Globally, curable sexually transmitted infections (STIs) are increasing, particularly in sub-Saharan Africa, yet epidemiological data remain limited, hindering progress towards the 2030 global STI targets. This study assessed the prevalence of self-reported STIs in the last 12 months among adolescent girls and women (AGW) and adolescent boys and men (ABM) aged 15–59 who ever had sex in Zambia and Zimbabwe at three time points. It also assessed whether observed changes across survey rounds persisted after adjusting for sociodemographic and sexual behaviour characteristics.
We analysed six rounds of Demographic and Health Surveys, three per country, collected between 2005 and 2018, using descriptive statistics and logistic regression, while accounting for survey design.
Zambia and Zimbabwe.
A total weighted sample of 86 366 AGW and ABM was included in the study.
Self-reported STIs in the last 12 months.
Overall, self-reported STI prevalence was higher in Zimbabwe than Zambia. Among Zambian ABM, self-reported STIs increased from 6.2% in 2007 to 7.1% in 2018 (adjOR=1.28, 95% CI 1.05 to 1.57, p=0.005). Among Zimbabwean AGW, prevalence decreased from 11.7% in 2005/2006 to 8.3% in 2015 (adjOR=0.72, 95% CI 0.61 to 0.85, p
These findings highlight differences in STI prevalence by sex and country across survey rounds, underscoring the need for tailored STI prevention, diagnostic and treatment strategies, particularly for high-risk groups.
Administering supplemental oxygen to prevent hypoxaemia is a fundamental treatment for patients hospitalised with acute injury or illness. However, the amount of oxygen administered frequently exceeds that needed to maintain normoxaemia, causing patients to experience hyperoxaemia and wasting supplemental oxygen. Closed-loop, autonomous oxygen titration systems are designed to optimise oxygen delivery by administering the lowest possible oxygen flow that maintains peripheral oxygen saturation (SpO2) within a predefined range. For adults hospitalised with an acute injury or illness, it remains uncertain whether the use of a closed-loop, autonomous oxygen titration system safely increases the proportion of time spent in normoxaemia (SpO2 90%–96%) compared with usual care.
The Strategy to Avoid Excessive Oxygen using Autonomous Oxygen Titration Intervention trial is a multicentre, unblinded, parallel-group, randomised trial being conducted at four level 1 trauma centres in the USA. The trial compares an autonomous oxygen titration system versus usual care among 300 adults hospitalised for major trauma, burn, acute care surgery or acute respiratory illness. The primary outcome is the proportion of patient-time spent within the targeted normoxaemia range (SpO2 90%–96%) as measured by continuous non-invasive pulse oximetry, during the first 72 hours after randomisation. Secondary outcomes include the amount of supplemental oxygen administered and the proportion of time spent in hypoxaemia (SpO22 >96%). Specifying the protocol and statistical analysis plan before the conclusion of enrolment increases the rigour, reproducibility and interpretability of the trial. Enrolment began on 6 May 2024.
The trial protocol was approved by the single institutional review board at the University of Colorado School of Medicine and the Office of Human Research Oversight at the Department of Defense. We will present the results at scientific conferences and submit them for publication in a peer-reviewed journal.
To evaluate the incremental diagnostic value and sub-phenotyping capability of Cardiovascular Magnetic Resonance (CMR) compared with Transthoracic Echocardiography (TTE) in patients with elevated left ventricular filling pressure (LVFP).
Prospective registry study. [Results from ClinicalTrials.gov ID NCT05114785]
A single NHS hospital in the UK.
The primary outcome was the rate of diagnostic discordance between TTE and CMR. Secondary outcomes included the characterisation of specific pathologies identified by CMR where TTE was normal, non-diagnostic or provided a non-specific diagnosis.
CMR demonstrated diagnostic discordance with TTE in 74% (n=194) of cases. In patients with a normal TTE (n=54), CMR identified heart failure with preserved ejection fraction (HFpEF) in 46% (n=25) and ischaemic heart disease (IHD) in 19% (n=10). For non-diagnostic TTE cases (n=15), CMR detected HFpEF in 53.3% (n=8) and IHD in 26.7% (n=4). Among those with non-specific left ventricular hypertrophy on TTE (n=47), CMR revealed HFpEF in 45% (n=21) and hypertrophic cardiomyopathy in 34% (n=16).
CMR markedly improves diagnostic precision and sub-phenotyping in patients with elevated LVFP, identifying key conditions like HFpEF, IHD and specific cardiomyopathies that TTE frequently misses. These findings highlight CMR’s critical role as a complementary imaging tool for refining diagnoses and informing management strategies in cardiovascular conditions.
Musculoskeletal (MSK) conditions account for up to one-third of general practice consultations and over one-fifth of emergency department attendances in the UK. Postpandemic, the elective orthopaedic surgery backlog remains one of the most substantial across surgical specialties. Despite this burden, undergraduate exposure to trauma and orthopaedics (T&O) remains limited and inconsistent. Most UK medical students receive only 2–3 weeks of T&O teaching, with up to 40% of foundation doctors feeling underprepared to manage MSK conditions. The Evaluation of Trauma and Orthopaedic Teaching in Medical Schools Nationally (TENDON Study) aims to evaluate the current state of undergraduate T&O education in UK medical schools from both student and educator perspectives.
This national, prospective, cross-sectional survey will be conducted between 25 July and 27 October 2025. A dual-instrument electronic survey was developed through Qualtrics, informed by the British Orthopaedic Association (BOA) Undergraduate Curriculum and UK Medical Licensing Assessment content map. Participants will include medical students (Years 1–6), foundation doctors and orthopaedic educators recruited through British Orthopaedic Medical Students Association and BOA networks, and designated school representatives. Survey domains include curriculum coverage, teaching methods, clinical exposure and self-reported competence. Quantitative data will be analysed using descriptive and inferential statistics; qualitative data will undergo thematic analysis. Reporting will follow the Checklist for Reporting Of Survey Studies framework, with relevant elements drawn from the Checklist for Reporting Results of Internet E-Surveys checklist.
Ethical approval was obtained from the Human Biology Research Ethics Committee, University of Cambridge. Findings will be disseminated via peer-reviewed publication, conference presentations and summary reports to curriculum leads and relevant educational bodies.
Three-dimensional high-resolution anorectal manometry (3D HRAM) is a minimally invasive test allowing the assessment of lower gastrointestinal tract function. Nowadays, it is performed in left lateral or supine position (non-physiological) in accordance with the London Protocol. 3D HRAM can disclose pathological defecation model such as dyssynergic defecation (DD) that might be a cause of constipation in a significant percentage of patients.
3D HRAM in healthy adults in lying position shows up to 67%–87% abnormal results during the bear-down manoeuvre; it may result from the non-physiological position taken during the examination.
The aim of this study is to assess the influence of body position on parameters of the bear-down manoeuvre during 3D HRAM in children with constipation and healthy volunteers.
This is a prospective, case-control study. Study participants of 5–18 years old will be recruited and divided into two groups: (I) patients with functional constipation and non-retentive faecal incontinence diagnosed according to the Rome IV criteria and (II) healthy controls. Tests will be performed both in supine and sitting positions, successively using 3D HRAM. The order in which the examination will be performed will be in accordance with the randomisation list generated by computer.
The primary endpoint of the study is the difference in the number of patients with DD detected in the sitting and supine positions.
The study was approved by the Ethics Committee of the Medical University of Warsaw, Poland (KB/178/2019). The results of this study will be submitted to a peer-reviewed journal no later than 1 year after data collection. The abstract will be presented at relevant national and international conferences.
Introducción. La calidad de vida es un conjunto de dimensiones que contribuyen al bienestar del ser humano, misma que está determinada por la percepción que tiene el individuo en relación a su entorno. Objetivo: Analizar la calidad de vida percibido por las madres y cuidadoras de los pacientes hospitalizados en los servicios de pediatría y neonatología del Hospital General Isidro Ayora de Loja. Metodología. Es un estudio cuantitativo, descriptivo, transversal desarrollado en 90 mujeres madres/cuidadoras. La recolección de información se realizó a través del cuestionario SF-36 (Short Form Health Survey), un instrumento válido y confiable que evalúa la función física, social, rol físico, emocional, salud mental, dolor corporal y salud general. Además, el presente trabajo fue revisado y aprobado por el Comité de Ética de Investigación en Seres Humanos (CEISH) de la UNL. Resultados. El nivel de calidad de vida en general es promedio (42,1%), por dimensiones, las muy bajas fueron el rol físico (34,4%) y emocional (36,7%), como promedio la salud general (41,1%) y cambio de salud (45,6 %), como alto el dolor corporal (35,6%), vitalidad (43,3%), función social (36,7%) y salud mental (41,1%); y finalmente solo la función física obtuvo un nivel muy alto (24,4%). Discusión. En la actualidad, la mujer es la principal en asumir el rol de cuidadora, generando una serie de problemas de salud en sí misma, desde un desgaste en el rol físico hasta un desequilibrio emocional, debido a la angustia y el cansancio que provocada el estado de salud del niño.
ABSTRACT
Introduction. Quality of life is a set of dimensions that contribute to human well-being, which is determined by the individual's perception of their environment. Objective: To analyze the quality of life perceived by mothers and caregivers of patients hospitalized in the pediatrics and neonatology departments at Isidro Ayora General Hospital in Loja. Methodology. This is a quantitative, descriptive, cross-sectional study conducted on 90 mothers/caregivers. Information was collected using the SF-36 (Short Form Health Survey) questionnaire, a valid and reliable instrument that assesses physical function, social function, physical role, emotional role, mental health, bodily pain, and general health. In addition, this study was reviewed and approved by the Human Research Ethics Committee (CEISH) of the UNL. Results.The overall quality of life level is average (42.1%). By dimension, the very low levels were physical (34.4%) and emotional (36.7%), average levels were general health (41.1%) and health change (45.6%), high levels were bodily pain (35.6%), vitality (43.3%), social function (36.7%), and mental health (41.1%); and finally, only physical function obtained a very high level (24.4%). Discussion. Currently, women are the main caregivers, which generates a series of health problems for themselves, from physical exhaustion to emotional imbalance, due to the distress and fatigue caused by the child's health condition.
The inadequate handling of obstetrical complications may be attributed to the suboptimal quality of prenatal care (PC) and a lack of trust in healthcare provider (HP) among pregnant women.
This study explores the perceptions of satisfaction among women without social security regarding the PC provided by public health services, and compares the dimensions of satisfaction between those who received group prenatal care (GPC) and those who received individual prenatal care (IPC), as well as to identify the dimensions of satisfaction most valued by women to support the inclusion of said dimensions in primary health guidelines.
We performed a qualitative analysis to explore women’s satisfaction perception regarding PC. Satisfaction was explored using the following dimensions: women-HP relationship, educational support, opportunity of PC, emotional support and perception of clinical procedures.
The study was conducted between 2015 and 2018 across eight primary health facilities, from which four implemented IPC and four implemented GPC. Semi-structured interviews were applied: 28 for women with IPC and 18 for women with GPC. The sample size was defined by theoretical saturation. Content analysis was performed using a combination of deductive–inductive process into dimensions and attributes. To analyse the relationship among dimensions and attributes, we performed onto semiotic networks. ATLAS.ti was used to analyse the information.
Women without social security who received PC care in public health facilities.
Women who received GPC reported higher satisfaction than those who received IPC. In GPC, the most valued dimensions were (1) women-HP relationship, particularly the continuity of care delivered by the same HP and (2) the trust in that same provider. According to semiotic networks, these dimensions showed interconnections with each other, but also connected with attributes of other dimensions. Therefore, they have the potential to enhance trust, communication, the effectiveness of educational activities and emotional support.
A holistic approach to GPC is essential for ensuring a positive prenatal experience. However, a hybrid model that incorporates elements of both IPC can further enhance overall satisfaction among women. Consistency in care, particularly by providing services in public health facilities with the same HP, should be a fundamental strategy in PC, as it can significantly improve women’s satisfaction.
This study aimed to determine the prevalence and antimicrobial susceptibility profile of non-fermenting Gram-negative bacilli (NFGNB) isolated from clinical samples in a tertiary care hospital in Niger.
Prospective, cross-sectional study.
The study was carried out in a tertiary care hospital in Niger.
All clinical samples received at the bacteriology laboratory during the study period for diagnostic purposes were included.
Out of 548 clinical Gram-negative isolates, 60 strains of NFGNB (10.94%) were isolated. These NFGNB strains were mainly isolated from male patients (62%, n=37) with a mean age of 41.2±27.3 years. NFGNB was more frequent in urine samples (91.7%), followed by pus (6.6%). Among the NFGNB strains isolated, Acinetobacter baumannii was predominant (60%), followed by Pseudomonas aeruginosa (18.3%) and Stenotrophomonas maltophilia (13.33%). 20% (n=12) of NFGNB isolated were multidrug-resistant (MDR), including 13.33% (n=8) carbapenem-resistant A. baumannii and 6.67% (n=4) carbapenem-resistant P. aeruginosa. There is no statistically significant association between MDR-NFGNB and age, sex and origin of patients (p>0.05).
Our study revealed a relatively high MDR-NFGNB prevalence rate in a Nigerien tertiary care hospital. These findings emphasise the need for vigilant antibiotic stewardship, with appropriate infection prevention and control practices to curb the emergence and spread of MDR-NFGNB infections in hospital settings.
Luis Cibanal escribe una reseña sobre el libro de Joseph Ratzinger y Jurgen Habermas: Dialéctica de la secularización. Sobre la razón y la religión. Ediciones Encuent
Objetivo. Determinar la validez de contenido de la Escala de Autoeficacia para el Amamantamiento en mujeres puérperas. Metodología. Diseño metodológico de validación, con cinco etapas: 1. Adaptación sociocultural de la escala; 2. Validación de contenido; 3. Prueba piloto; 4. Factibilidad pragmática mediante Ensayo Clínico Aleatorio; 5. Análisis factorial exploratorio. Resultados. Etapa 1-2: Los jueces modificaron en los 14 ítems, la palabra “poder”, por la palabra "Tengo la confianza". Índice de Validez por Ítem (1.7); Criterio de Validez (12%) y el Índice de Validez de Contenido (8.78). Etapa 3-4: Prueba piloto, α=.85. Se encontraron diferencias entre el grupo control y experimental en el re-test (p< .05). Etapa 5: Las subescalas explican el 39.91% de la varianza. Conclusión principal. Instrumento válido y confiable para medir la autoeficacia para el amamantamiento en mujeres puérperas. La intervención educativa y persuasión verbal mejora significativamente el nivel de autoeficacia mediante el componente educativo.