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The length of hospital stay for patients with physical illnesses is longer for those with mental health comorbidity, particularly in the presence of severe physical multimorbidity. Integrating psychosocial risk screening at hospital admission, with a subsequent care pathway, could address psychosomatic and social care needs early and reduce length of stay. However, implementation may be hindered by organisational factors such as increased staff workload and timely integration into existing processes. In addition, patient factors such as low acceptance of screening and follow-up may affect uptake. This pilot study aims to assess the feasibility of implementing this integrated approach to screening and follow-up in preparation for a confirmatory trial.
The present study is a single centre, randomised feasibility study conducted on a pilot ward. Patients will be enrolled and assigned to the intervention or the control group. Only the intervention group will receive tablet-based psychosocial risk screening conducted by ward physicians or medical students in their practical year. If the psychosomatic screening is positive and the patient agrees, he or she is referred to the psychosomatic consultation service. If the social service screening is positive, the patient will be seen by a social worker. The main objective of this study is to assess the feasibility of conducting a full-sized confirmatory trial. An informed consent rate of 30% of eligible patients is set as the feasibility criterion. A study period of 4 months is planned for the feasibility study. The feasibility study will be analysed using descriptive statistics.
The study protocol was approved by the Ethics Committee of the Medical Faculty of Heidelberg University (S-301/2024) on 24 May 2024. The results of this feasibility study will be published in a peer-reviewed journal.
Negative pressure wound therapy (NPWT) is widely used to facilitate healing by improving local perfusion, reducing edema and controlling exudate. The porous foam dressing is central to NPWT effectiveness, however, its performance in viscous, particle-rich exudates remains challenging. Standard industry tests often rely on protein-free aqueous solutions, which overlook the complex rheology and particulate load of real wounds. This study reports a bench evaluation of a multilayer foam prototype compared with three commercial dressings under NPWT, using a simulated viscous exudate with suspended particles. We recorded 60-min drainage curves and quantified effluent turbidity as a simple, interpretable proxy for particulate transport, summarised as percentage of input turbidity recovered. The mass-based endpoint (percent solid matter recovered) showed the same ranking as turbidity. At −75 mmHg, the prototype recovered 31.6% of input turbidity, exceeding commercial foams (≤ 9.7%). At −125 mmHg, particulate recovery decreased across all dressings (≤ 9.1%). A matrix-only control indicated that commercial effluents, particularly at −75 mmHg, clustered near background level, whereas the prototype evacuated substantially more particulate while maintaining robust fluid drainage. These findings suggest that moderate negative pressure and multilayer architecture can help preserve channel patency and reduce clogging in complex exudates. We highlight the need for test methodologies that incorporate viscosity and particulate content, and for practical guidance that links dressing architecture and pressure settings to exudate characteristics. Prospective validation, including larger-sample confirmation, particle-size distributions and ultimately clinical endpoints, is warranted.
Neoplastic foot ulcers are particularly challenging for dermatologists and specialists in hard-to-heal wounds because their location and comorbidities can delay accurate diagnosis. We performed a multicentre, retrospective study analysing clinical and histological data, focusing on neoplastic foot ulcers collected over the past 5 years. We evaluated patients' demographic characteristics, clinical features, histological diagnosis, tumour onset and ulcer site. Statistical analyses were conducted using SPSS software, v.30. In total, 106 patients affected by foot skin ulcers were enrolled in the present protocol (52 women, 54 men). The mean age was 70.15 years. In most cases, the neoplastic ulcer was due to primary tumour ulceration. The dorsum of the foot was the most common site of neoplastic ulcers (66%). From a clinical perspective, most lesions were classified as ulcerated nodules (n = 58), ulcerated plaques (n = 8) or hypergranulating ulcers (n = 25), all with thickened, atypical edges. Histological diagnoses included melanoma (n = 45), non-melanoma skin cancers (n = 34), benign tumours (n = 18) and rarer malignancies (n = 9). A statistically significant correlation was found between histotype and clinical lesion type, and between age and histotype. The study provided preliminary data on the clinical and histological characteristics of neoplastic foot ulcers, warranting further exploration in a prospective, multicentre study.
Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.
Objetivo: Interpretar las experiencias vividas del mundo subjetivo en mujeres violentadas por su pareja. Metodología: Estudio cualitativo en base a la Teoría de la Acción Comunicativa, realizado con 14 mujeres que acudieron al Taller de Relaciones Saludables implementado por la Secretaria de Salud de Aguascalientes. Se aplicó una entrevista semi-estructurada conformada por 7 preguntas sobre el mundo subjetivo. Resultados: Se obtuvieron 20 códigos que permitieron definir el siguiente fenómeno: La aceptación de la violencia como un estilo de vida, sin comprender el por qué permitir el abuso, lo cual origina sentimientos de autodestrucción física, emocional y familiar. Conclusiones: La sociedad ha construido una falsa igualdad cultural entre el hombre y la mujer; sin embargo, la ideología de la unión familiar le ha impedido a la mujer que se empodere y decida su forma de vida, esto lo transmiten a sus familias y éstas a su vez educan de tal forma a las mujeres, para que acepten “la vida que les tocó vivir”.
by Elisabetta Ferraro, Graziana Da Rold, Roberto Celva, Elisa Dalla Libera, Stefania Leopardi, Giulia Simonato, Paola De Benedictis, Nadia Cappai, Arianna Dissegna, Carlo Vittorio Citterio, Rudi Cassini, Federica Obber
The grey wolf (Canis lupus) population is expanding in parts of Europe due to legal protection and favorable ecological conditions. As wolves increasingly move into urban and suburban areas, interactions with domestic dogs become more frequent, raising the risk of pathogen transmission and posing potential threats to both wolf conservation and public health. This study investigated the health status of wolves in the Foreste Casentinesi National Park (Italy) using non-invasive fecal sampling conducted between May 2019 and March 2020. Samples were genetically analyzed to identify individuals and then screened for viral pathogens, Canine Coronavirus and Parvovirus, using PCR, Sanger sequencing, and phylogenetic analysis. Parasitological examinations were performed using flotation techniques on whole samples, and real-time PCR targeting Echinococcus granulosus and E. multilocularis was conducted on selected samples. Of the 260 samples collected, genetic analysis identified 80 individual wolves belonging to 8 packs. Only one sample tested positive for Coronavirus (1.2%), and none for Parvovirus. The detected sequence clustered with strains previously reported in wolves and foxes in Italy. Copromicroscopy revealed a high prevalence of veterinary-relevant endoparasites, including Eucoleus spp. (90.0%), Sarcocystis spp. (42.5%), Taeniids (28.7%), and Ancylostomatids (26.2%). Trichuris vulpis, Toxocara canis, and coccidia showed prevalence rates below 2%. All 104 samples tested for E. granulosus or E. multilocularis were negative. These findings suggest that while wolves in the FCNP commonly harbor several canine parasites, their role in the transmission of zoonotic pathogens appears limited. Although phylogenetic data suggest that coronavirus strains tend to cluster within wildlife species, molecular data on domestic dogs remain scarce. Nonetheless, the high prevalence of shared parasites highlights the need for ongoing surveillance in both wild canids and domestic carnivores. As wolves increasingly inhabit human-dominated landscapes, understanding disease dynamics at the wildlife–domestic interface is essential for effective conservation and public health strategies.by Wendy C. Hernández-Mazariegos, Felipe I. Torres, Manuel Rodríguez, Christian M. Ibáñez, Luis E. Escobar, Federico J. Villatoro
Cockroaches are vectors of pathogens and parasites that pose public health risks, especially in developing countries with poor hygiene and inadequate infrastructure. This study aimed to identify the household factors associated with the occurrence of cockroaches and the helminth parasites they carry in a rural community. Data on household infrastructure, presence of domestic animals, and insect control methods were collected from 70 households in rural Guatemala. Cockroaches were captured using traps and manually. A Generalized Linear Mixed Model revealed that households with concrete roofs had 94% lower abundance of cockroaches than those with metal sheet roofs, while the presence of cats increased cockroach abundance by 2.6 times (p Moniliformis moniliformis, were identified, marking the first report of such parasites in household cockroaches in Guatemala. These results highlight the need for improved housing infrastructure and integrated pest management strategies to mitigate the risks associated with cockroach-borne parasites in vulnerable communities.by Marianna Cortesi, Federico Pendenza, Elizabeth Haddon, Andrea Schiavio
Creative arts activities and mind-body practices, such as yoga, have been shown to benefit mental health and well-being. Research in higher education highlights the mental health challenges faced by students and staff in tertiary education; however, most studies on the potential of creative arts and mind-body practices have been conducted in the United States, with limited research investigating their impact in the UK higher education context. This qualitative study seeks to examine students’ and staff members’ views on extra-curricular creative and mind-body practices provided by one UK university, exploring how engagement in such activities can impact their understanding and awareness of mental health and well-being. In addition, it intends to investigate potential barriers to engagement with such activities. Drawing on questionnaire responses from 25 students and 20 staff members, findings highlight the effectiveness of art-based interventions and mind-body practices in raising awareness and understanding of mental health and well-being, while also having the potential to positively impact individuals’ mental health and well-being. Although personal interests and time restrictions may limit engagement, such activities were found to foster community-building, a particularly relevant factor in the post-Covid era, as institutions seek to re-engage students and staff through in-person activities. These findings have therefore important implications for the implementation of similar interventions in higher education and beyond to promote mental health and well-being awareness in diverse communities.Creating a healthy work environment requires balancing organizational goals with ethical responsibilities, where head nurses' ethical leadership can shape staff outcomes by mitigating work–family conflicts and promoting nurses' well-being, retention, and patient safety. This study aims to analyze the mediating role of work–family between head nurses' ethical leadership and nurses' reported errors, turnover intention, and physical and mental health.
Nationwide Multicenter cross-sectional study.
Validated self-report scales were used to assess nurses' perceptions of head nurses' ethical leadership, work–family conflict, error, turnover intention, physical and mental health. Descriptive and inferential analyses were conducted. Structural equation modeling examined the relationships among these variables based on Della Bella's and Fiorini's framework.
Data from 409 nurses across seven Italian hospitals was analyzed. The structural equation model showed an excellent fit. Head nurses' Ethical leadership was negatively associated with work–family conflicts, turnover intention, and errors, and positively associated with nurses' health. Work–family conflicts were significantly linked to turnover intention, errors, and nurses' health. Work–family conflicts mediate the relation between ethical leadership and turnover intention, errors, and nurses' health.
Promoting healthy work environments is crucial for nurses', patients', and organizations' well-being. Ethical leadership helps achieve this condition by reducing work–family conflicts, fostering nurses' well-being, decreasing turnover intention, and improving care quality. Disseminating ethical leadership programs and integrating with work–life balance policies can therefore strengthen both staff retention and organizational outcomes.
Ethical leadership can foster patient care, reduce turnover intention and errors, and improve nurses' well-being. Therefore, maintaining employee performance and organizational results requires integrating work–life balance policies with ethical leadership development programs.
The study adhered to The Strengthening the Reporting of Observational Studies in Epidemiology checklist.
This study did not include patient or public involvement.
The study was preregistered on the Open Science Framework https://osf.io/8jk37/overview.
This study did not include patient or public involvement in its design, conduct, or reporting.
by Federica Biassoni, Giulia Vismara, Martina Gnerre
The objective of this study was to examine whether different types of mental-imagery training focused on the vocal apparatus can enhance awareness of the vocal tract and diaphragm (vocal awareness) in non-professional singers.Sixty participants with no singing education received one of three training conditions: following instructions based on 1) a description of the physiological changes that take place during phonation (physiological description), 2) imitating an action using the vocal apparatus (imitative action), and 3) a metaphorical narration. Imitative action and metaphorical narration were conceptualized as more imaginative forms of training. Vocal awareness was assessed with a questionnaire that participants completed before and after the training. The questionnaire measured three indices: vocal apparatus representation, vocal apparatus interoceptive awareness, and vocal self-regulation. Results showed that all three types of training program significantly enhanced vocal awareness, but imitative action and metaphorical narration were more effective for interoceptive awareness, and metaphorical narration was more effective for self-regulation. In conclusion, the two imaginative forms of training were more effective than physiological description for improving vocal awareness.Regional differences in heart failure with preserved ejection fraction (HFpEF) care have been reported. We aimed to assess a physician-reported HFpEF management in the Russian Federation (RF) and a variation in the diagnosis and treatment of HFpEF between the RF and the European Union (EU).
It is a post hoc analysis of an academic web-based international HFpEF designed as a cross-sectional survey and conducted between May 2023 and July 2023.
Medical doctors who work in the fields of cardiology and general medicine.
Among 1460 medical doctors who completed the study were 166 Russian and 646 European specialists. The responders were comparable across the groups in most of the baseline characteristics, except that RF specialists were less likely to be heart failure specialists (RF: 2% vs EU: 26%) and less often worked in academic environments (RF: 17% vs EU: 61%). The utilisation of specific echocardiography parameters (RF: 66% vs EU: 80%) and natriuretic peptides (RF: 83% vs EU: 91%) to establish a diagnosis of HFpEF was less frequent in RF compared with EU, while HFpEF scores were more likely to be used by Russian physicians (RF: 58% vs EU: 40%). In the settings when all HF medications are available, responders of both regions prioritised sodium-glucose co-transporter type 2 inhibitors (SGLT2is) (mean rank: RF: 2.6 (IQR: 2.3–3) vs EU: 2.3 (IQR: 2.2–2.5)), followed by diuretics in the EU and ACE inhibitors in the RF. Every second responder in both regions preferred SGLT-2is if only one drug was available (RF: 57% vs EU 51%).
The results reveal discrepancies in physician-reported HFpEF management between RF and EU responders, particularly in the diagnostic workup. Although the utilisation of relevant diagnostic tests was lower in the RF compared with the EU, these were used by two-thirds of Russian respondents. Nevertheless, further measures are required to improve the care of HFpEF patients in the RF.
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