Conectar
Cancer remains a major public health concern worldwide. Patient navigation, developed in the 1990s to address disparities in cancer outcomes, aims to guide patients through the complex healthcare system and improve access to timely, quality care. Despite its proven benefits, little is known about the implementation or impact of patient navigation programmes in African settings.
This scoping review aims to map the current evidence on components, procedures, outcomes and impact, as well as barriers and challenges to implementation of patient navigation programmes in cancer care across Africa.
This scoping review will follow Arksey and O’Malley’s scoping review framework, as further developed by Levac et al. A systematic search will be conducted across PubMed, African Journals Online and Google Scholar to identify relevant studies published from database inception to the date of the final search, using a combination of relevant keywords and MeSH terms. Eligible studies must be reported in English, have been carried out in Africa, involved patients diagnosed with cancer or navigating the cancer care continuum, and report on the description, implementation or evaluation of patient navigation programmes. Screening will be managed with Rayyan and carried out through a two-stage process: screening by titles and abstracts, then by full-text screening based on the prespecified inclusion and exclusion criteria. Data will be extracted into a structured Excel spreadsheet and synthesised using qualitative content analysis to identify programme characteristics, outcomes, barriers and implementation challenges.
This scoping review does not require ethical approval. Our findings will be published in a peer-reviewed, open-access journal on completion.
The COVID-19 pandemic led to major disruptions in society across many spheres, including healthcare, the economy and social behaviours. While early predictions warned of an increased risk of suicide during and after the COVID-19 pandemic, rates of suicide deaths remained stable or decreased over that period for most countries. In contrast, the prevalence of suicidal ideation doubled and suicide attempts slightly increased during the COVID-19 pandemic in the adult general population worldwide, accompanied by a higher prevalence of major depressive disorder and anxiety disorders. While these data can tell us what happened, they cannot tell us why. Qualitative suicide research seeks to understand experiences of individuals with suicide-related thoughts and behaviours, provides an in-depth exploration of their lives and interactions with others and centres their views and unique context. There is little qualitative research focusing on suicidality during the pandemic. This study will use a qualitative approach to explore the extent and impact of the COVID-19 pandemic on Canadians who experienced suicidality and review their experiences of accessing mental healthcare to identify key components in supporting safety and recovery.
This study will involve approximately 100 semistructured interviews with participants across four Canadian provinces and will explore experiences with suicide-related thoughts and behaviours during the COVID-19 pandemic. Transcripts will be analysed through qualitative analysis informed by constructivist grounded theory.
The study was approved by the Research Ethics Board of the Centre for Addiction and Mental Health, Toronto Academic Health Sciences Network (for JZ: CAMH REB No 104-2022). In addition to traditional peer-reviewed presentations and publications, a report will make study findings accessible to policy makers, media and the public.
To examine how colleague violence affects professional image and career decisions among nursing students.
This cross-sectional study was conducted from February 1 to March 1, 2023, at two public universities in Turkey.
All nursing students who met the inclusion criteria and voluntarily agreed to participate were included without any special sample calculation, and a final sample of 357 students was obtained. Data were collected between February 1 and March 1, 2023. Data were collected using a survey form that included questions on sociodemographic characteristics, as well as three scales: the Exposure to Colleague Violence Scale (ECVS) scale, the Image of Nursing Profession Scale (INPS) scale, and the Career Decision Scale (CDS). Data analysis included descriptive statistics, t-tests, ANOVA, Pearson correlation, and regression analyses.
The mean ECVS score was 45.43 (20.80), the mean INPS score was 147.15 (13.51), and the mean CDS score was 79.67 (17.34). A weak negative correlation was found between colleague violence and nursing image, a weak positive correlation between colleague violence and career decision, and a moderate negative correlation between nursing image and career decision.
This study highlights the negative impact of exposure to colleague violence on nursing students, affecting both their professional image and career decision-making. Greater exposure to colleague violence correlates with more negative perceptions of the nursing profession and increased uncertainty in career choices. Implementing targeted interventions to reduce and prevent colleague violence, especially in clinical practice settings, is essential for promoting a positive professional image and supporting informed career decisions among nursing students.
Addressing and reducing colleague violence among nursing students can enhance their professional image and decision-making regarding their careers, which, in turn, may lead to improved patient care and more significant long-term commitment to the nursing profession.
This study adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies.
There was no patient or public involvement in this study.
Fractures over venous sinuses (FOVSs) are associated with difficulties in diagnosis and treatment resulting in a high level of morbidity and mortality. Despite its importance, there are limited aggregate data to guide the management of these fractures ultimately inflicting a major callenge to neurosurgeons. This protocol describes the methodology of a scoping review that aims to synthesise contemporary evidence on the management and outcomes of FOVSs.
The proposed study will be conducted in accordance with the Arksey and O’Malley’s framework for scoping reviews. The research question, eligibility criteria and search strategy were developed based on the population, intervention, comparator and outcome strategy. The following electronic bibliographic databases will be searched without restrictions on language and date of publication: PubMed, WHO Global Index Medicus, African Journals Online, SCOPUS, Embase, Cochrane and ProQuest Central. All peer-reviewed studies of primary data reporting on the management and outcomes of FOVSs will be included. The data extracted from included articles will be presented through descriptive statistics, pooled statistics and a narrative description.
Because this study did not directly involve human individuals, ethical approval was not necessary. Dissemination strategies will include publication in a peer-reviewed journal, oral and poster presentations at local, regional, national and international conferences and promotion over social media.
by Adedapo Olufemi Bashorun, Larry Kotei, Abdoulie F. Jallow, Ousubie Jawla, Emmanuel U. Richard-Ugwuadu, Muhammed Jagana, Lamin Bah, Amadou Tijan Bah, Karamo Conteh, Mamadou S.K. Jallow, Mehrab Karim, Bai Lamin Dondeh, Anne Segonds-Pichon, Gary M. Clifford, Iacopo Baussano, Bruno Pichon, David Jeffries, Ed Clarke
Human papillomavirus (HPV) infection is a primary cause of preventable deaths from cervical cancer, a condition of profound inequality with approximately 90% of deaths occurring in low- and middle-income countries, particularly in sub-Saharan Africa. In May 2018, the WHO Director-General declared a Joint Global Commitment to Cervical Cancer Elimination, highlighting the critical role of HPV vaccines in achieving this goal. However, there is a lack of systemically collected data on HPV prevalence in The Gambia, and impact data from high-income countries may not be reliably extrapolated to West African settings due to geographical variation in HPV types and distinct behavioural, biological, and sociodemographic exposures. The Gambia introduced a two-dose HPV vaccination schedule in 2019, but coverage has been very low, interrupted mainly by the COVID-19 pandemic. This presents a key opportunity to generate vital baseline data on HPV prevalence in the population before potential scale-up of vaccination efforts. The PHASE survey, a multi-stage cluster survey, aims to establish the baseline, population prevalence estimates of high-risk and low-risk, vaccine-type and non-vaccine-type HPV infection in 15- to 49-year-old females in The Gambia by measuring urinary HPV-DNA. The survey will also quantify the effects of various exposures on HPV prevalence, including sexual behaviour, the presence of other sexually-transmitted infections (STIs) - Neisseria gonorrhoea (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), syphilis, as well as blood borne viruses, human immunodeficiency virus (HIV), hepatitis B and hepatitis C; obstetric history, socio-demographic characteristics, and cervical cancer screening and/or treatment. Additionally, the study will provide important antimicrobial resistance (AMR) data for NG and MG in sub-Saharan Africa, a region poorly represented in global surveillance programs. This data is needed to guide regional treatment guidelines and advocate for new solutions, including gonococcal vaccines. The AMR data are expected to immediately influence recommendations regarding the appropriate choice of antibiotics for syndromic STI management in West Africa and hence to address an important driver of AMR in the sub-region. Leveraging on the Medical Research Council Unit The Gambia funded Health Demographic Surveillance system (HDSS) as its sampling frame, the survey will utilize validated diagnostic assays and culturally sensitive data collection methods, to ensure both scientific rigor and local relevance. Tools such as Audio Computer-Assisted Self-Interviewing (ACASI) technology, developed in consultation with local community advisory boards, are included to reduce social desirability bias in reporting sexual behaviour. This approach aims to maximize both the reliability and cultural appropriateness of the findings. This study directly addresses the critical need for baseline epidemiological data on HPV in a West African setting to accelerate vaccine impact and drive new interventions towards cervical cancer elimination. By understanding other factors that influence HPV (like other STIs, sexual behaviour, etc.), the study aims to ensure that, when the vaccine’s impact is measured later, changes in other confounding factors that may impact on HPV prevalence can be accounted for. The study will also establish the population prevalence of the measured STIs and their relationship to common symptoms and other adverse health outcomes related to STIs.Low-value care provides little or no benefit to patients, or its risk of harm outweighs the potential benefits. Non-nursing tasks refer to tasks performed by nurses below their scope of practice. With increasing pressure on the global nursing workforce, it is necessary to identify these concepts to deliver fundamental care.
To assess the prevalence, influencing factors and associations of low-value nursing care, and to identify non-nursing tasks and potential solutions in surgical hospital care settings.
The study followed a cross-sectional study design using a self-developed questionnaire.
A questionnaire on low-value care and non-nursing tasks was distributed to surgical wards in four hospitals in The Netherlands.
A total of 302 nurses responded to the survey. Five most prevalent low-value care practices were identified, including routine preoperative fasting (84.8%), taking over blood glucose monitoring (59.3%) and leaving in place any type of venous catheter (42.1%). These practices were mainly performed due to habitual practice, in accordance with an established protocol, or upon physicians' request. Most reported non-nursing tasks were administrative duties and cleaning patient rooms and equipment. Provided solutions included clearly defining responsibilities and taking personal responsibility.
Low-value care, provided by surgical nurses, is common in daily practice. This requires targeted de-implementation of each low-value care practice, based on influencing factors. Additionally, 85.8% of nurses perform non-nursing tasks daily or several times a day, underlining the need to re-organise nursing tasks.
De-implementing low-value care and reducing non-nursing tasks is necessary to ease pressure on the global nursing workforce and to improve fundamental care.
Low-value nursing care and non-nursing tasks persist when nurses lack leadership responsibility.
STROBE checklist.
No patient contribution.
Digital therapeutics (DTx) show promise in bridging mental healthcare gaps. However, treatment selection often relies on availability and trial-and-error, prolonging suffering and increasing costs. Personalised prediction models could help identify individuals benefiting most from specific DTx.
The aim of this secondary analysis was to establish a machine learning-based prediction model for positive treatment outcomes in patients with depressive or anxiety symptoms after 8 weeks of internet-delivered cognitive behavioural therapy (iCBT).
We analysed a large real-world dataset of patients from the online therapy unit iCBT programme in Saskatchewan, Canada (2013–2021). Clinically significant changes in depressive symptoms or anxiety were measured using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7). We trained six prediction models using sociodemographic and mental health-related factors at baseline, compared model performances and calculated Shapley values for feature importance.
Data from 4175 patients using 34 features for prediction, identified by least absolute shrinkage and selection operator regression, showed the Gradient Boosted Model (gbm) and logistic regression (log) performed best, with balanced accuracies of 0.76, 95% CI (0.70 to 0.83) and 0.70, 95% CI (0.63 to 0.77). Shapley values indicated GAD-7 scores at baseline as the most important predictor of clinically significant improvement, along with mental health history and sociodemographic variables.
The gbm and log models achieved comparable accuracy in predicting clinically significant improvement after iCBT, supporting the use of simpler, interpretable methods in clinical practice.
These findings could help improve mental health treatment selection, iCBT assignment, enhance effectiveness and optimise treatment for patients.
Childhood cancer accounts for a significant proportion of global childhood mortality, especially in low-income and middle-income countries (LMICs). Unlike many adult malignancies, primary prevention of childhood cancers is not possible. Improving survival requires a two-pronged strategy: earlier diagnosis and effective treatment. Our study aims to establish the feasibility, clinical and implementation effectiveness of an adapted early warning signs and symptoms (EWSS) intervention in Cameroon and Kenya. It will equip healthcare workers, Ministry of Health (MOH) representatives and National Cancer Institute leaders with evidence-informed guidance on implementing context-adapted interventions to improve the early detection and referral of childhood cancers in these countries.
The study is a quasi-experimental, hybrid type 2 implementation effectiveness study based on a Ghanaian adaptation of the ‘Saint Siluan’ EWSS campaign. Our protocol proposes context-specific adaptation and evidence-based implementation of the EWSS intervention through iterative engagement with country-level implementation teams to train healthcare workers and improve referral pathways for earlier childhood cancer diagnoses in each study country. Training effectiveness will be measured through pretraining and post-training tests of knowledge and application, as well as training satisfaction surveys. Clinical effectiveness will be assessed by using a REDCap database to track the number of newly diagnosed childhood cancer cases in the study regions and counties, healthcare timelines and paths to diagnosis, and the stage and proportion of metastatic disease at diagnosis. Implementation effectiveness will be evaluated through interviews with senior and mid-level health system partners and clinicians, tracking fidelity to the implementation process as laid out in The Implementation Roadmap Workbook, and analysis of meeting minutes from monthly local implementation team meetings.
This study has received ethical approval from The Hospital for Sick Children (REB # 1000080092) and all participating sites. We have received National Ethical Clearance from the Cameroon Ethical Board (#1699) and Regional Administrative Authorizations from our piloting regions (Centre and West). We have also received ethical clearance from Kenyatta National Hospital (KNH) (ERB# KNH-ERC/RR/955) and our National Commission for Science, Technology and Innovation in Kenya licence from the counties we are piloting in Kenya. As clinical data will be collected from existing health registries and patient charts, patient consent will not be required; however, we will obtain consent from all members of the leadership implementation teams and operational implementation teams for their participation in the implementation meetings and from all individuals participating in the semistructured interviews. We will disseminate findings to build awareness and share findings among various target audiences: (1) key county and regional parties (eg, clinical societies, advocacy groups, country MOHs and regional bodies such as the East African Community, Economic Community of West African States); (2) international bodies such as the WHO; and (3) the academic community.
This study aimed to gain insight into the thoughts, perceptions and needs of nurses caring for older adults with cardiometabolic multimorbidity regarding a planned machine learning-based clinical decision support system designed to classify care needs and prioritise nursing diagnoses; thereby providing a foundation for the necessity of integrating these systems into nursing practice.
Descriptive qualitative design.
Semi-structured interviews were conducted with twenty nurses caring for older patients with cardiometabolic multimorbidity between September and October 2024. Thematic analysis was performed using an inductive approach using Max Qualitative Data Analysis (MAXQDA) software.
Three main themes emerged: Experiences during the care process, classifying care needs and prioritising nursing diagnoses, and views on developing a decision support system.
This study revealed that nurses need a holistic approach to meet the complex care needs of older patients with multimorbidity, who often carry out a routinised nursing process with standardised diagnoses. Moreover, nurses hold positive views that such a clinical decision support system could enhance care quality and reduce workload; however, they express concerns regarding the integration process.
The findings of this study suggest that clinical decision support systems designed to classify the complex care needs of older patients with multimorbidity and support personalised nursing diagnoses offer an opportunity for holistic and quality care. By integrating these systems with authentic nursing knowledge, nurses can increase the visibility of nursing practice and personalise patient care more effectively.
The study was reported following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline.
No Patient or Public Involvement.
Patients with stage III non-small cell lung cancer (NSCLC) are at high risk of developing post-treatment recurrences (50–78%) during follow-up. As more effective treatments are now available, especially for patients with oligometastatic disease, earlier detection of recurrences may prolong survival and health-related quality of life (HRQOL). With the use of 2'-deoxy-2'-[18F]fluoroglucose positron emission tomography/CT ([18F]FDG PET/CT) during follow-up, recurrences may be detected earlier. Therefore, the primary objective of this study is to compare the 3-year overall survival of patients with stage III NSCLC during follow-up surveillance with [18F]FDG PET/CT versus follow-up with conventional CT (usual care). Secondary objectives address the number, location and timing of recurrences, as well as HRQOL, cost-effectiveness and patient experiences of PET/CT scans.
In this multicentre randomised controlled clinical trial, 690 patients with stage III NSCLC (8th edition International Association for the Study of Lung Cancer (IASLC) Tumor, Nodes, Metastasis (TNM) classification) who completed curative intended treatment and started follow-up care (which may include adjuvant therapy) will be randomised 1:1 to either the intervention ([18F]FDG PET/CT) or the control group (CT). Patients will undergo follow-up scans during visits at 6, 12, 18, 24 and 36 months. Data will be collected using validated questionnaires, electronic case report forms and data extractions from the electronic health records. Additionally, blood samples will be collected, and interviews will be conducted.
The study protocol has been approved by the Medical Ethical Committee of the Radboudumc and review boards of all participating centres. Written informed consent will be obtained from all participants. Study results will be published in international peer-reviewed scientific journals and presented at relevant scientific conferences. Data will be published in a data repository or other online data archive.
Cutaneous anthrax is a zoonotic bacterial infection that mostly involves the head, neck, and upper extremities. Periorbital involvement of cutaneous anthrax is a rare presentation that can lead to severe irreversible complications. Herein, we describe a 2.5-year-old girl with periorbital anthrax cellulitis. She presented with a severe swelling on the right side of her face and an ulceronecrotic lesion above the right eyebrow. After receiving an appropriate antibiotic regimen, her condition improved and she was discharged without any intraocular complications.
by Mahmoud Alfatafta, Nizar Alsubahi, Huda Alfatafta, Huthaifa Atallah, Amneh Alshawabka, Anthony McGarry, Alaeddin Ahmad
Lower extremity amputation (LEA) is a significant health concern in Jordan, yet comprehensive data on its demographic and clinical characteristics remain limited. This retrospective analysis evaluated 893 LEA cases collected from Al-Basheer Hospital and six private prosthetic clinics in Amman between 2017 and 2023. Transtibial amputations (68.99%) were the most common, followed by transfemoral amputations (24.53%). Males were three times more likely than females to undergo LEA, with an overall mean age of 48.43 years (SD = 20.42). Diabetes mellitus (55.88%) was the leading cause, followed by cancer (18.48%) and trauma (11.65%). Age and cause were significantly associated (pPre-eclampsia causes significant maternal and perinatal morbidity and mortality. It also causes changes in the cardiovascular, endothelial and metabolic systems, from which women may not fully recover after delivery. This study examined the association between the time of onset of pre-eclampsia and the risk for cardiovascular disease (using glucose tolerance, lipid profile and blood pressure) and renal function at 6 weeks post partum.
A prospective cohort study.
Lagos University Teaching Hospital, Idi-Araba, Mother and Child Centre, Gbaja, Surulere and Lagos Island Maternity Hospital, Lagos, Nigeria.
44 women with pre-eclampsia were studied and data on their sociodemographic characteristics, gestational age at diagnosis and blood pressure were collected on admission. They were followed up through delivery till 6 weeks post partum, when blood pressure check, 75 g oral glucose tolerance test, fasting lipid profile and serum creatinine were done.
The exposure was pre-eclampsia. The outcomes were cardiovascular disease risk markers, viz persistent hypertension, glucose intolerance and dyslipidaemia, and renal function at 6 weeks post partum in women who had pre-eclampsia.
Data were analysed using Stata V.16.1. Mann Whitney-U test was used to compare medians and Fisher's exact test was used to compare the categorical variables.
Of the women studied, 13 (29.5%) had early onset pre-eclampsia and 31 (70.5%) had late onset pre-eclampsia. Mean gestational age at diagnosis was 30.8±1.57 weeks in women with early-onset pre-eclampsia and 35.6±1.26 weeks in women with late-onset pre-eclampsia (p
The prevalence of persistent hypertension at 6 weeks post partum is high in women with pre-eclampsia. Serum triglyceride concentration was significantly higher in early onset compared with late onset pre-eclampsia; subsequent studies powered to determine the full cardiovascular risk and how long to follow postnatal women up will be beneficial.
Distal radius fractures account for one-fifth of all fractures in the active elderly population and may cause chronic pain, loss of hand function and reduced work productivity, imposing a significant socioeconomic burden. Most are initially treated with closed reduction and casting, but 30% subsequently require surgery due to insufficient realignment. The current approaches for analgesia for closed reduction are suboptimal. A brachial plexus nerve block provides complete pain relief and muscle relaxation distal to the elbow, potentially creating better conditions for realignment of the fractured bone ends. This may ultimately translate into reduced need for surgery and result in better functional outcomes and fewer complications compared to a haematoma block, which is the current standard care in Denmark.
The BLOCK Trial is an investigator-initiated, parallel-group, allocation-concealed, outcome assessor and analyst-blinded, superiority, randomised, controlled, clinical multicentre trial performed at 11 Danish emergency departments. Eligible adult patients with a distal radius fracture who need closed reduction will be included and allocated 1:1 to either an ultrasound-guided brachial plexus nerve block or a haematoma block. The primary outcome is the proportion of patients with distal radius fracture surgery 90 days after closed reduction. We will include 1716 participants to detect or discard a relative risk reduction of surgery of 20%. Secondary outcomes include treatment-related complications, patient-reported wrist function, pain during closed reduction and proportion of patients with unacceptable radiographic fracture position immediately after closed reduction.
The trial is approved by the Danish Medicines Agency and the Danish Research Ethics Committees (EU CT number: 2024-512191-35-00). All results will be summarised on www.theblocktrial.com, clinicaltrials.gov and euclinicaltrials.eu after publication. Primary and secondary outcome results from 0 to 90 days will be presented in the main article and submitted to a peer-reviewed journal. Results from outcomes on the 12-month follow-up will be presented separately.
Internet is women's primary source of information about cervical cancer and human papillomavirus. The aim of this study was to determine the associations of electronic health literacy with cervical cancer and human papillomavirus awareness among women of reproductive age. This is a cross-sectional study. The research sample consisted of 330 women of reproductive age (15-49 years), who were admitted to family health centers. The data were collected between July and August 2023 using eHealth Literacy Scale and the Cervical Cancer and Human Papillomavirus Awareness Questionnaire. Multiple linear regression analysis was performed to explore the predictors of cervical cancer and human papillomavirus awareness. In this study, the mean score of women's knowledge about cervical cancer and human papillomavirus was found to be low (4.54 ± 3.94), and the mean score of threat perception was found to be moderate (45.60 ± 6.54). eHealth literacy was found to be a predictor of women's knowledge about cervical cancer and human papillomavirus and threat perception. This result suggests that eHealth literacy should be considered for interventions to increase knowledge and awareness of women about cervical cancer and human papillomavirus. Work wellbeing, also known as workplace wellbeing, is a global concern for nurses, particularly because excessive stress and exhaustion contribute to burnout.
The Caring Science International Collaborative (CSIC), an international research network, empirically investigates nurse work wellbeing using the Profile of Caring, a psychometrically validated and reliable instrument.
The CSIC framework defines wellbeing intrinsically—as caring and clarity—and extrinsically—as the social and technical resources needed to work efficiently and effectively. The Profile of Caring explains 80% of work wellbeing in nursing without bias across 10 countries.
This research protocol describes an international multicenter observational study that measures nurse work wellbeing using the Profile of Caring and other concepts and outcomes measures.
The first 3 months post partum is a critical transition period for women and families, which is characterised by physical, psychological and social adaptation. The first year post partum is also a critical phase for women’s health, given their physical recovery and adjustment to motherhood. The WHO 2023 recommendations highlight the importance of a postnatal care focus, including maternal health assessment, mental health support, nutritional interventions, postpartum contraceptive use and home care visits. This scoping review aims to map the evidence of the effectiveness of postpartum care on women’s health and quality of life in the Southeast Asia region.
This scoping review will be guided by the methodological principles developed by Arksey and O’Malley. This review will also consider observational studies, including cohort studies, case-control studies and cross-sectional studies. For inclusion, studies should be selected for eligibility based on the following criteria: articles investigating the uptake of postpartum women (women who have had childbirth up to 42 days after delivery) in Southeast Asian countries. The search will comprise peer-reviewed articles from 2013 to 2023 from the following electronic databases: PubMed/MEDLINE, ProQuest, EBSCO, Scopus, Web of Science and Google Scholar. We use both keywords in the title and/or abstract and subject headings as appropriate. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Protocols to develop the protocol and use the PRISMA flow diagram to present the results for scoping reviews.
A scoping review is a novel approach for examining the breadth of literature regarding the connection between the effectiveness of postpartum care and women’s health and quality of life and, as a secondary analysis, does not require ethics approval. The results of this review will be submitted for publication in a peer-reviewed journal and presented at relevant conferences.
Leishmania spp. are intracellular protozoan parasites responsible for leishmaniasis, a globally prevalent vector-borne disease transmitted by phlebotomine sandflies. Within vertebrate hosts, the parasites preferentially infect macrophages and dendritic cells, leading to cell lysis and the formation of disfiguring lesions. Current treatment regimens are hampered by high toxicity, prolonged administration protocols, and severe side effects, underscoring the need for safer and more effective therapeutic alternatives. Mesenchymal stem cells (MSCs), multipotent non-haematopoietic progenitors with fibroblast-like characteristics, possess self-renewal capacity and the ability to differentiate into various functional cell types. Their intrinsic immunomodulatory and antimicrobial properties have positioned MSCs as promising candidates for combating infectious diseases, including leishmaniasis. This review systematically synthesises experimental evidence on the effects of MSCs on Leishmania parasites and the associated lesions, investigates the potential healing mechanisms of MSCs in the context of Leishmania infection, and outlines future research directions in this evolving field. A comprehensive literature search—spanning Scopus, PubMed, Web of Science, and Google Scholar up to 31 May 2024—identified 11 relevant studies: eight from Iran, two from Brazil, and one from Turkey. While Brazilian investigations utilised L. amazonensis, the others focused primarily on L. major, a leading cause of cutaneous leishmaniasis (CL). Across these studies, MSC-based therapy has shown immunomodulatory and antiparasitic effects, influenced by factors such as cell dosage, timing, route of administration, and the parasite burden. Despite promising findings, variability in experimental designs and outcomes highlights the early and exploratory stage of MSC application in CL therapy. Rigorous and standardised research is urgently needed to validate the therapeutic potential of MSCs and to support their clinical translation for leishmaniasis treatment.
by Braeden A. Terpou, Lauren Lapointe-Shaw, Ruoxi Wang, Danielle Martin, Mina Tadrous, Sacha Bhatia, Jennifer Shuldiner, Simon Berthelot, Niels Thakkar, Kerry McBrien, Bahram Rahman, Aisha Lofters, J. Michael Paterson, Rita McCracken, Christine Salahub, Tara Kiran, Noah M Ivers, Laura Desveaux
Walk-in clinics (WICs), appreciated for their accessibility and convenience, have become an increasingly popular healthcare option in Ontario for patients with and without primary care enrolment. Despite their utility, WICs face criticism for delivering lower-quality care compared to comprehensive, enrolment-based primary care models. Critics argue that WICs contribute to system inefficiencies and encourage practice patterns misaligned with population health goals. This study explored physician perspectives on two key outcomes often associated with low-quality care in WICs: repeat primary care visits and potentially inappropriate antibiotic prescribing. Using a qualitative descriptive approach, semi-structured interviews were conducted with Ontario-based family physicians (N = 19) who had experience practicing in both WICs and enrolment-based primary care. The findings highlight systemic challenges, including limited access to enrolment-based primary care and increasing healthcare demands, which have pushed WICs beyond their intended role. This misalignment has created tensions between their structure and purpose, resulting in visits that participants described as more transactional than those in primary care. These constraints—rooted in a lack of informational and relational continuity—often limited participants’ ability to provide in-depth engagement or follow-up care. Repeat visits were frequently linked to efforts to ensure continuity for complex or chronic conditions. Similarly, participants acknowledged the reality of potentially inappropriate antibiotic prescribing, attributing it to the high patient volume, desire to satisfy patient expectations, and a tendency to “err on the side of caution” when the nature of the illness is in question. The findings underscore how health system pressures and well-intended policies, such as Ontario’s primary care access bonus, can produce unintended consequences, including inequities in access and difficulties with care coordination across settings. Addressing these challenges requires reforms to better integrate WICs with the primary care system, alongside tailored training to support physician decision-making in episodic care contexts.Global research on nurse work wellbeing (WWB) has produced internationally-informed outcome models, yet few studies examine how these models apply within specific countries. Understanding WWB in the national context is essential to shape effective, locally relevant nursing policies and practices.
To explore WWB characteristics among hospital nurses in the Middle East and North Africa (MENA) and identify country-specific opportunities to improve nurse WWB.
A secondary analysis was conducted using WWB data from nurses in Jordan, Israel, and Türkiye, extracted from a broader 9-country study (2022–2023) involving 2546 nurses. The original study employed the 35-item Profile of Caring instrument to measure a 9-factor model of WWB. This analysis used descriptive statistics and linear regression to examine country-specific patterns among MENA nurses (n = 429).
Data from Jordan (n = 136), Israel (n = 175), and Türkiye (n = 118) revealed statistically significant differences (p < 0.001) across five of nine WWB factors by country. Country, as a variable, predicted 33% of the variance of caring-for-self and 20% of caring-of-manager, with Türkiye and Jordan reporting the lowest scores, respectively. Country explained 18% of satisfaction with professional growth and 16% in autonomy, with Türkiye scoring lowest on both. Fifteen percent of participative management was predicted by country, with both Türkiye and Jordan having lower scores than Israel.
Findings inform country-specific policy and operational improvements to support nurse WWB: strengthening manager-staff engagement, fostering self-care among nurses and caring and communicative behaviors from managers, supporting professional development, and enhancing autonomy and role clarity.
FreshRSS 