Conectar
To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
To identify distinct social network types among young-old adults based on the characteristics of social network structure and to explore the relationship between different types, socio-demographic characteristics and subjective cognitive decline.
A cross-sectional study was conducted from July 2022 to October 2023.
A total of 652 young-old adults aged 60–74 years completed the sociodemographic questionnaire, the subjective cognitive decline questionnaire-9 and the self-designed egocentric social network questionnaire. The types of social networks were identified by latent profile analysis. Univariate analysis and binary logistic regression were used to analyse the influencing factors of subjective cognitive decline.
The incidence of subjective cognitive decline was 38%. Social networks of young-old adults tended to be large, predominantly family-centred and characterised by strong contact strength, high density and significant demographic heterogeneity among network members. Four social network types were identified: diverse-moderate, family-dense, family-strong and friend-loose. Young-old adults embedded in the family-dense and family-strong types were more likely to develop subjective cognitive decline than those in the diverse-moderate type. Additionally, age, education level, previous occupation, daily sleep duration and exercise were related to the incidence of subjective cognitive decline.
The findings highlight the relatively high incidence of subjective cognitive decline in young-old adults that is notably influenced by the type of social network they are embedded in. More attention needs to be paid to identifying and supporting young-old adults at high risk of subjective cognitive decline, especially to promote their social integration and friend network building, to improve their subjective cognitive function.
The findings emphasise the importance of considering the structure and composition of social networks when addressing subjective cognitive decline among young-old adults. A diversified social network incorporating both familial and friendship ties may provide enhanced cognitive protection. Therefore, interventions targeting subjective cognitive decline should promote the expansion of friendship-based relationships and foster the development of more heterogeneous and multi-source networks.
STROBE checklist.
Not applicable.
Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient-centred care gains importance, evaluating the effects of this approach on patient-reported outcomes may be more relevant than widely assumed.
In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient-reported outcomes, such as anxiety and satisfaction.
This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Scoping Review extension guidelines.
Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS-I V2.0, RoB2 and ROB-E tools.
Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025.
Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking.
Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients.
No patient or public involvement.
by Rahil Mahmoudi, Maral Nabaee, Akram Kooshki, Saba Shourideh Yazdi, Mahboubeh Neamatshahi, Elaheh Foroumandi
BackgroundWith the high prevalence of diabetes worldwide and the known benefits of functional foods in controlling diabetes, this study aimed to explore the connection between prebiotic food intake and biochemical indices in diabetic patients.
MethodsThis cross-sectional study was conducted on 504 participants with type 2 diabetes who were part of the Sabzevar Persian Cohort study that was initiated in February 2018. A 148-items food frequency questionnaire was utilized to assess the daily amount of prebiotic food consumption. Blood serum samples were collected from participants to measure fasting blood sugar levels, lipid profile, and kidney function indicators. Additionally, anthropometric measurements were taken following standard protocols. Statistical analyses were performed using SPSS version 20, with correlation tests adjusted for confounders, and significance set at p Results
This study involved 44.9% male and 55.1% female participants, with an average age of 54.81 ± 7.65 years. A significant correlation was observed between soybean consumption and serum low density lipoprotein (LDL) status (R = −0.110, P = 0.014). Moreover, a higher intake of banana was linked to lower blood urea nitrogen (BUN) levels (R = −0.109, P = 0.015). Furthermore, the consumption of honey exhibited a negative association with both systolic blood pressure (BP) (R = −0.106, P = 0.018) and diastolic BP (R = −0.132, P = 0.003). Green peas intake was also inversely associated with DBP (R = −0.092, P = 0.039).
ConclusionThis study found a positive correlation between the regular intake of prebiotic foods and improved management of BUN, LDL, and BP in individuals with type 2 diabetes. However, further mechanistic studies are necessary to better understand the potential causal effects of prebiotic foods on metabolic health in this population.
by Linlin Bao, Haibo Zhao, Haiyue Ren, Chong Wang, Su Fang
Hair follicle stem cells (HFSCs) play critical roles in adult hair regeneration, owing to its self-renewal and multipotent differentiation properties. Emerging evidence has shown that long noncoding RNAs (LncRNAs) are implicated in biological processes such as proliferation, differentiation and apoptosis. However, the specific role of LncRNA RP11-818O24.3 in regulating HFSCs remains unclear. To explore the effect of LncRNA RP11-818O24.3 on HFSCs, stable LncRNA RP11-818O24.3 overexpression and knockdown HFSCs were established using a lentivirus vector system. The effect of LncRNA RP11-818O24.3 on proliferation was evaluated by Cell Counting Kit-8 (CCK8) and EdU incorporation experiments. The differentiation of HFSCs into neurons and keratinocyte stem cells was detected by immunofluorescence staining. We showed that LncRNA RP11-818O24.3 overexpression promoted the proliferation and inhibited cell apoptosis in HFSCs. High levels of LncRNA RP11-818O24.3 promoted the differentiation of HFSCs into CD34+K15+ keratinocyte progenitors and CD34+Nestin+neuron-specific enolase (NSE)+ neural stem cells. Additionally, LncRNA RP11-818O24.3 increased fibroblast growth factor 2 (FGF2) expression and the subsequent activation of the PI3K/AKT signaling pathway. These data demonstrated that LncRNA RP11-818O24.3 promotes self-renewal, differentiation, and the capability to inhibit apoptosis of HFSCs via FGF2 mediated PI3K/AKT signaling pathway, highlighting its potential role as a therapeutic strategy for treating hair loss diseases.There are substantial barriers to initiate advance care planning (ACP) for persons with chronic-progressive disease in primary care settings. Some challenges may be disease-specific, such as communicating in case of cognitive impairment. This study assessed and compared the initiation of ACP in primary care with persons with dementia, Parkinson’s disease, cancer, organ failure and stroke.
Longitudinal study linking data from a database of Dutch general practices’ electronic health records with national administrative databases managed by Statistics Netherlands.
Data from general practice records of 199 034 community-dwelling persons with chronic-progressive disease diagnosed between 2008 and 2016.
Incidence rate ratio (IRR) of recorded ACP planning conversations per 1000 person-years in persons with a diagnosis of dementia, Parkinson’s disease, organ failure, cancer or stroke, compared with persons without the particular diagnosis. Poisson regression and competing risk analysis were performed, adjusted for age, gender, migration background, living situation, frailty index and income, also for disease subsamples.
In adjusted analyses, the rate of first ACP conversation for persons with organ failure was the lowest (IRR 0.70 (95% CI 0.68 to 0.73)). Persons with cancer had the highest rate (IRR 1.75 (95% CI 1.68 to 1.83)). Within the subsample of persons with organ failure, the subsample of persons with dementia and the subsample of stroke, a comorbid diagnosis of cancer increased the probability of ACP. Further, for those with organ failure or cancer, comorbid dementia decreased the probability of ACP.
Considering the complexity of initiating ACP for persons with organ failure or dementia, general practitioners should prioritise offering it to them and their family caregivers. Policy initiatives should stimulate the implementation of ACP for people with chronic-progressive disease.
Endometriosis is a chronic condition affecting up to 11% of people presumed female at birth by the age of 44 years, characterised by the growth of tissue similar to the lining of the uterus on other organs. Endometriosis significantly impacts health-related quality of life (HRQoL) and imposes a substantial burden on both individuals and the healthcare system. International guidelines recommend the interdisciplinary management of endometriosis due to its significant biopsychosocial burden; however, research aimed at exploring psychological approaches for endometriosis is limited. This trial aims to evaluate the effectiveness of CodeEndo, an online co-designed interdisciplinary supportive care program, compared with a waitlist control (WLC), on HRQoL and biopsychosocial outcomes in people with a diagnosis of endometriosis.
A hybrid type 1 effectiveness and implementation randomised controlled trial (RCT) will be conducted. Eligible participants will be randomly allocated to either the CodeEndo program (n=176) or WLC group (n=176) for 8 weeks. The primary outcome will be HRQoL, and secondary outcomes will include psychological symptoms (anxiety, depression, stress), self-efficacy, menstrual, bladder and gastrointestinal symptoms, pain, fatigue, sleep, exercise, diet, symptom bothersomeness and physical and psychological well-being, measured at 8 weeks post-randomisation (T2) and 6-month follow-up (T3). Cost-effectiveness will also be examined. Longitudinal qualitative individual interviews (up to n=40) will be conducted with participants who complete the CodeEndo program to explore benefits, barriers and facilitators of ongoing use. Additionally, the CodeEndo program will undergo evaluation by a group of endometriosis healthcare providers, who will assess potential barriers and facilitators to its real-world implementation. Various process evaluation strategies will also be measured to inform future implementation. Data analyses will incorporate mixed-effects regression models on an intention-to-treat basis, cost-consequences and cost-utility, dietary and qualitative thematic analysis.
This protocol received ethics approval from Deakin University Research Ethics Committee (DUREC Ref: 2024-157). Dissemination is expected to include peer-reviewed journal articles, reports, conference presentations as well as websites or social media platforms of relevant chronic pain organisations. Participants will be sent a summary of trial results.
ACTRN12623000598684p.
Inherited retinal diseases (IRDs) are a broad range of diseases associated with abnormalities/degeneration of retinal cells. We aimed to identify the top 10 Australian research priorities for IRDs to ultimately facilitate more meaningful and potentially cost-effective research.
We conducted a James Lind Alliance priority setting partnership that involved two Australian-wide surveys and online workshops.
Australia-wide.
Individuals aged 16 years or older were eligible to participate if they had an IRD, were caregivers of an individual with an IRD or were health professionals providing care to this community.
In Survey 1, we gathered participants’ unanswered questions about IRDs. We grouped these into summary questions and undertook a literature review to verify if they were truly unanswered (ie, evidence uncertainties). In Survey 2, participants voted for the uncertainties that they considered a priority. Top-ranked uncertainties progressed for discussion and final prioritisation in two workshops.
In Survey 1, we collected 223 questions from 69 participants. We grouped these into 42 summary questions and confirmed 41 as evidence uncertainties. In Survey 2, 151 participants voted, with the 16 uncertainties progressing to final prioritisation. The top 10 priorities, set by the 24 workshop participants, represented (1) treatment/cure; (2) symptoms and disease progression; (3) psychosocial well-being and (4) health service delivery. The #1 priority was for treatment to prevent, slow down or stop vision loss, followed by the #2 priority to address the psychological impact of having an IRD.
The top 10 research priorities highlight the need for IRD research that takes a whole-person, systems approach. Collaborations to progress priorities will accelerate the translation of research into real-world benefits.
Structural MRI of the brain is routinely performed on patients referred to memory clinics; however, resulting radiology reports, including volumetric assessments, are conventionally stored as unstructured free text. We sought to use natural language processing (NLP) to extract text relating to intracranial volumetric assessment from brain MRI text reports to enhance routine data availability for research purposes.
Electronic records from a large mental healthcare provider serving a geographic catchment of 1.3 million residents in four boroughs of south London, UK.
A corpus of 4007 de-identified brain MRI reports from patients referred to memory assessment services. An NLP algorithm was developed, using a span categorisation approach, to extract six binary (presence/absence) categories from the text reports: (i) global volume loss, (ii) hippocampal/medial temporal lobe volume loss and (iii) other lobar/regional volume loss. Distributions of these categories were evaluated.
The overall F1 score for the six categories was 0.89 (precision 0.92, recall 0.86), with the following precision/recall for each category: presence of global volume loss 0.95/0.95, absence of global volume loss 0.94/0.77, presence of regional volume loss 0.80/0.58, absence of regional volume loss 0.91/0.93, presence of hippocampal volume loss 0.90/0.88, and absence of hippocampal volume loss 0.94/0.92.
These results support the feasibility and accuracy of using NLP techniques to extract volumetric assessments from radiology reports, and the potential for automated generation of novel meta-data from dementia assessments in electronic health records.
Type 2 diabetes mellitus (T2DM) and osteoarthritis (OA) are globally prevalent chronic diseases that affect millions of individuals in ageing populations. Hip and knee replacements are well established and effective treatments in patients suffering from end-stage OA. Understanding how T2DM influences the outcomes of these surgeries is important for optimising patient care and improving surgical results. This study aimed to explore the association of T2DM with reoperation (regardless of the reason), adverse events (AEs) and mortality after primary hip and knee replacement surgery.
Observational study based on prospectively collected registry data analysed retrospectively.
Data from several Swedish national quality registers and health data registers were used to create a study database. 109 938 and 80 897 primary hip and knee replacements due to OA, performed between 2008 and 2019 (hip) and 2009 and 2018 (knee), were included in the study.
The risk of complications, such as reoperation, AEs and mortality, was investigated by estimating HRs using Cox regression, and OR using logistic regression, unadjusted and adjusted for confounding factors, such as patient characteristics, socioeconomic status and comorbidities, and mediators, such as surgical factors.
Adjusted multivariable Cox-regression analysis showed no T2DM-associated risk of reoperation after hip or knee replacement, adjusted HR 1.10 (95% CI 0.99 to 1.23) and 1.09 (95% CI 0.96 to 1.24), respectively, while T2DM was associated with increased risk of death after hip and knee replacement, adjusted HR 1.40 (95% CI 1.34 to 1.47) and 1.38 (95% CI 1.31 to 1.45). Adjusted logistic regression analysis showed T2DM-associated increase of reoperation within 90 days (OR 1.23 (95% CI 1.05 to 1.43)) and increased mortality within 90 days (OR 1.42 (95% CI 1.01 to 1.95)) following hip replacement; however, this was not the case after knee replacement, OR 1.08 (95% CI 0.85 to 1.36) for reoperation and OR 1.29 (95% CI 0.84 to 1.94) for mortality. Several factors closely linked with T2DM, such as body-mass index and comorbidities, were identified as important when assessing risk of reoperation and mortality. Regarding AEs within 30 and 90 days, very slight but not statistically significant T2DM-associated increases were seen after either hip replacement, OR 1.01 (95% CI 0.91 to 1.11) and 1.07 (95% CI 0.98 to 1.16) or after knee replacement, OR 1.05 (95% CI 0.93 to 1.17) and 1.08 (95% CI 0.98 to 1.19).
The observed risk of reoperation suggests that T2DM alone was not a strong justification to advise against hip or knee replacement in individuals with T2DM deemed eligible for joint replacement. The T2DM-associated increased mortality after hip and knee replacement is challenging to interpret, as T2DM itself without undergoing hip or knee replacement surgery is associated with increased mortality.
Although lung cancer remains the leading cause of cancer deaths in the US, recent advances in early detection and treatment have led to improvements in survival. However, there is a considerable risk of recurrence or second primary lung cancer (SPLC) following curative-intent treatment in patients with early-stage non-small cell lung cancer (NSCLC). Professional societies recommend routine surveillance with CT to optimise the detection of potential recurrence and SPLC at a localised stage. However, no definitive evidence demonstrates the effect of imaging surveillance on survival in patients with NSCLC. To close these research gaps, the Advancing Precision Lung Cancer Surveillance and Outcomes in Diverse Populations (PLuS2) study will leverage real-world electronic health records (EHRs) data to evaluate surveillance outcomes among patients with and without guideline-adherent surveillance. The overarching goal of the PLuS2 study is to assess the long-term effectiveness of surveillance strategies in real-world settings.
PLuS2 is an observational study designed to assemble a cohort of patients with incident pathologically confirmed stage I/II/IIIA NSCLC who have completed curative-intent therapy. Patients undergoing imaging surveillance will be followed from 2012 to 2026 by linking EHRs with tumour registry data in the OneFlorida+ Clinical Research Consortium. Data will be consolidated into a unified repository to achieve three primary aims: (1) Examine the utilisation and determinants of CT imaging surveillance by race/ethnicity and socioeconomic status, (2) Compare clinical endpoints, including recurrence, SPLCs and survival of patients who undergo semiannual versus annual CT imaging and (3) Use the observational data in conjunction with validated microsimulation models to simulate imaging surveillance outcomes within the US population. To our knowledge, this study represents the first attempt to integrate real-world data and microsimulation models to assess the long-term impact and effectiveness of imaging surveillance strategies.
This study involves human participants and was approved by the University of Florida Institutional Review Board (IRB), University of Florida IRB 01, under approval number IRB202300782. The results will be disseminated through publications and presentations at national and international conferences. Safety considerations encompass ensuring the confidentiality of patient information. All disseminated data will be de-identified and summarised.
by Sanja Ljubičić, Vilko Petrić, Ljubomir Antekolović
Although it has been confirmed that overweight and obesity may have negative impact on jumping performance in school-aged children and adolescents, little evidence has been provided for pre-school children. The findings have provided inconclusive results, but mostly that overweight and obese pre-school children do not have an impaired jumping performance, in comparison to their normal weight peers. Therefore, the main purpose of the study was to examine the differences between normal weight and overweight/obese pre-school children in jumping performance outcomes and their correlations with anthropometric indices. Four-hundred and eleven pre-school children with the mean (SD) age = 4.9 (1.1) years, height = 111.2 (9.3) cm, weight = 20.0 (4.2) kg, 53.5% girls were recruited from 34 kindergartens in four major cities. Anthropometric indices included body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Normal weight, overweight and obesity were classified according to international norms. Jumping performance was evaluated by the countermovement jump (CMJ) without and with arm swing with Optojump system. In general, pre-school children with overweight and obesity exhibited poorer performance in vertical jumping; they had shorter flight time and flight height, lower power relative to body mass and lower relative strength index (RSI), compared to normal weight children. The strongest correlations were observed between WHtR and jumping outcomes, where higher WHtR values led to shorter flight time and flight height, and lower power relative to body mass in both boys and girls. This study adds new information related to nutritional status and jumping performance in pre-school children. Thus, overweight and obesity need to be considered, when monitoring vertical jumping performance.by Nour Aboalhaija, Hala Abulawi, Rania Hamed, Mohammad Alwahsh, Fatma Afifi, Heba Syaj, Elham Abusharieh, Ismail Abaza
Chiliadenus montanus (Vahl) Boiss. (Asteraceae) is a pharmacologically significant plant with different potent pharmacological properties. This study aimed to evaluate the phytochemical and anticancer activity of C. montanus, and to develop nanoemulsions (NEs) to enhance pulmonary delivery for lung carcinoma treatment. For that ethanol and water extracts, along with petroleum ether, chloroform, ethyl acetate, and methanol fractions, were assessed for total phenol and flavonoid contents, antioxidant activity, and cytotoxicity against H1299 and A549 lung cancer cell lines. The results showed that ethyl acetate fraction exhibited the highest phenol (47.94 ± 0.32 mg GAE/g of DW) and flavonoid (20.34 ± 1.48 mg rutin/g of DW) contents, while the ethanol extract showed the most potent antioxidant activity (IC₅₀ = 322.1 µg/mL) and selective cytotoxicity (IC₅₀ = 641.2 µg/mL) against H1299 cells. Nevadensin, chlorogenic acid, and sorbifolin were identified as the major constituents of the ethanol extract using liquid chromatography-mass spectrometry (LC-MS) analysis. Gas chromatography-mass spectrometry (GC-MS) analysis revealed α-phellandrene, 1,8-cineole, and α-cadinol as the lead volatile constituents. The major volatile compound of the aroma profile of the aerial parts, determined by solid phase micro extraction (SPME) was 1,8-cineole. Spontaneous emulsification was used to formulate ethanolic NE (S1-S4 NEs) with varying concentrations of ethanol extract, surfactant, cosurfactant, and oil phase. The optimal S4 NE demonstrated thermodynamic stability, appropriate pulmonary pH, and droplet sizes below 100 nm. These findings highlight the promising potential of C. montanus NE as a stable pulmonary drug delivery system for lung carcinoma therapy.by Namhee Kim, Bo Gyeong Lee
PurposeSleep quality is a multidimensional construct encompassing the effectiveness and restorativeness of sleep. The pre-sleep arousal scale is a widely used instrument for evaluating aspects of arousal that are closely related to sleep quality. This study aimed to evaluate the psychometric properties of the Korean version of the pre-sleep arousal scale (K-PSAS).
MethodsWe performed a secondary analysis of cross-sectional data from 286 adults aged 19–70 years who used electronic cigarettes or heated tobacco products. The original PSAS was translated into Korean, with content validity assessed by experts. Construct validity was evaluated via exploratory factor analysis, and concurrent validity was assessed by correlating the K-PSAS with the Insomnia Severity Index, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Reliability was examined using Cronbach’s α, and split-half reliability coefficient.
ResultsBoth the item-level content validity index for all items and the scale-level content validity index average for the K-PSAS-16 were 1.0. After removing the survey item on “being mentally alert and active at bedtime” (item 13) due to low factor loading, the K-PSAS-15 demonstrated a two-factor structure, with somatic and cognitive arousal factors explaining 42.36% and 10.19% of the variance, respectively. A significant positive correlation was observed between the two factors (ρ = 0.61, p Conclusion
The K-PSAS-15, which excludes one poorly performing item from the original scale, is a reliable and valid tool for assessing pre-sleep arousal.
by Susanne Jordan, Sarah Jane Böttger, Sabine Zinn
Health information about vaccinations is communicated via various sources of information and is crucial for vaccination decisions. Information sources such as interpersonal sources, traditional print and digital media as well as social media offer information about the risks and benefits of vaccination. During health crises such as the COVID-19 pandemic was, some information sources provide hanging or contradictory information, alongside with misinformation and disinformation. Little is known about the relationship between the reported persuasiveness of different sources of information for individual vaccination decisions and differences in this between the vaccinated and unvaccinated. Utilizing data from 10,284 participants in the “Corona-Monitoring Nationwide” survey in Germany from winter 2021/22, this study explored the relationship between the persuasiveness of information sources and vaccination decisions, considering socio-demographic and pandemic-related factors. For more than half of respondents, talks with family, friends, and acquaintances were the most convincing. Traditional media like television and radio were reported by 44%. Newspapers/magazines (online or print) and talks with physicians were each found the most convincing by around one third. About one fifth were persuaded by public authority’s flyers or websites. Less than a tenth each was convinced by social media/messenger services, brochures from pharmacies and health insurances, talks with pharmacy staff or online health portals. Significant differences emerged between vaccinated and unvaccinated individuals. Unvaccinated people were four times more likely to report social media and messenger services as convincing compared to vaccinated people. Reporting talks with doctors and flyers/websites from public authorities as very persuasive significantly reduced the likelihood of being unvaccinated. The findings suggest that in future health crises, information should be disseminated through diverse sources, using both traditional and digital media, as well as interpersonal communication. Proactive science communication on social media and messenger services is crucial to counteract misinformation and disinformation.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.
Heroin users have a high burden of respiratory morbidity, including premature lung function impairment. Further, methadone treatment has been found to aggravate lung function impairment and can independently cause asthma. However, the lung function status among heroin users on medication-assisted therapy (MAT) in Tanzania is yet to be studied. This study aimed to assess the magnitude, pattern and factors associated with lung function impairment among heroin users on MAT.
This was a quantitative, analytical cross-sectional study.
This study was conducted at MAT Clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania.
Individuals aged 18 years or above with heroin use disorder on stable dose of methadone without heroin withdrawal symptoms (Maintenance Phase of Treatment) were recruited.
Participants were enrolled through systematic sampling technique. Data were collected using a questionnaire, and lung functions were measured using a spirometer. Lung function impairment was defined as the percentage of participants with forced expiratory volume in 1 s (FEV1)
We enrolled 302 participants into the study (mean age of 42.78±7.56 years). Lung function impairment was observed in 28.5% of participants, with an average age of 44±8 years. Restrictive lung disease was the most common pattern of lung function impairment affecting 13.2% of the participants. The predictors of lung function impairment were being underweight (OR) 4.73, 95% CI) 2.61–8.59, p
Heroin users on MAT have a high magnitude of lung function impairment. Routine lung function testing is recommended.
The combination with corticosteroids as immunomodulators has been the subject of debate in different infectious syndromes. The main objective of this study is to evaluate the efficacy (the percentage of patients hospitalised with influenza with a status of 3 or higher according to the Hospital Recovery Scale (HRS) on day 7 after the start of treatment) and safety of dexamethasone.
Investigator-initiated multicentre, blinded, randomised placebo-controlled trial with two parallel treatment arms. The study population will consist of adult patients (over 18 years of age) hospitalised with severe influenza. One arm will receive one capsule of 6 mg of dexamethasone for 7 days, and the other arm will receive one capsule of placebo for 7 days of antibiotic treatment for 7 days or longer. Both groups will receive oseltamivir (75 mg/12 hours orally) for 5 days, extendable to 10 days depending on the investigator decision. Randomisation will occur in equal proportion (1:1). Patients with bronchial hyper-responsiveness that requires systemic corticosteroids for more than 24 hours, preinclusion treatment with corticosteroids for more than 24 hours at a dose equal to or higher than 1 mg/kg methylprednisolone (0.2 mg/kg dexamethasone or 1.25 mg/kg prednisone), inability to administer oral oseltamivir, patients with severe comorbidity with a life expectancy of
The study is approved by the Institutional Review Board of Alicante Health Department—Dr. Balmis General University Hospital (LOC-100061146). The results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal
Public involvement in mental health research enhances research quality. The use of citizen science methods in mental health research has been described as a conclusion of a movement towards increased public involvement; however, this field is in its early stages of development. Our objective was to create a theory of change (ToC) for how citizen science can be used to enhance mental health research quality.
Iterative consultation with the stakeholders of an existing citizen mental health science study, that is, change for citizen science to achieve co-production at scale (C-STACS: https://www.researchintorecovery.com/research/c-stacs/)
We co-developed a ToC through an iterative consultation with C-STACS stakeholders who were (a) representatives of mental health community organisations (n=10), individuals with public involvement experience (n=2) and researchers (n=5). In keeping with established ToC practice, entities were identified, including long-term impacts, outcomes needed to create an impact, stakeholder assumptions and indicators for tracking progress.
A desired primary long-term impact of greater co-production of research was identified between researchers and members of the public, which would create a secondary impact of enhancing public capacity to engage in citizen mental health science. We proposed long-term outcomes needed to enable this impact: (1) greater co-production of research objectives and pathways between researcher and the public, (2) greater embedment of citizen mental health science into funder processes (eg, the creation of specific funding calls for citizen mental health science proposals, (3) greater clarity on the boundaries between citizen science and other participatory approaches (eg, so that there is not loss of impact due to conceptual confusion between these, (4) increased knowledge around effective frameworks to enable mass public participation and (5) greater availability of technology platforms, enabling safe and accessible engagement with citizen mental health science projects.
The proposed ToC is grounded in the C-STACS project, but intended to be broadly applicable. It allows the continued formation of a community of practice around citizen mental health science and should be reviewed, as greater knowledge is developed on how citizen mental health science creates change.
Digital health interventions (DHIs) are changing the healthcare landscape. However, using these tools effectively for people with chronic conditions in rural areas comes with challenges, highlighting the need to understand their lived experiences. No systematic review was found that examines the inclusion of lived experience in DHI for individuals with chronic conditions in rural areas and how this impacts their acceptance of technology. A systematic review grounded by Technology Acceptance Model (TAM) will be conducted to examine the lived experiences of individuals in rural areas who use DHIs. Individuals with chronic conditions will be examined specifically and how their experiences influence the adoption, use and satisfaction with DHI for managing their health needs. This systematic literature review is significant because it will be used as a crucial starting point for a larger project aimed at creating digitally transformed primary healthcare in rural areas, particularly for Indigenous communities. The insights gained will inform the development of a digital transformation model for the larger project.
Guided by the TAM and PRISMA to explore the lived experiences of patients and caregivers with digital health, a search will be conducted for peer-reviewed studies on DHIs, including qualitative, quantitative and mixed-method approaches, including systematic reviews. The studies must be published in English from 2019 to the present and will be sourced from databases such as PubMed, EBSCO, Cochrane Library, Scopus and Web of Science. MeSH will be utilised to identify terms like user experience, acceptability and engagement with DHIs. Eligibility will be based on relevance, population, intervention and outcomes. A standardised data extraction form will be developed and tested to capture important information from each study included in the review. Data extraction and quality appraisal will be performed independently by two reviewers, with a third reviewer addressing any discrepancies. Software will be used to manage extracted data, assess risk of bias and synthesise the data. Meta-analysis will be included to enhance our findings if sufficient quantitative data is available. Our findings will be reported in accordance with the PRISMA guidelines. This review protocol was refined in June 2025; commencement of the study will be in July 2025 and will be completed in 2026.
This study used previously published literature and did not collect primary data from humans or animals. No ethical committee approval was required. Findings will be disseminated through peer-reviewed publication and will be presented at conferences related to the field.
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