Conectar
To explore factors affecting research engagement among Nurses, Midwives and Allied Health Professionals (NMAHPs) in England by examining perceptions of research capacity at organisational, team and individual levels.
Research engagement strongly correlates with improved care quality. However, NMAHPs face persistent participation barriers compared to medical colleagues, limiting the development of a multi-professional research workforce.
National descriptive cross-sectional study using a validated survey tool.
Data from NMAHPs across England were collected using the validated Research Capacity and Culture tool. Quantitative data were analysed descriptively and inferentially; qualitative free-text responses were evaluated thematically.
Perceived capacity was moderate organisationally and in teams. Organisational strengths included promoting evidence-based practice (68.7%) and leadership support (61.6%). Teams offered moderate research opportunities (58.6%) but limited mentorship (47.9%). Individually, participants showed competence in literature review (69.5%) and data collection (63.4%) but required support for funding acquisition (43.8%) and publication (50.0%). Qualitatively, research was a highly valued aspect of professional identity, though participation is severely constrained by structural conditions, including extreme resource pressures, unclear career pathways, and professional inequality.
Despite strong motivation for evidence-based practice, significant structural barriers restrict NMAHP research engagement. Strengthening capacity demands coordinated action across clinical and policy systems, ensuring equitable access to protected time, mentorship, and vital research infrastructure.
Supporting NMAHPs in research enhances evidence-informed decisions and service innovation. Embedding research into everyday clinical work, rather than viewing it as optional, builds a sustainable multi-professional culture.
This survey pinpoints the specific factors most strongly influencing NMAHP research engagement. It provides healthcare leaders actionable insights to build sustainable research infrastructure and inclusive clinical academic pathways.
This study adhered to STROBE guidelines for cross-sectional research.
No patient or public contribution.
Burns are a major cause of morbidity in Yemen, and their prevention relies heavily on community knowledge and safe practices. Understanding gaps in awareness and behaviour is essential for designing effective interventions. This study assessed the knowledge, attitudes and practices (KAP) regarding burn prevention and first aid among a Yemeni community. A cross-sectional survey was conducted among 380 participants using a structured questionnaire distributed via social media and community networks. Data were collected on demographics, educational level, occupation, residential area and KAP related to household, electrical and chemical burns. Associations between participant characteristics and burn-related KAPs were analysed. Participants were predominantly female (63.7%), aged 15–45 years (79.8%), urban residents (92.9%) and university-educated (82.1%). Healthcare workers comprised 50.8% of respondents. Knowledge of burn prevention and first aid was highest among university-educated and healthcare participants, with 84.6% correctly identifying initial burn management. Unsafe practices, such as applying honey or toothpaste and improper handling of chemical or electrical injuries, were more common among less-educated, rural and nonhealthcare respondents. Urban participants demonstrated better preventive practices, while cultural reliance on traditional remedies persisted across all groups. Among predominantly urban and educated populations in Yemen, knowledge and attitudes toward burn prevention and first aid are generally favourable; however, gaps persist, particularly in rural and less-educated communities. Cultural practices and misconceptions continue to limit optimal care. These findings underscore the urgent need for culturally sensitive, literacy-appropriate, community-based interventions to improve burn prevention, first aid practices and equitable health outcomes.
Nursing leadership is crucial for empowering nurses to excel in their roles. Among various leadership approaches, strengths-based leadership is particularly effective in harnessing staff potential to meet current workplace demands. However, the benefits of this leadership style on nurses' work ability remain underexplored, and the underlying mechanisms driving this relationship have not been thoroughly investigated.
Based on the Self-Determination Theory and the Self-Validation Theory, this study aimed to examine: (1) whether nurse managers' strengths-based leadership (as perceived by bedside nurses) could foster nurses' work ability, and (2) the mediating role of a growth mindset in this association.
Structural equation modeling in AMOS software was conducted, analyzing cross-sectional data from 209 bedside nurses using the Strengths-Based Leadership Scale, the Growth Mindset Scale, and the Work Ability–Personal Radar Scale. Participants were recruited via convenience sampling from October to December 2024 across three tertiary public hospitals in Cairo and Mansoura, Egypt.
Strengths-based leadership was significantly associated with nurses' work ability. Growth mindset of nurses partially mediated the positive association between strengths-based leadership and their work ability.
This study emphasizes the role of strengths-based leadership, an underexplored yet significant leadership style in the nursing literature. It is the first study to examine the effect of strengths-based leadership on nurses' work ability, mediated by a growth mindset.
by Ibrahim Naif Alenezi, Fathia Ahmed Mersal, Amal Ahmed Elbilgahy
BackgroundGenerative artificial intelligence (AI) tools such as ChatGPT are increasingly used in academic research, yet evidence on postgraduate students’ perceptions remains limited in non-Western and health-professional contexts. Understanding how students perceive AI’s benefits, risks, and ethical implications is essential for informing institutional research policies.
MethodsThis cross-sectional case study surveyed 267 master’s students enrolled in nursing and health profession programs at Northern Border University in Arar, Saudi Arabia. Data were collected between October 1 and November 15, 2025, using a validated 54-item questionnaire that assessed perceived benefits, perceived risks, privacy concerns, mistrust in AI, performance anxiety, social bias, regulatory matters, liability issues, and intention to adopt AI tools. Multiple linear regression with heteroscedasticity-robust (HC3) standard errors was used to identify predictors of AI adoption intention.
ResultsMost participants (85.0%) reported prior use of AI tools, predominantly ChatGPT. Perceived benefits were the strongest predictor of intention to adopt AI for research purposes (β = 0.588, p 2 = 0.560).
ConclusionsAmong nursing and health profession master’s students at a regional Saudi university, findings indicate pragmatic optimism toward AI integration in academic research, driven primarily by perceived benefits alongside heightened ethical and privacy awareness. Privacy concerns appear to reflect critical literacy rather than barriers to adoption.
To evaluate the association between non-steroidal anti-inflammatory drugs (NSAIDs) and miscarriage, which remains elusive in the actual literature, using modelling approaches to mitigate time-related bias.
Nationwide, population-based retrospective cohort study.
The study used data from the French National Mother-Child Register (EPI-MERES), developed from the French National Health Data System containing the health information (hospital admissions, drug dispensing, comorbidities, etc.) of about 99% French population.
4 857 907 pregnancies ended in a live birth, a stillbirth or a miscarriage from 2013 to 2019.
Exposure to NSAIDs from 2 weeks before conception to the 20th week of pregnancy.
Miscarriage (ie, spontaneous abortion before the 20th week of pregnancy) from the sixth week of pregnancy. The Cox regression with a time-dependent exposure that incorporated a 3-day lag was used to estimate HRs and their 95% CIs adjusted for maternal characteristics. The 3-day lag period allows for addressing protopathic bias.
In total, there were 163 666 (3,37%) miscarriage cases, and 349 294 (7.19%) pregnancies were exposed to NSAIDs. Unexposed pregnancies were used as the reference category in all analyses. In the main analysis, exposure to NSAIDs increased the risk of miscarriage (HR, 1.83; 95% CI 1.81 to 1.86). The effect of individual drugs was heterogeneous, with 7 of the 19 drugs evaluated shown to increase the risk (flurbiprofen had the highest risk (HR, 3.28; 95% CI 3.15 to 3.41) and naproxen the lowest (HR, 1.09; 95% CI 1.01 to 1.18)). In the sensitivity analyses, increasing the lag time decreased the estimated HR (from HR, 2.25; 95% CI 2.21 to 2.28 with no lag to HR, 1.56; 95% CI 1.54 to 1.59 with a 7-day lag). Overall, the risk of miscarriage remained statistically significant in all the analyses.
Our study found that early exposure to NSAIDs could increase the risk of miscarriage. This finding contributes to the body of evidence on their safety profile and may help inform future recommendations for their use in pregnant women.
This study examined the interplay among spirituality, self-efficacy and resilience in this context.
A cross-sectional study.
A total of 178 parents of children newly diagnosed with diabetes mellitus; the instruments used for data collection were the Parental Self-Efficacy Scale for Diabetes Management, The Arabic version of The Walsh Family Resilience Questionnaire and the Spiritual Perspective Scale.
Self-efficacy had a significant positive direct effect on family resilience. Spirituality also had a significant positive direct effect on family resilience. Additionally, self-efficacy had a significant positive indirect effect on family resilience through its effect on spirituality.
The findings underscore the impact of spirituality and self-efficacy on a family resilience.
Nurses should prioritise self-care and personal reflection to enhance their spiritual well-being. This can help them better understand and empathise with their patients' spiritual needs, allowing for more effective and compassionate care.
Upon the initial diagnosis of diabetes in a child, parents undergo a profound emotional and psychological upheaval. They are faced with the daunting task of managing their child's condition while also coping with their feelings of distress, uncertainty and fear. Amidst these challenges, factors such as self-efficacy and resilience play pivotal roles in determining how parents adapt to and navigate this new reality.
Nurses can use spiritual care to give parents a sense of meaning, purpose and hope, bolstering their self-efficacy and resilience.
The relevant reporting method has been adhered to, that is, STROBE.
In our research, data collection is assisted by nurses working in community-based settings.
To examine the impact of delays in intensive care unit (ICU) admission on patient outcomes, specifically clinical deterioration and mortality among patients transferred from the emergency department (ED) or general wards following acute deterioration in an Australian public hospital.
This prospective cohort study was conducted over a 12-month period (15 April 2022–14 April 2023) in a 209-bed regional hospital. It included adult patients (aged ≥ 18 years) admitted to the ICU from ED or general wards following acute deterioration. Primary outcomes measured were duration of delay in ICU admission, ICU and hospital mortality and changes in Sequential Organ Failure Assessment (SOFA) scores over time to assess organ dysfunction and progression.
A total of 403 patients were included. Of these, 276 (68.5%) experienced delays in ICU admission, ranging from 25 min to 347.25 h (median: 7.13 h). Delayed ICU admission was associated with increased mortality. Each one-point increase in the highest recorded SOFA score was linked to a 7.5% rise in mortality odds, while each one-point increase in the initial or 24-h SOFA score corresponded to a 6.8% increase.
Delayed ICU admission was significantly associated with increased mortality, particularly in patients with elevated SOFA scores, indicating worsening organ dysfunction and clinical instability.
These findings highlight the urgent need for improved triage systems, early warning protocols and streamlined escalation pathways to expedite ICU transfers for deteriorating patients. Timely intervention is essential to reduce harm and improve outcomes.
This study reinforces the clinical risks of delayed ICU admission and supports timely escalation of care in emergency and ward settings across Australian public hospitals.
Conducted in accordance with STROBE guidelines.
No direct patient or public involvement. The study used routinely collected clinical data to evaluate systemic and clinical outcomes.
To identify the individual and community-level factors associated with barriers to accessing healthcare services among currently married women in Somalia.
A cross-sectional analysis using data from the 2020 Somalia Demographic and Health Survey.
Somalia.
A nationally representative sample of 30 311 currently married women aged 15–49 years with complete data on outcome and explanatory variables.
The primary outcome was ‘reporting at least one barrier to accessing healthcare’, a composite binary variable based on four specific problems: obtaining permission to go for treatment, getting money for treatment, distance to the health facility and not wanting to go alone.
A substantial majority (77.06%) of married women reported experiencing at least one barrier to accessing healthcare. Financial cost was the most common barrier (69.91%), followed by distance to health facilities (65.95%), reluctance to go alone (49.64%) and the requirement for permission (46.03%). Multilevel analysis confirmed that higher household wealth was strongly protective (richest vs poorest: adjusted OR (aOR)=0.27, 95% CI 0.24 to 0.32). Paradoxically, factors typically considered protective were associated with increased barriers: women with secondary education (aOR=1.19, 95% CI 1.00 to 1.41) and those with educated husbands (aOR=1.23, 95% CI 1.14 to 1.33) reported more obstacles. Similarly, urban residents faced higher odds of barriers than their nomadic counterparts (aOR=1.40, 95% CI 1.27 to 1.55). Significant regional disparities were evident, with community-level context explaining 26.30% of the total variance in reporting barriers.
Access to healthcare for married women in Somalia is predominantly hindered by economic, educational and community-level constraints. Targeted interventions addressing socioeconomic disparities, infrastructural deficits and specific community contexts are essential to alleviate these barriers.
Chronic kidney disease (CKD) is a significant public health problem that requires effective preventive and conservative methods to limit morbidity and death.
This study aims to give clinical practice an evidence-based basis for the clinical practice of healthcare professionals by methodically looking for the best available data on conservative strategies and CKD prevention in high-risk and early-stage patients.
The 6S evidence resource model was followed and states that evidence retrieval was done top-down, gathering necessary studies from January 2014 to July 30, 2024. Databases searched included BMJ Best Practice, DynaMed, NICE, GIN, SIGN, JBI Evidence Synthesis, JBI Evidence Implementation, Cochrane Library, and PubMed. Following the JBI grade of evidence and recommendation methodology, two reviewers independently examined and assessed the literature, extracting and summarizing evidence.
Seventy-nine publications were identified: 18 guidelines, 1 randomized controlled trial, 2 expert consensus statements, 36 evidence summaries, and 22 systematic reviews and meta-analyses. Key findings were summarized across eight aspects: risk assessment and early detection, risk factors and prevention of genetic factors, management of diabetic nephrology, impact of bariatric surgery on preventing CKD, screening and diagnosis, treatment and prevention strategies, lifestyle modifications, and CKD prevention.
This study summarized the best evidence for preventing CKD from eight aspects, which can help clinical or community medical professionals develop and apply CKD preventive strategies for high-risk groups and early-stage patients. By using these evidence-based strategies, healthcare professionals can reduce the incidence and progression of CKD, leading to fewer hospitalizations, improved kidney function preservation, and enhanced long-term survival and quality of life for patients. Future research should address identified gaps and explore the implementation of these strategies in diverse clinical settings.
Older adults face growing risks of depression and anxiety, yet stigma, comorbidities, cost, and limited access impede receipt of conventional care. Digital mental health interventions (DMHIs), including immersive virtual reality (VR), exergaming, and mobile apps, may reduce these barriers.
To evaluate the efficacy of DMHIs in reducing depressive and anxiety symptoms among adults aged ≥ 50 years.
We conducted a PRISMA adherent systematic review and meta-analysis of randomized controlled trials. Interventions included immersive VR, exergaming/physical digital platforms, mobile applications, and digital cognitive training. Standardized mean differences (SMDs) were pooled with random effects models; heterogeneity was assessed with I 2.
Nineteen RCTs (n = 718; mean ages 50.9–84.7 years) met inclusion criteria. Across studies, DMHIs significantly reduced depressive symptoms (SMD = −0.656, 95% CI = −0.932 to −0.380; p < 0.001) and anxiety symptoms (SMD = −0.559, 95% CI = −0.740 to −0.380; p < 0.0001). Immersive and physically engaging modalities (e.g., VR, exergaming) outperformed app-based approaches. Heterogeneity ranged from moderate to high (I 2 ≈ 69.6%–97%).
Offer DMHIs: especially VR or exergaming when access to in-person therapy is limited or as an adjunct to usual care. Provide brief onboarding and, when feasible, caregiver support to boost adherence and confidence with technology. Select or configure age-friendly interfaces (e.g., large fonts, simple navigation) to address common usability barriers. Integrate DMHIs into stepped-care or rehabilitation pathways and monitor outcomes with validated tools (e.g., GDS, STAI). Address equity by supplying devices/connectivity solutions and consider cost-effectiveness and long-term engagement in implementation plans.
Trial Registration: PROSPERO ID: CRD420250655153
The Infant Gut Bacterial Study in Nigeria (INBUGS-NG) investigates how delivery mode, antibiotic exposure, feeding practices and environmental factors shape gut microbiome development and acquisition of antibiotic resistance genes (ARGs) during the first year of life in northern Nigeria.
Between February and July 2024, 90 mother–infant dyads were enrolled at a tertiary hospital in Kano city, Nigeria. This was a prospective longitudinal cohort with follow-ups at 10 scheduled time points: days 0, 1, 3, 5, 7, 14, 28, 90, 180 and 365. We also intensified stool sampling after infant antibiotic administration, enabling dense early-life sampling. To date, the cohort has contributed 480 infant stool samples, 232 maternal rectal swabs, 254 breast milk samples and 806 environmental samples (total 1772). In parallel, socio-demographic, clinical and cultural data were collected using Research Electronic Data Capture (REDCap) and household visit diaries.
Baseline data show that 84/90 mothers (93.3%) received postpartum antibiotics, and 26/90 infants (28.9%) received antibiotics within the first 3 months of life. Only 8% of infants were exclusively breastfed, with early water supplementation common. Caesarean deliveries accounted for 25% of births, and the mean gestational age was 38.5 weeks. Across the cohort, high retention was achieved, and the study has generated a unique long-read metagenomic resource from an African infant population, with analyses ongoing.
Shotgun long-read metagenomic sequencing (Oxford Nanopore) will enable strain-level and plasmid-level profiling of microbial communities and ARGs. Planned analyses include associations between early-life exposures and resistome dynamics, as well as cross-cohort comparisons with a parallel study in Pakistan. Follow-up will continue through 12 months.
Poor access to surgical wound swabbing in the community often results in delayed or inappropriate antibiotic prescribing for surgical site infections. This delay can contribute to prolonged wound healing and poor antimicrobial stewardship. Patient self-swabbing at home could improve access to diagnostic testing, but its feasibility and acceptability remain unexplored.
TREASURE is a multicentre, mixed-methods feasibility study. A total of 40 patient participants and 10 staff stakeholders will be included. 40 adult patients undergoing cardiac surgery via median sternotomy will be recruited from Harefield Hospital (n=25) and the Royal Sussex County Hospital (n=15). Eligible participants will receive a coproduced self-swabbing set of instructions and kit at discharge and perform wound swabbing at home within 1–21 days, observed remotely by a researcher via Microsoft Teams. Swabs will be couriered to a central laboratory for bacterial culture with antimicrobial susceptibility testing for pathogens.
The primary feasibility outcome is the proportion of patients successfully completing self-swabbing at home to obtain usable culture swabs with samples received at the laboratory within 24 hours and deemed suitable for processing. Secondary safety and acceptability outcomes include usability of the kit and instructions; patient satisfaction; viability of samples for laboratory analysis; and recruitment and retention rates. A 30-day follow-up will capture wound complications, antibiotic prescribing and healthcare utilisation via patient questionnaires, case note review, general practitioner confirmation and patient interviews. 10 staff stakeholders will be interviewed to inform pathway development.
Quantitative data will be analysed descriptively, with proportions reported alongside 95% CIs. Qualitative data from patients will undergo thematic analysis, and stakeholder interviews will be coded using Normalisation Process Theory. An early health economic model will be developed to explore resource use, costs and proportions of appropriate and timely antibiotic use between current pathways and a proposed pathway, including self-swabbing.
West of Scotland Research Ethics Service has reviewed and approved the study (REC reference: 25/WS/0079). Findings will be disseminated through the study website, a webinar, peer-reviewed publications, conference presentations, patient and public involvement-led activities and engagement with National Health Service (NHS) stakeholders.
by Dinesh Dadarwal, Kira Crooks, Patricia Lainetti, Ryan Dickinson, Khawaja Ashfaque Ahmed, Colin Palmer
This study aimed to evaluate the effects of a single postpartum administration of pegbovigrastim, a recombinant bovine granulocyte colony-stimulating factor (rG-CSF), on peripheral leukocyte profiles, granulocyte function, and uterine cytology in healthy Holstein dairy cows. We hypothesized that rG-CSF would enhance leukocyte counts and granulocyte function without adversely affecting uterine immune cell composition. Twenty-three cows between 19–23 days in milk were randomly assigned to receive either rG-CSF (n = 12) or saline (n = 11). Blood samples were collected on the day of injection and on Days 3, 6, 10, and 21 post-treatment to assess total and differential leukocyte counts. Granulocyte phagocytosis of fluorescein isothiocyanate (FITC)-labeled Staphylococcus aureus and oxidative burst capacity following PMA stimulation were evaluated using flow cytometry. Vaginoscopy and transrectal ultrasound examinations were conducted at each time point, and uterine cytobrush samples were collected from a subset of cows for cytological analysis. Compared to controls, rG-CSF-treated cows exhibited a significant (2–3 fold) increase in total leukocytes and neutrophils (P P P = 0.04) and phagocytic activity as well as capacity (P = 0.01) that peaked on Days 3 and 6 post-treatment, respectively, following rG-CSF treatment. Furthermore, uterine samples from treated cows showed higher proportions of neutrophils (Days 6, 10, and 21) and macrophages (Day 10) compared to controls (Pby Marwa Elshazly, Sondus Jawad, Ayesha Ahmed, Hager ElGeed, Kazeem Babatunde Yusuff
There is a paucity of studies focused on the predictors of community pharmacists’ readiness to deprescribe inappropriate medications for older adults especially in developing settings. The study aimed to use the situational theory of leadership to determine community pharmacists’ readiness to implement deprescribing of inappropriate medications for older adults, and as well as its significant predictors. A theory-driven cross-sectional assessment of the readiness (knowledge and confidence) of 252 community pharmacists was conducted in Qatar with a pre-tested 40-item questionnaire. Knowledge and confidence were assessed with a 2-point and 4-point Likert-type scale respectively. The maximum obtainable score for readiness was 16. Readiness was categorized as high (≥ median) or low (by Eslam T. Mashaqbeh, Tamam El-Elimat, Osama Y. Alshogran, Iyad Hamzeh, Zahraa M. Obeidat, Ahmed H. Al Sharie, Feras El Hajji
The concurrent use of herbal dietary supplements with prescription medications raises safety concerns due to the potential for clinically significant interactions. Matcha, a shade-grown green tea consumed as an ultra-fine powder, is rich in catechins that may inhibit the transport of P-glycoprotein (P-gp) substrates such as nadolol. This study investigated the effects of administering single and multiple doses of matcha on the pharmacokinetics of nadolol in an in vivo animal model. Male Sprague-Dawley rats (n = 32) were randomly assigned to four groups. Group 1 (negative control) was administered normal saline followed by a single oral dose of nadolol (10 mg/kg). Group 2 (matcha single-dose) was administered a single dose of matcha (250 mg/kg) whisked in normal saline, followed by nadolol (10 mg/kg) after 30 min. Group 3 (positive control) received itraconazole (50 mg/kg), followed by nadolol (10 mg/kg) after 30 min. Group 4 (matcha multiple-dose) received matcha (250 mg/kg daily for 21 days) before administering nadolol (10 mg/kg) on day 21. Blood samples were collected at 0, 0.33, 0.66, 1, 1.5, 2, 3, 4, 5, 8 and 24 h. Nadolol concentrations in plasma were measured by a validated high-performance liquid chromatography with fluorescence detection (HPLC-FL) method. Pharmacokinetic parameters were estimated using the PK solver add-in for Microsoft Excel. To ensure quality control, caffeine, a key marker compound of matcha green tea, was quantified using HPLC with ultraviolet detection (HPLC-UV). A single oral dosage of matcha (250 mg/kg) had no statistically significant effects on the pharmacokinetics of nadolol compared to the control group (p > .05). Although the multiple-dose matcha group showed an increase in Cmax (~45%), AUC0-t (~18%), and AUC0-∞ (~22%) for nadolol compared to the control group, these differences were not statistically significant (p > .05). In contrast, the t½ (h) of nadolol increased significantly from 4.0 ± 1.6 in the control group to 7.7 ± 4.2 (p = .039) in the matcha multiple-dose group. Itraconazole co-administration significantly increased systemic exposure (AUC) of nadolol (p = .009), confirming the validity of the animal model. Caffeine, a key marker compound in matcha tea, was quantified at 4.18 ± 0.44% w/w of dry matcha tea powder, equivalent to 41.8 ± 4.4 mg/g. This is the first study to explore the potential pharmacokinetic interaction between matcha tea and nadolol. Single and multiple oral doses of matcha green tea had negligible effects on most pharmacokinetic parameters of nadolol, except for an increased half-life in the multiple-dose group. Further research is needed to establish the clinical relevance of this interaction before definitive recommendations on the safety of matcha tea and nadolol coadministration can be made.Racialised immigrant communities in Western nations face disproportionate risks for sexually transmitted and blood-borne infections (STBBIs) due to systemic barriers, including racism, stigma and limited access to culturally appropriate care. While the need is well-established, a comprehensive synthesis of effective, culturally responsive sexual health interventions is lacking. This scoping review aims to map the available evidence on sexual health intervention needs and protective factors of racialised immigrants, and to identify and describe existing culturally appropriate programmes in Western nations.
The review will follow the JBI methodology for scoping reviews and be reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search strategy, developed and peer-reviewed by a health sciences librarian, will be executed in MEDLINE, Embase, CINAHL and Scopus, alongside grey literature sources, with no date limit. Two independent reviewers will screen titles/abstracts and full texts against the inclusion criteria. Data will be extracted using a standardised tool, analysed via narrative synthesis and framed by a socio-ecological model to categorise interventions across individual, interpersonal, community and structural levels.
Ethical approval is not required for this review. Findings will be disseminated through a peer-reviewed publication, academic presentations and tailored summaries for community organisations and policy-makers to ensure practical application.
Open Science Framework (https://osf.io/9qah6).
Recent advances in treatment and care have improved survival rates for children and young adults with severe blood disorders such as sickle cell disease (SCD), transfusion-dependent beta-thalassaemia (TDT) and acute leukaemia. However, their quality of life and reproductive and psychosocial outcomes are not yet well studied. For SCD and TDT, robust survival data are mainly limited to North America. Thus, there is a need to fill these knowledge gaps to guide improvements in care, address unmet clinical needs and rigorously assess the efficacy of emerging novel therapies.
This is an observational population-based mixed-methods study of individuals diagnosed with SCD, TDT or acute leukaemia when under the age of 18 in England, involving a data linkage component and a patient-reported outcomes measures survey. Data linkage-eligible participants will be identified from national and regional databases, including the Hospital Episode Statistics, Yorkshire Specialist Register of Cancer in Children & Young People and the National Congenital Anomaly and Rare Diseases Registration Service. Data linkage will be processed within the NHS England and the University of Leeds’ secure, trusted research environments. Data will be accessed without consent under section 251 and approval by the confidentiality advisory group. It will assess survival rates for SCD and TDT as well as clinical, educational and mental health outcomes for SCD, TDT and acute leukaemia diagnosed in childhood.
Survey-eligible participants for SCD, TDT and acute leukaemia cohorts will be checked for their suitability to participate by the North of England clinical care teams. An NHS-approved survey provider will facilitate data checks with the NHS National Data Opt-Out Service. Consent is required for participation in the survey and for subsequent data linkage to existing databases. Surveys are conducted in various formats (online, paper and phone), with reminders sent after 21 days. The survey will assess quality of life and psychosocial and reproductive outcomes. Participants can withdraw at any time, and support is available via telephone helplines.
The study has received ethical and information governance approval from the Health Research Authority (Reference 24/YH/0186) and the Confidentiality Advisory Group (CAG 24/CAG/0138) to process identifiable data without consent. Study results will be available to patients, physicians, researchers, stakeholders and others through open-access publishing, results sharing via media platforms and presentations at conferences and meetings.
To explore the factors affecting the sustainable improvement of nurses' evidence-based practice (EBP) competency after receiving an EBP training program.
A sequential mixed-methods study.
Thirty-seven ICU nurses participated from an adult ICU in Egypt. The qualitative phase used a category-generating approach with focus group interviews and content analysis. The quantitative phase followed a cross-sectional descriptive design using self-report questionnaires. The study adhered to the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines and was registered with ClinicalTrials.gov (NCT05941364).
Qualitative analysis generated six subcategories, organised into three overarching themes: working environment challenges, job dissatisfaction and organisational obstacles. Quantitative findings revealed low levels of motivation (M = 19.1, SD = 2.2, out of 60), self-efficacy (M = 18.4, SD = 8.66) and self-regulation (M = 124.9, SD = 52.6). The highest mean score was observed for the Sustained Implementation Support Scale (M = 94.7, SD = 5.0, out of 140). These variables showed negative correlations with the sustainability gap. Integration of findings through a joint display demonstrated a convergence of results regarding training program burden and low motivation.
Sustaining nurses' EBP literacy requires addressing long-term obstacles such as inadequate job satisfaction, limited workplace support and lack of team cohesion. Sustained organisational support and leadership development are essential for EBP clinical integration.
The study highlights key strategies for nurses' development to enhance care quality, including improving self-efficacy through mentorship and fostering a supportive work environment. Health policies should establish EBP as a core competency, offer flexible schedules, ongoing training, adequate resources, and empower nurse leaders for successful implementation.
This study addresses the critical challenge of sustaining nurses' competency improvements after EBP training. The findings are crucial for healthcare administrators, policymakers and educators aiming to design effective EBP training programs. By addressing these factors, the study has the potential to improve patient outcomes.
No patient or public contribution.
FreshRSS 