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From Hair to Healing: Follicular Unit Transplantation for Chronic Ulcer Management—A Case Series

ABSTRACT

Scalp follicular unit (FU) transplantation is a highly effective yet underutilised minimally invasive technique for promoting healing in chronic and recalcitrant cutaneous wounds. In this case series, five patients with long-standing nonhealing leg ulcers of mixed etiologies were treated exclusively with single FU grafts harvested from the scalp with a 0.9–1-mm punch. Complete re-epithelialization occurred in three cases by 6, 3 and 1 month, respectively, while the remaining two cases showed marked partial improvement at 6 months, with reduction in ulcer area and pain. Overall, all five patients experienced a favourable clinical outcome. Case reports suggest that the transplantation of a minimum of 4 FU grafts/cm2 is required to promote effective wound closure, with higher graft densities being associated with faster healing. However, the optimal graft density and placement, whether uniform distribution or targeting the wound edge to exploit an ‘edge effect’, require further investigation. Considered alongside prior reports, these results suggest that 1-mm single-FU grafting achieves wound healing comparable to, and often faster than, 2–3-mm punch grafts. Additionally, the technique is less invasive and causes less bleeding, overall supporting wider use as an adjunct in multidisciplinary wound care.

Level of Evidence: IV

Early health technology assessment (eHTA) approaches focused on human stem cell-related technologies: a scoping review protocol

Por: Francis · T. · Hassan · S. · Bielecki · J. · Abdi · A. · Stewart · U. · Laflamme · M. A. · Rac · V.
Introduction

The growing advancement of innovative stem cell technologies requires careful evaluation of their economic, clinical and societal impacts. Early economic evaluations are essential for developing new medical technologies and supporting key decisions about commercialisation and market access. This scoping review explores Early Health Technology Assessment (eHTA) approaches specifically related to human stem cell technologies. By examining how eHTA can support the commercialisation of these therapies, we aim to clarify its role in optimising resource allocation and enhancing both the clinical and societal benefits of stem cell technologies.

Methods and analysis

To explore the use of eHTA in the development of stem cell-related technologies, a scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review Extension guidelines. Systematic searches were conducted across scientific databases (MEDLINE, International HTA database, EconLit, PAIS Index and EconPapers), grey literature sources (Overton) and through hand-searching to identify eligible articles published from inception to 14 April 2026. No limits were imposed on language. Reviewers will independently record data from eligible studies using a standard data abstraction form. The gathered information will be synthesised both quantitatively and narratively.

Ethics and dissemination

Formal ethical approval is not required, as this study does not involve the collection of primary data. The findings will be shared through professional stem cell networks, published in national and international health technology assessment conference proceedings and submitted for open-access, peer-reviewed publication.

Burnout, associated factors and coping strategies among nursing professionals in Kerala, India: a cross-sectional study

Por: Ambujam · J. K. · Francis · P. T. · Olickal · J. J. · Sarma · P. S. · Thankappan · K. R.
Objectives

To determine burnout prevalence, associated factors and coping strategies used by nursing professionals.

Design

Cross-sectional analytical study.

Setting

Public and private healthcare institutions in Kerala, India.

Participants

Nursing professionals in Kerala (n=349).

Primary and secondary outcome measures

Burnout levels (assessed with the Burnout Assessment Tool (BAT)) and coping strategies. Log-binomial regression was performed to identify factors associated with burnout.

Results

High burnout was reported by 36.1% of participants (126/349; 95% CI 31.1 to 41.4). Burnout prevalence was higher among nurses with an MSc (Master of Science) or higher educational qualification (adjusted prevalence ratio (APR)=1.46; 95% CI 1.04 to 2.03); those working in urban settings (APR=1.41; 95% CI 1.04 to 1.90); those who were single, divorced or separated (APR=1.58; 95% CI 1.18 to 2.12); those with travel time ≥30 min (APR=1.36; 95% CI 1.03 to 1.79); and those engaged in clinical/direct patient care duties (APR=1.75; 95% CI 1.18 to 2.59). Commonly reported coping strategies included active coping (59.6%), seeking instrumental social support (58.7%) and venting (54.4%), whereas negative strategies, such as substance use, were less frequent (22.9%).

Conclusions

Over one-third of the nurses in our study reported high burnout. Efforts to reduce burnout should focus on nurses with higher qualifications, those working in urban settings, those with higher travel time, those who are single/divorced/separated and those involved in clinical duties to enhance healthcare quality.

A Nurse‐Led Educational Intervention for Patients With Type 1 Diabetes Using Continuous Glucose Monitoring

ABSTRACT

Background

The primary barrier to maximizing the benefits of intermittently scanned continuous glucose monitoring (isCGM) is low scan frequency. Higher daily scan frequency correlates with better glycemic control.

Aim

To evaluate the effect of a nurse-led educational intervention on scan frequency and behavioral change in adults with type 1 diabetes (T1D) showing low scanning frequency.

Methods

In this 12-week quasi-experimental study, adults with T1D using isCGM and low scan frequency participated in a single, individualized, direct education session led by a diabetes nurse educator. The intervention focused on increasing daily scan frequency and supporting patient engagement in self-management.

Results

Thirty-four patients using isCGM participated. Mean daily scan frequency increased from 3.1 to 6.1 scans/day following the intervention. This rise was associated with an 8.0% improvement in TIR. A positive correlation was observed between scan frequency and TIR, with each additional daily scan associated with a 0.51% increase in TIR.

Linking Evidence to Action

A single, targeted educational session can significantly improve isCGM adherence and glycemic control in adults with T1D and low adherence, supporting its value as a practical strategy in routine clinical care.

Trial Registration

The protocol was publicly registered at ClinicalTrials.gov (NCT05570162)

Intervenciones de enfermería para una toma de decisiones compartida en oncología

Introducción: La Toma de Decisiones Compartida (TDC) es una competencia de enfermería que busca respetar y promover la autonomía del paciente, favorecer la relación de confianza con el profesional, mejorar el cuidado y tener a la persona como centro de su cuidado. El cáncer se está convirtiendo en una enfermedad crónica que genera incertidumbre y una continua decisión en el cuidado. Existen estudios que revelan los beneficios en la salud de una TDC a partir de una relación de confianza entre el paciente y la enfermera. Objetivos: Conocer las intervenciones de enfermería para una TDC en el ámbito de la oncología y diseñar un plan de implementación de intervención de enfermería para una TDC en una unidad de oncología. Metodología: revisión narrativa de la literatura. Se revisaron las bases de datos Pubmed y CINAHL. Resultados: se incluyeron cinco artículos para el análisis de los resultados: una revisión sistemática (RS) y cuatro ensayos clínicos aleatorizados (ECAs). La calidad de estos fue evaluada con el instrumento Critical Appraisal Skills Programme español (CASPe). Se encontraron varias intervenciones de ayuda para la TDC dirigidas a los profesionales y a los pacientes, teniendo todas ellas en común la capacitación a los profesionales, y considerando los valores y preferencias del paciente. Conclusiones: Las intervenciones de ayuda para la TDC mejoran la actitud en los profesionales de enfermería, y aumenta la satisfacción del paciente en los cuidados al preservar su autonomía, aumentar su participación y mejorar la relación con el profesional, por lo que mejora un cuidado centrado en la persona.

ABSTRACT

Introduction: Shared Decision Making (DBT) is a nursing competence that seeks to respect and promote patient autonomy, favor the relationship of trust with the professional, improve care and, ultimately, have the person as the center of their care. Cancer is becoming a chronic disease that generates uncertainty and a continuous decision in care. There are studies that reveal the health benefits of a DBT from a relationship of trust between the patient and the nurse. Objectives: To know the nursing interventions for a DBT in the field of oncology and to design a plan for the implementation of a nursing intervention for a DBT in an oncology unit. Methodology: narrative review of the literature. We reviewed the Pubmed and CINAHL databases. Results: We included five articles for outcome analysis: one systematic review and four RCTs. The quality of these was assessed with the Spanish Critical Appraisal Skills Programme (CASPe) instrument. We found several interventions to help BDD aimed at professionals and patients, all of which had in common the training of professionals, taking into account the values and preferences of the patient. Conclusions: Interventions to help with DBT improve the attitude of nursing professionals and increase patient satisfaction in care by preserving their autonomy, increasing their participation and improving the relationship with the professional, thus improving person-centered care.

Nursing Doctoral Theses Across Eight Countries: A Document‐Based Qualitative Study

ABSTRACT

Background

Doctoral research in nursing is central to advancing scientific knowledge, strengthening professional identity, and informing evidence-based practice, education, and health policy. Analyzing the thematic content of doctoral theses offers insight into research priorities and national variations in nursing scholarship. Yet, no systematic cross-country analysis has examined the thematic focus of such work.

Objective

To explore and describe the diversity and scope of doctoral nursing research themes across eight countries in the Sigma Europe Region, identifying key areas of scholarly focus and shared priorities.

Design

A document-based qualitative study using reflexive thematic analysis, as outlined by Braun and Clarke, to examine patterns of meaning within thesis summaries.

Participants and Setting

The study included doctoral nursing thesis summaries defended between January 2020 and December 2023, sourced from national and institutional repositories in eight countries of the Sigma Europe Region. A total of 15 repositories (4 national, 11 institutional) were systematically searched, and additional summaries were obtained via direct contact with universities offering doctoral nursing programmes.

Methods

Data were collected between September 2024 and February 2025 using predefined inclusion and exclusion criteria. In total, 431 eligible thesis summaries were analyzed following Braun and Clarke's six-phase framework, supported by MAXQDA software for data management and coding.

Results

Thematic analysis identified three overarching domains: (1) foundations of nursing practice and care philosophy, (2) systemic and organizational dimensions of nursing, and (3) clinical innovation and public health impact. Ten interrelated themes emerged, including holistic and patient-centred care; emotional, psychological, and quality-of-life dimensions; communication in healthcare; workforce challenges; transforming nursing practice; maternal, neonatal and pediatric health; digital and virtual health innovations; public health and chronic disease management; and disease management, caregiving, and outcomes. Cross-cutting elements such as cultural sensitivity and resilience spanned multiple themes.

Conclusion

This cross-national synthesis demonstrates the breadth and depth of doctoral nursing research in the Sigma Europe Region. Findings highlight nursing's pivotal role in addressing healthcare needs through innovative, person-centred, and evidence-informed solutions, and underscore the value of international collaboration in shaping resilient, equitable, and future-ready healthcare systems.

Moving Beyond the Scale: Guidance for Food Equity‐Oriented Nurse Engagement in Education, Research and Community Care

ABSTRACT

Aim

To provide guidance on food equity-oriented nurse engagement in education, research, and practice and to develop a glossary of food equity terms to serve as a resource to nurse educators and to fuel nurse engagement in food equity work.

Design

A discussion paper outlining guidance for nurse engagement in food equity efforts.

Conclusions

We provide guidance for nurse engagement in three areas: Education, Research and Community Care. Additionally, through literature review, we created a glossary of food-related terms that can be used in nurse advocacy for food equity. Although not an exhaustive list, we compiled and provided definitions of equity-oriented food-related concepts across three categories: food environment, consumer/community-based and social safety net/anti-hunger terms.

Implications for the Profession

Nurses can be instrumental in advancing food equity, thereby helping to prevent chronic diseases related to poor nutrition, yet nutrition and food equity content are not typically integrated into nursing education.

Patient or Public Contribution

No patient or public contribution.

Temporal Assessment of Pressure and Stiffness in Compression Therapy for Venous Leg Ulcers: Implications for Clinical Optimization

ABSTRACT

To measure and compare the temporal variations in sub-bandage pressure compression systems in the Andalusian Health System (SAS). Additional objectives included assessing the relationship between pressure and healing, analysing the influence of the healthcare professional applying the bandage, and determining bandage stiffness. This prospective observational and multicentre study included 140 patients with active VLUs in Andalusia. Sub-bandage pressures were measured at three anatomical points in the leg for 96 h, under different positions and activities. The bandage application technique was standardised through specific training provided to advanced practice nurses. The initial pressures were higher than those recommended by guidelines, but showed a notable reduction within the first 24 h, stabilising within therapeutic ranges for the remainder of the 96-h study period. Most systems showed low dynamic and static stiffness. No significant pressure differences were found attributable to the nurses or the location of the injury. The observed pressure dynamics, initially high, with a subsequent drop and final stabilisation, suggest a high material settlement or application to compensate for the expected loss. The sustained pressure stability confirms the effectiveness of the systems over 96 h.

ReFIT study (reversing frailty in transplantation): protocol for a longitudinal study to assess clinical and biomedical changes in frailty through kidney transplantation

Por: Payne · T. · Shaw · A. · Hanjani · L. S. · Homes · R. · Giddens · F. · Ravuri · H. G. · Yap · C. X. · Walsh · J. · Kumar · V. · Garton · F. C. · Rhee · H. · Huang · A. · Francis · R. S. · Reid · N. · McAdams-DeMarco · M. · Gordon · E. · Midwinter · M. · Hubbard · R.
Introduction

Losses of functional reserve across multiple physiological systems have been identified in frail patients, yet the exact aetiology of frailty remains unclear. Although strongly associated with chronological age, frailty often develops at a younger age in patients with organ failure. Frailty is prevalent in patients with kidney failure; however, individuals experience improvements in physical frailty measures following kidney transplantation. This makes younger patients with kidney failure a unique population for studying both the accelerated onset of frailty and its reversal. This research project aims to test the hypothesis that frailty secondary to organ failure and age-related frailty are associated with similar molecular and physiological measures.

Methods and analysis

This longitudinal study will recruit 150 patients in three groups. Group A (kidney transplant recipients aged ≥40 years; n=50) and Group B (patients aged ≥40 years active on the kidney transplant waitlist; n=50) will comprise younger adults with frailty from organ failure. Group C (adults aged ≥65 years (or ≥55 years for Aboriginal and Torres Strait Islander patients); n=50) will comprise older community dwellers. The primary outcome is the Frailty Index (FI). Secondary outcomes include the change in FI over time, and at baseline when considering various clinical metadata, immune parameters, kidney function and nutrition intake which will be measured at baseline and 12-month time points. Longitudinal changes in frailty will be analysed using linear mixed models with multiple testing corrections for false discovery rates.

Endocrine profiles and metabolomics, measures of immune function and microcirculatory dysfunction, will be measured by liquid chromatography-mass spectrometry and/or gas chromatography-mass spectrometry. The gut microbiome will be sequenced via shotgun metagenomics (Illumina NextSeq500, 150 bp paired-end, 3Gbp/sample). Circulating cell-free DNA/mitochondrial DNA will be quantified through droplet digital PCR. Microcirculation will be assessed via sublingual dark field videomicroscopy with glycocalyx markers measured by ELISA.

Ethics and dissemination

This study will be conducted with all stipulations of this protocol, and the conditions of the ethics committee approval. Ethical principles have their origin in the Declaration of Helsinki, all Australian and local regulations and in the spirit of the standard of Good Clinical Practice (as defined by the International Conference on Harmonisation). Organs/tissues will be sourced ethically and will not be sourced from executed prisoners or prisoners of conscience or other vulnerable groups.

Ethics approval was received by the Metro South Health Research Ethics Committee (HREC/2023/QMS/95392) and ratified by the University of Queensland.

Results will be disseminated through peer-reviewed publications, academic conferences, participant newsletters and health organisation collaboration.

Feasibility of a phase 3 partially randomised clinical trial to assess the safety and efficacy of paediatric praziquantel for schistosomiasis treatment in children aged 3 months to 6 years in endemic regions of Brazil: a pilot study

Objective

This study assessed the feasibility of implementing a phase 3 field-based clinical trial protocol to evaluate paediatric praziquantel (PED-PZQ) for the treatment of Schistosoma mansoni infection in children aged 3 months to 6 years in endemic areas of Brazil, focusing on operational aspects such as recruitment logistics, documentation management, investigational product handling and protocol adherence.

Design

Pilot and feasibility study for a phase 3 clinical trial, comprising two components: a randomised, open-label, parallel-group, two-arm trial and a single-arm trial.

Setting

Conde, Bahia, Brazil, from December 2024 to January 2025.

Participants

Two trials aim to screen 5774 participants from three rural areas in Bahia and three in Sergipe, states in northeastern Brazil, and enrol 403 children eligible for either randomisation or allocation. Trial 1 will randomise (1:1 ratio) 240 children aged 4–6 years into the PED-PZQ treatment arm or the standard praziquantel (PZQ) 1. Trial 2 will enrol 163 children aged 3 months to 3 years, all receiving PED-PZQ. Both trials are open label. Eligible participants shall meet age criteria, test positive for S. mansoni and fulfil other inclusion criteria. In the first recruiting centre, Conde (Bahia), it was estimated that 650 participants would need to be screened for trial 1 and 552 for trial 2, assuming schistosomiasis prevalence of 5% and 4%, respectively. This pilot study reports on the first 60 participants enrolled.

Primary and secondary outcome measures

The primary outcome of this pilot study is the feasibility of implementing the research protocol in a real-world field setting, focusing on key aspects such as study documentation challenges, participant safety, investigational medicinal product custody chain and protocol adherence. In addition to providing preliminary data on the parasitological cure rate, secondary outcomes include the prevalence of S. mansoni infection and the reduction in S. mansoni egg count (Kato-Katz method). Furthermore, the occurrence and severity of drug-related adverse events are monitored from drug administration to day 21 post-treatment, alongside changes in renal, hepatic and cardiac functions assessed through biochemical markers.

Results

A total of 60 participants were recruited, and 55 provided stool samples for screening. The pilot phase demonstrated the feasibility of implementing the clinical protocol under field conditions, with successful completion of all planned procedures and minimal protocol deviations. Operational challenges were identified mainly in documentation processes, participant recruitment and investigational product management and were addressed through preventive and corrective quality assurance actions. The experience also highlighted logistical and infrastructural barriers typical of field-based trials in remote endemic areas, which informed adjustments for the subsequent phase 3 study. Preliminary parasitological results indicated an overall S. mansoni prevalence of 9.1% (5/55), with 21% in trial 1 and 2.8% in trial 2. All infected participants met the eligibility criteria, received treatment and completed follow-up. Four achieved a parasitological cure, and one case of treatment failure was observed (trial 1, PZQ group). Two mild adverse events (diarrhoea) were reported, with no serious complications or clinically significant changes in biochemical parameters.

Conclusions

This pilot study demonstrated the feasibility of implementing a field-based phase 3 clinical trial protocol for PED-PZQ in endemic areas of Brazil. The findings confirm that the protocol can be successfully applied in primary care settings, despite operational challenges related to recruitment, logistics and documentation. The study also provided preliminary evidence supporting the safety and effectiveness of the paediatric formulation and highlighted the need to revise prevalence assumptions to improve future screening strategies. Overall, the experience offers valuable insights to guide the large-scale phase 3 trial and supports the incorporation of PED-PZQ into national schistosomiasis control policies.

Trial registration number

Brazilian Clinical Trials Registry; RBR-86kcy37.

Stress and Health‐Related Quality of Life in Adults With Type 1 Diabetes: The Mediating Role of Perceived Support and Treatment Adherence

ABSTRACT

Aims

To examine the associations among diabetes-related stress, treatment adherence, perceived social support, and health-related quality of life (HRQoL) in adults with type 1 diabetes mellitus (DM1), and to explore the mediating roles of support and adherence in this relationship.

Design

A cross-sectional observational study using self-report standardised measures and mediation analysis.

Methods

A total of 772 Spanish adults with DM1 completed validated instruments measuring diabetes-related distress, perceived social support, treatment adherence, and HRQoL. Hierarchical multiple regression and serial mediation analysis (PROCESS Model 6, 10,000 bootstraps) were conducted, controlling for age, sex, and time since diagnosis.

Data Sources

Not applicable (primary data collection, not a review).

Results

Diabetes-related stress was the strongest predictor of lower HRQoL. Perceived social support and treatment adherence also contributed significantly. Mediation analyses indicated that the impact of stress on HRQoL was partially mediated by perceived social support and, in sequence, by treatment adherence. The indirect path through social support alone and the sequential path involving both mediators were significant.

Conclusion

Stress and social support are critical in understanding and improving HRQoL in adults with DM1. Treatment adherence appears to be influenced by perceived support, highlighting an indirect mechanism linking stress to quality of life.

Implications for the Profession and/or Patient Care

Healthcare professionals should integrate psychosocial assessments and interventions into routine diabetes care. Targeting stress reduction and enhancing social support may improve adherence and overall well-being in adults with DM1.

Impact

What problem did the study address? The study addressed the need to understand how psychosocial factors—specifically stress, perceived social support, and treatment adherence—contribute to HRQoL in adults with DM1. While prior research often focused on paediatric or clinical populations and rarely explored mediation models, this study sought to fill those gaps with data from a large community sample of adults.

What were the main findings? The main findings indicate that diabetes-related stress is the most significant predictor of reduced HRQoL. This relationship is partially mediated by perceived social support and, sequentially, by treatment adherence. While stress directly affects HRQoL, its negative impact is also channelled through diminished social support and decreased adherence. The indirect effect through treatment adherence alone was not significant.

Where and on whom will the research have an impact? The research has implications for adults living with DM1, particularly those in community settings outside of clinical supervision. It informs healthcare providers, diabetes educators, and policymakers on the importance of addressing emotional distress and strengthening support networks to improve both treatment adherence and overall quality of life.

Reporting Method

This study adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies. All methods and results are reported in alignment with EQUATOR Network recommendations for transparent and rigorous research reporting.

Patient or Public Contribution

The study was conducted in collaboration with the Spanish Diabetes Federation (FEDE), which supported participant recruitment and dissemination through its affiliated associations. Patient input was incorporated throughout the study. A person with lived experience of type 1 diabetes contributed to the conceptual development of the research questions and the interpretation of findings. Their perspective helped ensure that the study design, choice of measures, and implications were relevant and meaningful to people living with the condition. This involvement supported a patient-centred approach to both the research and the manuscript preparation. Patients' participation as voluntary contributors was essential to the data collection process.

Intervenciones de telemedicina para actuar en sedentarismo de pacientes trastorno mental grave: revisión de alcance

Objetivo. Resumir la literatura científica disponible sobre el uso de las intervenciones de telemedicina para actuar sobre el sedentarismo de los pacientes con Trastorno Mental Grave. Metodología. Revisión exploratoria o de alcance. Metodología: se realizaron y analizaron búsquedas en las bases de datos PubMed, CINAHL, Cuiden, Lilacs, Cochrane, APA PsycINFO. Se incluyeron finalmente 19 artículos. Resultados. 15 tenían metodología cuantitativa, 3 cualitativa y 1 enfoque mixto. Las patologías principales estudiadas fueron esquizofrenia, trastorno bipolar y trastorno depresivo mayor. Todos demostraron aplicaciones, utilidad e influencia de la telemedicina para tratar el sedentarismo y así aumentar la salud en la parte física, mental o social. Algunos estudios describieron problemas y dificultades señaladas por los pacientes, familiares y profesionales a nivel práctico. Una minoría de estudios analizaron la satisfacción de los usuarios con este tipo de intervenciones digitales, que se puede catalogar como media-alta. Discusión. Las intervenciones de telemedicina son usadas en la actualidad por los profesionales para medir mejor el nivel de sedentarismo. También como herramienta para mejorar la adherencia, realizar seguimiento del proceso de enfermedad y humanizar la asistencia sanitaria. Hay pocos estudios de investigación en esta materia. Se necesitan enfoques cuantitativos y cualitativos para aumentar el éxito de las intervenciones.

ABSTRACT

Objective. Summarize the available scientific literature on the use of telemedicine interventions to act on the sedentary lifestyle of patients with Severe Mental Illness. Methodology. Exploratory or scoping review. Methodology: searches were performed and analyzed in the PubMed, CINAHL, Cuiden, Lilacs, Cochrane, APA PsycINFO databases. Finally, 19 articles were included. Results. 15 had quantitative methodology, 3 qualitative and 1 mixed approach. The main pathologies studied were schizophrenia, bipolar disorder and major depressive disorder. All demonstrated applications, usefulness and influence of telemedicine to treat sedentary lifestyle and thus increase health in the physical, mental or social part. Some studies described problems and difficulties reported by patients, family members and professionals at a practical level. A minority of studies analyzed user satisfaction with this type of digital intervention, which can be classified as medium-high. Discussion. Telemedicine interventions are currently used by professionals to better measure the level of sedentary lifestyle. Also, as a tool to improve adherence, monitor the disease process and humanize healthcare. There are few research studies on this matter. Quantitative and qualitative approaches are needed to increase the success of interventions.

Tissue-specific mitochondrial pathway remodeling linked to longevity in honeybee queens

by Clément Joël Lucien Chevret, José Francisco Echegaray, Alexander Walton, Maryam Lo, Olav Rueppell, Hélène Lemieux

Mitochondrial metabolism plays a critical role in determining lifespan across animal taxa. In our study, we used the Western honeybee (Apis mellifera) as a model, capitalizing on the stark lifespan difference between queens, which often live more than two years, and summer workers, which survive only about 30 days, despite sharing the same genetic background. We investigated mitochondrial function in head tissue, thoracic muscle, and abdominal fat tissue of queens and workers, comparing early (7 days) and late adult stages (28–30 days in workers; 2 years in queens). No significant differences in mitochondrial flux control ratio for the NADH- Succinate- and glycerophosphate (Gp) pathways were found in thoracic muscles across castes or age groups. In head and abdominal fat tissues, early-life queens showed reduced reliance on NADH-linked pathways for maximal respiratory flux compared to workers. The decrease in the NADH-pathway was compensated by an increase in the Gp-pathway contribution. Queens exhibited reduced phosphorylation-pathway control over OXPHOS compared to workers, both in head tissue during early life and in abdominal fat tissue later in life. These findings reveal caste- and tissue-specific patterns of mitochondrial regulation that may contribute to dramatic lifespan divergence observed in eusocial insects. They suggest that early-life metabolic flexibility could play an important role in shaping life history evolution in Apis mellifera.

Recent Trends in Doctoral Theses in Nursing Across Eight Countries: A Scoping Review

ABSTRACT

Aim

To explore and map the landscape of doctoral nursing research across eight countries.

Design

A scoping review.

Methods

This review followed the Joanna Briggs Institute methodology for scoping reviews and included doctoral theses in nursing defended between 2020 and 2023 in Austria, Italy, Israel, the Netherlands, Poland, Portugal, Slovakia and the United Kingdom.

Data Sources

Searches were conducted across 15 national and university repositories (4 national, 11 university) in the eight participating countries.

Results

This review included 431 doctoral nursing theses, the majority of which employed quantitative methodologies and focused on patient populations and healthcare professionals. Key topics included clinical nursing care, quality of care, quality of life, home care, perinatal care and the work environments.

Conclusion

Nursing doctoral research shows progress in healthcare delivery, patient care and education via digital tools, holistic approaches and professional development. Yet gaps persist in mental health, paediatrics and marginalised groups. Limited qualitative/mixed-methods research and weak interdisciplinary collaboration reveal further opportunities.

Implications for the Profession and/or Patient Care

This review underscores that nursing doctoral research is addressing major healthcare and professional challenges. Nonetheless, the identified gaps emphasise the need for more comprehensive and inclusive research to enhance equity and guide future nursing practices and policies.

Impact

This review provides an overview of the scope of doctoral nursing research across eight countries, identifying key trends and research gaps. The findings are expected to inform nursing academia, policymakers, and healthcare professionals by guiding future research priorities, fostering interdisciplinary collaboration, and promoting equitable, patient-centred care practices.

Patient or Public Contribution

No direct involvement in data collection; one lay reviewer gave feedback on readability and practice implications, informing minor refinements.

El extinguido hospital de San Hermenegildo de Sevilla: Enfermería, iconografía y musicoterapia

RESUMEN

Se pretende describir la Enfermería del Hospital de San Hermenegildo (1455-1837), aplicar una visión enfermera actual, a la obra iconográfica de El Tránsito de San Hermenegildo y relacionar Enfermería, iconografía y musicoterapia atendiendo a la obra pictórica del extinguido Hospital de San Hermenegildo. Para realizar este trabajo se ha utilizado el método histórico descriptivo, la recogida de información se ha realizado a través de fuentes primarias y secundarias. Como resultados, resaltar la Enfermería en el Hospital de San Hermenegildo, pieza clave en la atención sanitaria, indicando sus funciones e intervenciones, así como la descripción del cuadro de “El Tránsito de San Hermenegildo”, situado en el extinguido Hospital de San Hermenegildo de Sevilla, así como aplicar una Mirada Enfermera a esta obra pictórica, resumiendo un Plan de Cuidados utilizando la nomenclatura NANDA-NIC-NOC. relacionando dicha iconografía con la Terapia Musical.

La Fundación del Hospital de San Hermenegildo en 1455, conocido popularmente como hospital del Cardenal, supuso un cambio, un avance en la Medicina, en la Enfermería, en los Cuidados, en las formas de curar, siguiendo una metodología diferente e innovadora.

Dar a conocer el extinguido hospital de San Hermenegildo, describir la Enfermería del Hospital de San Hermenegildo (1455-1837), aplicar una visión enfermera actual, a la obra iconográfica de El Tránsito de San Hermenegildo, así como relacionar Enfermería, iconografía y musicoterapia/terapia musical atendiendo a la obra pictórica del extinguido Hospital de San Hermenegildo de Sevilla.

Palabras clave: Enfermería; hospital de San Hermenegildo; Sevilla; iconografía; plan de cuidados de enfermería; musicoterapia; terapia musical; historia de la enfermería.

Experiencias de enfermería en el uso de herramientas informáticas de Planes de Cuidados

Introducción. Los planes de cuidados en enfermería (PCE) son instrumentos para documentar e informar las actividades de enfermería. Actualmente existen varias herramientas digitales totalmente de PCE (softwares y/o aplicaciones móviles).

Objetivo: Comprender los significados de las experiencias vividas por los profesionales de enfermería que laboran en servicios de hospitalización de unidades de segundo y tercer nivel de atención de Sevilla y Alicante (España) con el uso de herramientas informáticas de PCE.

Metodología: Se realizó un estudio fenomenológico en unidades de segundo y tercer nivel de atención en salud de Sevilla y Alicante (España). Mediante muestreo intencional se incluyeron 9 profesionales de enfermería de servicios de hospitalización. Los datos se obtuvieron en septiembre y octubre de 2023 mediante una entrevista semiestructurada y fueron analizados mediante un enfoque fenomenológico interpretativo.

Resultados: Se comprendieron las siguientes categorías descritas por los profesionales de enfermería: experiencias positivas tales como generación de Planes de Cuidados Estandarizados de Enfermería, experiencias negativas como ambigüedad de las herramientas informáticas e inadecuada accesibilidad a las herramientas y la propuesta ideal para desarrollar un software de Planes de Cuidados Individualizado de Enfermería (PCIE).

Conclusiones: Se lograron comprender los significados de las experiencias vividas de los profesionales de enfermería acerca del uso de las herramientas informáticas de PCE, las cuales posteriormente sirvieron para generar un software de PCIE que permita responder a las necesidades actuales en salud de individualizar el cuidado de enfermería.

Comfort Needs of Renal Transplant Recipients: A Qualitative Analysis Guided by Kolcaba's Theory of Comfort

ABSTRACT

Aim

To analyse the comfort needs of patients following renal transplantation, guided by Kolcaba's Theory of Comfort.

Design

A qualitative design was employed.

Methods

This study was conducted at a Brazilian university hospital's renal transplant outpatient clinic. Forty-six post-transplant patients were purposively sampled by age, transplant time and clinic attendance. Face-to-face interviews were audio-recorded, transcribed and conducted using a semi-structured script. Data were analysed through thematic content analysis, guided by Kolcaba's Comfort Theory and relevant literature.

Results

Participant narratives were categorised according to the contexts outlined by Kolcaba's Theory of Comfort: Physical, Environmental, Sociocultural and Psychospiritual. In the physical context, pain was identified as a major factor diminishing comfort after renal transplantation. In the environmental context, elements such as light, odour, sound, temperature and uncomfortable furnishings contributed to discomfort. In the sociocultural context, family support was highlighted as essential. In the psychospiritual context, religiosity played a key role in enhancing the comfort of transplant recipients.

Conclusion

Spirituality, strengthened social support networks and non-pharmacological comfort measures are essential for promoting comfort among patients following renal transplantation. These findings underscore the importance of integrated care approaches that address physical, emotional and social aspects to improve quality of life for this population.

Implications for the Profession and/or Patient Care

Conceptual models in nursing provide a critical perspective for care and support the delivery of effective, evidence-based interventions. By identifying the multidimensional comfort needs of post-renal transplant patients, this study informs the development of targeted, holistic strategies for nursing and multidisciplinary practice in outpatient settings.

Impact

This study examined the multidimensional comfort needs of post-renal transplant patients and found that comfort is shaped by physical, environmental, sociocultural and psychospiritual factors. The results may guide global nursing and multidisciplinary outpatient care by informing integrated approaches that enhance the quality of life of transplant recipients.

Reporting Method

This study was reported according to the COREQ framework.

Patient or Public Contribution

No patient or public contribution.

The MenoStim Trial: Study Protocol for a Randomised, Sham-Controlled, Double-Blinded, Pilot Clinical Trial Exploring the Neurophysiological, Cognitive, Mood and Biochemical Effects Associated with Non-Invasive Brain Stimulation During the Menopause Transi

Por: Metri · N.-J. · Cavaleri · R. · Alhassani · G. · Ee · C. · Lim · C. K. · Francis · H. M. · Hochstrasser · D. · Bou Merhy · R. M. · Steiner-Lim · G. Z.
Introduction

Intermittent theta-burst stimulation (iTBS) is a non-invasive brain stimulation technique that has been shown to improve cognition and mood when applied to certain brain structures and regions. Despite research demonstrating that iTBS may have clinical utility in treating cognitive and mood changes, no study has yet been conducted to explore the potential to modulate the neurophysiological changes that can underpin cognitive and mood changes during the menopause transition. Cognitive and psychological symptoms are commonly reported by females experiencing the menopause transition, and it is thought that these symptoms arise due to various neurophysiological, metabolic and endocrinological changes. Despite being common, there is a lack of treatments available for managing these symptoms and a scarcity of data regarding the mechanisms by which they occur.

Methods and analysis

The aim of this 5-week randomised, sham-controlled, double-blinded pilot clinical trial (n=72) is to assess the underlying mechanisms of action of iTBS in females in the late menopause transition and the relationship with cognition and mood. Data will be analysed using StataTM. Normality checks will guide the choice between parametric and non-parametric tests. Generalised linear models will assess within-subject and between-subject effects across timepoints, with additional regression analyses exploring associations between biomarkers, cognition and mood. Effect sizes, CIs and relevant test statistics will be reported, with significance set at p

Ethics and dissemination

The study protocol has been reviewed and ethically approved by the Western Sydney University Human Research Ethics Committee (H16200; 8 November 2024). All participants will provide written informed consent prior to enrolment. Results from this trial will be disseminated via peer-reviewed publications and conference presentations, with findings shared in accordance with open science and data transparency principles.

ANZCTR registration number

ACTRN12625000030471, Australian New Zealand Clinical Trials Registry

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