Conectar
To map how simulation-based education supports the development of critical thinking skills required for nurses to recognize delirium in clinical practice.
A scoping review guided by the Joanna Briggs Institute methodology and the framework developed by Arksey and O'Malley, refined by Levac and colleagues.
Two reviewers independently screened and extracted data to identify studies evaluating simulation-based education designed to strengthen nurses' delirium recognition and associated critical thinking processes. A narrative approach was used to chart and synthesize findings across varied simulation modalities and clinical contexts.
The search was conducted on 4 September 2025, using MEDLINE, CINAHL and PsycINFO. No timeframe was applied to the search.
Fourteen studies met inclusion criteria. Simulation-based education consistently enhanced skills aligned with critical thinking, including observational accuracy, recognition of fluctuating cognitive cues, clinical reasoning, reflective awareness, empathy and communication within interprofessional teams. Structured debriefing played a central role in helping nurses analyse decision-making processes and integrate experiential learning into clinical judgement. Several studies reported changes in practice, including more consistent use of delirium identification tools and improved clarity of clinical documentation.
Simulation-based education strengthens interconnected domains of critical thinking that underpin nurses' capacity to recognize delirium early and respond effectively to its fluctuating presentation. These findings highlight the educational value of immersive, theory-informed simulation for developing the clinical judgement required in cognitively complex patient situations.
Integrating structured simulation into nursing education and professional development may enhance timely delirium recognition, foster more effective interprofessional communication and support safer, higher-quality care for hospitalized adults.
Simulation-based education offers a practical and scalable strategy for improving delirium recognition across care settings. By supporting nurses in noticing subtle cognitive changes, interpreting clinical patterns and communicating concerns with clarity and confidence, simulation contributes to stronger workforce preparedness and patient safety.
This review adhered to PRISMA-ScR reporting guidance.
This study did not include patient or public involvement in its design, conduct or reporting.
Perinatal depression is a common, yet understudied, mental health disorder among women and contributes to poor engagement in prevention of mother-to-child transmission (PMTCT) of HIV in sub-Saharan Africa. Male partners are positioned to provide critical forms of social and economic support during pregnancy and postpartum, and also may contribute to women’s stress, depression and anxiety through intimate partner violence and withholding of social support. Despite the critical role of men in pregnancy outcomes and HIV prevention, few interventions have engaged men around women’s depressive symptoms, nutrition and health, and engagement in PMTCT. We will conduct a pilot trial of Mphatso, a couple-based intervention based on problem-solving therapy with couple relationship skills to reduce depressive symptoms in perinatal women, improve food insecurity and prevent HIV transmission to the infant.
We will employ a two-arm pilot randomised controlled trial in the Zomba district of Malawi to assess the feasibility and acceptability of Mphatso (meaning ‘gift’ or the child) and explore health impacts on depressive symptoms, PMTCT engagement and food insecurity. We will enrol 60 pregnant women in the second or third trimester who are living with HIV and meet criteria for probable depression based on the Edinburgh Postnatal Depression Scale and their male partners. Couples will be randomised to receive either five sessions of Mphatso (problem-management skills plus health education and relationship skills) or enhanced usual care. Feasibility and acceptability outcomes will include session attendance rates, satisfaction levels and retention at 3 months and 6 months postpartum. Exploratory analyses using regression models including time and treatment arm will be conducted to explore effects on the mothers’ and fathers’ depressive symptoms, adherence to PMTCT (antiretroviral therapy, nevirapine use, HIV testing and exclusive breastfeeding) and food insecurity.
The pilot trial has been approved by the University of California, San Francisco (Human Research Protection Program (HRPP); Protocol Number 23-40685), and the study has also been approved by the National Health Sciences Research Committee in Malawi (NHSRC; Protocol Number 24/05/4431). Results will be disseminated to study participants, health officials, policymakers, community leaders and care providers, as well as through presentations at conferences and publications in peer-reviewed journals.
In sub-Saharan Africa, young women face disproportionate challenges transitioning from school to employment, with high rates of those not in education, employment or training (NEET). Structural barriers—including unequal gender norms, early marriage and unpaid labour—limit their economic participation. The Campaign for Female Education (CAMFED) Livelihoods programme supports young women’s transition from school to independent adulthood through mentoring, life skills, business and agricultural training and access to financial resources.
This study will evaluate the impact, process and mechanisms of change, and cost-benefit of CAMFED Livelihoods programme in Tanzania and Zimbabwe (2024–2027), focusing on outcomes related to economic activity, empowerment, leadership, mental health, subjective well-being and sexual and reproductive health among adolescent and young women (aged 15–24 years).
We will conduct a mixed-method, longitudinal evaluation across five districts in Tanzania and three districts in Zimbabwe. The quantitative component includes a pre-post cohort with a comparison group in Tanzania (n=1520) and a single-cohort design in Zimbabwe (n=500), with data collected at baseline, midline and endline. Primary outcomes are NEET status and leadership, complemented by measures of well-being, empowerment and health. The qualitative component will explore mechanisms of change and programme delivery. A cost-benefit analysis will estimate social and economic returns using a provider perspective. Youth researchers will be engaged to enhance participatory learning.
We have received ethics approvals from the London School of Hygiene and Tropical Medicine (31266), the National Health Research Ethics Committee (6732) in Tanzania and the Medical Research Council of Zimbabwe (MRCZ/A/3239) in Zimbabwe. Results of this study will be published in peer-reviewed academic journals and shared with policymakers, study participants and the other stakeholders in Tanzania and Zimbabwe.
by Jabir Aman, Bikila Balis, Naol Oda, Dawit Tamiru, Tadesse Gure Eticha, Dawit Firdisa, Aboma Motuma
BackgroundMeconium aspiration syndrome is a life-threatening respiratory disease affecting around 5% of neonates worldwide. Although several studies have been conducted in developed countries, data on meconium aspiration syndrome and its associated factors remain limited in low-resource settings, including Ethiopia. Therefore, this study aimed to determine the meconium aspiration syndrome and associated factors among neonates admitted to the neonatal intensive care unit at public hospitals in Harari region, Eastern Ethiopia.
MethodA retrospective hospital-based cross-sectional study design was conducted among all neonates admitted from January 1 to December 30, 2023 and data were extracted from patient charts during April 1–30, 2025. A simple random sampling technique was employed to select 417 charts of neonates admitted to the neonatal intensive care unit. The data were collected by a data extraction checklist via Kobo Toolbox. Descriptive statistics and binary logistic regression were used in SPSS version 25 (IBM Corp., Armonk, NY, USA) for the analysis. Adjusted odds ratios with 95% confidence intervals were used to declare statistical significance at a p-value ≤ 0.05.
ResultsThe prevalence of meconium aspiration syndrome among neonates admitted to the neonatal intensive care unit was 24.2% [95% CI, 20.2–28.6]. Factors significantly associated with meconium aspiration syndrome were post-term gestation [AOR = 9.05, 95% CI 2.38–34.41], antepartum hemorrhage [AOR = 3.34, 95% CI 1.31–8.60], prolonged labor [AOR = 3.06, 95% CI 1.27–7.36], premature rupture of membranes [AOR = 3.65, 95% CI 1.28–10.45], low Apgar scores at 5th minute [AOR = 11.27, 95% CI 3.44–36.92] and intrapartum thick meconium passage [AOR = 5.98, 95% CI 2.6–13.6].
Conclusions and recommendationsThese findings indicate a high prevalence of meconium aspiration syndrome, and to reduce its impact, targeted clinical interventions should be implemented. Pregnancies reaching 42 weeks of gestation, prolonged labor, and high-risk conditions such as antepartum hemorrhage, premature rupture of membranes, or the presence of thick meconium are important factors to consider. Careful monitoring and appropriate management may be warranted in these cases.
by Boru Abera Ebsa, Maleda Tefera, Dawit Tamiru, Abraham Negash, Naol Oda, Merga Dheresa
BackgroundThe neonatal period is the most vulnerable time for an infant’s survival, particularly for preterm neonates. Preterm birth is among the leading causes of neonatal mortality. Many neonatal complications can be prevented, but preterm birth remains a leading cause of admission, death, and long-term complications, highlighting the need for further research on outcome and survival disparities across populations and settings. Therefore, this study aimed to assess survival status and predictors of mortality among preterm neonates admitted to neonatal intensive care units at public hospitals in the Harari region and Dire Dawa administration, Eastern Ethiopia, from November 1, 2021 to October 30, 2024.
MethodsThe hospital-based retrospective cohort study was conducted among preterm neonates admitted to the neonatal intensive care unit at public hospitals of the Harari region and Dire Dawa administration, Eastern Ethiopia. A simple random sampling technique was used, and data were extracted from neonates’ medical records and registration formats using a structured checklist prepared in English. Descriptive statistics, life table, Kaplan-Meier curves, and Log-rank test were used to estimate and compare survival time. Predictors of mortality were identified using the Cox Proportional Hazard model.
ResultsOut of 612 preterm neonates, 205 (33.5%; 95% CI: 29.76–37.39) died, corresponding to an incidence rate of 52.76 deaths per 1,000 preterm neonate-days (95% CI: 46.01–60.50), with a median survival time of 18 days. As multivariable cox-regression result, ≥ 4 antenatal care contact (AHR = 0.56; 95% CI: 0.36–0.89), receiving KMC (AHR = 0.16; 95% CI: 0.09–0.27), 5th minute APGAR score Conclusion
The incidence of preterm neonatal mortality was high in this study. Adequate Antenatal care (ANC) and kangaroo mother care (KMC) significantly improved preterm survival, while low APGAR score, resuscitation with bag and mask, neonatal sepsis, PNA, and RDS were major predictors of preterm neonatal death. Emphasis should be placed on strengthening antenatal and perinatal care, along with early detection and management of identified neonatal complications.
Cadmium is a metal that poses significant health risks, particularly in occupational environments where exposure can happen. The main objective of this scoping review is to review the cadmium exposure levels in the different occupational settings in the European Union (EU), considering the regulatory measures currently in place. The secondary objectives, depending on the availability of data, are (a) to identify the occupational settings where higher exposure levels occur, (b) to identify any geographical and temporal differences and trends within the EU and (c) to identify the most relevant co-exposures reported.
A scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. Studies reporting quantitative occupational data on cadmium exposure obtained through human biomonitoring and/or air monitoring will be included. A descriptive analysis of the findings will be performed.
This protocol for a scoping review does not require ethical approval as it is based on secondary data. The dissemination plan of the scoping review includes its publication in a scientific journal of reference, as it is expected that it will provide important knowledge to support ongoing and future occupational health interventions in the EU, at the technical and regulatory levels.
This study is registered at the Open Science Framework (OSF), 7 April osf.f2w3h.
To develop and validate a model to predict cognitive decline within 12 months for home care clients without a diagnosis of dementia.
We included all adults aged ≥ 18 years who had at least two interRAI Home Care assessments within 12 months, no diagnosis of dementia and a baseline Cognitive Performance Scale score ≤ 1. The sample was randomly split into a derivation cohort (75%) and a validation cohort (25%). Significant cognitive decline was defined as an increase (deterioration) in Cognitive Performance Scale scores from ‘0’ or ‘1’ at baseline to a score of ≥ 2 at the follow-up assessment.
Using the derivation cohort, a multivariable logistic regression model was used to predict cognitive decline within 12 months. Covariates included demographics, disease diagnoses, sensory and communication impairments, health conditions, physical and social functioning, service utilisation, informal caregiver status and eight interRAI-derived health index scales. The predicted probability of cognitive decline was calculated for each person in the validation cohort. The c-statistic was used to assess the model's discriminative ability. This study followed the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) reporting guidelines.
A total of 6796 individuals (median age: 82; female: 60.4%) were split into a derivation cohort (n = 5098) and a validation cohort (n = 1698). Logistic regression models using the derivation cohort resulted in a c-statistic of 0.70 (95% CI 0.70, 0.73). The final regression model (including 21 main effects and 8 significant interaction terms) was applied to the validation cohort, resulting in a c-statistic of 0.69 (95% CI 0.66, 0.72).
interRAI data can be used to develop a model for identifying individuals at risk of cognitive decline. Identifying this group enables proactive clinical interventions and care planning, potentially improving their outcomes. While these results are promising, the model's moderate discriminative ability highlights opportunities for improvement.
To explore the impact of intergenerational relationships on the social resilience of elderly populations in Arab societies. Additionally, the study aimed to identify the factors that influence the quality of these relationships and their role in enhancing or diminishing the resilience of older adults.
A qualitative study.
Semi-structured interviews were conducted between June and July 2024 with 12 elderly participants from urban and semi-urban communities in Al-Ahsa, Saudi Arabia. Data were analysed using both deductive framework analysis, guided by social support theory, and inductive thematic analysis to identify key themes related to intergenerational relationships and social resilience.
The study involved 12 participants aged 61–85 years (average age of 72 years), with a mix of educational backgrounds and living arrangements. Strong intergenerational ties were found to significantly enhance social resilience by providing emotional support and a sense of security. Participants in multi-generational households reported more positive outcomes compared to those with less frequent family contact. However, generational differences and modern-life pressures posed challenges to maintaining these relationships.
The findings underscore the importance of fostering strong intergenerational relationships to support the social resilience of elderly populations in Arab societies. Future research should explore interventions that bridge generational gaps and strengthen family ties, particularly in the context of evolving social structures.
Healthcare practitioners and policymakers should consider the role of intergenerational relationships when designing interventions aimed at improving the well-being and resilience of older adults in a culturally sensitive approaches.
The Consolidated Criteria for Reporting Qualitative Research (COREQ).
The engagement and interview data from elderly participants provided valuable insights into the dynamics of intergenerational relationships and their impact on social resilience.
The over 14 million African children who are HIV-exposed but uninfected (CHEU) are at risk for poor health outcomes, including neurodevelopmental conditions such as autism; however, no study to date has examined autism in CHEU in Africa, where the vast majority of these children live. Scalable diagnostic and neurobehavioural tools, including powerful, low-cost approaches such as eye-tracking, for detection and study of mechanistic neural processes are necessary to advance autism research in these settings. The objective of this study is to examine autism diagnostic outcomes and eye-tracking biomarkers in relation to CHEU while at the same time building capacity for neuro-health research in Kenya.
This study will leverage a longitudinally assessed cohort of CHEU and children who are HIV-unexposed and uninfected (CHUU) with well characterised HIV-related and contextual exposures. We will first determine and compare autism diagnostic outcomes between young CHEU and CHUU across a large cohort (n=850) of Kenyan children using research-grade autism assessment tools, and, second, determine whether neurobehavioural eye-tracking markers predict autism outcomes across this cohort.
Human subjects approvals have been obtained from Moi University Institutional Review and Ethics Committee (IREC; IREC/909/2024; Approval #0004835), Kenya’s National Commission for Science, Technology and Innovation (NACOSTI; Reference #NACOSTI/P/25/415028), the Institutional Review Board of the Indiana University School of Medicine (Protocol #23171), with reliance agreements executed with Purdue University and Boston University. Dissemination of findings will occur through multiple channels within the research and clinical community, including peer-reviewed journal publications and conference abstracts and presentations. As part of capacity building efforts, the research team will also communicate study results to policy makers, the lay public and other health systems involved in the care of young children with disabilities via study-hosted workshops and conferences.
Heart failure is a leading cause of hospitalisation and often coexists with seven comorbid conditions on average. This study aimed to examine the gender differences in disease burden, symptom burden, and quality of life among older adults with heart failure and multimorbidity.
Cross-sectional study.
This study utilised a baseline survey from an ongoing cohort study in 2022–2023. Adults aged ≥ 50 years with heart failure and more than one chronic condition were recruited from a university-affiliated hospital using an electronic patient portal. Disease burden was measured using a modified Disease Burden Impact Scale. The Edmonton Symptom Assessment Scale and EuroQoL-5D-5L assessed symptom burden and quality of life. Gender differences in baseline outcomes were examined using Pearson's Chi-square tests, Welch's t-tests, and multiple linear regressions.
Among 353 participants who completed the baseline survey, the mean (±SD) age was 70 (±9.5) years, and 50.1% were women (mean age: 67 ± 9 vs. men: 72 ± 10). In adjusted models, women had 4.9 points higher disease burden (p = 0.003) and reported higher symptom scores of pain (p = 0.018), tiredness (p = 0.021), nausea (p = 0.007), and loss of appetite compared to men (p = 0.036). Women had significantly more moderate/severe problems in usual activities and pain/discomfort and 0.07 points lower EuroQoL index than men (p = 0.010).
There were gender differences in disease/symptom burdens and quality of life. Women living with heart failure and multimorbidity had higher burdens but lower quality of life.
Identifying gender differences among people with heart failure and multimorbidity can be the first step to explaining health disparities. Research should take more inclusive and equitable approaches to address these differences. Healthcare providers, including nurses, should implement targeted strategies for effective multimorbidity management by considering these differences and disparities in clinical settings.
STROBE checklist, cross-sectional.
No patient or public contribution.
Investigate if UK healthcare professionals have the resources and knowledge to provide cardiovascular prevention and rehabilitation to people with ischaemic non-obstructive coronary artery disease (INOCA), and explore what type of care healthcare professionals believe patients should receive.
Electronic cross-sectional survey of UK healthcare professionals, circulated between 7 January and 7 March 2022.
Quantitative data were analysed descriptively. Qualitative data were analysed inductively.
Healthcare professionals lacked knowledge and capacity to care for this patient group. Healthcare professionals recommended patients receive two unsupervised sessions per week, for 8 weeks, at home and in person. Recommend include physical activity advice/exercise training, health behaviour support, psychological support, smoking cessation, dietetics/nutritional support, weight management, counselling and medication titration.
In the UK, healthcare professionals lack resources and knowledge to provide cardiovascular presentation and rehabilitation to people with INOCA. Recommended care reflected care currently available to other patient groups.
There is a need to create and evaluate educational material for healthcare professionals.
Before people with INOCA are offered cardiovascular prevention and rehabilitation it was necessary to determine if healthcare professionals had sufficient clinical knowledge and resources to provide care. We conclude that additional training and resources are required to enable health professionals to deliver care to people with INOCA.
Researchers should create and evaluate educational material for cardiovascular prevention and rehabilitation programmes. Programmes also require additional resources to deliver care to this group.
Reporting adheres to the Cherries guidelines.
A patient (SB) was consulted on study design, data collection, and interpretation, and manuscript preparation.
To explore the perceptions of resilience among nurses using the Society-to-Cells Resilience Theory and examine how multilevel factors influence their ability to maintain resilience in high-stress environments.
A qualitative study using semi-structured interviews.
Sixteen registered nurses from various healthcare settings in the Asir region, Saudi Arabia, participated in face-to-face interviews conducted from February to April 2024. The interviews were analysed thematically to identify key factors affecting resilience at individual, familial, institutional and societal levels.
Four key themes emerged: individual coping strategies, family and social support, institutional support mechanisms and societal recognition. Nurses identified personal coping methods, such as mindfulness and exercise, as essential for maintaining resilience. Family and social networks played a crucial role in emotional support. Institutional factors, such as adequate staffing and leadership support, were vital to resilience, while a lack of societal recognition negatively impacted nurses' well-being.
Resilience in nursing is a multifaceted process influenced by individual, institutional and societal factors. Supportive work environments, adequate resources and recognition of nurses' contributions are critical in fostering resilience.
The findings emphasise the need for healthcare institutions to implement policies and support mechanisms that address both the personal and professional challenges nurses face. Promoting resilience can improve nurse retention, job satisfaction and patient care outcomes.
This study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.
No patient or public contribution.
by Saad Al-Lahhaam, Raghad Dweikat, Tala Nazzal, Aman Maraqa, Joud Khalil, Tala Albadawi, Raghad Doufish, Wa'd Amer, Mustafa Ghanim, Mohammad Abuawad, Amer Ghrouz, Samar Alkhaldi, Laith El-lahham, Majdi Dwikat, Maha Rabayaa, Malik Alqub
BackgroundTinnitus is a prevalent condition worldwide, particularly among adolescents, that has a substantial impact on quality of life, yet it remains an understudied issue.
ObjectivesThis study aims to determine the prevalence of tinnitus and its associated risk factors among Palestinian adolescents aged 15–18.
MethodsA cross-sectional study was conducted from January to March 2025. A convenience sample of participants was recruited. The study utilized the European School for the Interdisciplinary Tinnitus Research Screening Questionnaire.
ResultsA total of 1,131 participants were enrolled in the study, with 64.5% being females. The prevalence of tinnitus among the study sample was 532, representing 47% of the population. Females had a higher prevalence of tinnitus, with 370 affected (50.7%) compared to males (40.4%). Significant associations were found between tinnitus and several factors: age, positive family history of tinnitus (threefold increased risk), sensitivity to external sounds (2.7 times higher likelihood), slight hearing difficulty in noisy environments (1.7 times higher risk), pain symptoms (double the risk), and difficulty falling asleep (1.8 times higher risk). Notably, the majority of affected participants (71.5%) had never sought professional care for their tinnitus.
ConclusionAlthough Tinnitus is common among Palestinian adolescents aged 15–18 years, the majority of affected participants did not seek professional care for tinnitus. These findings highlight the importance of conducting further research to shed insight into this prevalent and neglected health priority.
by Forest W. Arnold, Leslie Wolf Parrish, Subathra Marimuthu, Jamie Findlow, Angela Quinn, Vidyulata Salunkhe, Daniya Sheikh, Phillip Bressoud, T’shura Ali, Dawn Balcom, Mohammad Ali, Ryan S. Doster, Deepti Deepti, Mohammad Tahboub, Fama Ndiaye, Jay Lucidarme, Stephen A. Clark, Ray Borrow, Paul Balmer, Steven Gootee, for the CERID study group
BackgroundNeisseria meningitidis is a cause of meningitis and outbreaks of it among young adults, especially college students. Rates of nasopharyngeal colonization and prevalence of specific capsular groups vary with age, geography as well as time, and may be influenced by meningococcal vaccination. The objective of this study was to measure the change in colonization rate, and define which meningococcal genogroups were present, in college students over a 3-month semester.
MethodsThis was a prospective, longitudinal cohort study with sequential oropharyngeal swabbing among college students at the University of Louisville (UofL) in Louisville, Kentucky from August to November 2022. Participants were ≥18 years of age and were enrolled within 48 hours of moving to campus-affiliated housing. Oropharyngeal swabs were collected at enrollment, one month and at three months. Samples were screened for N. meningitidis, and isolates were characterized using phenotypic and genotypic methods. Behavior questionnaires were obtained at each visit to identify risk factors for N. meningitidis colonization.
ResultsA total of 1047 participants were seen initially, of whom 821 attended all three visits. The baseline colonization rate was 3.5% followed by 3.9% after one month and 5.7% after three months. The genogroups of recovered isolates were capsule null (48%), B (38%; of which 11% were expressing capsule) and E (12%). No genogroup ACWY isolates were recovered. A total of 36% of participants had a history of receiving at least one MenB vaccine dose and 74% had a history of receiving at least one MenACWY vaccine. Risk factors for N. meningitidis nasopharyngeal carriage included being a second-year student, living on campus for the second year, smoking/vaping, kissing and sexual contact.
ConclusionsAn increase in N. meningitidis colonization over the 3-month semester was observed from 3.5% to 5.7%. The overall proportion of student carriers was significantly lower, and there were no genogroup A, C, W or Y strains isolated compared to studies conducted prior to the availability of meningococcal vaccines and the COVID-19 pandemic. However, genogroup B carriage, transmission and acquisition were almost identical to pre-COVID pandemic studies. This study reinforces the importance of periodic epidemiological monitoring of carriage as well as disease.
The National Institute for Health and Care Research (NIHR) has 20 Biomedical Research Centres (BRCs) and 28 Clinical Research Facilities (CRFs) that work with NHS organisations and universities to translate cutting-edge research into new interventions. As mandated by NIHR, all BRCs/CRFs have an Equality, Diversity and Inclusion (EDI) strategy which details how they will implement EDI through their practices, research and organisational systems. This UK-based study aimed to conduct a pilot qualitative analysis of EDI strategies to compare all 20 NIHR BRCs/CRFs, identify common priorities and improve inclusion across research infrastructures. The analysis was presented at the first in-person seminar for NIHR EDI professionals (Birmingham, October 2024).
Qualitative content analysis of publicly available EDI strategy documents.
48 research infrastructures (20 BRCs and 28 CRFs).
EDI strategies were collated into NVivo and Microsoft Excel where inductive coding and content analysis was executed for objectives, action plans and success measures. Both quantitative and qualitative content analyses were conducted to analyse the prevalence of categories and similarities or differences between them. Logic models were developed to map the process of implementing EDI for each main category generated.
The most common main category across objectives was ‘Cultural change in workplaces’ for BRCs and ‘Leadership, governance and policy’ for CRFs. For action plans, codes for ‘Collaborations and Networks’ and ‘Research development and delivery’ were most prevalent for BRCs—for CRFs, it was ‘Workforce culture change’ and ‘Research development and delivery’. Success measures for both BRCs and CRFs most often related to ‘Summary reports, feedback, audits and monitoring’. Differences between BRCs and CRFs reflected their organisational roles and strategic maturity, with BRCs tending to have more comprehensive, measurable strategies.
This study provides the first systematic analysis of EDI strategies across all NIHR BRCs and CRFs, offering a comprehensive mapping of how EDI priorities are articulated and operationalised across objectives, action plans and success measures. While both infrastructures align with NIHR’s inclusion goals, BRCs generally showed more strategic maturity than CRFs. As the analysis was based solely on publicly available strategy documents, it could not determine the extent to which any strategy had been implemented in practice. Future research is needed to examine implementation and impact. The contribution of this work lies in demonstrating systematically and for the first time the ways in which EDI commitments are framed across NIHR infrastructures and their varying levels of depth and maturity. Our findings support the development of more measurable EDI frameworks and highlight opportunities to strengthen inclusion across NIHR-funded research infrastructures.
Palliative care supports the physical, emotional, social and spiritual needs of people with serious life-limiting illness. Future research must align with the priorities of people approaching the end of their lives, and those close to them.
To undertake a refresh of the James Lind Alliance Palliative and End of Life Care Priority Setting Partnership, to identify and prioritise areas for future research.
The James Lind Alliance process was applied, between May 2023 and February 2025. An initial online survey collected areas for future research from participants. These were synthesised into a long list of questions and shortlisted through a second online survey. Final ranking of priorities was achieved using an adapted Nominal Group Technique within a prioritisation workshop.
People living with serious life-limiting illnesses, carers, friends and family members supporting them, bereaved people, health and social care professionals, volunteers working in palliative and end-of-life care and members of the public.
1032 and 626 responses were received to survey 1 and 2, respectively. 20 people with lived and professional experience attended the prioritisation workshop. An updated list of 24 priorities for palliative and end-of-life care research was produced.
The priorities reflect the range of issues shaping end-of-life experiences and serve as a call to action for researchers and funders.
Increased risks and concerns regarding patient safety in early-phase studies exist because knowledge about the new intervention is still accumulating. This means that narrow eligibility criteria are needed. However, if early-phase studies are narrow in their inclusion, for example, by not including diverse populations, there is a potential risk that new therapies have insufficient relevant efficacy and safety data. Existing research has explored equity, diversity and inclusion (EDI) factors in early-phase pharmaceutical studies, but it has not been possible to find studies that have systematically examined whether EDI factors have been considered in surgical studies reporting innovative procedures. We aim to examine how EDI factors are considered in early-phase surgical studies and surgical innovation reports to explore how this may impact on later-phase evaluation and inclusive intervention implementation.
A scoping review following the JBI (Joanna Briggs Institute) and Arksey and O’Malley’s five-step process is being conducted. We will search Scopus, PubMed and Web of Science for surgical early-phase studies. A two-step screening process for eligibility is being used. Independent double screening will take place for 20% of the papers. Eligible articles will report early evaluation of an innovative surgical/invasive procedure. Excluded will be comparative and later-phase studies and early evaluations of pharmaceutical products even in a surgical setting. Data on article details, patient eligibility and whether protected characteristics are reported and considered will be extracted. Information about EDI considerations reported in the introduction or discussion of the papers will also be extracted. Findings will be discussed with a patient advisory group. A content synthesis approach will be undertaken and descriptive summaries presented.
This study does not require ethical approval being a secondary analysis. The findings will be disseminated through academic journal publications and oral presentations.
Many medical students with mental health problems do not seek help. However, it is unclear what medical schools can do to promote help seeking. We sought to establish the effect of medical school initiatives on help seeking for mental health problems among medical students.
A systematic review and meta-analysis of studies published between 2013 and 2023.
MEDLINE Ovid, EMBASE Ovid, PsycINFO Ovid, Web of Science, ERIC, BEI and Education Abstracts.
Studies that assess the effect of an intervention delivered by a university or healthcare organisation on medical students’ attitudes towards help seeking or their help-seeking behaviour for mental health problems.
Two reviewers independently screened studies for inclusion and extracted data. Risk of bias was assessed using Cochrane Risk of Bias 2 (for randomised controlled trials (RCTs)) and Risk Of Bias In Non-randomized Studies of Interventions (for non-randomised studies). Studies were grouped according to intervention type. Meta-analysis was conducted using random-effects models. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluations.
The evidence from the meta-analyses was of very low to low certainty. Improvements in help seeking were noted in the meta-analyses of pre-post studies investigating the effect of interventions with a lived-experience component (five studies, n=492, standardised mean difference (SMD) 0.62, 95% CI 0.33 to 0.91, p
Overall, the evidence is of very low to low certainty, due to the serious risk of bias in the included studies, most of which used uncontrolled pre-post designs. Interventions with a lived-experience component may improve medical students’ help-seeking attitudes. Standard clinical clerkships did not appear to impact personal help seeking, despite multiple previous studies suggesting they reduce stigma, suggesting barriers to help seeking extend beyond stigma and mental health literacy in this student population. Further high-quality research, particularly RCTs with long-term follow-up, is needed to firm up the evidence base in this area.
CRD42024319771.
by Paola Ximena Gonzalez-Lerma, Crystal Lloyd, Scarlet J. Park, Ken Dawson-Scully
Chemotherapeutic agents used for most common cancers are frequently associated with neurotoxicity, which often include debilitating side effects such as seizures. Docetaxel, one of the most widely and effectively used chemotherapeutic drugs, is associated with an array of symptoms referred to as Docetaxel-Induced Peripheral Neuropathies (DIPNs), including motor neuropathy, tingling, muscle weakness, and numbness. In this study, we use the electroconvulsive assay to model DIPN-related muscle weakness in C. elegans, via shock induction. We show that acutely or chronically exposing nematodes to docetaxel increases time to recovery from shock-induced seizure-like behaviors. Additionally, we find that sildenafil citrate, a PDE-5 inhibitor, and a novel bicyclic bridge compound, Resveramorph-3 (RVM-3), are both effective at rescuing the animals from prolonged seizure-like movement duration following acute and chronic exposure to docetaxel. The results demonstrate that sildenafil citrate and RVM-3 are potential candidates for mitigating the neurological deficits resulting from DIPNs.To assess malaria service readiness and its associated factors among health facilities that provide antenatal care (ANC) services in Ethiopia.
Nationally representative cross-sectional facility-based study.
A total of 1156 public and private health facilities that reported providing ANC services at the time of the survey.
Health facilities across nine regions and two city administrations of Ethiopia based on data from the 2021/2022 Ethiopia Service Provision Assessment survey.
Only 15.7% (95% CI 13.8 to 18.0) of facilities demonstrated full malaria service readiness, while 14.3% had none of the key components. Substantial regional variation was observed: facilities in Somali region were more likely to be ready (adjusted OR (AOR)=1.53; 95% CI 1.19 to 1.95), whereas readiness was significantly lower in several regions, including Amhara, Oromia, Gambella, Harari, Addis Ababa, Dire Dawa and Sidama, compared with Southern Nations, Nationalities and Peoples’ Region. Governance-related factors were strong predictors of readiness—the presence of a client suggestion box (AOR=1.60; 95% CI 1.12 to 2.29), recent report submission (AOR=2.79; 95% CI 1.15 to 6.76) and monthly staff meetings (AOR=1.64; 95% CI 1.26 to 2.14) were associated with higher readiness.
Malaria service readiness in Ethiopian health facilities providing ANC services is low and unevenly distributed across regions. Strengthening supply chains, staff training and governance systems may improve facility preparedness and support more effective malaria service delivery for pregnant women.
FreshRSS 