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Commentary on: Yıldız E, Yıldırım Ö. The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia. J Psychiatr Ment Health Nurs. 2024. (in press) doi: 10.1111/jpm.13040.
Implications for practice and research Mental health nurses’ training could be more focused on clinical skills and knowledge in enhancing psychological flexibility to minimize the impact of psychotic symptoms on comorbid depression in people with schizophrenia. Further development of the intervention of building psychological flexibility is of research interest for the clinical management of people with schizophrenia.
Schizophrenia is a mental disorder affecting approximately 23.9 million people worldwide, significantly contributing to the global disease burden, revealing 14.8 (10.9–19.1) million years lived with disability in 2021.
Commentary on: Considine J, Casey P, Omonaiye O, et al. (2024). Importance of specific vital signs in nurses' recognition and response to deteriorating patients: A scoping review. Journal of Clinical Nursing, 00, 1–18.
Implications for practice and research There is a need to develop training and protocols that will enhance nurse’s documentation and utilisation of vital signs in clinical decision-making and patient care. To further guide the creation of training curricula and standards, future studies should examine how nurses prioritise and make decisions about vital sign assessments and their use in patient care.
Vital signs are essential markers of a patient’s physiological state, and these include heart rate, temperature, blood pressure, oxygen saturation, respiration rate and level of consciousness. Consequently, accurate assessment, documentation and interpretation of these markers are vital for early detection of patients’ deterioration and timely intervention.
This is a perspective on Ridgway et al ‘Creative health a joke or valuable learning experience’. Creative health encompasses creative and arts activities that benefit health and well-being. The article evaluates a creative health placement designed to facilitate students’ learning about creative health and social prescribing, with opportunities to take part in arts activities.
Take home messages Creative health placements equip future nurses with knowledge about social prescribing initiatives to offer holistic person-centred care. The article provides valuable insights into placements that future-proof registrants’ knowledge and skills with the shift towards prevention and a neighbourhood health service. Building creative health placements into the curriculum in other institutions will improve access to this valuable learning opportunity.
A pilot creative health placement for undergraduate student nurses at a UK...
Commentary on: Zhao et al. The impact of education/training on nurses caring for patients with stroke: a scoping review. BMC Nurs 23:90
Implications for practice and research Nurses working in clinical stroke care could benefit from leadership and management strategies that encourage empowerment and time and space to reflect on current evidence, training and practice. Comprehensive evaluation strategies are needed to assess the impact and effectiveness of empowerment-based stroke education and training on patient outcomes.
Stroke nursing is widely recognised for its significant role across the whole multidisciplinary stroke care pathway.
Commentary on:Michelson KA, Rees CA, Florin TA, et al. Emergency department volume and delayed diagnosis of serious pediatric conditions. JAMA Pediatr. 2024;178:362–8. doi:10.1001/jamapediatrics.2023.6672
Implications for practice and research Low-paediatric-volume emergency departments (EDs) can increase paediatric readiness by improving diagnostic tools, expanding paediatric expertise (eg teleconsultation) and using electronic clinical decision support. Further research is needed to examine the costs and effectiveness of specific interventions to improve readiness in low-volume paediatric EDs.
Children sometimes have subtle illness presentations and symptom overlap with non-serious conditions.
Commentary on: Velthuijs ELM, Jacod BC, Videler-Sinke L, et al. Outcome of induction of labour at 41 weeks with Foley catheter in midwifery-led care. Midwifery 2024 Aug;135:104026. doi: 10.1016/j.midw.2024.104026. Epub 9 May 2024. PMID: 38781793.
Implications for practice and research Performing induction of labour with a Foley catheter and subsequent amniotomy in midwife-led care is associated with worse neonatal outcomes and equivalent maternal outcomes compared with consultant-led care. Future research should further explore the cost-effectiveness, feasibility and neonatal outcomes associated with midwife-led care in different patient populations.
Although care for low-risk births in the Netherlands is primarily conducted by midwives, the use of consultant-led care has been increasing for a variety of indications, leading to a high patient burden for consultants. The induction of labour (IOL) of late-term pregnancies has historically been an indication for consultant-led care. This study by Velthuijs et...
Commentary on: Doyle J, Alsan M, Skelley N, et al. Effect of an intensive food-as-medicine programme on health and healthcare use: a randomized clinical trial. JAMA Intern Med. 2024;184(2):154–163. doi:10.1001/jamainternmed.2023.667
Implications for practice and research Food-as-medicine programmes could enhance patient engagement with preventive healthcare. Further adjustments are needed within these programmes to improve glycaemic control significantly. Food-as-medicine programmes interest nurses, as these programmes are sensitive to nursing interventions.
Type 2 diabetes mellitus (T2DM) is a significant public health issue, with diet playing a crucial role in its management.
Commentary on: Kearns, RJ, Kyzayeva, A, Halliday, LO, et al. Epidural analgesia during labour and severe maternal morbidity: population based study. BMJ 2024;385.
Implications for practice and research Health research, policy and information should emphasise the advantages of intrapartum epidurals beyond pain relief, especially for women with pre-existing conditions and preterm labour. Health services must provide access to a 24-hour epidural service within their maternity care.
The use of intrapartum epidurals to manage pain during labour and birth has been globally accepted for decades.
Commentary on: Hunt K, Davies A, Fraser A, Burden C, Howell A, Buckley K, Harding S, Bakhbakhi D. Exposure to microplastics and human reproductive outcomes: A systematic review. BJOG. 2024 Apr;131(5):675-683. doi: 10.1111/1471-0528.17756. Epub 2024 Jan 29. PMID: 38287142.
Implications for practice and research Plastic exposure may be associated with increased deposition of microplastics in reproductive tissues, and the quantity of microplastics in these tissues may lead to adverse clinical outcomes. Future research should aim to provide high-quality, generalisable evidence to further demonstrate the impact of plastic exposure and microplastics on reproductive outcomes in humans.
As a result of the mass scale of production of plastics since the 1950s, microplastics, defined as particles 1 Microplastics have been linked to reproductive toxicity in both cell culture...
Interpretative phenomenological analysis (IPA) is a widely recognised and well-established method of qualitative inquiry designed to explore personal experience in detail, focusing on participants’ understandings and sense-making.
IPA was developed in the mid-1990s by Jonathan Smith and emerged out of health psychology, and since the early 2000s has increasingly been adopted by nursing and health researchers more generally. At the time of writing, a Google Scholar search of the terms ‘interpretative phenomenological analysis’ and ‘nursing’ yielded more than 35 000 results. IPA is primarily interested in undertaking...
Commentary on: MacGregor KA, Ho FK, Celis-Morales CA, et al. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med. 2023;21:488.
Implications for practice and research Fat mass, physical activity level and cardiorespiratory fitness were identified as factors that influence the relationship between the menstrual cycle and levels of glucose, triglycerides, the triglyceride-to-glucose index, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol and the total-to-HDL cholesterol ratio. Future studies should investigate whether these relationships indicate a causal mechanism responsible for the variations in metabolic control throughout the menstrual cycle.
The rate of impaired metabolic regulation is rising among premenopausal women, characterised by decreased insulin sensitivity, increased fasting blood sugar levels and abnormal lipid profiles.
Commentary on: Timmins KA, Hales TG, Macfarlane GJ, et al. Childhood maltreatment and chronic ‘all over’ body pain in adulthood: a counterfactual analysis using UK Biobank. Pain. Published Online First: 15 November 2024. doi: 10.1097/j.pain.0000000000003457
Implications for practice and research Healthcare providers should routinely screen for childhood maltreatment in patients with chronic pain and integrate targeted mental health interventions. Future research should prioritise longitudinal studies to establish clearer interactions between childhood maltreatment, mental health, adult stressors and chronic pain development.
Adverse childhood experiences (ACEs), including maltreatment (abuse, neglect) and household challenges, have been identified as risk factors for various health conditions in adulthood.
Commentary on: Veresova M, Michail M, Richards H, et al. Emergency department staff experiences of working with people who self-harm: A qualitative examination of barriers to optimal care. Int J Mental Health Nurs. 2024. doi: 10.1111/inm.13353
Implications for practice and research Support from specialist mental health clinicians is a key mechanism for improving self-harm care among emergency department (ED) staff. Findings underpin the need for compassion and empathy when treating people presenting in distress, especially those who present multiple times. Future research should focus on strategies for improving implementation of self-harm clinical guidelines in EDs.
Emergency departments (EDs) have a crucial role in suicide prevention. Around 18% of people who died by suicide presented to ED in the month prior to death, commonly for self-harm.
Commentary on: Lykkeberg B, Noergaard MW, Bjerrum M. Experiences and expectations of parents when young people with congenital heart disease transfer from pediatric to adult care: A qualitative systematic review. J Child Health Care. doi:10.1177/13674935241231024
Implications for practice and research To inform family-centred transition programmes, more high-quality qualitative research describing parental experiences should be conducted, particularly in non-European and low- and middle-income countries. Congenital heart disease transition programmes should consider adopting a family-centred approach that incorporates informational and psychosocial support resources for parents.
A growing number of individuals born with congenital heart disease (CHD) are surviving well into adulthood, and a successful transition from paediatric to adult healthcare is essential for their long-term health. However, discontinuity in care is prevalent.
Commentary on: Alanazi N, Gu F, Li CS, et al.Lorenz RA, Hong CC. Sleep Quality and Associated Factors Among Survivors of Breast Cancer: From Diagnosis to One Year Postdiagnosis. Oncol Nurs Forum. 2024 Feb 19;51(2):163-–174. doi: 10.1188/24.ONF.163-–174. PMID: 38442284.
Implications for practice and research Sleeping disorders are common in breast cancer patients and increase in the first year after diagnosis. Nurses should be aware of the high frequency of these disturbances, which persist after the conclusion of most therapies. The determinants of worsening sleeping quality in breast cancer survivors need to be understood, including the role of treatments, the type of surgery and psycho-social or contextual factors.
Breast cancer is the most common cancer in women worldwide. While research in recent decades has focused on minimising treatment, the disease still impacts women’s lives in many ways. Because increased sleep disturbances affect approximately...
Commentary on: Szymczak JE, Hayes AA, Labellarte P, et al. Parent and clinician views on not using antibiotics for mild community-acquired pneumonia. Pediatrics. 2024 Jan 1;153(2):e2023063782.
Implications for practice and research Awareness of the possibility to abstain from antibiotic treatment in mild community-acquired pneumonia in young children has to increase. Not only is research needed on improvement of diagnostics and safety of the ‘no antibiotic’ strategy, but also on how to address social, emotional and logistical barriers.
Mild community-acquired pneumonia (CAP) in children under 5 years is often viral in origin. Because of this, routine antibiotic treatment of mild CAP is discouraged in the 2011 Pediatric Infectious Diseases Society (PIDS)/Infectious Diseases Society of America (IDSA) guideline.
Commentary to: Woodward A, Nimmons D, Davies N, et al. A qualitative exploration of the barriers and facilitators to self-managing multiple long-term conditions amongst people experiencing socioeconomic deprivation. Health Expect 2024;27(2):e14046. doi: 10.1111/hex.14046.
Implications for practice and research Addressing socioeconomic barriers is crucial to develop patient-centred care models to help self-managing multiple long-term conditions (MLTCs). Managing MLTCs is not solely an individual responsibility, and community-based interventions should aim to strengthen social support networks and reduce social isolation. The extent of the beneficial effects of social support networks on health outcomes and MLTCs self-management should also be addressed in research.
Worldwide, one in three adults lives with multiple long-term conditions (MLTCs) and requires ongoing management and self-management. Socioeconomic deprivation exacerbates health inequalities due to limited resources and opportunities. In England, people living in deprived areas tend to develop MLTCs earlier and have a...
Self-treatment of benign symptoms using hot water bottles, steam inhalation or hot tea is common in households and poses risks of severe scald injuries. This study aims to investigate associated hazards and identify high-risk patient groups to facilitate targeted prevention. A retrospective, single-center descriptive study was conducted on adult burn patients with scald injuries from hot water bottles, steam inhalation or hot tea. Demographic information, injury mechanism and outcomes were analysed. A total of 43 patients (mean age: 37.5 years; female:male ratio 23:20) were included. Injuries were caused by hot water/tea (37.2%), steam (34.9%) and hot water bottles (27.9%). The average burned total body surface area (TBSA) was 4%, with 79.1% of injuries being superficial partial-thickness burns. Surgical intervention was required in 13.9% of cases. Hot water bottle injuries predominantly affected young females (75%, mean age 32.6 years), with a high incidence of genital burns (58.3%). Hot tea-related injuries were more frequent in older males (62.5%, mean age 41.6 years), involving greater TBSA (6.5%) and a higher necessity for skin grafting (18.8%). Common self-treatment strategies can cause serious scalds, particularly in specific demographic groups, thereby burdening healthcare systems. Awareness of these risks is pivotal for effective education and prevention.
by Thomas C. Scheier, Richard Whitlock, Mark Loeb, Philip James Devereaux, Andre Lamy, Michael McGillion, MacKenzie Quantz, Ingrid Copland, Shun-Fu Lee, Dominik Mertz
Sternal surgical site infections after cardiac surgery can lead to significant morbidity, mortality, and cost. The effects of negative pressure wound management and adding vancomycin as perioperative antimicrobial prophylaxis are unknown. The PICS-PREVENA pilot/vanguard trial, a 2x2 factorial, open label, cluster-randomized crossover trial with 4 periods, was conducted at two major cardiac surgery hospitals in Ontario, Canada. Sites were randomized to one of eight sequences of the four study arms (Cefazolin or Cefazolin + Vancomycin (not analyzed) and standard wound dressing or a negative pressure 3M Prevena incision management system (Prevena). Only diabetic or obese patients were eligible for the latter comparison. This trial investigated feasability including adherence to protocol of each intervention (goal: > 90% each) and loss to follow-up (goal:by Lei Xiong, Ke Li, Wendy Siuyi Wong
BackgroundDigital media usage has become an integral part of daily life, but prolonged or emotionally driven engagement—especially during late-night hours—may lead to concerns about behavioral and mental health. Existing predictive systems fail to account for the nuanced interplay between users’ internal psychological states and their surrounding ecological contexts.
ObjectiveThis study aims to develop a psychologically and ecologically informed behavior prediction model to identify high-risk patterns of digital media usage and support early-stage intervention strategies.
MethodsWe propose a Dual-Channel Cross-Attention Network (DCCAN) architecture composed of three layers: signal identification (for psychological and ecological encoding), interaction modeling (via cross-modal attention), and behavior prediction. The model was trained and tested on a dataset of 9,782 users and 51,264 behavior sequences, annotated with labels for immersive usage, late-night activity, and susceptibility to health misinformation.
ResultsThe DCCAN model achieved superior performance across all three tasks, especially in immersive usage prediction (F1-score: 0.891, AUC: 0.913), outperforming LSTM, GRU, and XGBoost baselines. Ablation studies confirmed the critical role of both psychological and ecological signals, as well as the effectiveness of the cross-attention mechanism.
ConclusionsIncorporating psychological and ecological modalities through attention-based fusion yields interpretable and accurate predictions for digital risk behaviors. This framework shows promise for scalable, real-time behavioral health monitoring and adaptive content moderation on media platforms.
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