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Burns are a major cause of morbidity in Yemen, and their prevention relies heavily on community knowledge and safe practices. Understanding gaps in awareness and behaviour is essential for designing effective interventions. This study assessed the knowledge, attitudes and practices (KAP) regarding burn prevention and first aid among a Yemeni community. A cross-sectional survey was conducted among 380 participants using a structured questionnaire distributed via social media and community networks. Data were collected on demographics, educational level, occupation, residential area and KAP related to household, electrical and chemical burns. Associations between participant characteristics and burn-related KAPs were analysed. Participants were predominantly female (63.7%), aged 15–45 years (79.8%), urban residents (92.9%) and university-educated (82.1%). Healthcare workers comprised 50.8% of respondents. Knowledge of burn prevention and first aid was highest among university-educated and healthcare participants, with 84.6% correctly identifying initial burn management. Unsafe practices, such as applying honey or toothpaste and improper handling of chemical or electrical injuries, were more common among less-educated, rural and nonhealthcare respondents. Urban participants demonstrated better preventive practices, while cultural reliance on traditional remedies persisted across all groups. Among predominantly urban and educated populations in Yemen, knowledge and attitudes toward burn prevention and first aid are generally favourable; however, gaps persist, particularly in rural and less-educated communities. Cultural practices and misconceptions continue to limit optimal care. These findings underscore the urgent need for culturally sensitive, literacy-appropriate, community-based interventions to improve burn prevention, first aid practices and equitable health outcomes.
The 2024 revision of the Declaration of Helsinki (DoH) marks a pivotal shift in biomedical research ethics, with significant implications for nursing research. This paper critically evaluates the Declaration's relevance to nursing practice, with particular attention to challenges in low-resource settings. Key updates emphasising global health equity, environmental sustainability, participant-centred consent and artificial intelligence (AI) governance are examined through nursing's ethical lenses of justice, beneficence and patient advocacy.
Using a multidimensional ethical framework grounded in Virtue Ethics, utilitarianism and phenomenology, the manuscript explores how nurses can ethically engage vulnerable populations, safeguard data privacy and advance inclusive, community-based research.
It highlights gaps in the Declaration, particularly regarding algorithmic bias and digital consent and proposes practical strategies for nurse researchers, such as AI governance tools, dynamic consent models and context-sensitive sustainability practices.
Rather than treating ethics as an abstract principle, the paper grounds theory in real-world practice, offering case examples that reflect the lived constraints of nursing researchers in underfunded and culturally diverse environments. By aligning ethical ideals with operational realities, this work reinforces nursing's critical role in shaping equitable and ethically resilient research practices under the revised Declaration.
Age acceleration in survivors of breast cancer is a critical issue because cancer and its treatment can increase structural and numerical chromosomal aberrations, while simultaneously shortening telomere length and changing ageing phenotype. Therefore, the current study will be using machine learning architectures to accurately predict the factors that contribute to age acceleration among survivors of breast cancer.
The Cancer Survivors’ Trajectories of Ageing Research (C*STAR) is a hospital-based cross-sectional study involving multi-ethnic Malaysian survivors of breast cancer and a non-breast cancer control group, frequency-matched by age group (±5 years), sex and ethnicity. The three main stages of this study will be conducted in the predictive model development. First, a set of validated questionnaires will be used to collect the data on modifiable factors of ageing phenotypes and behavioural determinants of health. Second, 3 mL non-fasting blood samples will be collected, and lymphocytes will be isolated to determine telomere length using real-time PCR as a biomarker of age acceleration. Lastly, a machine learning architecture will be deployed to identify modifiable factors that may contribute to age acceleration in survivors of breast cancer and controls, with these factors used as input and ageing biomarkers of telomere length as output. The study outcomes may serve as guidance to enhance the quality of life of survivors of breast cancer and hinder the recurrence of cancer while ageing successfully.
Ethical approval was obtained from the Research Ethics Committee, Universiti Kebangsaan Malaysia (JEP-2022-700) to carry out this study. Written informed consent will be obtained from each survivor of breast cancer and each cancer-free woman prior to participation. The results of this study will be published for future research and clinical applications.
This study aimed to quantify how patient risk factors relate to COVID-19 severity across categories 1–5 in a prospective, hospital-based cohort. We hypothesised that greater severity would be associated with higher odds of intensive care unit (ICU) admission and in-hospital mortality. Secondary aims were to assess associations with age, viral variants, symptom clusters, lymphocyte count, fasting blood glucose and cytokine profiles.
Prospective cohort study.
A secondary-care/tertiary-care hospital and linked community settings in Cheras, Kuala Lumpur, Malaysia.
This study was nested within the COVGEN project, a prospective COVID-19 cohort conducted at Hospital Canselor Tuanku Muhriz UKM (HCTM), Cheras Health Clinic and the Bandar Tun Razak COVID-19 Assessment Centre in Cheras, Kuala Lumpur, Malaysia, from 1 August 2021 to 31 October 2022. 2532 participants were enrolled at baseline. Eligible participants were Malaysian citizens aged 12–18 years (paediatric/adolescent) or ≥18 years who had reverse transcription-polymerase chain reaction–confirmed COVID-19 at recruitment and resided in Kuala Lumpur or Selangor. Patients who had a clinically unstable condition and those who declined participation (personally or via a next-of-kin or legal representative) were excluded. This analysis included 559 patients hospitalised at HCTM; after excluding five with incomplete questionnaires, 554 remained for analysis (413 admitted to general wards and 141 to ICUs). Categories 3–5 comprised hospitalised patients, whereas categories 1–2 included hospitalised individuals and a subset recruited from community settings.
Primary outcomes included disease severity (categories 4–5 vs 1–3), ICU admission and in-hospital mortality. Secondary outcomes included associations with age strata, viral variant (delta vs omicron), symptom clusters, lymphocyte count, fasting blood glucose and cytokines: interferon gamma-inducible protein 10, interferon gamma, interleukins 8, 10, 2, 6 and 7 and tumour necrosis factor alpha.
141 of 554 (25.5%) patients required ICU care. Compared with milder categories, category 5 was associated with markedly higher odds of ICU admission (OR 204.50; 95% CI 37.54 to 1114.18; p55 versus
An increasing clinical severity category was strongly associated with ICU admission and mortality. Age, delta infection, specific symptom clusters, lymphopenia, hyperglycaemia and pro-inflammatory cytokines identified higher-risk patients, supporting risk-stratified management and prioritisation for enhanced monitoring.
A common complication of post-surgical procedures is surgical site infections (SSIs), and wound healing can be gravely affected by these SSIs. Perfumes are known for their use in personal hygiene; however, their role in surgical wound healing and SSIs has not been thoroughly studied. The present study explores the post-operative usage of perfumes in the context of SSIs and wound healing. This was a case–control study conducted in Hail City's Tertiary Care Hospital in Saudi Arabia for 9 months (April–December). The participants were adults undergoing clean elective plastic surgeries. Sixty-three patients were divided into case (n = 31) and control (n = 32) groups; the former used perfumes continuously post-operation and the latter refrained from them. All patients were observed and followed for three follow-up periods. Data on their demography, characteristics of wounds, patterns of perfume use (Arabic, Western and mixed), and infection outcomes were collected and statistically analysed using SPSS v22 at the significance level of < 0.05. In the present study, 49.21% of the total participants kept using perfume after their surgeries. The abdomen was the most common operative site in the control (16, 32%) and case (15, 48.38%) groups. The majority of the patients in the control (15, 46.87%) and case (21, 67.74%) groups had wound size > 15 cm (p > 0.05). Amongst 31 patients in the case group, most of the patients used mixed (Arabic and Western) perfumes (12, 38.7%, p = 0.65). The frequency of perfume application varied, as most participants (11, 35.48%) reported using perfume twice daily (p = 0.49). Meanwhile, 22 (71%) used 2–4 sprays per application (p < 0.05). During the first follow-up, SSIs were only reported amongst patients in a case group (2, 6.45%, p = 0.14). During the second follow-up, SSIs were observed in 3 (9.67%) and 2 (6.25%) patients in the case and control groups, respectively (p = 0.61). Meanwhile, in the third follow-up, the SSI pattern was changed, and patients in the control group developed SSIs (p = 0.10). Furthermore, a non-significant (p > 0.05) association was observed amongst the risk factors, including age, comorbidities, perfume types, operation type, wound site and wound size with infection rates. SSIs are not significantly associated with perfume usage after surgeries, even though the rates were higher amongst the non-perfume users. Future research can explore the biochemical analyses of different perfume types and their psychophysiological effects on wound healing.
To describe the point prevalence of cognitive impairment in hospitalised adults and evaluate the association with care needs and perceived risks of complications.
Multi-site cross-sectional study on a single day in May 2023.
Trained clinician auditors screened adult inpatients in acute medical, surgical, oncology, geriatric, mental health, convalescent, and rehabilitation wards for cognitive impairment using the 4AT in seven healthcare facilities and recorded need for support with basic activities of daily living, incontinence, and perceived risks of complications (falls, pressure injuries, and malnutrition). Data were summarised and compared across 4AT categories, and the strength of association between 4AT and each outcome was estimated using multivariable regression models.
Data were available for 1145 inpatients on 68 wards (mean age 68 years [SD = 18], 583 [58.9%] female, 449 [39.2%] on acute medical units). Cognitive impairment (4AT of 1 or more) was identified in 482 (42.1%) participants. Participants with 4AT 1–3 had 2.0–3.6 times the odds of need for supervision or assistance with activities of daily living, while those with 4AT 4 or more had 2.9–5.3 times the odds of need for assistance.
Cognitive impairment is very common in adult inpatients and is associated with significantly higher physical care needs.
Hospital care models must support staff to address the higher care needs in people with cognitive impairment to protect a large patient group from hospital-acquired harm.
No patient or public contribution.
This study adheres to the STROBE reporting guidelines.
by Mohammad Z. Darabseh, Aseel Aburub, Ragad Alkaraki, Abdullah Saber Alshammari, Yazan Almansi, Ghaith Dalalah, Csaba Melczer, Pongrác Ács
To evaluate pulmonary function and respiratory muscle strength in Mejwez players compared to predicted norms, and to assess the influence of smoking behaviours on these outcomes. A cross-sectional study was conducted involving adult Mejwez players. Spirometric parameters (forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC) and respiratory pressures (maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)) were measured and compared to predicted values. Multiple linear regression was used to assess the impact of smoking behaviours on respiratory outcomes. Mejwez players demonstrated significantly higher FEV₁ (+0.38 L, pIncidental pulmonary nodules (IPNs) are commonly encountered on chest radiographs (CXRs) performed for routine clinical indications and may represent early manifestations of significant pulmonary pathology, including lung cancer. While low-dose CT screening has mortality benefits in selected high-risk populations, its implementation remains limited in many healthcare settings. Artificial intelligence (AI)-assisted CXR interpretation has the potential to enhance pulmonary nodule detection. However, evidence from Malaysian clinical practice is scarce. This study aims to evaluate the diagnostic performance of AI-assisted CXR interpretation for detecting IPNs across healthcare facilities in the Klang Valley, Malaysia.
This prospective, multicentre study will include 2452 CXRs from patients aged ≥35 years over a 6-month period across four Klang Valley healthcare facilities. Each CXR will be independently interpreted by an experienced radiologist (>5 years of experience) and analysed separately using an AI system (qXR-LNMS). An independent thoracic radiologist will determine the final classification for analysis if there is IPN detection discordance. Diagnostic performance metrics (sensitivity, specificity, positive and negative predictive values, and overall accuracy) will be calculated using a 2x2 classification matrix. Agreement between AI-assisted interpretation and radiologist reports will be assessed using Cohen’s kappa statistic. The prevalence of IPNs detected by AI-assisted interpretation and radiologist reporting will be compared using a two-proportion z-test. AI discriminative performance will be evaluated using receiver operating characteristic curve analysis and area under the curve estimation. Statistical analyses will be conducted using Statistical Package for the Social Sciences V.29, with p
Ethical approval has been obtained from the Universiti Kebangsaan Malaysia Research Ethics Committee and the Ministry of Health Malaysia Medical Research and Ethics Committee. Written informed consent will be obtained from all participants. The findings will be disseminated through peer-reviewed publications, scientific conferences and engagement with relevant stakeholders.
Stroke is one of the top causes of disability in Malaysia, yet caregivers have limited access to structured, culturally tailored education to support poststroke care.
To develop and validate the CaknaStrok Education Package (CEP), a blended learning intervention comprising a printed guidebook and a trilingual mobile health application for informal stroke caregivers in Malaysia.
Methodological study involving the development and validation of a caregiver education programme guided by the Analyse, Design, Develop, Implement, Evaluate (ADDIE) instructional design framework.
Development and validation were conducted in Malaysia between January 2022 and December 2023. Both experts and caregivers were recruited from two tertiary hospitals on the East Coast of Malaysia, with caregivers identified from inpatient wards and outpatient clinics at these hospitals.
Content validation involved 10 multidisciplinary experts. Face validation involved 14 informal stroke caregivers who met eligibility criteria, and all completed the study.
CEP was developed based on prior needs assessment and expert input. Content validation was undertaken using the Content Validity Index (CVI) and face validation using the Face Validity Index (FVI), both assessed on a four-point Likert scale. Qualitative feedback was also obtained from the participants.
CEP consists of six modules delivered via a printed guidebook and a trilingual app with videos, assessment tools and local resources. Experts rated the content highly valid (Scale-level (S)-CVI/the average method (Ave): 0.97–0.99 across domains). Caregivers reported strong acceptability (S-FVI/Ave: 0.95–0.99). Qualitative feedback from experts and caregivers informed refinements to content clarity, usability and presentation, including improved navigation, consistent language use and enhanced visual design. Suggestions requiring substantial structural changes were documented for future iterations.
The CEP shows strong content and face validity as a blended caregiver education tool. By combining printed and digital formats, CEP addresses cultural and access challenges and provides a scalable model for stroke caregiver education in Malaysia. Further pilot or feasibility studies are warranted to evaluate usability, engagement and implementation in real-world settings prior to effectiveness evaluation.
Non-communicable diseases (NCDs) are rapidly escalating in developing countries and social factors such as the dynamics of the family play an important part in the lifestyle choices that lead to the onset and maintenance of chronic illness. There remains a gap in Malaysia as the majority of the studies were focused on the normal population rather than directly towards persons having NCDs. This study aimed to examine emerging risk factors such as family functionality and its association with NCD.
A cross-sectional survey was conducted using a multistage random sampling method.
Urban residential areas in Selangor, Malaysia.
A total of 2542 adults residing in urban areas of Selangor were recruited.
Family functionality was measured using the APGAR (Adaptation, Participation, Gain or Growth, Affection and Resources) scale and multiple logistic regression was performed to measure the association between emerging risk factors and NCD.
The prevalence of diabetes mellitus and hypertension was 10.8% and 6.1%, respectively. Widowed/separated status (adjusted OR (AOR) 41.53, 95% CI 19.06 to 90.48, p value=0.001) was reported to be a predictor of diabetes. As for hypertension, familial functionality (AOR 4.2, 95% CI 1.11 to 14.50, p value
There is a growing concern that family functionality is an emerging risk factor for NCDs. Future family-centred health promotion programmes should be incorporated to improve self-management behaviours and health outcomes.
This study aims to investigate the association between physical fitness and markers of cognitive function in adults aged 40 and above in Qatar.
A cross-sectional study.
The Qatar Biobank, data of 1000 adults aged 40 and above.
A population of 1000 adults aged 40 years and older was included. Available data comprised measures of physical fitness including cardiorespiratory fitness, muscular strength, body composition and physical fitness capacity, as well as cognitive function assessed through tests of short-term visual memory and psychomotor coordination.
This paper investigated the physical fitness effect on cognitive functioning through short-term visual memory and psychomotor coordination testing. Logistic regression was used to measure the association between physical fitness and cognitive functioning tests.
Our study showed that lower physical fitness capacity was significantly associated with lower psychomotor coordination in females (OR=1.57, p=0.040) and showed no significant association in males (OR=1.65, p=0.062). For short-term visual memory, the association was significant in females (OR=1.68, p=0.042) unlike in males (OR=1.58, p=0.062). Males with greater muscle strength were about half as likely to have lower psychomotor coordination (OR=0.48, p=0.04). In females, a higher body fat percentage was associated with poorer cognitive function, with each 1% increase in body fat being linked to 6% higher odds of low short-term visual memory (p=0.02) and low psychomotor coordination (p=0.006). Cardiorespiratory fitness showed no statistically significant association with short-term visual memory and psychomotor coordination level in either sex.
Our findings suggest that overall physical fitness capacity is associated with better cognitive function in Qatari adults. The relationship between specific fitness measures and cognitive function varied by sex, with muscle strength having a stronger effect for males and body composition for females. These results highlight the potential importance of maintaining physical fitness for cognitive health in adulthood.
Racialised immigrant communities in Western nations face disproportionate risks for sexually transmitted and blood-borne infections (STBBIs) due to systemic barriers, including racism, stigma and limited access to culturally appropriate care. While the need is well-established, a comprehensive synthesis of effective, culturally responsive sexual health interventions is lacking. This scoping review aims to map the available evidence on sexual health intervention needs and protective factors of racialised immigrants, and to identify and describe existing culturally appropriate programmes in Western nations.
The review will follow the JBI methodology for scoping reviews and be reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search strategy, developed and peer-reviewed by a health sciences librarian, will be executed in MEDLINE, Embase, CINAHL and Scopus, alongside grey literature sources, with no date limit. Two independent reviewers will screen titles/abstracts and full texts against the inclusion criteria. Data will be extracted using a standardised tool, analysed via narrative synthesis and framed by a socio-ecological model to categorise interventions across individual, interpersonal, community and structural levels.
Ethical approval is not required for this review. Findings will be disseminated through a peer-reviewed publication, academic presentations and tailored summaries for community organisations and policy-makers to ensure practical application.
Open Science Framework (https://osf.io/9qah6).
Nutrition counselling is recommended after pancreatic cancer surgery given the complex nutritional problems patients experience. In practice, access and delivery of nutrition counselling after pancreatic surgery varies across settings. To address this gap, our study team developed the Support Through Remote Observation and Nutrition Guidance (STRONG) programme, an implementation strategy that addresses common barriers to nutrition care delivery in oncology.
The STRONG programme includes a standardised protocol to specify the timing and amount of nutrition counselling that should be delivered and patient-mediated implementation strategies including collection of patient-reported information, an educational brochure summarising common nutrition problems and recommended dietary strategies after pancreatic surgery and a question prompt list for the patient-dietitian encounter. A pilot randomised controlled trial will be conducted to assess the feasibility and acceptability of the STRONG programme compared with usual care in pancreatic cancer surgery patients after hospital discharge (n = 80). The trial is designed to be pragmatic and integrated into existing workflows and clinic teams. The primary goal will be to compare feasibility and acceptability outcomes against pre-planned benchmarks. Data will be collected from patients and caregivers and healthcare providers who assist with STRONG implementation. Secondary goals include collecting preliminary data on effectiveness and implementation outcomes that will support a future definitive hybrid implementation-effectiveness trial.
This study was approved by the Moffitt Cancer Center Institutional Review Board of Record, Advarra (Pro00071143). Participants will be required to provide written consent prior to enrolment. Study findings will be disseminated through plain language summaries, conference abstracts and peer-reviewed publications.
ClinicalTrials.gov NCT06001268. Registered on 21 August 2023, prior to participant enrolment.
by Afsana Anwar, Mahmood Parvez, Farhan Azim, Uday Narayan Yadav, Saruna Ghimire, Ateeb Ahmad Parray, Shovon Bhattacharjee, ARM Mehrab Ali, Rashidul Alam Mahumud, Md Irteja Islam, Md Nazmul Huda, Mohammad Enamul Hoque, Probal Kumar Mondal, Abu Ansar Md Rizwan, Suvasish Das Shuvo, Sabuj Kanti Mistry
BackgroundFrailty and disability often emerge with ageing and affect quality of life. Older adults residing in Rohingya refugee camp in Bangladesh are particularly susceptible to frailty and disability due to adverse physical and social environment along with limited health and social care services available in the camp. This study aimed to investigate the prevalence and factors associated with frailty and disability among Rohingya older adults living in Bangladesh.
MethodsThis cross-sectional study was conducted among older adults aged ≥60 years residing in the Rohingya refugee settlement in Bangladesh. The primary outcomes were frailty and disability, explored using the ‘Frail Non-Disabled (FiND) questionnaire. Data were collected face-to-face during November-December 2021, using a semi-structured questionnaire. A multinomial logistic regression model was used to identify the factors associated with frailty and disability.
ResultsThe majority of participants (n = 864) were aged 60–69 years (72.34%), male (56.25%), married (79.05%), and without formal education (89.0%). The study revealed a high prevalence of frailty (36.92%) and disability (55.21%) among the participants. The multinomial regression analysis showed that the likelihood of experiencing disability was significantly higher among participants who were aged 70–79 years (RRR = 2.65, 95% CI: 1.25, 5.66) and ≥80 years (RRR = 8.06, 95% CI: 1.05, 61.80), were female (RRR = 3.93, 95% CI: 1.88, 8.1.9), had no formal education (RRR = 4.34, 95% CI: 2.19, 8.63), were living in a large family (RRR = 1.82, 95% CI: 1.05, 3.18) and were suffering from non-communicable diseases (RRR = 2.36, 95% CI: 1.32, 4.22) compared to their respective counterparts. The regression analysis also revealed that frailty was significantly higher among participants who were female (RRR = 2.82, 95% CI: 1.34, 5.94), were suffering from non-communicable diseases (RRR = 2.28, 95% CI: 1.27, 4.09), and had feeling of loneliness (RRR = 2.16, 95% CI: 1.11, 4.22).
ConclusionsThe findings underscore the need for long-term care and health promotion activities to alleviate the burden of frailty and disability among older adults in humanitarian settings. Efforts should particularly target the most vulnerable groups- older individuals (≥80 years), women, those without formal education, those living in large families, and those with non-communicable diseases.
La formación del profesional de enfermería incluye tradicionalmente teoría y práctica estructurada en entornos hospitalarios y/o ambulatorios, con la finalidad de que desarrollen las habilidades necesarias para interpretar, intervenir y cuidar a los pacientes. Para el presente estudio se describen las Experiencias del Aprendizaje de la Práctica Clínica en Pasantes de la Licenciatura en Enfermería del periodo 2024-2025. Estudio de tipo cualitativo con enfoque fenomenológico, con nueve pasantes de servicio social seleccionados de 110 de forma aleatoria, a quienes se les realizó entrevista de 20 minutos promedio. El presente estudio se apegó a los lineamientos de la secretaria de Salud en materia de investigación en seres Humanos y a la declaración de Helsinki. Los resultados van desde las experiencias, vivencias, aprendizaje auténtico, escenarios clínicos, habilidades, profesores del área clínica. Se puede concluir que se divide las experiencias en dos momentos primer y segundo semestre, el primero, los estudiantes percibían la pasantía como una oportunidad esencial para aplicar conocimientos teóricos y desarrollar habilidades prácticas en un entorno real. Sin embargo, esta visión inicial estaba acompañada de emociones como miedo y ansiedad, reflejo de la inseguridad ante las exigencias del ámbito clínico y las expectativas de aprendizaje técnico y adaptación a nuevas responsabilidades; en la segunda mitad de la práctica clínica, los participantes valoran la pasantía como una experiencia transformadora, donde adquirieron competencias técnicas como el manejo de equipos médicos y habilidades socioemocionales como la empatía y la resolución de conflictos.
by Roberto Germano, Owen Alexander Higgins, Emanuela Cristiani, Alessia Galbusera, Carmen Esposito, Dulce Neves, Carmine Pellegrino, Alessandra Sperduti, Giorgio Manzi, Luca Bondioli, Alessia Nava
This study investigates health, dental development, diet, and human-environment interactions in individuals buried in the necropolises of Pontecagnano (Campania, Italy, 7th-6th century BCE), using an integrated approach merging dental histomorphometry and calculus micro-residue analysis. The sample consists of 30 permanent teeth (canines, first and second molars) from 10 individuals. Histomorphometric analysis of dental thin sections allowed the estimation of crown formation times, initial cusp formation, crown completion, and enamel extension rates. The prevalence of Accentuated Lines, marking physiological stress events, was analyzed chronologically across tooth classes. Dental calculus analysis was performed on five individuals, identifying plant micro-remains and fungal spores. Crown formation times varied by tooth class, with canines forming the longest (mean = 1,977 ± 295 days), followed by second molars (mean = 1,176 ± 179 days) and first molars (mean = 1,094 ± 154 days). Initial cusp formation values, estimated through chronological overlap between teeth, allowed for a more accurate reconstruction of crown completion timing. Accentuated Lines prevalence peaked at 12 and 44 months, likely reflecting early childhood dietary transitions and the differential recording of stress events across different crown regions. Calculus analysis identified starch granules from cereals (Triticeae) and legumes (Fabaceae), fungal spores (Saccharomyces), and plant fibers, indicating diverse dietary practices, food processing, and extra-masticatory activities. This interdisciplinary approach reinforces the validity of combining histomorphometric and micro-residue analyses to reconstruct childhood health, adult diet, and lifestyle. Our findings align with previous research while emphasizing population-specific variations. This study enhances understanding of Iron Age biocultural adaptations, offering insights into developmental and dietary behaviors in this ancient Italian community.by Yeahyea Ahmed, Md Abdullah Saeed Khan, Laila Afroz, Mohammad Nurunnabi, Md Golam Abbas
BackgroundStreet adolescents often engage in early sexual activity, have multiple partners, and are at high risk of sexual abuse and exploitation. Despite the significance of this issue, there is a critical gap in understanding the sexual and reproductive health (SRH) needs, practices, and challenges of this marginalized population in Bangladesh, which this study aimed to explore.
MethodsA cross-sectional study was conducted from August to December 2023, involving 311 street adolescents aged 16–19 years in Sylhet City Corporation, Bangladesh. Data were collected through face-to-face interviews using a semi-structured questionnaire. The questionnaire covered sociodemographic characteristics, pubertal changes, SRH status, and SRH-seeking behaviors.
ResultsOf all participants, 62.8% were males and 37.2% were females, with a mean age of approximately 17.3 years for both sexes. Sexual intercourse was reported by 32.56% of participants, with a significant gender disparity (76.79% females vs. 6.35% males, p Conclusion
Street adolescents in Sylhet City face severe SRH challenges, including high rates of sexual abuse, low contraceptive use, and limited STD knowledge, with significant gender disparities, which should be addressed through appropriate and urgent interventions.
To determine the prevalence of internet addiction and examine its association with psychological factors specifically depression, anxiety and loneliness among Malaysian public university students.
Cross-sectional study.
All public universities in Malaysia, 20 universities.
The study included 7278 students from 20 public universities in Malaysia.
Statistical analyses were performed usingSTATA V.17 software. Descriptive statistics summarised participants’ demographic characteristics, prevalence of internet addiction and psychological distress (depression, anxiety and loneliness). Pearson’s correlation was used to assess bivariate relationships between internet addiction and psychological variables, while multiple logistic regression identified independent factors associated with internet addiction after adjusting for significant confounders.
The study found that 38.6% of the students showed signs of internet addiction, along with a high level of psychological distress; 24.8% had depressive symptoms, 32.4% experienced anxiety and 35.5% reported loneliness. Moderate positive correlations were observed between internet addiction and depression, anxiety and loneliness (p
The findings indicate significant associations between internet addiction and psychological factors such as depression, anxiety and loneliness. A comprehensive, multifaceted approach is essential to address psychological distress among university students and reduce the risk of internet addiction.
To propose a conceptual model of dignity-centred care for hospitalised older adults using Levine's Conservation Model as a theoretical framework.
A discursive approach.
Data were obtained from an extensive search of five databases and grey literature without date restrictions for information on patient dignity, dignified care for hospitalised older adults and the Levine Conservation Model.
Dignity is a multifaceted concept encompassing an inherent self-worth and self-worth acquired through personal accomplishments and associations. Hospitalised older adults are at risk of dignity erosion due to complex health conditions, poor healthcare professional- patient communication, inadequate health information, loss of autonomy, inadequate privacy, and infrastructural and systemic barriers. Key components of dignified care include respect, autonomy, privacy, effective symptom management, effective communication and active patient involvement in decision-making. The proposed conceptual model integrates Levine's principles of conservation into a dignity-centred care framework. This model identifies threats to dignity in hospitalised older adults and outlines practical interventions to mitigate these threats in order to maintain or restore dignity.
The proposed conceptual model of dignity in care for hospitalised older adults, underpinned by the Levine Conservation Model, offers a practical framework to guide healthcare professionals in providing care that upholds the dignity and well-being of older adults. The model can serve as a foundation for developing institutional policies and training programmes that reflect the multidimensional nature of dignity in care for older adults.
The study addressed both the conceptual ambiguity and skills gap surrounding dignity-centred care for older adults by offering a practical guide for integrating dignity-centred principles into routine clinical practice. The findings hold substantial relevance for healthcare practice, providing a structured, theory-informed model to advance dignity-centred care and protect the dignity of hospitalised older adults.
Not applicable.
Preventing central line associated bloodstream infections is feasible; although numerous hospitals continue to face challenges in achieving this important patient safety goal.
The aim of this project was to reduce the incidence of central line associated bloodstream infections in the intensive care unit.
This evidence-based practice quality improvement project was conducted in the general intensive care unit with 35 beds in King Abdullah Medical City in response to an increase in reported central line associated bloodstream infections cases. A searchable clinical question was formulated, and the relevant literature was reviewed and critically appraised to identify effective prevention strategies. Multimodal Interventions were then implemented and evaluated. The Plan, Do, Study, Act methodology was integrated with an evidence-based practice model to enhance the effectiveness, sustainability, and overall quality of the initiatives.
Central line associated bloodstream infection rates decreased from 1.37 to 0.62 per 1000 central line days in the intensive care unit following implementation of the interventions. Moreover, the project generated a total cost savings of $244,201 USD (915,756 SAR), reflecting reduced costs associated with central line associated bloodstream infection cases over the subsequent 18 months.
Implementation of multimodal interventions is essential to decrease central line associated bloodstream infection rate in intensive care units.
FreshRSS 