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Emerging evidence supports a role for interleukin 6 (IL-6), a pro-inflammatory cytokine, in the pathogenesis of treatment-resistant major depressive disorder (TRD). However, interventional studies targeting IL-6 in this population remain scarce. Tocilizumab is a humanised monoclonal antibody that inhibits IL-6 signalling and is approved for the treatment of autoimmune conditions such as rheumatoid arthritis. The primary objective of this study is to examine whether IL-6 inhibition via tocilizumab can impact depressive symptoms, inflammation-related biomarkers and cognition in patients with TRD. A secondary objective is to compare the biological profiles of patients with TRD with elevated inflammation to those of healthy controls.
This is a proof-of-concept, randomised, parallel-group, triple-blind, placebo-controlled clinical trial. 22 adult outpatients diagnosed with TRD and evidence of low-grade inflammation (serum C reactive protein≥3 mg/L) will be randomised (1:1) to receive either one intravenous infusion of tocilizumab (8 mg/kg; maximum 800 mg) or normal saline, administered as an add-on to their ongoing treatment. Psychiatric, cognitive and biomarker assessments will be performed at baseline and at follow-up visits on days 7, 14 and 28 post-infusion. Additionally, 10 healthy controls with no psychiatric history will undergo the same baseline assessments for biomarker comparison.
The study has been approved by the Research Ethics Committee of the Hospital de Clínicas de Porto Alegre (Project number: 2025-0245, CAAE: 88904825.7.0000.5327). Findings will be disseminated through peer-reviewed publications, scientific meetings and, on request, lay summaries for participants.
To explore the impact of acute worsening events (AWEs), defined as clinically relevant deteriorations in peak expiratory flow, reliever use and/or symptoms, on patients’ daily lives and identify behaviours linked to their recognition and management.
A qualitative international substudy was conducted in the Netherlands, Spain, the USA, Canada and the UK (2023–2024).
19 patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) from a randomised clinical trial participated. Interviews, triggered by AWEs and repeated 6 weeks later, were audio-recorded, transcribed and analysed.
Patients varied in identifying bad days, reporting inability to perform physical activities, symptom worsening or the need for add-on treatment. Recognition of AWEs depended on their duration: shorter events (
AWEs significantly impact daily life but vary widely in recognition and thresholds for seeking care. Limited awareness of daily disease variations may contribute to both under-reporting of worsening events to healthcare providers and suboptimal self-management in COPD.
Leprosy is a chronic disease caused by the bacillus Mycobacterium leprae and remains a public health concern in endemic countries. Early diagnosis is fundamental to prevent transmission and irreversible disabilities. Histopathological identification of acid-fast bacilli in tissue specimens is traditionally considered the laboratory reference standard; however, its sensitivity is limited, particularly in paucibacillary forms. Immunohistochemistry (IHC) has been proposed as an adjunctive diagnostic tool for detecting M. leprae antigens in tissue samples, but its diagnostic accuracy has not been systematically synthesised. This protocol outlines a systematic review aimed at evaluating the sensitivity and specificity of IHC in the laboratory diagnosis of leprosy.
This systematic review of diagnostic test accuracy studies will include analytical observational studies and clinical trials evaluating IHC in human subjects with suspected leprosy. The reference standard will be defined as the identification of acid-fast bacilli in skin biopsy specimens from patients with compatible clinical presentation using conventional staining methods (eg, Fite-Faraco), with the exclusion of alternative mycobacterial infections when applicable. Searches will be conducted in PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Scopus, Web of Science and BVS/LILACS (Biblioteca Virtual em Saúde/Latin American and Caribbean Health Sciences Literature), as well as grey literature sources, at 31 May 2026. Two independent reviewers will perform study selection, data extraction using a standardised Microsoft Excel form and risk of bias assessment using the Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity estimates will be calculated. If appropriate, a bivariate random-effects meta-analysis will be conducted using RevMan (Review Manager) and Stata.
Ethical approval is not required because this study will use publicly available data. The results will be submitted to a peer-reviewed journal and presented at scientific conferences.
To systematically map the landscape of central venous access device research from 2014 to 2024, identifying critical gaps in evidence that may impact nursing practice and patient outcomes across the full device lifecycle from selection through to removal.
This review was conducted in accordance with the Guidance for producing a Campbell evidence and gap map and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.
PubMed, Cumulative Index to Nursing and Allied Health Literature Complete, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched with additional hand-searching of reference lists from included reviews.
We systematically reviewed literature published between 2014 and 2024, mapping 710 studies on central venous access device interventions and outcomes. Studies were categorised by design, population, setting, device characteristics, intervention types, and outcomes. Evidence was evaluated using the National Health and Medical Research Council levels of evidence framework.
Of 710 included studies, 89 were systematic reviews and 621 primary studies, of which 41.1% (n = 292) were randomised controlled trials. Research was primarily conducted in high-income countries (n = 405, 65.2%) and focused on adults (n = 370, 59.6%) in hospital inpatient settings (n = 588, 94.7%). Catheter insertion and infection prevention dominated the evidence base, while device selection and removal procedures were less studied. Infection outcomes were extensively reported (bloodstream infection: n = 455, 13.6% of 3349 outcomes), while patient-reported outcomes (n = 218, 6.5%) and cost (n = 60, 1.8%) were underrepresented.
This review reveals that central venous access device research is predominantly focused on insertion and infection prevention while other key parts of nursing practice are under-supported.
Future nursing research should address these gaps to improve evidence-based care across diverse populations and healthcare contexts, particularly focusing on understudied device types, settings, and vulnerable populations.
This review was conducted and reported in accordance with the Guidance for producing a Campbell evidence and gap map.
This study did not include patient or public involvement in its design, conduct, or reporting.
Chagas disease affects millions of individuals across Latin America and imposes a substantial economic burden on healthcare systems, particularly in rural and underserved regions. Chronic Chagasic cardiomyopathy remains one of the leading causes of heart failure-related mortality in endemic countries. Tissue inhibitor of metalloproteinases-1 (TIMP-1) has emerged as a potential biomarker of myocardial fibrosis in cardiomyopathies. This study was designed to investigate the association between TIMP-1 and myocardial fibrosis in chronic Chagas disease and to assess its potential as an early biomarker of fibrotic remodelling.
Bottom of form: The PTICH trial is a single-centre, prospective observational cohort study conducted at a government reference clinic in Pernambuco, Brazil. The study aims to enrol 210 adults with Chagas heart disease: 140 without ventricular dysfunction (left ventricular ejection fraction (LVEF) ≥52% in women and ≥54% in men) and 70 with ventricular dysfunction (LVEF
The Research Ethics Committee (REC) of Chagas disease and heart failure outpatient clinic—PROCAPE approved the PTICH trial (CAAE number: 65746322.8.1001.5192). Written informed consent has been obtained from all participants enrolled to date, and data handling is in compliance with applicable privacy and data protection regulations. Study findings will be disseminated through targeted outreach to civil society, the scientific community, healthcare professionals and Brazilian Unified Health System (SUS) policymakers; school-based science communication activities conducted in collaboration with state education departments (potentially including oral health educational materials); policy briefs and targeted reports for public health managers; technical meetings and institutional presentations; a plain-language summary published on the institutional website; and submissions to peer-reviewed journals and presentations at academic and health policy conferences.
RBR-3dcrj98.
by Ana Laura Januário Lelis, Leandro Aparecido Ferreira da Silva, Daniel Moretto Casali, Tiago Leiva, Murilo Chuba Rodrigues, José Paulo Roman Barroso, Pedro Veloso Facury Lasmar, Camila Lisboa Tomaz, Anabelle Jorge Barbosa, Camila Cesario Fernandes Sartini, Johnny Maciel de Souza, Danilo Domingues Millen
This study evaluated the effects of increasing narasin doses on ruminal fermentation, nutrient digestibility, ruminal pH stability, papillae histology, and microbial composition in Angus cattle fed feedlot diets. Three rumen-cannulated Angus steers (average body weight: 680 kg) were assigned to a 3 × 3 Latin square design and received diets containing 13, 20, or 27-ppm of narasin. Each experimental period consisted of 14 days of adaptation followed by seven days of sampling. Ruminal degradability was assessed on days 15–17, apparent digestibility on days 15–19, continuous ruminal pH on days 19–20, and samples for short-chain fatty acids (SCFA), microbiota, and ruminal histology were collected on days 20 and 21. Ruminal degradability was not affected by narasin dose. Digestibility of acid detergent fiber (ADF) was significantly influenced, with the greatest values observed at 27-ppm (P = 0.01). Increasing narasin doses improved ruminal pH stability, as indicated by a linear increase in minimum pH (P = 0.01) and a reduction in the duration of pH below 5.6 (P = 0.10). At 13 ppm, SCFA production, particularly acetate and propionate, increased (P P P = 0.02), and butyrate (P P P = 0.03). Narasin supplementation altered ruminal microbial composition, increasing the relative abundance of Lachnospiraceae and Isotricha while reducing lactic acid–producing bacteria. In terms of ruminal morphology, supplementation with 20-ppm of narasin increased the keratin layer thickness of ruminal papillae (P = 0.02), suggesting enhanced epithelial development. Overall, narasin supplementation modulated ruminal function and microbial ecology, with doses between 13 and 20-ppm providing the most favorable balance between fermentative efficiency and ruminal health in feedlot cattle.Doctoral research in nursing is central to advancing scientific knowledge, strengthening professional identity, and informing evidence-based practice, education, and health policy. Analyzing the thematic content of doctoral theses offers insight into research priorities and national variations in nursing scholarship. Yet, no systematic cross-country analysis has examined the thematic focus of such work.
To explore and describe the diversity and scope of doctoral nursing research themes across eight countries in the Sigma Europe Region, identifying key areas of scholarly focus and shared priorities.
A document-based qualitative study using reflexive thematic analysis, as outlined by Braun and Clarke, to examine patterns of meaning within thesis summaries.
The study included doctoral nursing thesis summaries defended between January 2020 and December 2023, sourced from national and institutional repositories in eight countries of the Sigma Europe Region. A total of 15 repositories (4 national, 11 institutional) were systematically searched, and additional summaries were obtained via direct contact with universities offering doctoral nursing programmes.
Data were collected between September 2024 and February 2025 using predefined inclusion and exclusion criteria. In total, 431 eligible thesis summaries were analyzed following Braun and Clarke's six-phase framework, supported by MAXQDA software for data management and coding.
Thematic analysis identified three overarching domains: (1) foundations of nursing practice and care philosophy, (2) systemic and organizational dimensions of nursing, and (3) clinical innovation and public health impact. Ten interrelated themes emerged, including holistic and patient-centred care; emotional, psychological, and quality-of-life dimensions; communication in healthcare; workforce challenges; transforming nursing practice; maternal, neonatal and pediatric health; digital and virtual health innovations; public health and chronic disease management; and disease management, caregiving, and outcomes. Cross-cutting elements such as cultural sensitivity and resilience spanned multiple themes.
This cross-national synthesis demonstrates the breadth and depth of doctoral nursing research in the Sigma Europe Region. Findings highlight nursing's pivotal role in addressing healthcare needs through innovative, person-centred, and evidence-informed solutions, and underscore the value of international collaboration in shaping resilient, equitable, and future-ready healthcare systems.
To identify obstacles faced by nurses when using health technologies in Intensive Care Units (ICUs).
Systematic review following PRISMA and registered in PROSPERO.
Six databases were searched. Two reviewers independently screened studies and appraised methodological quality using the Joanna Briggs Institute tool. Data were synthesized narratively.
Eight studies met eligibility criteria. Barriers clustered around limited training and technical competence, shorter professional experience, increased workload with multiple devices, organizational culture, and reduced direct patient contact, which may undermine patient-centered care. Heterogeneity of study designs precluded meta-analysis.
Obstacles to technology use in ICUs arise from individual and organizational factors. Addressing these barriers requires structured education, mentoring for novice nurses, workload management, and supportive policies that integrate technology without displacing bedside care.
Nursing leaders and educators should implement ongoing, ICU-specific technology training and mentoring. Managers and policymakers must ensure adequate staffing and promote Health Technology Assessment to align device implementation with clinical needs, safeguarding patient safety and the human dimensions of care.
To explore and map the landscape of doctoral nursing research across eight countries.
A scoping review.
This review followed the Joanna Briggs Institute methodology for scoping reviews and included doctoral theses in nursing defended between 2020 and 2023 in Austria, Italy, Israel, the Netherlands, Poland, Portugal, Slovakia and the United Kingdom.
Searches were conducted across 15 national and university repositories (4 national, 11 university) in the eight participating countries.
This review included 431 doctoral nursing theses, the majority of which employed quantitative methodologies and focused on patient populations and healthcare professionals. Key topics included clinical nursing care, quality of care, quality of life, home care, perinatal care and the work environments.
Nursing doctoral research shows progress in healthcare delivery, patient care and education via digital tools, holistic approaches and professional development. Yet gaps persist in mental health, paediatrics and marginalised groups. Limited qualitative/mixed-methods research and weak interdisciplinary collaboration reveal further opportunities.
This review underscores that nursing doctoral research is addressing major healthcare and professional challenges. Nonetheless, the identified gaps emphasise the need for more comprehensive and inclusive research to enhance equity and guide future nursing practices and policies.
This review provides an overview of the scope of doctoral nursing research across eight countries, identifying key trends and research gaps. The findings are expected to inform nursing academia, policymakers, and healthcare professionals by guiding future research priorities, fostering interdisciplinary collaboration, and promoting equitable, patient-centred care practices.
No direct involvement in data collection; one lay reviewer gave feedback on readability and practice implications, informing minor refinements.
Chronic respiratory diseases (CRDs), such as asthma and chronic obstructive pulmonary disease (COPD), are among the leading non-communicable diseases (NCDs) worldwide. However, diagnosing CRDs in low-income and middle-income countries (LMICs) remains challenging due to limited access to spirometry and trained professionals. Aggravating the burden, CRDs often coexist with other NCDs, increasing healthcare costs, reducing quality of life and elevating mortality. These challenges highlight the need for simple case-finding approaches for CRDs, such as the COPD in Low-Income and Middle-Income Countries Assessment (COLA-6) questionnaire, to support prompt identification and appropriate care within NCD services in LMICs.
To evaluate the discriminative accuracy, feasibility and implementation of the COLA-6 questionnaire in identifying and managing CRDs in Brazilian Primary Healthcare (PHC) services for NCDs.
The Multimorbidity Approach for REspiratory Solutions (MARES) study consists of three work packages to be conducted in PHC services in São Carlos/SP and São Paulo/SP, Brazil.
MARES-1: A cross-sectional observational study enrolling 859 individuals with at least one NCD receiving care in PHC. The COLA-6 questionnaire will be administered by the research team and compared with quality-assured spirometry. The Chronic Airways Assessment Test (CAAT), Asthma Control Questionnaire (ACQ-7) and fractional exhaled nitric oxide (FeNO) will also be assessed. The diagnostic performance of COLA-6 for identifying CRDs—including COPD, asthma, preserved ratio impaired spirometry, restriction and overlaps—will be assessed using area under receiver operating characteristic curves and 95% CIs.
MARES-2: A cross-sectional observational study enrolling 20 healthcare professionals (physicians, physiotherapists, community health agents and nurses) from five PHC services. These professionals will apply the COLA-6 during routine NCD care to a total sample of 1000 patients. Qualitative interviews will be conducted to explore barriers and facilitators to the implementation of COLA-6, using deductive thematic analysis.
MARES-3: A longitudinal, prospective observational study in which patients from MARES-1 and MARES-2 will be reassessed at 6-month follow-up. A total sample of 473 participants with abnormal spirometry, a diagnosis of CRD or high risk for CRDs is expected. Participants will undergo spirometry, and a subset will be interviewed to explore their healthcare experiences through qualitative thematic analysis. Access to diagnostic and treatment services in Brazil will be assessed. Changes in spirometry values, FeNO, CAAT and ACQ-7 scores from baseline to 6 months in patients from MARES-1 will be analysed.
This study has been approved by the Ethics Committees of Federal University of São Carlos and University of Santo Amaro (UNISA). Ethical approval was also granted by the University College London. Results will be disseminated through peer-reviewed medical journals and presentations at international conferences. Results will improve identification of CRDs, addressing a significant gap in current PHC settings.
To analyse the comfort needs of patients following renal transplantation, guided by Kolcaba's Theory of Comfort.
A qualitative design was employed.
This study was conducted at a Brazilian university hospital's renal transplant outpatient clinic. Forty-six post-transplant patients were purposively sampled by age, transplant time and clinic attendance. Face-to-face interviews were audio-recorded, transcribed and conducted using a semi-structured script. Data were analysed through thematic content analysis, guided by Kolcaba's Comfort Theory and relevant literature.
Participant narratives were categorised according to the contexts outlined by Kolcaba's Theory of Comfort: Physical, Environmental, Sociocultural and Psychospiritual. In the physical context, pain was identified as a major factor diminishing comfort after renal transplantation. In the environmental context, elements such as light, odour, sound, temperature and uncomfortable furnishings contributed to discomfort. In the sociocultural context, family support was highlighted as essential. In the psychospiritual context, religiosity played a key role in enhancing the comfort of transplant recipients.
Spirituality, strengthened social support networks and non-pharmacological comfort measures are essential for promoting comfort among patients following renal transplantation. These findings underscore the importance of integrated care approaches that address physical, emotional and social aspects to improve quality of life for this population.
Conceptual models in nursing provide a critical perspective for care and support the delivery of effective, evidence-based interventions. By identifying the multidimensional comfort needs of post-renal transplant patients, this study informs the development of targeted, holistic strategies for nursing and multidisciplinary practice in outpatient settings.
This study examined the multidimensional comfort needs of post-renal transplant patients and found that comfort is shaped by physical, environmental, sociocultural and psychospiritual factors. The results may guide global nursing and multidisciplinary outpatient care by informing integrated approaches that enhance the quality of life of transplant recipients.
This study was reported according to the COREQ framework.
No patient or public contribution.
Telerehabilitation (TR) programmes are increasingly recognised for their feasibility and potential benefits, such as eliminating travel time, reducing costs and providing a more comfortable rehabilitation experience at home. However, the comparative efficacy of remote physiotherapy compared with traditional in-person sessions for individuals with Parkinson’s disease (PD) remains uncertain. This study aims to evaluate the effects of TR compared with in-person physiotherapy in individuals with PD, focusing on both motor and non-motor outcomes.
This is a randomised, single-blind clinical trial with a mixed-methods approach. A total of 22 individuals diagnosed with PD will be randomly assigned to one of two groups. The experimental group will receive TR, consisting of remote physiotherapy sessions conducted once a week for 1 hour over a 4-month period. The control group will receive the same interventions in person. Interventions will include global muscle strengthening exercises, balance training, gait and motor coordination exercises, and cognitive training. The primary outcome will be motor function, measured using part III of the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale. Secondary outcomes will include cognition (Montreal Cognitive Assessment), gait (Functional Gait Assessment), mobility (Timed Up and Go Test) and quality of life (Parkinson’s Disease Questionnaire). Data will be analysed using repeated measures analysis of variance to compare outcomes between groups across four assessment points (baseline, midpoint, postintervention and 2 months follow-up). Additionally, a qualitative phase will explore participants’ perceptions and experiences regarding TR and in-person interventions, with assessments carried out 2 months after the completion of the 24-week interventions, through semistructured interviews that will be analysed using Bardin’s Content Analysis technique.
This protocol was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte (approval number: 5.553.701). All participants will provide written informed consent before inclusion. Results will be disseminated through peer-reviewed publications, scientific conferences and communication with participants and healthcare professionals.
RBR-6h5knrj.
Ambulatory care sensitive conditions (ACSCs) are conditions for which the provision of timely and skilled primary care can reduce risks of hospitalisation when preventing, treating or controlling a disease. For this reason, hospitalisations for ACSC have been commonly employed by health systems as an indicator of effectiveness for the primary level of care. This study aims to evaluate whether the provision of primary care services by physicians with residency training in family medicine is associated with rates of general hospitalisations for ACSCs in the Brazilian Unified Health System network in the city of Belo Horizonte, Brazil.
Longitudinal ecological study using a Generalised Linear Model for Gamma-distributed variables.
Primary healthcare centres in Belo Horizonte, Brazil, from January 2017 to December 2021, aggregated at the primary healthcare centres level.
Data aggregated at the primary healthcare centre level, encompassing socioeconomic, professional and health-related variables.
Incidence rates of hospitalisations for ACSCs, adjusted for age and sex.
After adjusting for age, sex and socioeconomic variables using the Health Vulnerability Index, a higher concentration of family physicians was significantly associated with a lower incidence of hospitalisations for ACSCs. If all physicians in the primary care network were family physicians, compared with a scenario in which none were, an estimated 11.89% reduction in hospitalisations would be expected (95% CI 7.3% to 16.3%, p
The findings suggest that specialisation in family medicine positively impacts health outcomes by reducing hospitalisations for ACSCs. These results can inform the development of evidence-based public policies to enhance primary care effectiveness.
The development of effective vaccines targeting human papillomavirus (HPV) has significantly contributed to disease prevention, highly relevant in immunosuppressed patients who have higher incidence of HPV-related cancers than their non-immunosuppressed counterparts. However, the acceptance and uptake of the HPV vaccine among immunosuppressed individuals pose unique challenges. Immunocompromised patients’ acceptance of the HPV vaccine is influenced by multifaceted factors, including concerns about safety and effectiveness, interactions with immunosuppressive medications and uncertainties due to their compromised immunity. This systematic review aims to identify the main factors influencing HPV vaccine acceptance among immunosuppressed patients.
A comprehensive search strategy will be executed across databases such as MEDLINE/PubMed, Embase, Scopus, Web of Science, ScienceDirect, Latin American and Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature and Cochrane Database. The review will encompass the three WHO-endorsed HPV vaccines (quadrivalent, bivalent and nonavalent) and will consider studies related to HPV vaccines and their administration. The scope includes study focusing on immunosuppressed patients who received organ transplants, cancer treatments or are HIV-positive. No temporal restrictions will be applied, and searches will be conducted until December 2025. Observational studies, including retrospective/prospective cohorts, case–control and cross-sectional studies, reporting factors influencing HPV vaccination in immunosuppressed populations will be included. Studies with overlapping patient populations will be excluded. Data extraction will include study details, demographics, vaccine type, risk/protective factors, outcomes and medical history. Validation and cross-verification will ensure data accuracy. Risk of bias will be assessed using ROBINS-I (Risk Of Bias In Non-randomised Studies of Interventions), and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will rate evidence certainty. Meta-analysis, guided by Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will employ fixed/random-effects models, assessing heterogeneity using I² statistics.
This research will analyse previously published data, so ethical approval is not required. The results of the systematic review will be submitted for publication in a peer-reviewed journal.
CRD42023452537.
Cardiovascular (CV) disease is the leading cause of morbidity and mortality globally. Low-density lipoprotein cholesterol (LDL-C) is an important modifiable risk factor of major adverse cardiovascular events. Patients without prior myocardial infarction (MI) or stroke but with established risk factors and elevated LDL-C may benefit from intensive lipid-lowering therapy (LLT); however, the size and potential healthcare burden of this population globally are not known. The benefits of evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, in these patients, are currently being studied in the phase 3 Effect of Evolocumab in Patients at High Cardiovascular Risk Without Prior Myocardial Infarction or Stroke (VESALIUS-CV) trial. To characterise the high-risk pre–CV-event (VESALIUS-CV–like) individuals in the real world, an observational study is being conducted across multiple countries.
This retrospective cohort study will use a common protocol and an analytical common data model approach to characterise VESALIUS-CV–like individuals in the real world across different geographical regions and healthcare settings. The study period will be from 2010 to 2022, subject to data availability in study sites. Patients aged 50 years and older at high risk of CV disease but without prior MI or stroke will be included in this study. VESALIUS-CV–like individuals are defined through a combination of the following: (1) one diagnosis of coronary artery disease, cerebrovascular disease, peripheral artery disease or diabetes with microvascular complications or chronic insulin use; (2) an elevated LDL-C measurement and (3) other high-risk factors. The objectives of this study are to estimate the prevalence of VESALIUS-CV–like individuals, describe their characteristics and care pathways and estimate their incidence rates of CV events and healthcare costs. The prevalence of VESALIUS-CV–like individuals will be expressed as annual prevalence; patient characteristics at index date will be presented using summary statistics; care pathways will be summarised as LLT prescription across time; and the incidence of defined CV events will be expressed as events per person-years as well as at certain time periods. Healthcare costs will be presented as CV-related costs in different time periods.
Approvals of the study protocol were obtained from relevant local ethics and regulatory frameworks for each participating database. The results of the study will be submitted to peer-reviewed scientific publications and presented at scientific conferences.
The COVID-19 pandemic’s unprecedented nature has exposed significant vulnerabilities in most public health systems and highlighted the importance of coordinated responses across various levels of government. A global debate emerged on the types of health measures necessary to curb the rapid spread of contagious and/or lethal diseases. However, some of these measures involved restricting individual rights, raising significant ethical, legal and public health questions. The protocol of this systematic review aims to address a critical gap in the literature by analysing how Public Health Surveillance services worldwide implemented compulsory right-restricting measures during the COVID-19 pandemic, and what impacts these measures had on public health outcomes and individual rights.
This protocol focuses on studies about right-restricting measures enacted by Public Health Surveillance services during the COVID-19 pandemic. It will be unrestrictive as to period (starting in 2019, when the outbreak was identified), language or publication status in a preliminary stage. It will include only peer-reviewed publications, discarding opinion articles, editorials, conference papers and non-peer-reviewed publications. Considering the PICo strategy, the research question of this systematic review can be formulated as follows: Problem—right-restricting measures enacted by Public Health Surveillance services; Interest—implementation modalities and impacts on individual rights and public health outcomes; Context—COVID-19 pandemic. This protocol will use the following databases: Pubmed, Cochrane/CENTRAL, Embase, Scopus and Web of Science. Considering the various measures that may have been adopted, the following categories of analysis will be used: (i) Public Health Surveillance as a field, (ii) the various specific areas of Health Surveillance, (iii) law enforcement, (iv) right-restricting measures and consent, (v) interactions between right-restricting measures and routine Public Health Surveillance functions, (vi) differences between countries and (vii) Health Surveillance lessons learnt from the COVID-19 pandemic. These categories are not strictly mutually exclusive; however, each study will be assigned to the category most aligned with its primary focus. To ensure the validity and reliability of findings, each study will have its risk of bias assessed at both the study and outcome levels.
Patients and the public were not involved in the design, conduct, reporting or dissemination plans of this systematic review. The results will be presented in one or more articles to be submitted to scientific journals and may also be presented at scientific conferences and to public policy makers.
This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 20 November 2024 (registration number CRD42024613039).
The way communication is conducted directly influences the professional–patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication.
Scoping review.
This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004–2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample.
The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented—considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening.
Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted.
This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.
This study aimed to describe the process of construction, validation, and usability of the chatbot ESTOMABOT to assist in the self-care of patients with intestinal ostomies. Methodological research was conducted in three phases: construction, validation, and usability. The first stage corresponded to the elaboration of a script through a literature review, and the second stage corresponded to face and content validation through a panel of enterostomal therapy nurses. In the third phase, the usability of ESTOMABOT was assessed with the participation of surgical clinic nurses, patients with intestinal elimination ostomies, and information technology professionals, using the System Usability Scale. The ESTOMABOT content reached excellent criteria of adequacy, with percentages of agreement equal to or greater than 90%, which were considered adequate, relevant, and representative. The evaluation of the content validity of the script using the scale content validity index/average proportion method reached a result above 0.90, and the Fleiss κ was excellent (P Objetivo: Comprender e identificar, utilizando referencias y producciones científicas, sobre la importancia de la lactancia materna en el contexto de las hospitalizaciones de recién nacidos prematuros en la Unidad de Cuidados Intensivos Neonatales, además del trabajo de los profesionales de enfermería en la educación y estímulo a la lactancia materna. Method: Se realizó una revisión integradora realizada en las bases de datos de la Biblioteca Virtual en Salud (BVS) basada en el cruce de los descriptores, se realizó una encuesta bibliográfica en las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Base de Datos de Enfermería (BDENF). Results: Se seleccionaron nueve artículos que abordaron la importancia de la lactancia materna, las condiciones para la promoción y sensibilización de la lactancia materna en Brasil y el papel de los profesionales de enfermería en el contexto de la lactancia materna en Brasil. Conclusions: Este estudio destacó la importancia de la lactancia materna para la salud pública y el desempeño de los profesionales de enfermería en este contexto, actuando como apoyo, promoción, estímulo y orientación para la práctica adecuada de la lactancia materna.
FreshRSS 