Conectar
by Johanna Charlotte Neubauer, Anna Kaiser, Leon Lettermann, Tobias Volkert, Alexander Häge
ObjectiveThis study evaluates the performance of four large language models—ChatGPT 4o, ChatGPT o1-mini, Gemini 2.0 Flash, and Gemini 1.5 Flash—in answering multiple-choice questions in child and adolescent psychiatry to assess their level of factual knowledge in the field.
MethodsA total of 150 standardized multiple-choice questions from a specialty board review study guide were selected, ensuring a representative distribution across different topics. Each question had five possible answers, with only one correct option. To account for the stochastic nature of large language models, each question was asked 10 times with randomized answer orders to minimize known biases. Accuracy for each question was assessed as the percentage of correct answers across 10 requests. We calculated the mean accuracy for each model and performed statistical comparisons using paired t-tests to evaluate differences between Gemini 2.0 Flash and Gemini 1.5 Flash, as well as between Gemini 2.0 Flash and both ChatGPT 4o and ChatGPT o1-mini. As a post-hoc exploration, we identified questions with an accuracy below 10% across all models to highlight areas of particularly low performance.
ResultsThe accuracy of the tested models ranged from 68.3% to 78.9%. Both ChatGPT and Gemini demonstrated generally solid performance in the assessment of in child and adolescent psychiatry knowledge, with variations between models and topics. The superior performance of Gemini 2.0 Flash compared with its predecessor, Gemini 1.5 Flash, may reflect advancements in artificial intelligence capabilities. Certain topics, such as psychopharmacology, posed greater challenges compared to disorders with well-defined diagnostic criteria, such as schizophrenia or eating disorders.
ConclusionWhile the results indicate that language models can support knowledge acquisition in child and adolescent psychiatry, limitations remain. Variability in accuracy across different topics, potential biases, and risks of misinterpretation must be carefully considered before implementing these models in clinical decision-making.
To explore how frail older patients experience their stay and nursing care during boarding time at the emergency department.
A qualitative explorative interview study.
Purposive sampling was used, with a two-step selection process: (1) Patients 65 years or older spending at least 4 h at the emergency department waiting for a hospital bed, referred to as boarding time, were (2) screened for frailty using the FRail Elderly Support researcH group screening instrument. If screening identified a patient as frail, they were eligible for an interview. Individual semi-structured interviews (n = 19) were conducted during patients' boarding time at the emergency department. Data was collected between March and April 2019. The theoretical Fundamentals of Care framework shaped the interview guide. Interviews were transcribed and an inductive latent content analysis was performed.
The findings resulted in four main categories: Frail older patients felt disregarded, defenceless, and resigned during boarding time at the emergency department, yet also hopeful. The experience of hope resulted from confidence in the nurses, good nursing care, patience towards one's situation, and hope in emergency care.
The frail older patient experienced boarding time in the emergency department through an overarching theme: ‘being left in no-man's land in the emergency department but still feeling hopeful’. A trusting nurse–patient relationship, integrating the provision of fundamental care, is a favourable factor for the well-being of the frail older patient.
The study addressed the increased number of older adults with complex health needs, coupled with overcrowded emergency departments. Frail older patients perceive the boarding time as being left in a ‘no-man's-land’, addressing unclear information and lack of caregiver responsibility. This highlights the need for tailored guidelines and care practices that promote person-centred care and ensure safety for this vulnerable group in emergency settings.
Not applicable.
by Charlotte J. Whiffin, Kathleen Joy O. Khu, Brandon G. Smith, Isla Kuhn, Santhani M. Selveindran, Laura Hobbs, Samin Davoody, Yusuf Docrat, Orla Mantle, Upamanyu Nath, Lara Onbaşı, Stasa Tumpa, Ignatius N. Esene, Harry Mee, Fergus Gracey, Shobhana Nagraj, Tom Bashford, Angelos G. Kolias, Peter J. Hutchinson
Following calls for more qualitative research in neurosurgery, this scoping review aimed to describe the range and reach of qualitative studies relevant to the field of neurosurgery and the patients and families affected by neurosurgical conditions. A systematic search was conducted in September 2024 across six databases: Medline via Ebsco; Embase via OVID; PsycINFO via Ebsco; Scopus; Web of Science Core Collection; and Global Health via Ebsco. Eligibility criteria were based on Population, Concept, and Context. The search identified 18,809 hits for screening with 812 included in the final analysis. Seven themes were identified from a content analysis of study aims: 1 Perspectives of living with a neurosurgical condition; 2 Family perspectives; 3 Perceptions of neurosurgery; 4 Perceptions of general healthcare care; 5 Decision making; 6 Advancing neurosurgery; and, 7 Understanding neurosurgical conditions. Traumatology was identified as the most researched sub-specialty (43.2%) yet few studies were led explicitly by a neurosurgeon (1.6%) or those with a neurosurgical affiliation (10.5%). Lead authors were predominantly from high income countries (93.7%), as were most multi-author teams (86.6%). There was a trend towards increasing publication over time; however, only 8.4% of papers were published in neurosurgical specific journals. The data set had an average Field Weighted Citation Impact of 0.96 and Field Weighted Views Impact of 1.11, 18.9% were cited in policy documents in 15 countries. This scoping review provides a comprehensive picture of the current qualitative research base in neurosurgery and suggests ways to improve the conduct and reporting of such studies in the future. Addressing these challenges is crucial if qualitative research is to advance the neurosurgical evidence base in a rigorous way.by Alessandro Roman, Charlotte Linthout, Ben Raymond, Constantianus J. M. Koenraadt
Various vector control strategies are in place to reduce the spread of arthropod-borne viruses. Some of these, such as application of insecticides, are encountering operational challenges and a reduced overall effectiveness due to evolution of resistance. Alternative approaches for mosquito population control, such as the sterile insect technique, depend on efficient mass-rearing of healthy mosquitoes prior to mass-release in the field. Therefore, improving efficiency and quality of mass-rearing techniques is crucial to obtain fit mosquitoes. Previous studies have shown that Acetic Acid Bacteria of the genus Asaia can have a mutualistic effect on larval development in different mosquito species and can thus contribute to improved rearing output. However, whether improved performance in the larval stages may have knock-on effects in the adult stage, for example by increasing their capability to transmit arbovirus, remains unclear. Such effects may jeopardize future control efforts. We tested the effects of two Asaia species, Asaia krungthepensis and Asaia bogorensis, on development time and adult size under two rearing conditions: individual rearing and group rearing of Culex pipiens larvae. Besides investigating development and size, we also investigated whether Asaia spp. exposure during the larval stage can influence the vector competence of Culex pipiens pipiens for West Nile virus (WNV). Our work shows the potential of improving mass-rearing efficiency by employing Asaia krungthepensis as a mutualist for Culex pipiens pipiens. Importantly, this study reveals no significant increase in dissemination and transmission rate of WNV by Culex pipiens pipiens when inoculated with Asaia spp., although an increase in viral titer in the legs and the saliva was observed when the mosquitoes were inoculated with the two Asaia species. Interestingly, we confirmed that Asaia spp. bacteria did not establish as a permanent member of the microbiota of Culex pipiens pipiens. As Asaia spp. did not establish in adult mosquitoes, the observed change in WNV titers can be a result of indirect interactions of Asaia with the native Culex pipiens pipiens microbiome. Our results stress the importance of carefully evaluating host-symbiont interactions to avoid the potential of releasing mosquitoes with enhanced vector competence.To justify the use of focus group interviews with patients and healthcare professionals within a phenomenological-hermeneutic approach inspired by the theory of the French philosopher Paul Gustave Ricoeur.
Methodological guidance and discussion grounded in Ricoeur's theory on narrative, dialogue, threefold mimesis and interpretation.
This phenomenological-hermeneutical approach to focus group interviews yields significant, in-depth understandings of lived experiences from both patients and healthcare professionals.
Ricoeur-inspired phenomenological-hermeneutical focus group interviews with patients and healthcare professionals offer a promising approach for exploring and generating new, valuable insights into the complexities of clinical nursing practice. Thus, this paper argues for an integration of focus group interviews and a phenomenological-hermeneutical approach within nursing science.
The approach has significant implications for nursing practice. By incorporating Ricoeur-inspired dialogue-based collective voices of patients and healthcare professionals in focus group interviews, nursing practices can be refined, leading to improved patient care and more effective clinical interventions. Thus, this approach advocates for a broader adoption of Ricoeur-inspired focus group interviews in nursing research and in health research in general to enhance the understanding and development of clinical models.
No available EQUATOR guidelines were applicable to this methodological paper, as no new data were created or analysed.
As this is a methodological paper, no new patient or public contributions are included.
To explore how youth understand and manage risk associated with food allergy in everyday life, aiming to inform future advanced nursing and care initiatives.
Qualitative study based on critical psychological practice research.
Data was generated through participant observation and informal interviews during a 2-day camp with youth aged 18–23years (n = 10), diagnosed with food allergy in childhood. Data analysis used thematic analysis informed by a critical psychology theoretical framework.
Risk associated with food allergy is an integrated aspect of the youth life trajectories. The allergy clinic plays a crucial role in how they come to understand and manage risk. Paradoxically, knowledge of risk fosters safety as well as uncertainty. Bodily awareness plays a crucial role in managing food allergy, but minor bodily sensations can trigger anxiety and fear of anaphylaxis. Establishing routines emerges as a key strategy for managing risk, as routines reduce anxiety and facilitate participation in everyday social activities.
The study highlights the complexity of managing food allergy in the everyday life of youth. How risk knowledge is translated from the clinic into everyday life varies and impacts risk management strategies in different ways.
HCP must address both physical and psychosocial aspects of living with the risk associated with food allergy. Individually tailored risk communication that considers personal circumstances and experiences can help reduce anxiety and support strategies for managing food allergy in everyday life.
Integrating patients' everyday perspectives and risk management into healthcare fosters personalised care. Nurses and doctors should help patients bridge the gap between medical advice and its practical application, addressing both physical and emotional aspects of managing health risks.
The SRQR guideline for reporting qualitative research.
Patient representatives were involved in developing the protocol, research questions and study aims.
by Gabriel Dumitrescu, Jovan Antovic, Nida Soutari, Charlotte Gran, Aleksandra Antovic, Kais Al-Abani, Jonathan Grip, Olav Rooyackers, Apostolos Taxiarchis
Complement and extracellular vesicles (EVs) association with thrombogenic tendencies is acknowledged, but limited evidence exists for their link to COVID-19 venous thromboembolism. This study aims to examine the relationship between pulmonary embolism and the expression of complement and other proteins related to thrombogenesis in severe Covid-19 patients. We included prospectively 207 severe COVID-19 patients and retrospectively screened for pulmonary embolism (PE). This analysis comprises 20 confirmed PE cases and 20 matched patients without PE. Blood samples taken at the admission in the intensive care unit were analyzed for complement using ELISA. EVs derived from neutrophils, endothelium, or platelets, as well carrying complement or tissue factor were analyzed using flow cytometry. Complement levels were markedly elevated, with a notable increase in C3a and Terminal Complement Complex. The most prevalent EV population was identified as tissue factor (TF)-carrying EVs which peaked in patients with PE during ICU days 4–9. However, for both the complement and analyzed EV populations, no statistically significant differences were found between the patients who developed pulmonary embolism and those who did not. In conclusion, complement factors and EVs expressing tissue factor, along with EVs derived from endothelial cells and platelets, are elevated in severe COVID-19 patients, regardless of the presence of pulmonary embolism. However, the involvement of complement and procoagulant EVs in peripheral plasma in the development of pulmonary embolism is still unclear and requires further investigation.Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID-19 and Influenza vaccines in the nursing community.
This multisite, cross-sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023.
Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k-means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One-way ANOVA and chi-square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters.
Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine-confident and had a consistent history of accepting the Influenza and COVID-19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine-confident individuals (profile A).
This study has identified specific sociodemographic and occupational factors that are related to vaccine hesitancy in an international sample of nurses. Additionally, attitudes contributing to hesitancy were identified, with worries about unforeseen future effects of the vaccine being identified as a critical attitude that may undermine confidence and increase hesitancy in nursing. This study also sheds light on the influence that social media platforms have on vaccine hesitancy and, as such, indicates which platforms are effective to disseminate vaccination campaigns to global nursing communities.
Global vaccination campaigns should focus on specific profiles and clusters to promote vaccination in the international nursing community. Empowering nurses early in their careers will help to instill positive vaccination behaviors, ensuring a sustained uptake of vaccinations throughout the individual's career and beyond, with an impact on promoting vaccination at the public health level as well.
This study aimed to evaluate assistant nurses' knowledge of and attitudes towards pressure injuries in a clinical setting. It employed a cross-sectional design, using two validated surveys: PUKAT 2.0 and APUP, alongside open-ended questions. A convenience sample of 88 assistant nurses from five wards across two departments at a 600-bed university hospital in Sweden participated. Participants answered the questionnaire and open-ended questions, followed by a learning seminar led by the study leader covering PUKAT 2.0 knowledge questions. The seminar ended with an evaluation of this training approach. Results revealed a significant knowledge gap in pressure injury prevention among assistant nurses, with a mean PUKAT 2.0 knowledge score of 33.8 and a standard deviation of ±11.7 (a score of 60 is deemed satisfactory). Only 3.4% (n = 3) of participants achieved a satisfactory knowledge score. However, attitudes towards pressure injury prevention, assessed by the APUP tool, were generally positive among the majority of the participants. Open-ended questions and evaluations of the seminar showed assistant nurses' desire for pressure injury prevention training and their appreciation for the seminar format. Further studies need to evaluate recurrent training procedures and departmental strategies aimed at reducing the knowledge gap among healthcare staff.
To explore relatives' needs in terms of bereavement care during euthanasia processes, how healthcare providers respond to these needs, and the degree of commonality between relatives' and healthcare providers' reports.
A phenomenological design was employed, utilising reflexive thematic analysis to examine interviews conducted with relatives (N = 19) and healthcare providers (N = 47).
Relatives' needs throughout euthanasia processes are presented in five main themes and several subthemes, with similar findings between both sets of participants. Although relatives infrequently communicated their needs explicitly to healthcare providers, they appreciated it when staff proactively met their needs. Healthcare providers aimed to assist with the relatives' grief process by tending to their specific needs. However, aftercare was not consistently offered, but relatives did not have high expectations for professional follow-up care.
Our research offers important directions for healthcare professionals, empowering them to provide needs-based bereavement care during euthanasia processes. Moreover, it emphasises the importance of recognising the unique needs of relatives and proactively addressing them in the period before the loss to positively contribute to relatives' grief process.
Insights into relatives' needs in the context of euthanasia. Good practices on how healthcare providers can attend to relatives' needs before, during and after the loss
Current literature and guidelines on needs-based bereavement care in the context of euthanasia and, more generally, assisted dying, are limited. These findings provide concrete directions for practice in supporting (nearly) bereaved relatives in the context of euthanasia, potentially mitigating adverse health outcomes.
Standards for Reporting Qualitative Research (SRQR checklist).
Relatives of deceased cancer patients were involved in the conduct of the study.
To explore Danish women's experiences with opting out of cervical cancer screening and the role of the nurse in the women's decision-making process.
A qualitative study using semi-structured, individual interviews with a phenomenological-hermeneutic approach.
Interviews were conducted with 13 women with experience in opting out of cervical cancer screening. Women were recruited through a public flyer and interviewed virtually or by phone. The interviews were analysed using the theory of interpretation from Paul Ricoeur and consisted of three levels: naïve reading, structural analysis, and critical discussion and analysis. The present study adheres to the COREQ guidelines.
The women experience various personal causes for opting out of cervical cancer screening, such as low accessibility of screening appointments, discomfort during the smear test, fear of being sick, and insufficient information about the relevance of screening to the individual woman. The perceived disadvantages of screening outweighed their perceived advantages. The women's experiences did not include the role of the nurse in the procedures and knowledge sharing related to cervical cancer screening. However, nurses were described as having good communicative and relational qualifications relevant to being involved in cervical cancer screening.
It was challenging for the women to weigh the advantages and disadvantages of cervical cancer screening and thus to make an informed decision about participation. They expressed a need for more information on which to base their decision. This places nurses in a much needed, yet unexplored, role of identifying and lowering potential personal barriers that may outweigh the women's perceived benefits of participating in screening.
Nurses should play a more active role in cervical cancer screening such as improving general knowledge and facilitating two-way communication about its relevance.
The present study adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
No patient or public contribution.
Patients with diabetic foot ulcers are advised to limit weight-bearing activity for ulcers to heal. Patients often disregard this advice although the reasons are not yet fully understood. This study explored (1) patients' experiences of receiving the advice and (2) factors influencing adherence to the advice. Semi-structured interviews were conducted with 14 patients with diabetic foot ulcers. Interviews were transcribed and analysed using inductive thematic analysis. Advice regarding limiting weight-bearing activity was described by patients as directive, generic and conflicting with other priorities. Rapport, empathy and rationale supported receptivity to the advice. Barriers and facilitators to limiting weight-bearing activity included demands of daily living, enjoyment of exercise, sick/disabled identity and burden, depression, neuropathy/pain, health benefits, fear of negative consequences, positive feedback, practical support, weather and active/passive role in recovery. It is important that healthcare professionals pay attention to how limiting weight-bearing activity advice is communicated. We propose a more person-centred approach in which advice is tailored to individuals' specific needs with discussion around patient priorities and constraints.
Patient safety is one of the cornerstones of high-quality healthcare systems. Evidence-based practice is one way to improve patient safety from the nursing perspective. Another aspect of care that directly influences patient safety is missed nursing care. However, research on possible associations between evidence-based practice and missed nursing care is lacking.
The aim of this study was to examine associations between registered nurses' educational level, the capability beliefs and use of evidence-based practice, and missed nursing care.
This study had a cross-sectional design. A total of 228 registered nurses from adult inpatient wards at a university hospital participated. Data were collected with the MISSCARE Survey-Swedish version of Evidence-Based Practice Capabilities Beliefs Scale.
Most missed nursing care was reported within the subscales Basic Care and Planning. Nurses holding a higher educational level and being low evidence-based practice users reported significantly more missed nursing care. They also scored significantly higher on the Evidence-based Practice Capabilities Beliefs Scale. The analyses showed a limited explanation of the variance of missed nursing care and revealed that being a high user of evidence-based practice indicated less reported missed nursing care, while a higher educational level meant more reported missed nursing care.
Most missed nursing care was reported within the subscales Planning and Basic Care. Thus, nursing activities are deprioritized in comparison to medical activities. Nurses holding a higher education reported more missed nursing care, indicating that higher education entails deeper knowledge of the consequences when rationing nursing care. They also reported varied use of evidence-based practice, showing that higher education is not the only factor that matters. To decrease missed nursing care in clinical practice, and thereby increase the quality of care, educational level, use of evidence-based practice, and organizational factors must be considered.
To explore patients' and healthcare professionals' (HCPs) experiences of oral care during hospitalisation to identify needs and challenges.
Daily oral care is important to patients' health and well-being, to prevent diseases in the oral cavity, systemic infections and increased morbidity, which subsequently can lead to prolonged hospitalisation and, at worst, increased mortality. Despite this knowledge, oral care is a neglected part of nursing practice. Studies do not clearly identify barriers regarding oral care, as the existing knowledge is inadequate.
A qualitative study exploring participants' experiences to gain new in-depth knowledge of oral care among hospitalised patients.
A phenomenological-hermeneutic approach was applied. Participant observations were conducted on five hospital wards, combined with individual semi-structured interviews with 16 patients and 15 HCP. Data analysis was based on Ricoeur's theory of narrative and interpretation.
Four themes describing the challenges regarding oral care emerged: Oral care as a gut feeling; oral care fades into the background; even self-reliant patients need help with oral care; and the mouth reflects the life lived.
The identified challenges show there is a need for improvement in the health professional approach to oral care in nursing practice. Focus on increasing HCPs' knowledge, skills and competences can increase their nursing agency and support patients' self-care capacity.
Investigation of oral care during hospitalisation revealed four main challenges concerning both patients' and HCPs' lack of knowledge and awareness of oral care. Thus, patients and HCPs should be included in developing solutions to improve oral care in nursing practice.
The COREQ criteria for reporting qualitative research were adhered to.
A patient representative was involved in the discussion of the proposal, conduct and results of the study.
FreshRSS 