Conectar
by Patricia Fiorino, Luigi Fernandes Rosa Cauduro, Danielle Silberspitz Konig, Leonardo Fernandes Rosa Cauduro, Caio de Araujo Santos, Juliana Alves Kavai, Isadora Durigan Duarte, Anna Laura Viacava Américo
Zebrafish (Danio rerio) are widely used as models in cardiovascular research due to their rapid development, optical transparency, and genetic similarity to humans. However, the lack of standardized experimental conditions, particularly regarding developmental stage and microenvironmental parameters, limits reproducibility across studies. This study aimed to characterize cardiovascular function in Zebrafish larvae and evaluate the impact of developmental stage and environmental factors. Wild-type AB embryos were maintained under standard conditions, and heart rate (HR), cardiac output (CO), and ejection fraction (EF) were measured at 24, 30, 48, 52, 56, 72, 78, and 80 hours post-fertilization (hpf). The effects of variations in temperature (27.0, 27.5, and 28.0 °C) and pH (7.0, 7.4, and 8.0) were also assessed. Results showed a progressive increase in HR from 24 to 72 hpf, stabilizing thereafter. CO exhibited two phases of elevation: an early rise between 24–48 hpf and a stronger increase between 48–56 hpf. EF remained generally stable, with a transient reduction at 48 hpf. Cardiovascular performance reached a physiologically stable state after 72 hpf, defining a reliable window for functional studies. Environmental conditions modulated these parameters: temperature variation induced approximately 20% difference in HR and reduced EF, while CO was minimally affected. In contrast, pH variations within the physiological range had no significant impact on HR, CO, or EF. These findings highlight developmental and environmental variables that may influence cardiovascular measurements in Zebrafish larvae and support the development of more consistent experimental approaches in cardiovascular and toxicological research.
by Wasim Labban, Juan Forero, Lindsey Westover, Mark Sommerfeldt, Stephanie Nathanail, Lauren Beaupre
ObjectivesTo compare dynamic postural stability, measured by time to stabilization (TTS) and postural stability indices (PSI), after double-leg counter-movement jump (CMJ) landing in individuals 9–24 months following anterior cruciate ligament reconstruction (ACLR) and healthy controls. Additionally, to explore the effect of sex and ACLR status on postural stability.
MethodsThis cross-sectional laboratory-based study included 41 participants: 21 individuals (10 females) 9–24 months post-ACLR and 20 healthy controls (10 females). Participants performed double-leg countermovement jumps (CMJs) on force plates, landed, and maintained the landing position for 10 seconds. Time to stabilization (TTS), defined as the time (s) required for the ground reaction force to reach and maintain a stable state following landing, and postural stability index (PSI), a composite measure of the ability to maintain equilibrium during the transition from dynamic to static conditions, were calculated and compared between groups.
ResultsThe ACLR group exhibited significantly higher TTS values than healthy controls, indicating a longer duration to achieve stability. Specifically, the resultant vector TTS when combined from both force plates (RVTTS-C), and the vertical TTS in the operated leg (VTTS-op) was higher in the ACLR than the healthy controls (p = 0.03, p = 0.02, respectively). Furthermore, males with ACLR demonstrated higher VTTS combined (VTTS-C) and VTTS-op than females post-ACLR (p = 0.03, p Conclusion
Our study revealed significant deficits in dynamic postural stability in individuals post ACLR, with notable sex differences. The findings suggest a need for targeted neuromuscular rehabilitation to improve landing stability post ACLR and reduce the risk of secondary injury. Further research is needed to understand sex-specific postural stability mechanisms for tailored rehabilitation.
Globally, a lower-extremity amputation occurs every 20 s as a complication of a diabetic foot ulcer, underscoring the urgent need for effective preventive strategies. Previous studies have shown that temperature-based foot monitoring can reduce both the incidence and severity of diabetic foot ulcers. However, real-world adherence data for remote temperature monitoring remain limited, particularly in diverse or resource-constrained communities. We conducted a pilot implementation study of 20 adults with diabetes and a history of diabetic foot ulcers to assess adherence to a remote foot temperature monitoring mat within the context of receiving podiatric care. Participants are instructed to stand on the mat for 20 s daily, and data are transmitted wirelessly for remote monitoring. Adherence was defined as use of the mat at least four times a week. Participants demonstrated high adherence to the foot monitoring mat, averaging 6 scans per week, with sustained adherence over the 6-month study period. These findings suggest that high-risk patients with diabetes can reliably engage with the foot temperature monitoring technology, supporting its potential as a management tool to improve outcomes and reduce the burden of diabetic foot ulcer-related complications in high-risk, resource constrained patient populations.
Diabetic foot ulceration (DFU) contributes significantly to diabetes-related morbidity and amputation. In Barbados, where amputation rates are among the highest globally, the influence of socioeconomic factors on ulceration outcomes remains underexplored. Educational attainment, a social determinant of health, may influence health behaviours, engagement with healthcare services, and ultimately clinical outcomes. This study examines whether educational attainment is associated with diabetic foot ulcer severity, as measured by the SINBAD scoring system, and six-week healing outcomes among inpatients with DFU. A prospective observational study was conducted over 6 months at Barbados' sole public hospital. A total of 176 participants admitted with a diagnosis of DFU were recruited. Baseline demographics, comorbidities, and ulcer characteristics were collected, and SINBAD scores were determined. Random forest modelling was employed to evaluate predictors of complete healing at 6 weeks and to assess ulcer severity stratified by educational attainment. Of the cohort, 17.5% reported primary education as their highest attainment level, compared with 2.9% of the general adult population. The mean SINBAD score was 2.45 among those with primary education and 2.51 among those with secondary education (p > 0.05). No statistically significant association was found between educational attainment and healing outcomes at 6 weeks. Educational attainment in this inpatient DFU cohort was lower than that of the general Barbadian population; however, it was not significantly associated with ulcer severity or six-week healing outcomes. In a universal healthcare setting, equitable access to care may attenuate the effect of educational attainment on clinical outcomes. These null findings highlight the need for future adequately powered studies incorporating health literacy assessment and key clinical confounders. Nonetheless, the observed disparity in educational attainment among DFU inpatients suggests that foot health education initiatives should be designed to be accessible to individuals across all educational levels.
To develop machine-learning (ML) models during the COVID-19 pandemic and adjacent time periods to evaluate the impact of data drift on model performance.
This prognostic study used population-level administrative health data to develop ML prediction models.
Alberta, Canada during 2019–2023.
All patients over 18 who received at least one opioid dispensation from a community pharmacy within the province of Alberta between 2019–2023.
Each opioid dispensation served as the unit-of-analysis.
Opioid-related outcomes were identified from linked health administrative datasets. Light Gradient Boosting-machine models were developed on pre-pandemic, pandemic and endemic data and temporally validated on 2023 data (pre-pandemic model was also validated on 2020–2021 data) to predict the risk of emergency department visit, hospitalisation or mortality within 30-days of an opioid dispensation. We described key feature distributions across the study time period and changes in model prediction performance on the validation sets using relevant metrics.
Among 1.2 million study participants representing over 13 million opioid dispensations, there were 59 809 (2.1%), 134 402 (2.4%) and 62 143 (2.3%) events reported in the pre-pandemic (2019), pandemic (2020 and 2021) and endemic (2022) time periods, respectively (estimated 2023 validation set pre-test probability of 2.8%). Notable differences in key features were observed in the 2020–2021 model relative to other years. In the 2023 validation set, discrimination performance was highest for the pre-pandemic and endemic models compared with the pandemic model (0.81, 0.83, 0.74, respectively). A similar trend regarding changes from pre-test to post-test probabilities in higher categories of predicted risk (23%, 40%, 16%) was observed. 2020–2021 had the lowest discrimination performance (0.71) and uninformative post-test probabilities (
COVID-19 pandemic health data contributed to significant ML drift. Although ML approaches allow for quick re-training to mitigate drift, health regulators should approach ML prediction with caution when using pandemic-times data.
Perinatal depression is a common, yet understudied, mental health disorder among women and contributes to poor engagement in prevention of mother-to-child transmission (PMTCT) of HIV in sub-Saharan Africa. Male partners are positioned to provide critical forms of social and economic support during pregnancy and postpartum, and also may contribute to women’s stress, depression and anxiety through intimate partner violence and withholding of social support. Despite the critical role of men in pregnancy outcomes and HIV prevention, few interventions have engaged men around women’s depressive symptoms, nutrition and health, and engagement in PMTCT. We will conduct a pilot trial of Mphatso, a couple-based intervention based on problem-solving therapy with couple relationship skills to reduce depressive symptoms in perinatal women, improve food insecurity and prevent HIV transmission to the infant.
We will employ a two-arm pilot randomised controlled trial in the Zomba district of Malawi to assess the feasibility and acceptability of Mphatso (meaning ‘gift’ or the child) and explore health impacts on depressive symptoms, PMTCT engagement and food insecurity. We will enrol 60 pregnant women in the second or third trimester who are living with HIV and meet criteria for probable depression based on the Edinburgh Postnatal Depression Scale and their male partners. Couples will be randomised to receive either five sessions of Mphatso (problem-management skills plus health education and relationship skills) or enhanced usual care. Feasibility and acceptability outcomes will include session attendance rates, satisfaction levels and retention at 3 months and 6 months postpartum. Exploratory analyses using regression models including time and treatment arm will be conducted to explore effects on the mothers’ and fathers’ depressive symptoms, adherence to PMTCT (antiretroviral therapy, nevirapine use, HIV testing and exclusive breastfeeding) and food insecurity.
The pilot trial has been approved by the University of California, San Francisco (Human Research Protection Program (HRPP); Protocol Number 23-40685), and the study has also been approved by the National Health Sciences Research Committee in Malawi (NHSRC; Protocol Number 24/05/4431). Results will be disseminated to study participants, health officials, policymakers, community leaders and care providers, as well as through presentations at conferences and publications in peer-reviewed journals.
Biomarkers related to the diagnosis, prognosis and treatment of dementia will play a key role in future clinical practice. The overarching aim of the ODIN (blood and cerebrospinal fluid) Biobank is to study biomarkers for dementia and contribute to the transition from cerebrospinal fluid to blood-based biomarkers.
ODIN recruited 451 patients (median age 74 years, 53% females) referred to the Department of Neurology at Aarhus University Hospital, Denmark, for diagnostic assessment of dementia. Enrolment started in March 2020 and ended in July 2025. Patients referred for a lumbar puncture were eligible for inclusion. Cerebrospinal fluid and blood samples (plasma, serum and buffy coat) were stored at –80°C. Information about sociodemographic, educational level, dementia subtype, cognitive test scores, neuroimaging results, hypertension, diabetes, height, weight, alcohol consumption and smoking was collected.
The most frequent diagnoses were Alzheimer’s disease (n=268, 59%), frontotemporal dementia (n=26, 5.8%) and mixed Alzheimer’s and vascular disease (n=23, 5.1%). N=82 (18%) were cognitively unimpaired or had mild cognitive impairment but not dementia. The median Mini–Mental State Examination score was 23 (IQR: 20–26) and the median Addenbrooke’s Cognitive Examination score was 68 (IQR: 58–77).
ODIN will contribute to the development, validation and implementation of new biomarkers related to diagnosis, prognosis and treatment of dementia. Furthermore, the cohort will assist the transition from cerebrospinal fluid to blood-based biomarkers.
To explore the long-term communicative experiences of tracheostomised ICU survivors 12 months after discharge; to identify facilitators and barriers to communication with caregivers, family members, and healthcare professionals; to describe coping and communicative adaptation strategies; and to assess perceived quality of life and self-esteem.
This is a qualitative-dominant mixed methods study based on a multicentre Italian sample.
Twenty-three adult patients from several Italian hospitals were interviewed using a semi-structured guide 12 months after discharge. Qualitative data were analysed using reflexive thematic analysis. Quantitative data were collected through the EQ-5D-5L, EQ-VAS, and Visual Analogue Self-Esteem Scale (VASES), and analysed using descriptive statistics to explore patterns of QoL and self-esteem.
Four major themes emerged: (1) A body that speaks no more, reflecting the initial experience of voicelessness and emotional isolation; (2) Finding new ways to be heard, describing adaptive communicative strategies and the supportive role of family; (3) When the voice returns, so does life, highlighting the transformative meaning of regaining one's voice; and (4) Living differently, capturing long-term psychological and social adjustments. Quantitative data confirmed reduced self-esteem and QoL (mean EQ-5D index = 0.61; EQ-VAS = 58.4; VASES = 54.2). Integrated findings revealed that communication impairment remained a determinant of reduced well-being 1 year after discharge.
This is the first Italian study to investigate in depth the communicative trajectories of tracheostomised ICU survivors. Findings highlight the crucial role of voice recovery in emotional adjustment and quality of life, supporting the need for structured, multidisciplinary post-ICU follow-up focused on communication and psychosocial rehabilitation.
These findings support health professionals in developing individualised post-ICU interventions to restore communication, improve QoL, and enhance social reintegration.
COREQ checklist was followed.
No patient or public contribution.
Non-muscle-invasive bladder cancer is often treated with repeated weekly intravesical instillations of chemotherapy or immunotherapy. The number of instillations received influences the risk of recurrence and progression; thus, treatment completion is crucial. However, previous research indicates that nearly half of patients do not adhere to treatment for various reasons. This scoping review aims to define the concept of treatment adherence to intravesical instillation therapies and identify and map the factors that influence treatment adherence in intravesical instillation therapies.
This scoping review will adhere to the Joanna Briggs Institute’s Manual for Evidence Synthesis and will be reported in accordance with the PRISMA Extension for Scoping Reviews. A comprehensive search strategy will be employed to guide the literature search across databases, including MEDLINE, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Central Register of Controlled Trials.
We will include studies on intravesical instillation therapies with BCG or Mitomycin C for non-muscle-invasive bladder cancer, as well as studies that describe factors influencing patients’ adherence to treatment. Screening of abstracts and full texts, as well as data charting, will be performed independently by two researchers using the Covidence software. We will collect and chart data concerning characteristics of the source and setting, treatment specifics, reasons for non-adherence and any factors that affect adherence.
We will summarise each included source and present the identified factors in a narrative synthesis. Furthermore, we will describe how the results inform the review objective.
Ethical approval is not required for this scoping review, as all data have been published. The findings of the scoping review will be disseminated in a scientific publication and widely presented to researchers, healthcare professionals and patients.
To explore how receiving gerontological nurse telephone support assisted caregivers of older adults to provide care after hospital discharge.
Informal caregivers are vital to the recovery of older patients after hospital discharge, but often feel under-prepared and unsupported. The need to strengthen caregiver support is becoming increasingly important due to the growing population of older adults and their needs for hospital services. This secondary analysis of a randomized controlled trial examined how nurse telephone support assisted caregivers in their caring role at the time of hospital discharge.
A qualitative descriptive study. A purposive sample of informal caregivers (n = 47) who had received nurse telephone support was recruited. In-depth semi-structured interviews were conducted with participants at six (March 21–January 23) and 12 months (August 2021–June 2023) after the older adult's discharge. The nurses used a problem-solving approach to provide support. Transcripts were analysed inductively using content narrative analysis.
Two themes emerged: (i) mastery and skills to care; (ii) empowerment to care. Caregiver mastery was developed through nurses providing tailored support that assisted caregivers to develop a structured approach to problem-solving, apply problem-solving to their personal circumstances, increase capacity and skills, and manage workload more effectively. Empowerment resulted from nurses creating a nurturing environment where caregivers developed a positive inner dialogue, increased confidence and capacity to foster a positive relationship with the care recipient and valued themselves. Synthesizing these themes via a concept map explained how nurse support assisted caregivers of older adults become more prepared to care and increase self-efficacy.
Nurse telephone support can facilitate caregivers of older adults discharged from hospital to undertake problem-solving that is effective for their individual circumstances and empower them to care. Telephone calls enabled nurses to provide timely, tailored support for caregivers of older adults after hospital discharge.
Nurses can provide expert, professional guidance via telephone to support caregivers be more prepared to care when older adults are discharged from hospital. This support should extend beyond instructions related to the care recipients' immediate needs and include the provision of knowledge and coaching to support a structured approach to problem-solving. Allocating dedicated time for hospital nurses to deliver caregiver support should be considered an integral component of person-centred care. This research strengthens the evidence for the valuable contribution that nurses can make to improving hospital discharge services.
This study was reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
The research team includes consumer investigator (HL) who provided input throughout the research, including design, procedures, data analysis and manuscript authorship.
Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12620000060943
To explore how patients experience, interpret, and respond to missed nursing care during hospitalization in a Danish hospital context.
A qualitative design was employed.
Individual semi-structured interviews were conducted with fifteen patients who had been admitted to medical or surgical wards at a Danish university hospital. Data were analysed using reflexive thematic analysis.
The overarching theme, ‘Nursing care experienced through a filter of empathy and understanding’, captured how patients perceived omissions and delays as understandable responses to systemic pressures rather than neglect. Although they experienced missed nursing care, patients rationalized these omissions as inevitable, adapting to organizational constraints with empathy toward nurses, awareness of workload pressures, and a wish not to be a burden. Three subthemes illustrated this process: ‘Not wanting to be a burden: negotiating physical needs’, ‘Moderating expectations: the subtle importance of psychosocial care’ and ‘Waiting patiently: a sense of shared responsibility for timely care’.
Patients' empathy and adaptation sometimes obscured unmet needs and contributed to the normalization of missed nursing care. Missed nursing care thus emerged as a relational, co-constructed phenomenon shaped by both system pressures and patients' efforts to avoid burdening nursing staff.
Reducing missed nursing care requires action beyond staffing, addressing relational and cultural dimensions across clinical, organizational and policy levels through proactive, person-centered approaches.
By foregrounding patients' perspectives, this study reframes missed nursing care as co-constructed by both system constraints and patient adaptations, offering new insight to guide policy, leadership, and practice efforts toward more responsive and person-centered nursing care.
Reporting followed the consolidated criteria for reporting qualitative research.
Patients contributed as interview participants but were not involved in the design, conduct, or reporting of the study.
Research and innovation are essential for advancing clinical practice and safeguarding patient safety in healthcare. This review aims to assess the research capacity of Advanced Practice Nurses in Australian healthcare settings. By identifying the barriers and enablers to, the findings aim to inspire research engagement of paediatric nurses.
A rapid review methodology was used to systematically identify, appraise and synthesise data relevant to Advanced Practice Nurses' research capacity.
A comprehensive search of Ovid Medline and Cumulative Index to Nursing and Allied Health Literature databases was conducted, covering publications from 1 July 2010 to May 2024. Additional reference checks and grey literature searches were undertaken to identify relevant studies.
Data extraction and quality appraisal were conducted independently and checked by the research team. The Mixed Methods Appraisal Tool was used for quality assessment and a descriptive narrative synthesis approach integrated findings across qualitative, quantitative, and mixed methods studies.
Eight studies met the inclusion criteria. Findings revealed that while Advanced Practice Nurses value research and evidence-based practice, barriers—such as time constraints, limited resources, and lack of organisational support—restricted their engagement. Leadership support and structured mentorship were identified as critical enablers of research capacity.
This review highlights the need for targeted strategies to enhance Advanced Practice Nurses' research capacity within Australian healthcare. Addressing identified barriers and fostering a supportive environment can empower Advanced Practice Nurses to better utilise their roles, contributing to improved patient care and healthcare innovation.
This research addresses the limited understanding of research capacity among Advanced Practice Nurses identifying challenges and opportunities for engagement. It is particularly relevant for healthcare organisations, policymakers, and educational institutions seeking to strengthen research capacity among APN roles. Findings will inform evidence-based practice, patient outcomes, and research culture in Australian healthcare services.
International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42024539163
Indigenous peoples living with diabetes face unique challenges accessing comprehensive specialty diabetes care. A small diabetes virtual care clinic oriented towards Indigenous individuals, and those in rural and remote communities, has provided care to over 400 individuals.
We characterised the distinguishing features of care provided at this clinic and used the Consolidated Framework for Implementation Research 2.0 (CFIR) to explore the enablers and barriers to implementing this model of care, from the perspective of the clinic’s staff and providers.
Guided by CFIR, we conducted eight semi-structured interviews with six clinic staff members. Deductive thematic analysis was used to identify relevant enablers and barriers.
The aspirational features of care were cultural safety, comprehensiveness and virtual delivery. The implementation of this model of care was enabled by an internal culture of relational care; a nimble, resourceful, pragmatic and client-centred approach to virtual delivery; wayfinding and resources from key external organisations; community engagement and a small team of motivated and independent providers. Key barriers included the lack of physical interactions and uncertain or limited resources and funding.
The identified enablers and barriers to implementing an Indigenous-focused virtual diabetes care clinic have implications for future interventions to improve rural Indigenous chronic disease care, and for governments and adjacent organisations tasked with meeting Canada’s Truth and Reconciliation Commission’s calls to action in healthcare. Further research examining the effectiveness of virtual diabetes care at this clinic is ongoing.
Surgical site infection (SSI) following transmetatarsal amputation (TMA) is common and associated with significant morbidity. However, there is limited evidence to guide perioperative strategies for SSI prevention in this population. A prospective, cross-sectional survey was conducted among vascular specialists. The questionnaire assessed current practice in SSI prevention for TMA, perceptions of evidence gaps, and willingness to participate in future research. Responses were analysed descriptively. Eighty-four valid responses were analysed, with 64.3% from consultant vascular surgeons and 84.5% from UK centres. Most respondents (84.5%) considered SSI after TMA to be a significant issue. The majority preferred primary closure in clean wounds (78.6%) and commonly used short-course antibiotics and interrupted sutures. Over 70% agreed no clear best practice exists, and 65.5% felt high-quality randomised trials are needed. Ninety-three percent expressed willingness to engage in future studies. Equipoise existed regarding interventions including antibiotic duration, wound adjuncts, and closure techniques. Opinion varied regarding whether TMA and major lower limb amputation should be pooled when undertaking research into SSI prevention. Current practice in SSI prevention for TMA is highly variable. This survey demonstrates broad support for rigorous trials to establish effective strategies and highlights the feasibility of future research in this area.
To present the process of establishing a Doctor of Nursing Practice (DNP) policy analysis project option at one nursing school, offering examples of diverse student and graduate analyses to guide other institutions.
Nurses are skilled patient advocates, and their advocacy forms a crucial foundation for influencing health policy. This, in turn, enhances population health and addresses health disparities, particularly for vulnerable groups. DNP students are educated to use innovative methods to integrate current evidence to inform practice and policy, yet some nursing schools lack resources to support comprehensive DNP policy analysis projects.
The article presents a case example of how one institution developed a pathway and instructional support to formally offer DNP students the option to perform a DNP policy analysis project.
Essential elements to support students' successful completion of a DNP policy analysis project include adequate faculty expertise in health policy and a structured institutional framework. Residency activities must deepen a student's understanding and knowledge about policy and the health problem trying to be solved with policy. Clear documentation of these unique residency activities is crucial. There is a strong emphasis on the need for clear communication and guidance between programme faculty, programme mentors and students. DNP policy analysis projects enrich students' knowledge, skills and networks, fostering future policy leaders and facilitating collaboration with clinical experts across diverse research fields.
Nurturing DNP students completing policy analysis projects is vital for translating evidence into practice, developing future nurse policy leaders and ensuring health equity and access to quality healthcare.
DNP policy projects can positively influence nursing practice and policy. Expanding upon previous DNP students' policy analysis projects also provides a unique opportunity to build and broaden nursing's impact on policy development.
To describe the prevalence and determinants of workplace violence against nurses in the Italian home care setting.
Secondary cross-sectional analysis of data from the multicentre study AIDOMUS-IT.
Nurses employed in home care services provided by Italian Local Health Authorities were interviewed using a variety of instruments. A multivariable binary logistic regression model was performed to model the risk of workplace violence against nurses in the last 12 months. Variables related to violence were selected among sociodemographic characteristics (such as age and gender), work-related factors (including years of experience, team composition, overtime working, previous experience in mental health care, burnout) and organisational elements (including leadership and support, workload, staffing and resources adequacy, and time to reach the patients' homes). Adjusted odds ratios (aOR) were used to present the results.
A total of 3949 nurses participated in the study and 20.49% of them reported to have experienced an episode of violence in the last 12 months. Determinants of higher risk of violence episodes were younger age (aOR = 1.02, p = 0.002), higher workload (aOR = 1.01, p = 0.002), working in a multiprofessional team (aOR = 1.24, p = 0.018), perception of inadequate managerial leadership and support (aOR = 1.38, p = 0.003), and higher burnout levels (aOR = 1.01, p < 0.001).
The prevalence of workplace violence against Italian home care nurses is high. Several modifiable determinants were found to be associated with a higher risk of violence, which can potentially be mitigated with tailored interventions.
Effective preventive strategies must be developed to lessen workplace violence against nurses in the home care setting. These strategies should focus on strengthening nursing managers' leadership and support skills, enhancing team-building strategies, avoiding inadequate workload, monitoring nurses' burnout, estimating optimum staffing levels, and assigning advanced-career nurses to home care services. These measures are imperative to guarantee the quality and safety of home care organisations and to attain favourable outcomes in the provision of care.
This study aimed to explore the prevalence and determinants of workplace violence against nurses in the Italian home care settings. We found that out of the 3949 nurses surveyed, 20% of the sample reported one episode of violence during the last 12 months. Determinants of this violence included younger age, higher workload and burnout, being in a multiprofessional team, and perception of lack of leadership and support by the nurse manager. The results of this study can be used to tailor interventions aimed at mitigating the risk factors of violence, particularly those that can be modified (e.g., workload, burnout, and leadership).
The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
We aim the isolated and combined effects of sedentary behaviour exposure time and physical activity levels on muscle strength in older adults.
This prospective observational cohort study, analytical in nature, using exploratory survey methods and physical performance testing. With 5-year longitudinal follow-up (2015–2020).
A total of 459 older adults participated in the baseline, with a total of 224 being included/located again in the follow-up. We evaluate muscle strength using handgrip tests and sit-to-stand tests. The international physical activity questionnaire was used to measure physical activity and sedentary behaviour. Generalised Estimation Equations tested both independent and combined effects, reporting results as β coefficients and confidence intervals.
Older adults exhibiting low sedentary behaviour displayed enhanced handgrip strength compared to those with high sedentary behaviour. Notably, older adults who were sufficiently active with low sedentary behaviour, sufficiently active with high sedentary behaviour, and insufficiently active with low sedentary behaviour showed increased handgrip strength compared to their counterparts who were insufficiently active with high sedentary behaviour. This trend was consistent for lower limb strength.
Interventions that encourage a reduction in sedentary behaviour and an increase in physical activity are essential to maintain muscle strength among older adults.
The findings of this study underscore the importance of addressing both sedentary behaviour and physical activity levels in clinical interventions aimed at preserving muscle strength in older adults. Routine assessments of physical activity and sedentary behaviour could help tailor personalised exercise programs, potentially enhancing functional independence and reducing the risk of frailty and disability in older patients.
Patients were involved in the sample of the study.
This study was conducted in accordance with the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.
by Víctor Herrera, María Consuelo Miranda, Anyela Lozano-Parra, Diana Niño, Luis Ángel Villar, Rosa Margarita Gélvez Ramírez, Thomas Jaenisch, Laura Pezzi, Claudia Acevedo, Jürg Niederbacher
BackgroundZika virus (ZIKV) infection has been inconsistently associated with neurodevelopmental delay (ND). We aimed to compare the incidence of ND between ZIKV-exposed and ZIKV-unexposed children within the ZIKAlliance (ZA) cohort, in Colombia, assessed 2 years after birth (2018–2021).
MethodsWe performed a neurodevelopmental evaluation on normocephalic children (aged 40–72 months) from the ZIKAlliance cohort. Children were classified as ZIKV-exposed (maternal positive RT-qPCR or virus neutralization test – VNT) or unexposed (maternal negative IgG ELISA or VNT in paired antenatal samples). A trained psychologist, blinded to exposure status, administered the Denver Developmental Screening Test II (DDST-II). Children were considered at ND risk if they presented ≥1 delay or ≥2 cautions in one or more areas, within their age range in the DDST-II scale. Inconclusive initial tests were re-evaluated. Adjusted odds ratios were estimated using logistic regression.
ResultsWe analyzed conclusive DDST-II results from 153 children (mean age: 4.7 years; 53.8% male). Overall, 57.2% (n = 83) were classified as cases of ND. Children with ND were more likely to be male (61.4% versus 43.5%) and less likely to attend daycare or school (42.2% versus 11.3%) than children with normal development. After adjusting for child age, sex, household size, and education, the association between in utero ZIKV exposure and ND was not statistically significant (OR = 0.71; 95% CI: 0.32–1.59, p = 0.320). However, children attending daycare or school had a significantly lower risk of ND compared to those who stayed at home.
ConclusionsPrenatal ZIKV exposure was not associated with ND in this cohort of normocephalic preschool children. Instead, attending a community daycare or school emerged as a significant protective factor against developmental delays.
by Maria Elizabeth Mitri, Antoinette Ludwig, Joanne Tataryn, Salima Gasmi, Mandy Whitlock, Peter A. Buck, Annie-Claude Bourgeois
Mosquito-borne arboviruses pose a growing public health concern in Canada, particularly in the context of climate change and increased global travel. This study aimed to quantify the burden of endemic and non-endemic mosquito-transmitted arboviral diseases in Canada by examining hospitalization trends from 2002 to 2023. Using administrative hospital data from the Canadian Institute for Health Information (CIHI) and national West Nile virus (WNV) surveillance data, we analyzed patient demographics, temporal and spatial patterns, and disease classification. Hospitalizations were classified as endemic (e.g., WNV) or non-endemic (e.g., dengue, chikungunya, Zika, yellow fever) based on historical presence and vector establishment in Canada. A total of 2,470 unique hospitalizations were identified, with 56.4% attributed to endemic diseases and 39.7% to non-endemic diseases. WNV accounted for over 99% of endemic-related hospitalizations, with peaks in 2003, 2007, and 2012 aligning with national surveillance data. Hospitalizations were highest among males aged 75–79 years, particularly in the southern regions of Saskatchewan, Manitoba, and Ontario. Non-endemic disease hospitalizations, primarily due to dengue and chikungunya, increased after 2010 and were more evenly distributed throughout the year, reflecting travel patterns. Younger adults (20–49 years) were most affected. The study highlights limitations in diagnostic coding and surveillance coverage, particularly the exclusion of Quebec data and underreporting of emerging arboviruses. These findings underscore the utility of hospital administrative data in complementing traditional surveillance systems and identifying populations at risk for severe outcomes. As climate change and travel continue to influence arboviral disease dynamics, integrated data sources are essential for guiding public health planning and response.
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