Conectar
Medical device-related pressure injuries (MDRPIs) are a patient safety concern in acute and critical care settings. Registered nurses must implement preventive strategies, yet gaps remain in their knowledge, attitudes, and clinical practices related to MDRPI prevention. This study aimed to evaluate the effectiveness of a structured educational intervention in improving registered nurses' knowledge, attitudes, and practices related to MDRPI prevention. A quasi-experimental pre–post intervention study was conducted in a tertiary care hospital in Saudi Arabia, with 311 registered nurses participating. Data were collected using a questionnaire assessing knowledge, attitudes, and practices related to MDRPI prevention. Participants received a one-day structured educational program based on the knowledge, attitude, practice (KAP) framework and the evidence-based SKINCARE bundle. The educational intervention resulted in significant improvements. Mean scores increased from 14.17 (SD = 2.38) pre-intervention to 16.25 (SD = 1.97) post-intervention (t = −11.81, p < 0.001). The intervention demonstrated a moderate-to-large effect size (Cohen's d = 0.67), indicating meaningful improvement in nurses' preventive competencies. Structured educational programs can enhance registered nurses' knowledge and practices in MDRPI prevention. Integrating evidence-based training programs into routine hospital education may strengthen pressure injury prevention guidelines and improve patient safety outcomes.
Multivitamins and minerals (MVMs) are readily available dietary supplements that help prevent nutritional deficiencies and boost energy. This study examined the prescribing and consultation practices of healthcare professionals (HCPs) related to MVM supplements in Pakistan.
This cross-sectional study used a web-based structured questionnaire to collect data from HCPs from February 2021 to January 2022. The study link, which included a consent form and questionnaire, was circulated on social media platforms, and all individuals who provided consent and completed the forms were included in the study.
A total of 524 HCPs participated in the study, with the majority being males, holding MBBS or Fellow of the College of Physicians and Surgeons qualifications, and working in urban settings. Findings revealed that HCPs prescribe MVMs for varied reasons. We assessed differences based on various factors like gender, education level, area of practice and specialty. Most of the differences observed were not statistically significant, except for a few related to area of practice and education level that were found significant. The primary conditions prompting MVM prescriptions included osteoporosis and bone pain (80% for vitamin D and calcium), fatigue and weakness (over 70% for iron) and numbness/tingling (more than half for folate and vitamin B12). Regarding biospecimen analysis before prescribing MVMs, 46% of HCPs required laboratory investigations before prescribing vitamin D and calcium and 60% for iron prescriptions. Common formulations prescribed include cholecalciferol for vitamin D deficiency (62%) and ferrous sulfate for iron deficiency (76%).
Our study findings highlight that the prescribing practices of MVMs by HCPs are primarily in line with the known physiological roles of these supplements. However, a few identified gaps in practices highlight the need for standardised guidelines to ensure patients’ health and well-being.
by Mohammad Nazmol Hasan, Md. Robin Islam, Rafee Shahrier, Md. Bayazid Hossen
Abiotic stressors, such as drought, salinity, and heavy metals, induce physiological changes, nutritional imbalances, molecular alterations, and oxidative stress in plants, which significantly reduce productivity. However, the secondary transporters, multidrug and toxic compound extrusion (MATE) proteins, transport substrates and metabolites. Accordingly, in response to abiotic stressors, these proteins strengthen plants’ immune systems, detoxify toxins, and enhance growth and development. Although the roles of MATE proteins responding to abiotic stresses have been investigated in several plants, their functions in sunflower have not yet been discovered. Therefore, this study identified 74 MATE proteins in sunflower (HanMATE) based on phylogenetic analysis, which were distributed into four subgroups. Their MATE-like properties were then validated using the domain, motif, gene structure, gene duplication, and physicochemical analysis. The HanMATE proteins in various cell organelles play a crucial role in abiotic stress tolerance, scavenging reactive oxygen species (ROS), and regulating transcription. Subsequently, Most HanMATE genes are enriched with biological processes and molecular functions that transport micro- and macro-molecules, drugs, negatively charged ions, organic anions, and citrate. The important Cis-regulatory elements (CREs), abscisic acid-, light-, and MeJA-responsive elements in HanMATE genes regulate plants’ growth and development in stress conditions. The synteny analysis indicated that 41 HanMATE proteins exhibit over 75% sequence similarity with 40 established stress-responsive (SR) MATE proteins from various plant species, suggesting their potential SR characteristics. Furthermore, this study identified 136 microRNAs linked to 58 HanMATE proteins, including 19 major hub microRNAs and 31 hub HanMATE proteins, which may enhance sunflower agronomic traits and abiotic stress resistance. The HanMATE proteins are conserved in other species that contribute to detoxification and have stable binding affinity with flavonoids and citric acid, validated from 3D structural modeling, molecular docking (MD), dynamic simulation, and functional prediction. These findings demonstrate that HanMATE genes are essential for sunflower abiotic stress tolerance (AST), and genetic engineering can be applied to develop more robust sunflower.Non-communicable diseases (NCDs) have become the leading cause of mortality globally, with a sharp rise in Iran due to lifestyle changes and urbanisation. Although many NCD risk factors are modifiable, limited understanding of their determinants hinders effective prevention. To address this, the Prospective Epidemiological Research Studies in Iran (PERSIAN) Cohort was established in 2014 to study NCDs nationwide. The Sabzevar PERSIAN Cohort Study (SPECS) is the first in northeastern Iran, aiming to investigate environmental and social factors influencing NCDs in a unique regional context.
SPECS enrolled 5174 adults (aged 35–70 years) in northeastern Iran between January 2018 and January 2019 through a census and an online registration process. The baseline data collection included demographic verification, informed consent, health questionnaires, anthropometric measurements and biological samples (blood, urine, hair, nails). The annual follow-up began in April 2019, with full reassessments every 5 years over a 15-year period. The data is gathered via an active and passive follow-up, supported by trained staff and registry linkages.
Of the 5174 participants, 4241 (81%) remained in the study. Among the cohort, 54.5% were female, with a mean age of 50.5 years. The majority were married (93.5%), and nearly half had at least high-school education (46.5%) and moderate socioeconomic status (49.4%). Drug abuse history (smoking/drugs) was reported by about 15% of the sample. The mean body mass index was 26.9 kg/m², and the average blood pressure was higher in males (118.1/74.0 mm Hg) than in females (111.5/70.2 mm Hg). The common conditions included hypertension (22.8%), kidney stones (22.4%), fatty liver (15.4%) and diabetes (13.8%). Cancer had the highest treatment rate (100%), while fatty liver had the lowest (70.1%). Stroke had the highest mean age of onset (51.2 years), and epilepsy the lowest (23.7 years). All health data were self-reported.
SPECS, part of the national PERSIAN cohort initiative, is the only adult NCD-focused study in Khorasan Razavi. Its 15-year follow-up aims to generate region-specific insights into the incidence of NCDs and their risk factors. The ethnically homogeneous sample enhances statistical power, and the findings may inform culturally tailored health policies. While self-reported data have limitations due to bias, high initial participation and access to free healthcare support long-term engagement, especially among lower-income groups.
Commentary on: Shen K, McGarry BE, Gandhi AD. Health care staff turnover and quality of care at nursing homes. JAMA internal medicine. 2023 Nov 1;183(11):1247–54.
Implications for practice and research Reducing staff turnover in nursing homes can lead to significant improvements in the quality of care. Future research should focus on the factors influencing staff retention and the mechanisms through which turnover affects care quality.
This study investigates the association between healthcare staff turnover and quality of care in nursing homes.
To evaluate the maximum number of patients per nurse before quality and safety outcomes deteriorate in medical-surgical settings.
A secondary analysis of cross-sectional survey data.
We analysed data from 609 direct care nurses working in British Columbia's medical-surgical areas. The relationship between nurse-to-patient ratios and quality and safety outcomes was analysed using both two-level and one-level regression models, including visualisations such as boxplots and scatterplots with LOESS curves. The analysis controlled for nurse demographics and hospital clustering effects.
Ratios ranged from 1:1 to 1:9, with outliers above 1:9 excluded. For desirable outcomes, last shift quality of care, unit safety grade, and recommending units to friends/family and to colleagues, the means were generally positive for ratios ranging from 1:2 or 1:3 to 1:4 but negative for ratios ranging from 1:5 to 1:8 or 1:9. This pattern was reversed for adverse outcomes, undone tasks and emotional exhaustion; the means were generally negative for ratios between 1:1 and 1:3 to 1:4 but became positive for ratios between 1:5 and 1:6 to 1:8. A turning point (crossing zero) was found between the ratios of 1:4 and 1:5 for all outcomes except patient adverse events, where the turning point was between the ratio of 1:3–1:4.
The findings provide preliminary evidence in support of minimum nurse-to-patient ratios of 1:4 in British Columbia's medical-surgical areas. Policy-makers and decision-makers should augment minimum nurse-to-patient ratios with other nurse-driven tools and nurse-management staffing methods that provide more flexibility to better meet fluctuating environmental, patient and staffing needs.
This study did not include patient or public involvement in its design, conduct, or reporting.
Minimum ratios should be complemented by nurse-driven tools and flexible staffing strategies to account for contextual and resource variability.
This secondary analysis of 2015 survey data from 609 medical-surgical nurses in British Columbia, Canada supported a minimum nurse-to-patient ratio of 1:4 using a series of quality and safety outcomes for patients and nurses. This finding provides important preliminary evidence in support of the specific minimum nurse-to-patient ratios of 1:4 as the province prepares to implement this ratio in medical-surgical settings. Existing staffing models using minimum nurse-to-patient ratios may be augmented by employing additional staffing tools and methodologies that provide more flexible resource allocation.
This study adheres to STROBE guidelines.
Negative pressure wound therapy (NPWT) is widely used to facilitate healing by improving local perfusion, reducing edema and controlling exudate. The porous foam dressing is central to NPWT effectiveness, however, its performance in viscous, particle-rich exudates remains challenging. Standard industry tests often rely on protein-free aqueous solutions, which overlook the complex rheology and particulate load of real wounds. This study reports a bench evaluation of a multilayer foam prototype compared with three commercial dressings under NPWT, using a simulated viscous exudate with suspended particles. We recorded 60-min drainage curves and quantified effluent turbidity as a simple, interpretable proxy for particulate transport, summarised as percentage of input turbidity recovered. The mass-based endpoint (percent solid matter recovered) showed the same ranking as turbidity. At −75 mmHg, the prototype recovered 31.6% of input turbidity, exceeding commercial foams (≤ 9.7%). At −125 mmHg, particulate recovery decreased across all dressings (≤ 9.1%). A matrix-only control indicated that commercial effluents, particularly at −75 mmHg, clustered near background level, whereas the prototype evacuated substantially more particulate while maintaining robust fluid drainage. These findings suggest that moderate negative pressure and multilayer architecture can help preserve channel patency and reduce clogging in complex exudates. We highlight the need for test methodologies that incorporate viscosity and particulate content, and for practical guidance that links dressing architecture and pressure settings to exudate characteristics. Prospective validation, including larger-sample confirmation, particle-size distributions and ultimately clinical endpoints, is warranted.
by Saad Al-Lahhaam, Raghad Dweikat, Tala Nazzal, Aman Maraqa, Joud Khalil, Tala Albadawi, Raghad Doufish, Wa'd Amer, Mustafa Ghanim, Mohammad Abuawad, Amer Ghrouz, Samar Alkhaldi, Laith El-lahham, Majdi Dwikat, Maha Rabayaa, Malik Alqub
BackgroundTinnitus is a prevalent condition worldwide, particularly among adolescents, that has a substantial impact on quality of life, yet it remains an understudied issue.
ObjectivesThis study aims to determine the prevalence of tinnitus and its associated risk factors among Palestinian adolescents aged 15–18.
MethodsA cross-sectional study was conducted from January to March 2025. A convenience sample of participants was recruited. The study utilized the European School for the Interdisciplinary Tinnitus Research Screening Questionnaire.
ResultsA total of 1,131 participants were enrolled in the study, with 64.5% being females. The prevalence of tinnitus among the study sample was 532, representing 47% of the population. Females had a higher prevalence of tinnitus, with 370 affected (50.7%) compared to males (40.4%). Significant associations were found between tinnitus and several factors: age, positive family history of tinnitus (threefold increased risk), sensitivity to external sounds (2.7 times higher likelihood), slight hearing difficulty in noisy environments (1.7 times higher risk), pain symptoms (double the risk), and difficulty falling asleep (1.8 times higher risk). Notably, the majority of affected participants (71.5%) had never sought professional care for their tinnitus.
ConclusionAlthough Tinnitus is common among Palestinian adolescents aged 15–18 years, the majority of affected participants did not seek professional care for tinnitus. These findings highlight the importance of conducting further research to shed insight into this prevalent and neglected health priority.
This study aimed to evaluate the ability of three generative artificial intelligence tools (ChatGPT, Gemini and DeepSeek) to generate clinically accurate, comprehensive, and readable nursing care plans aligned with standardised nursing taxonomies (North American Nursing Diagnosis Association International, Nursing Interventions Classification, and Nursing Outcomes Classification). The study further explored variations in tool performance across different nursing specialties.
A descriptive comparative design was used.
Ten expert-validated clinical scenarios representing five nursing specialties (Fundamentals of Nursing, Medical, Surgical, Paediatric and Psychiatric Nursing) were presented to the three artificial intelligence tools. Each tool responded to four standardised prompts based on the latest North American Nursing Diagnosis Association International, Nursing Interventions Classification and Nursing Outcomes Classification taxonomies. Outputs were assessed for quality, accuracy, completeness and readability by expert evaluators using validated scales.
All tools produced nursing care plans of moderate-to-high quality. DeepSeek demonstrated slightly higher accuracy and completeness compared with Gemini and ChatGPT. Surgical nursing scenarios yielded the highest performance, likely reflecting the more protocolised and pathway-driven nature of perioperative care. However, all outputs were incomplete and written at a college-level readability, limiting accessibility for clinical use.
Generative artificial intelligence tools can support the production of structured nursing care plans requiring expert review and adaptation, particularly in less standardised clinical domains, but their limitations in completeness and readability indicate they should be regarded only as preliminary drafts requiring expert review and adaptation.
The study examined whether generative artificial intelligence can reliably assist in creating nursing care plans. All tools performed moderately well, with DeepSeek showing slight advantages, but outputs were incomplete and difficult to read. Findings are relevant to clinical nurses, educators, healthcare managers and policymakers worldwide who are exploring artificial intelligence in nursing workflows.
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Wound care in calciphylaxis remains poorly defined without evidence-based consensus on timing and technique of surgical intervention. We demonstrate that surgical debridement and subsequent wound closure are safe and effective in calciphylaxis and describe a systematic multidisciplinary approach to intervention. We retrospectively reviewed a cohort of patients with calciphylaxis at our institution. Those who underwent surgical debridement and wound closure were analysed with emphasis on wound healing, progression to amputation and mortality. Sixty-two patients with calciphylaxis underwent surgical debridement. Twenty patients had wound closure by skin grafting, five were excised with primary wound closure, and 37 were debrided and allowed to heal by secondary intention. There were excellent rates of healing in all groups, and no patients demonstrated wound progression or new lesions following operative intervention. Surgical debridement and wound closure are safe and effective in treating wounds related to calciphylaxis.
by Ece Zengin, Aybuke Ucgun, Mehmet Emir Çevik, Sehnaz Evrimler, Ihsaniye Suer Dogan
BackgroundEpicardial adipose tissue (EAT) is associated with cardiometabolic disorders such as diabetes mellitus (DM), hyperlipidemia, and nonalcoholic fatty liver disease. However, its potential relationship with pancreatic steatosis and pancreatitis remains unclear, and existing studies offer inconsistent findings. Therefore, a clearer understanding of whether EAT reflects broader systemic ectopic fat burden or inflammatory processes is needed.This study evaluated the relationships between EAT thickness and DM, hyperlipidemia, hepatosteatosis, pancreatic steatosis, and pancreatitis.
MethodsThis retrospective, single-center study included 200 patients who underwent abdominal CT between 2022 and 2024. EAT thickness was measured at the mid-RCA and LAD levels, and subcutaneous fat was measured at the umbilical level. Liver and pancreatic steatosis were assessed with CT or MRI. Demographic and clinical data (age, gender, LDL cholesterol, diabetes, and history of pancreatitis) were collected. Mann-Whitney U, Spearman correlation, and logistic regression were used in analyses; p Results
Of the 200 patients, 31.4% had diabetes, 42% had hepatosteatosis, and 73.5% had a history of pancreatitis. EAT and subcutaneous fat were significantly higher in women at all levels (p Conclusions
EAT thickness is significantly associated with DM, LDL cholesterol, pancreatitis history, and age, supporting its role as a potential imaging biomarker of cardiometabolic risk. These findings suggest that EAT may serve as an imaging marker of broader metabolic and inflammatory burden, supporting its relevance for cardiometabolic risk assessment.
The second phase of the Chiba Study of Mother and Child Health (C-MACH) was initiated to investigate how environmental exposures from the fetal period to early childhood influence maternal and child health outcomes. The sub-cohort focuses specifically on detailed assessments of indoor environmental factors and neighbourhood-built and social environments. By integrating environmental metrics with biological, behavioural and sociodemographic data, the study aims to elucidate their role in the development of allergies, neurodevelopmental disorders and other non-communicable diseases in early life.
Between June 2021 and April 2023, 505 pregnant women were enrolled in the second phase of the C-MACH main study. Of these, 298 participants consented to join the sub-cohort study, including 258 in the sleep and physical activity monitoring option (Option 1) and 148 in the indoor allergen exposure sub-study (Option 2). The study includes biological sampling, environmental monitoring and repeated questionnaire surveys. At baseline, 253 live births were recorded from 251 pregnancies.
Of the 298 women, 272 completed early pregnancy questionnaires. The mean maternal age was 33.1 years (SD 4.6); 97.8% were married. University-level education was reported by 51.0% of mothers and 53.7% of fathers. Most households had an annual income of 6 to
Longitudinal follow-up will continue until the children reach age 15. Future analyses will examine associations between environmental exposures and allergic, developmental, endocrine/metabolic and obesity-related outcomes.
To report on the unique perspectives of senior nursing leaders on the value proposition of the Clinical Nurse Specialist (CNS) role, their organisational experience and the barriers and facilitators to optimise and promote the long-term sustainability.
A qualitative sub-study of a larger multi-method study focused on informing policy recommendations to optimise the CNS workforce, informed by integrated knowledge translation.
Chief Nursing Officers (CNOs) and other senior leaders in all health authorities in British Columbia, Canada, were invited to participate in semi-structured interviews via video call between August–December 2023. We recruited 13 participants from diverse health regions, including 5 CNOs.
Leaders collectively conveyed a renewed interest in the CNS role to support nursing and multidisciplinary teams to better meet patient and system needs, and a sense of urgency to optimise the role in diverse settings. The overarching theme of “success by design” was supported by three thematic priorities: (1) understanding the CNS role, (2) a role that needs protection and connections and (3) moving forward together. Views were aligned to co-construct implementation-ready policy recommendations to guide provincial strategies.
Senior leaders reported a common understanding of the value-add of the CNS workforce and had a shared experience of barriers to optimisation. Contemporary policy guidance is needed to equip health systems to address this gap.
Across international regions, the role of CNSs is not fully optimised. This is a wasted opportunity to address the pressing need for nursing practice leaders to transform health systems and improve outcomes. This study provides new knowledge about the perspectives of Chief Nursing Officers and other nursing leaders to shape comprehensive and targeted policy recommendations and address enduring and new challenges to realise the full impact of the CNS workforce.
We have adhered to COREQ reporting guidelines (See supplemental file).
This study did not include patient or public involvement in its design, conduct, or reporting.
Therapy-associated thrombosis remains a challenge in the management of patients with acute lymphoblastic leukaemia (ALL). Thrombosis associated with asparaginase-containing chemotherapy complicates patient management strategies, prompting the need for effective prophylaxis. Assessing the relationship between chemotherapy-induced thrombosis and patient outcomes is crucial for optimising ALL management strategies. The aim of this systematic review is to provide a synthesis on whether the development of thrombosis during asparaginase-containing chemotherapy regimens impacts the overall and event-free survival of patients with ALL.
Data sources: to identify relevant studies, a comprehensive search will be conducted on the major electronic databases, including MEDLINE (PubMed), Web of Science (Clarivate), Academic Search Complete (EBSCOhost), clinicaltrial.gov and the Cochrane Central Register of Controlled Trials from inception to 30 January 2026.
Inclusion criteria for selecting studies: randomised and non-randomised clinical studies evaluating the impact of asparaginase-containing chemotherapy-associated thrombosis on survival outcomes in patients with ALL will be included. Two reviewers will independently screen the retrieved studies, extract data and assess study quality using a predefined criteria. A narrative synthesis will be undertaken, and if feasible, meta-analyses will be conducted. A subgroup and sensitivity analysis will be performed to explain the sources of heterogeneity. The quality of cumulative evidence will be assessed using the grading of recommendations assessment, development and evaluation tool. The findings from this systematic review will inform evidence-based clinical guidelines for thrombosis risk assessment and management in patients with ALL, potentially improving treatment outcomes and reducing thrombosis-related morbidity.
No ethical approval will be required and the findings of this meta-analysis will be published in a peer-reviewed journal.
CRD42024532665.
Current research lacks a comprehensive understanding of evidence-based practice (EBP) adoption and its predictors across diverse healthcare professionals (HCPs) in the Eastern Mediterranean Region (EMR), particularly with a direct comparison between nurses and other professional groups.
This study aims to evaluate the EBP competencies, adoption levels, identified barriers, and associated predictors among nurses and other healthcare professionals (HCPs) within the EMR.
A cross-sectional, correlational, and comparative design was used. An electronic survey was distributed (April 27th–August 17th, 2023) via convenience/snowball sampling, inviting nurses, physicians, physiotherapists, dentists, and pharmacists across the EMR to complete the survey. Multivariate regression analysis and structural equation modeling (SEM) were used to identify predictors of EBP adoption.
A total of 4673 HCPs participated and reported several barriers to EBP adoption, including time constraints, difficulties in interpreting statistics, lack of authority to change practices, and insufficient equipment. Nurses had fewer postgraduate degrees but more work experience and full-time employment than other HCPs. Despite reporting more workplace EBP support, nurses read less research, had lower EBP scores and adoption propensity, and perceived greater barriers than other HCPs (p < 0.002). Multivariate regression showed the highest barrier scores in Syria/Tunisia and the lowest in the United Arab Emirates. Nurses reported significantly higher barriers compared to other HCPs (p < 0.001). Fear of Change was not a primary barrier overall, but was elevated in specific subgroups of nurses. SEM showed good fit: RMSEA = 0.077, SRMR = 0.053, CFI = 0.80, χ 2(df) = 917, p < 0.001. SEM showed that EBP adoption propensity and fear of change significantly mediate the relationship between HCPs' characteristics and EBP scores.
Despite having a positive attitude and propensity towards EBP, nurses lack the necessary knowledge and support to adopt it, and they face more barriers than other healthcare professionals. Nurses require greater support from healthcare leaders to enhance their EBP competencies and address the reported barriers. Policymakers and organizations should prioritize tailored, role-specific training and supportive structures and environments to ensure equitable and effective EBP implementation for improving patient outcomes across the EMR.
by Afsana Anwar, Mahmood Parvez, Farhan Azim, Uday Narayan Yadav, Saruna Ghimire, Ateeb Ahmad Parray, Shovon Bhattacharjee, ARM Mehrab Ali, Rashidul Alam Mahumud, Md Irteja Islam, Md Nazmul Huda, Mohammad Enamul Hoque, Probal Kumar Mondal, Abu Ansar Md Rizwan, Suvasish Das Shuvo, Sabuj Kanti Mistry
BackgroundFrailty and disability often emerge with ageing and affect quality of life. Older adults residing in Rohingya refugee camp in Bangladesh are particularly susceptible to frailty and disability due to adverse physical and social environment along with limited health and social care services available in the camp. This study aimed to investigate the prevalence and factors associated with frailty and disability among Rohingya older adults living in Bangladesh.
MethodsThis cross-sectional study was conducted among older adults aged ≥60 years residing in the Rohingya refugee settlement in Bangladesh. The primary outcomes were frailty and disability, explored using the ‘Frail Non-Disabled (FiND) questionnaire. Data were collected face-to-face during November-December 2021, using a semi-structured questionnaire. A multinomial logistic regression model was used to identify the factors associated with frailty and disability.
ResultsThe majority of participants (n = 864) were aged 60–69 years (72.34%), male (56.25%), married (79.05%), and without formal education (89.0%). The study revealed a high prevalence of frailty (36.92%) and disability (55.21%) among the participants. The multinomial regression analysis showed that the likelihood of experiencing disability was significantly higher among participants who were aged 70–79 years (RRR = 2.65, 95% CI: 1.25, 5.66) and ≥80 years (RRR = 8.06, 95% CI: 1.05, 61.80), were female (RRR = 3.93, 95% CI: 1.88, 8.1.9), had no formal education (RRR = 4.34, 95% CI: 2.19, 8.63), were living in a large family (RRR = 1.82, 95% CI: 1.05, 3.18) and were suffering from non-communicable diseases (RRR = 2.36, 95% CI: 1.32, 4.22) compared to their respective counterparts. The regression analysis also revealed that frailty was significantly higher among participants who were female (RRR = 2.82, 95% CI: 1.34, 5.94), were suffering from non-communicable diseases (RRR = 2.28, 95% CI: 1.27, 4.09), and had feeling of loneliness (RRR = 2.16, 95% CI: 1.11, 4.22).
ConclusionsThe findings underscore the need for long-term care and health promotion activities to alleviate the burden of frailty and disability among older adults in humanitarian settings. Efforts should particularly target the most vulnerable groups- older individuals (≥80 years), women, those without formal education, those living in large families, and those with non-communicable diseases.
by Nasrin Akter, Farhana Faruque Zerin, Bilkis Banu, Fatema Afrin Kanta, Shahnaz Begam, Sarder Mahmud Hossain
BackgroundTo combat growing prevalence of hypertension in Bangladesh, it is critical to have an in-depth understanding about quality of life (QOL) among people living with hypertension and related factors. In the recent COVID-19 pandemic the QOL of hypertensive people got downsized. This study aimed to measure QOL among hypertensive people in a selected tertiary hospital in Dhaka city, and its association with the basic characteristics of the patients.
MethodsThis study was conducted among randomly selected 300 hypertensive patients from two departments of Square Hospitals Limited, using the patient register record. Data were collected through face-to-face interview methods. The WHOQOL-BREF questionnaire was used to assess the QOL of the subjects. Descriptive statistics were used to examine mean scores of quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analysis was used to measure the association between QOL domains and independent variables.
ResultsBoth overall WHOQOL-BREF and each domain had a good internal consistency, (r = 0.13–0.77, p Conclusion
The results revealed low QOL in psychological and social domain, including significant factors associated with the poor QOL in all domains. Planning and implementation of effective interventions are needed to improve QOL among hypertensive patients targeted towards aged, diabetic, lower income group who had positive COVID-19 infection and poor lifestyle through health system strengthening.
by Gianluigi Serio, Consiglia Pacelli, Claudia Piccoli, Nazzareno Capitanio, Giuseppe Cibelli, Anna Antonia Valenzano, Francesca Landini, Leonardo Carlucci, Paola Palladino
The ketogenic diet (KD) is a low-carbohydrate diet that induces and sustains a ketosis state and minimizes somatic glucose levels. Several psychological studies have described the positive effects of ketosis on cognitive functions for a wide range of neuropsychiatric conditions (e.g., Alzheimer’s disease; epilepsy), leading to greater interest in the KD today. However, the psychological and cognitive effects of inducing ketosis via diet remain unclear, especially in healthy people. From an initial pool of thirty participants, eight undergraduate students performed a cognitive assessment before (baseline) and after three weeks (follow-up) of an isocaloric ketogenic diet. Several neuropsychological measures and psychometric tests have been administered to investigate psychological chronotype, sleep quality, eating habits, anxiety and cognitive components of attention, inhibition, and memory. Non-parametric Bayesian analysis showed that the ketogenic diet affected cognitive functions. Participants performed cognitive tests faster at follow-up than at baseline, showing improvements in visual-motor cognitive and processing speed components. However, they were less accurate on working memory tasks, suggesting a decreasing performance of higher cognitive functions. Finally, no differences in anxiety levels were found between baseline and follow-up. The results could have significant implications for identifying specific cognitive models of students based on specific lifestyle habits and nutritional patterns, allowing the implementation of targeted interventions to improve university learning conditions.Musculoskeletal (MSK) conditions account for up to one-third of general practice consultations and over one-fifth of emergency department attendances in the UK. Postpandemic, the elective orthopaedic surgery backlog remains one of the most substantial across surgical specialties. Despite this burden, undergraduate exposure to trauma and orthopaedics (T&O) remains limited and inconsistent. Most UK medical students receive only 2–3 weeks of T&O teaching, with up to 40% of foundation doctors feeling underprepared to manage MSK conditions. The Evaluation of Trauma and Orthopaedic Teaching in Medical Schools Nationally (TENDON Study) aims to evaluate the current state of undergraduate T&O education in UK medical schools from both student and educator perspectives.
This national, prospective, cross-sectional survey will be conducted between 25 July and 27 October 2025. A dual-instrument electronic survey was developed through Qualtrics, informed by the British Orthopaedic Association (BOA) Undergraduate Curriculum and UK Medical Licensing Assessment content map. Participants will include medical students (Years 1–6), foundation doctors and orthopaedic educators recruited through British Orthopaedic Medical Students Association and BOA networks, and designated school representatives. Survey domains include curriculum coverage, teaching methods, clinical exposure and self-reported competence. Quantitative data will be analysed using descriptive and inferential statistics; qualitative data will undergo thematic analysis. Reporting will follow the Checklist for Reporting Of Survey Studies framework, with relevant elements drawn from the Checklist for Reporting Results of Internet E-Surveys checklist.
Ethical approval was obtained from the Human Biology Research Ethics Committee, University of Cambridge. Findings will be disseminated via peer-reviewed publication, conference presentations and summary reports to curriculum leads and relevant educational bodies.
FreshRSS 