studies were selected based on predefined inclusion criteria focusing on non-pharmacological or complex interventions. Data extraction was performed using the Template for Intervention Description and Replication checklist to ensure detailed and structured summaries of each intervention.
Fifteen quantitative studies were included, most of which were pilot randomised control trials, pre-post studies and with generally small sample sizes (20 to 2365). Interventions were categorised into integrated and coordinated care, behavioural and psychological interventions and physical and lifestyle interventions. Delivery methods varied, with most interventions being face-to-face, while a few used digital platforms such as mobile apps and telephone support. Disease-level and patient-level outcomes were mainly reported, while only three examined system-level outcomes. 13 of 15 included studies showed positive results in managing comorbidity. The variability in follow-up periods (ranging from 1 week to 12 months) and measurement instruments across studies limited the ability to draw consistent long-term conclusions.
This scoping review highlights the role of psychosocial and non-pharmacological interventions, particularly collaborative/integrated care and behavioural therapies, in managing comorbid hypertension and depression. These interventions consistently improve depressive symptoms, with mixed effects on blood pressure control. Further research is needed to standardise core outcomes and evaluate the long-term effectiveness and scalability of these interventions.
Diabetes distress (DD) constitutes a negative emotional experience for patients with diabetic retinopathy (DR), having a detrimental impact on their physical and mental health.
The aim of this study was to understand the current status and influencing factors of DD in patients with DR and to explore the relationship between self-efficacy, coping styles and DD.
A cross-sectional study.
The study was conducted at the Eye Hospital of Wenzhou Medical University, Zhejiang Province, China.
Patients diagnosed with DR.
The Diabetes Distress Scale was used to assess DD.
DD was present in more than half (53.07%) of patients with DR. There were significant differences in DD among patients with DR who reported different employment statuses, modes of residence and body mass index. Coping styles partially mediated the relationship between self-efficacy and DD, with the mediating effect accounting for 71% of the total effect.
Considering the high prevalence of DD among patients with DR, healthcare professionals should pay more attention to the psychological needs of patients with DR. Effective interventions could be used to promote self-efficacy and coping styles of patients with DR, leading to lower levels of DD.
The EPHOR-NIGHT cohort was established to investigate how night shift work influences biological pathways and chronic disease risk using a comprehensive working-life exposome approach, focusing on cardiometabolic, mental health, cognitive and biological ageing outcomes.
The cohort includes 937 workers aged 20–65 years (88% female), primarily from the healthcare sector (96%) in Spain, Sweden, Denmark and the Netherlands. Participants were categorised as permanent day (39%), permanent night (35%) or rotating/other shift workers (26%). Data collection included questionnaires, daily ecological momentary assessments, wearable sensors tracking light, physical activity, heart rate and environmental exposures and biological samples (blood collected once and saliva collected during five points across the day), with harmonised protocols across countries.
From the 937 participants contributing data to the cohort, 708 had complete information from questionnaires, sensors and blood and saliva, with subsets undergoing advanced biological analyses, including genomics, targeted and genome-wide DNA methylation, telomere length and mtDNA copy number, metabolomics, transcriptomics, proteomics, hormone profiling and inflammatory biomarkers and blood metals. Many reported prevalent chronic conditions, including anxiety (27%), depression (18%) and metabolic disturbances. Night shift and rotating shift workers had greater exposure to long shifts and more scheduled rest days compared with day workers. Sleep duration and quality were poorest among permanent night shift workers.
A 2-year follow-up was completed in June 2025, including the collection of additional biomarker data, psychosocial work environment data and data related to female sexual and reproductive health. Findings from the EPHOR-NIGHT study aim to inform prevention strategies and occupational health policies. Data will be made available to support broader research efforts on shift work and health.
by Saleh A. Alqahtani, Shadan AlMuhaidib, Dimitri A. Raptis, Waleed K. Al-Hamoudi, K. Rajender Reddy, Dieter C. Broering, Saad A. Alghamdi, The OTCE Collaborative
BackgroundLiver transplantation (LT) represents the life-saving treatment for advanced liver disease. We aim to investigate LT indication trends and outcomes in Saudi Arabia, following the evolution of effective therapies for hepatitis C virus (HCV) and the rising fatty liver disease prevalence.
MethodsWe retrospectively analyzed data from adult patients who underwent LT from 2011 to 2023 at a tertiary referral center in Saudi Arabia. We assessed demographics, LT indication trends, Model for End-stage Liver Disease (MELD) scores, donor type, and survival outcomes.
ResultsA total of 1,419 patients were included. The median age was 56.9 years, with 37.4% female. Living donor LT (LDLT) represented 79.8% of all transplants, and 22.0% of recipients had hepatocellular carcinoma (HCC). Metabolic dysfunction-associated steatohepatitis (MASH) was the predominant indication for LT (33.2%), followed by HCV (18.0%) and hepatitis B virus (HBV) (17.1%). Overall survival rates at 1-, 2-, 3-, 5-, and 10-years post-transplantation were 87.9%, 85.0%, 82.4%, 77.7%, and 71.3%, respectively. Hazard ratios (HR) for mortality were lower in patients with HBV compared to MASH (HR: 0.44, 95% CI: 0.28–0.69, p Conclusions
MASH represents the leading indication for LT in this large cohort, necessitating preventive strategies and early detection efforts.
(1) Explore the role of core abdominal exercise in people living with a stoma in Australia; (2) determine whether the presence of a parastomal hernia influenced participant symptoms and complications, health status, experiences with different types of exercise, recall advice given by healthcare professionals; (3) determine whether there is an appetite for supervised/supported exercise programs.
A cross-sectional, anonymous survey.
Between August and September 2022. The survey included Likert scales and a single free text response. Logistic regression and Cramer's V were used to explore relationships between variables.
Approximately half (45.5%) of 105 participants reported a parastomal hernia. Those with a parastomal hernia were less likely to recall having received advice (15.20%) or demonstration (9.40%) pertaining to exercise. Less than a quarter of all participants completed strengthening (23.80%) or vigorous (22.90%) exercise. Fear of vigorous exercise, abdominal exercise and heavy lifting were high in both groups. Relationships between healthcare advice, exercise-related fears and avoidance of heavy lifting were observed.
Many Australians living with a stoma are not achieving physical activity recommendations. While exercise behaviours did not differ between people with and without a parastomal hernia, recall of healthcare advice around exercise did. Fear-avoidance relationships were observed.
Most people living with a stoma do not recall advice about core abdominal exercises. Healthcare practitioners need to be aware of fear-avoidance related to lifting among people living with a stoma. This was the first study in Australia, exploring perspectives and experiences regarding exercise; providing foundations for future research particularly exercise programs.
This study adhered to relevant EQUATOR guidelines and the reporting of survey studies (CROSS).
This study did not include patient or public involvement in its design, conduct, or reporting.
To examine older persons' experiences and participation in life-enhancement activities in a long-term care facility.
Convergent mixed-methods design.
Naturalistic observations of 20 life-enhancement activity sessions were conducted in a single long-term care facility that includes 111 older persons in September 2024. Data were collected through guiding questions and fieldnotes for systematic observation. We used Kruskal-Wallis and Mann–Whitney U tests for quantitative analysis. Fieldnotes were analyzed using a six-phase reflexive thematic analysis approach.
Engagement levels (self-initiative, assistance-seeking frequency, and social interaction frequency) significantly differed across 16 different life-enhancement activities. Social interaction frequency also varied by mobility status (wheelchair, walker, independent). Participants displayed significantly more distractions in the TV Room than in the Activity Room. Four themes emerged from thematic analysis: (1) participation barriers, (2) activity contextual factors, (3) facilitator support strategies, and (4) social interactions and emotional well-being.
Structural elements (purposefully designed rooms, activity design and complexity, and the resident-preferred music), relational elements (facilitators' hands-on support, conflict resolution, and positive reinforcement), and individual factors (mobility status) influence older persons' participation in life-enhancement activities. Life-enhancement activities benefit older persons when they are provided with choices and adaptive equipment.
Findings support allocating distraction-free spaces for life-enhancement activities, incorporating resident-preferred music and game-layered physical exercises, and providing facilitator training in adaptive coaching, hands-on support, and conflict resolution.
Life-enhancement programs can promote psychosocial well-being among older persons in long-term care facilities by transforming routine recreational activities into personalized and socially engaging experiences that may reduce feelings of loneliness.
Journal Article Reporting Standards for Mixed Methods Research.
No Patient or Public Contribution.
Stroke nurses must perform dysphagia screening on all suspected stroke patients, adhering to best practice guidelines. While comprehensive training is essential for safe and competent screening, the variability in dysphagia screening tools leads to significant differences in education.
This scoping review aims to collate and report what education is provided to stroke nurses on the use of dysphagia screening tools.
A scoping review guided by the PRISMA-ScR checklist.
A systematic review of three electronic databases identified 318 peer-reviewed studies. After screening and eligibility assessment in COVIDENCE, 10 studies were included. Data from these studies was analysed using Arksey and O'Malley's thematic framework.
MEDLINE, CINHAL, Scopus.
Ten studies were included in this review which yielded the following major themes: (1) comprehensive and structured training; (2) diversity of training methods; (3) ongoing education and competency assessment; and (4) standardised protocols and tools.
Offering comprehensive training programs to stroke nurses on dysphagia screening tools is associated with more timely interventions and improved outcomes; however inconsistent approaches to training make it difficult to benchmark outcomes of the education provided. Future research should explore stroke nurses' experiences with current training to guide future training program development.
This review highlights the importance of training stroke nurses to use dysphagia screening tools to improve patient outcomes.
No patient or public contribution.
FreshRSS 