Conectar
The incidence of depression among children and adolescents has been increasing in recent years, posing significant challenges to public health and clinical care. A variety of treatments, including pharmacotherapy, psychotherapy and physical interventions, are widely used in clinical practice. However, a comprehensive synthesis of the evidence on the efficacy and acceptability of all these treatment modalities is currently lacking. This study aims to use network meta-analysis (NMA) to compare the efficacy and acceptability of all available treatments for depression in children and adolescents, offering valuable insights to inform clinical decision-making and guide future research in this critical area.
We will include randomised controlled trials evaluating active interventions for depressive disorders in children and adolescents. Seven electronic databases (PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO, Scopus and ClinicalTrials.gov) were searched from inception to 2 July 2024 and updated on 2 November 2025. Two of four investigators will independently screen studies, extract data from eligible articles and assess the risk of bias using the Cochrane Risk of Bias 2.0 tool. The primary outcome will be the change in depressive symptoms. Secondary outcomes will include acceptability (all-cause discontinuation), response rate, remission rate and overall functioning. Pairwise and Bayesian NMA will be conducted. Small-study effects and publication bias will be assessed. The certainty of the evidence will be evaluated according to the Confidence in Network Meta-Analysis approach.
As this review involves secondary analysis of previously published studies, ethical approval is not required. The findings will be disseminated through publication in peer-reviewed journals.
PROSPERO-ID CRD42024557384.
by Ningjing Guo, Xuyan Li, Xiaoxue Li, Congmin Kang, Xiaoyan Gong, Xinyu Ji, Jie Zheng
BackgroundExploratory applications of large language models within the specialized field of metabolic and bariatric surgery have begun to emerge. Nevertheless, existing research remains fragmented, lacking comprehensive integration.
ObjectiveTo conduct a scoping review of studies on the application of large language models in the field of metabolic and bariatric surgery, aiming to provide a reference for clinical practice and future research.
MethodsThis scoping review adhered to the Joanna Briggs Institute methodological framework and followed the preferred reporting items for systematic reviews and meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines.PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, CNKI, Wanfang, and VIP databases were searched for relevant studies, with the search timeframe from database inception to November 2025. The included literature was summarized and analyzed.
ResultsA total of 21 English-language studies were included. LLMs were primarily applied in scenarios such as patient education and information consultation, clinical decision support, and professional knowledge assessment. While LLMs performed well in information-provision tasks, they showed low consistency with expert opinions in complex clinical tasks such as individualized surgical recommendations. Performance varied across different models, with GPT-4 generally demonstrating superior performance, and domain-specific models showing professional potential. Current research still faces challenges regarding information accuracy, readability, and clinical applicability.
ConclusionLarge language models hold auxiliary potential in the field of metabolic and bariatric surgery, particularly for knowledge dissemination and patient education. However, their reliability in complex clinical decision-making remains limited. Future efforts should focus on conducting high-quality studies, advancing model specialization and standardized evaluation, and exploring safe and effective human-AI collaboration models.
In individuals at-risk of rheumatoid arthritis (RA), to investigate how joint tenderness and patient-reported joint pain (PRJP) relate to ultrasound abnormalities and assess whether these exploratory results could be used to assist future evaluation of symptom/signs-guided ultrasound scanning approaches in this population.
This is a cross-sectional analysis from a Leeds (UK) cohort of anti-cyclic citrullinated peptide (anti-CCP) positive individuals with new musculoskeletal complaints and no clinical arthritis. Assessments included physical examination, a mannequin where participants ticked joints that were painful and ultrasound scans of wrists, metacarpo-phalangeal joints 1–5 (MCPs1-5), proximal interphalangeal joints 1–5 (PIPs1-5), elbows, knees, ankles, metatarso-phalangeal joints 1–5 (MTPs1-5), finger flexor tendons (2-5) and extensor carpi ulnaris. Grey scale (GS), power Doppler (PD), tenosynovitis and erosions were assessed. A generalised estimating equations model was used to evaluate potential associations between tenderness/PRJP and ultrasound findings at the joint-level, adjusting for age and sex. Positive and negative predictive values for ultrasound changes were calculated.
323 participants were analysed. Joint tenderness was associated with ultrasound abnormalities, predominantly PD in wrists, MCPs, PIPs, elbows, knees and MTPs. GS and erosions were also associated with tenderness, but to a lesser degree. Association of PRJP with ultrasound abnormalities was more inconsistent and mostly for GS in the feet (all p≤0.05). Absence of symptoms and signs had a negative predictive value between 97% and 100% in all joints, except in wrists; which was slightly lower.
In anti-CCP positive individuals at risk of RA, tenderness, predominantly in the small joints, was associated with local inflammatory changes on ultrasound. The association of PRJP and ultrasound was limited. In the absence of tenderness, the presence of PD, tenosynovitis or erosions was uncommon. These findings may inform future studies evaluating symptom/sign-guided ultrasound assessment approaches in at-risk populations.
This study provides up-to-date knowledge on the correlates of workplace loneliness among Finnish nurses in the post-COVID-19 era. We examined the factors (background, work-related and dispositional) that were associated with loneliness among nurses. We also investigated the relationship between loneliness and job burnout, which was used as a mental health outcome in this study.
Workplace loneliness can be a notable stressor in contemporary working life. However, it has received little attention in nursing since COVID-19. Consequently, the present study focused on the antecedents and outcomes of workplace loneliness in nursing.
Cross-sectional survey design was used.
The dataset (n = 5893) was collected in the spring of 2024 from members of the Finnish Union of Practical Nurses. Analyses were conducted via regression analysis.
Regarding prevalence, over 20% of the nurses reported workplace loneliness at least occasionally. Psychosocial factors were most strongly related to greater loneliness: lack of co-worker and supervisory support, experiences of being bullied, and workaholism. Moreover, loneliness was also associated with the core symptoms of job burnout.
Loneliness can be experienced in nursing in contemporary working life, and it is likely to be one potential risk factor for nurses' job burnout. Social interventions should be developed and implemented in nursing organisations to tackle workplace loneliness. These interventions should concentrate on providing social support, preventing bullying, and increasing awareness of the ‘dark side’ of workaholism.
To identify and differentiate workload patterns across shifts and to provide evidence for optimizing nursing workforce allocation in emergency departments:
A cross-sectional study.
Real time data were collected from an emergency department in a general hospital in Seoul, South Korea, between October 30, 2023 to October 24, 2024. Smartphones, beacons, and smartwatches were used to capture nursing time, physical activity, work-related characteristics, and location transitions across 238 shifts. A multiclass eXtreme Gradient Boosting model was developed and evaluated to classify working shifts (day, evening, night). Shapely Additive exPlanations were applied to identify key contributing features, and shift-specific differences were examined using analysis of variance with post hoc tests.
The model demonstrated strong performance in distinguishing shifts. Key features included the number of admissions, discharges, assigned patients, and both direct and indirect nursing time, all of which varied across shifts. In contrast, location transition patterns were relatively consistent.
Shift-specific nursing workloads in emergency departments can be effectively identified using multidimensional, real-world nursing activity data.
Findings support the development of staffing strategies that account for variation in workload across shifts, with potential to improve efficiency and maintain quality of care.
This study addresses the lack of objective evidence for shift-specific workload differences in emergency nursing. It demonstrates that multidimensional activity data can distinguish workload patterns across shifts. The findings may inform staffing decisions for emergency department nurses and support improvements in workforce management and patient care.
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.
No patients or members of the public were involved in the design, conduct, analysis, or reporting of this study.
Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia in children. In East Asia, the prevalence of macrolide-resistant MP (MRMP) has surged, leading to treatment failures and prolonged illness. While doxycycline is an effective alternative, its use in young children has historically been limited due to concerns about tooth discolouration. This study aims to evaluate the efficacy and safety of doxycycline compared with azithromycin as a first-line treatment for children with pneumonia suspected of MRMP infection.
This is a multicentre, randomised, open-label, parallel-group superiority trial conducted at 14 tertiary hospitals in South Korea. A total of 208 children (aged 3–17 years) with pneumonia and confirmed or suspected MP infection will be randomised 1:1 to receive either doxycycline (4 mg/kg/day in two divided doses for 7–14 days) or azithromycin (10 mg/kg on day 1, then 5 mg/kg on days 2–5) (). Randomisation will be stratified by age (3–7 years vs 8–17 years). A standardised ‘rescue therapy’ protocol ensures patient safety by allowing control group patients to switch to doxycycline if no clinical improvement is observed within 48–72 hours. The primary outcome is the defervescence rate within 72 hours after randomisation. Secondary outcomes include treatment failure rate, length of hospital stay, symptom duration and adverse events. Safety assessment will specifically include tooth discolouration evaluation at Day 28, focused on children aged
This study has been approved by the Institutional Review Boards (IRB) of all participating centres. Written informed consent will be obtained from parents or legal guardians, and assent will be obtained from children aged 7 years and older. Results will be disseminated through peer-reviewed publications and conference presentations.
Despite the intention of international psoriasis treatment guidelines to cover all patients globally, disparities persist in the availability and accessibility of adequate therapy in many countries. The Global Healthcare Study on Psoriasis (GHSP) aims to study patient characteristics, disease impact, treatment accessibility and healthcare systems worldwide. This study provides a description and data analysis of 22 countries.
The GHSP cohort was initiated in 2020, and the number of recruiting centres has gradually grown. Participants are recruited by dermatologists at reference centres worldwide. Data are collected using a standardised assessment questionnaire comprising 88 items, administered by trained experts.
By 26 October 2024, cross-sectional data had been collected from 3950 psoriasis patients at 130 reference centres in 22 countries on six continents. The majority (55.7%) of patients were male, and the median (IQR) body mass index was 26.5 (23.7–30.1) kg/m2. The median (IQR) Psoriasis Area and Severity Index was 5.0 (2.0–11.4), and median (IQR) Dermatology Life Quality Index was 7.0 (2.0–14.0). Psoriatic arthritis was present in 20.2% of the patients and nail psoriasis in 36.7%. Additionally, 16.5% of patients were current smokers, and 26.4% reported regular alcohol consumption.
By identifying inequalities, special patient populations and country-specific differences, the GHSP will guide the development of strategies to enhance psoriasis care on a global level. Future directions include expanding the study to additional countries and sites worldwide, while transitioning into a long-term global registry of skin diseases, including atopic dermatitis and hidradenitis suppurativa, termed ‘Global Healthcare Registry on Skin Diseases’.
This study aimed to evaluate the factors associated with care modality among older adults with chronic disease and disability in rural China. We hypothesised that marital status, family structure, duration of disability and the number of chronic diseases would be significantly associated with care modality.
This was a cross-sectional observational study using survey data to identify demographic and health-related factors associated with care modality.
The study was conducted in a rural mid-sized county in China and focused on older adults with chronic disease and disability.
A total of 608 older adults aged ≥60 years with chronic disease and disability residing in Qinghe County, Hebei Province, China, completed the survey. Eligible participants had at least one chronic disease and partial or complete loss of self-care ability.
The primary outcome was care modality (home-based care vs institutional care). Secondary outcomes included specific chronic disease care needs.
Of the participants, 18.59% received institutional care. Divorced, widowed or unmarried participants had higher odds of institutional care use (OR=3.113, 95% CI 2.01 to 4.82, p
Marital status, number of children, duration of disability and number of chronic diseases were significantly associated with care modality in this population. These findings highlight the need to improve institutional care quality and availability and to better address the chronic disease management needs of this population. Future research should focus on longitudinal studies to explore the evolving care needs of this growing demographic.
by Min Jung Kim, Eun-Gee Park, Changyoung Kim, Dong Yoon Kang, Borim Ryu, Kichul Shin
BackgroundA treat-to-target strategy involving treatment modification improves outcomes in gout, but evidence remains limited regarding the optimal approach when initial urate-lowering therapy (ULT) fails. This study aimed to investigate real-world ULT sequence patterns and evaluate treatment retention based on the initial agent, modification type, and comorbidities.
MethodWe analyzed electronic health record data collected from 2010 to 2022 from the common data model databases of two hospitals. Adults aged 18 years or older diagnosed with gout who initiated ULT and were followed for at least 2 years were included. Outcomes included the frequency and sequence of ULT prescriptions. Treatment modification, defined as switching to another ULT or adding an additional agent, was considered the end of retention for the previous regimen. Subgroup analyses were performed based on comorbidity.
ResultsAmong 2220 patients, febuxostat was the most common first-line agent (51.4%), with 90.9% maintaining therapy. Among those who modified febuxostat therapy, switchers and add-on users continued treatment similarly (91.5% vs. 86.8%, P = 0.33). Of allopurinol initiators, 55.8% changed therapy, mainly switching to febuxostat or benzbromarone rather than adding another agent (51.4% vs. 4.1%, P vs. 86.8%, P = 0.33). Among benzbromarone initiators, 57.2% changed therapy (switchers, 56.7%; add-on users, 0.5%; P P = 1.00). Chronic kidney disease was associated with low variability in ULT sequence.
ConclusionsULT demonstrated durable retention when used as first- or second-line treatment, with switching being more common than add-on therapy and maintaining similar retention rates.
This study examines the effects of perceived managerial care from head nurses and individual resilience on nurse-to-nurse lateral violence among newly graduated registered nurses and determines whether individual resilience mediates the effect of perceived managerial care from head nurses and nurse-to-nurse lateral violence.
Previous studies have examined how managerial care contributes to lateral violence among nurses. However, few studies have examined how individual resilience contributes to reducing lateral violence among newly graduated registered nurses.
This cross-sectional survey study used a three-stage, stratified convenient sampling method, which involved 425 newly graduated registered nurses. Participants completed the Chinese version of the Management Caring Assessment Scale, the Connor–Davidson Resilience Scale, and the Nurse-to-Nurse Negative Behaviour Scale. Structural equation modelling and mediation effect analysis were used to explore the relationships among perceived managerial care from head nurses, individual resilience, and nurse-to-nurse lateral violence.
New nurses experienced moderate levels of lateral violence. The final model accounted for 76.4% of the total variance of lateral violence. Managerial care and individual resilience both had a direct effect on lateral violence. Individual resilience mediated the correlations between managerial care and lateral violence.
Newly registered nurses, especially from rural areas with low levels of education and an inability to perform night shifts independently, are a special group that requires higher attention from nursing management.
Head nurses' managerial care plays an important role in ensuring that new nurses adapt well to their new role and promoting the formation of psychological resilience among nurses. Nursing managers should increase the level of concern they display for new nurses, especially those from rural areas, those with low levels of education, and those who are unable to perform night shifts independently.
Patients contributed to data collection through completing questionnaire surveys.
Chronic wounds pose a substantial global health challenge, marked by persistent inflammation, infection, hypoxia, and impaired tissue regeneration. Traditional oxygen-based therapies, including hyperbaric and topical oxygen treatments, often suffer from limited efficacy, high costs, restricted accessibility, and difficulties in achieving sustained oxygen delivery. In contrast, microalgae offer a promising and sustainable alternative, owing to their biocompatibility, glucose consumption, and continuous oxygen production via photosynthesis. Innovative delivery platforms, such as hydrogels, scaffolds, sutures, microneedles, and microrobots, have demonstrated enhanced wound healing by mitigating hypoxia, reducing infection, and modulating inflammation. Recent advances in genetic engineering and 3D bioprinting further enhance the therapeutic potential of these systems. This review explores current progress in microalgae-based wound healing approaches, with a particular focus on photosynthesis-driven oxygen delivery technologies.
To assess cardiovascular health (CVH) metrics using the American Heart Association’s Life’s Simple 7 (LS7) tool as a comprehensive measure of several metabolic and behavioural risk factors for cardiovascular diseases.
Cross-sectional study, nationally representative Iran STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) survey 2021.
Iran, 2020–2021.
25 202 adult individuals aged 25 years and older participated in the STEPS survey.
Using the LS7 framework, seven factors were assessed: current smoking, body mass index (BMI), physical activity level, modified healthy diet score components, total cholesterol, blood pressure and fasting plasma glucose (FPG). Each factor was categorised into three levels of poor, intermediate and ideal, according to the LS7 methodology.
The study participants had a sex distribution of 55.5% females. The findings revealed a high prevalence of ideal levels of smoking (80.1%; 95% CI 79.3 to 81.0), total cholesterol (69.4%; 95% CI 68.5 to 70.4) and FPG (61.0%; 95% CI 60.0 to 62.1). BMI and blood pressure were ideal in about one-third of the population (33.0%; 95% CI 32.1 to 34.0, and 30.5%; 95% CI 29.6 to 31.4, respectively). However, only 13.3% (95% CI 12.6 to 14.0) of participants achieved ideal levels of physical activity, and a mere 0.4% (95% CI 0.3 to 0.6) adhered to an ideal healthy diet. Modest disparities in CVH metrics were observed across provinces and between two sexes. Ideal CVH status was significantly associated with lower risks of major diseases such as ischaemic heart disease, diabetes and chronic kidney disease.
Despite favourable scores in some CVH metrics, critical gaps in diet and physical activity highlight the need for intensive public health efforts to enhance CVH in Iran. The study emphasises the urgency of implementing region- and sex-specific public health policies.
The roles of pharmacy staff have expanded to include public health functions, such as delivering harm reduction services for people who use drugs (PWUD), particularly unregulated substances and non-medical drug use, in response to an ongoing drug overdose crisis. Nonetheless, their involvement across the full spectrum of harm reduction services remains underexplored. This study mapped existing research describing or evaluating the implementation of harm reduction services for PWUD provided by pharmacy staff.
Scoping review.
MEDLINE, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (inception to July 2025).
Studies reporting on the description or evaluation of harm reduction services for PWUD provided by pharmacy staff.
Two team members screened studies for eligibility and extracted the data. The data were analysed primarily to describe harm reduction services and the role of pharmacy staff.
43 articles were included. The most frequently reported harm reduction services were sexually transmitted and blood-borne infection care (33%), needle and syringe programmes (21%), naloxone distribution (19%) and medication treatment for opioid use disorder (19%). Pharmacy staff were integrated into multidisciplinary teams (79%), with their roles varying from education to medication prescribing. Included studies reported harm reduction services for PWUD delivered by pharmacy staff as effective, feasible and safe. However, implementations were not tailored to equity-deserving populations. Services primarily addressed opioid-related harms, while strategies focusing on the use of non-opioid substances were limited.
This scoping review highlights the diverse roles pharmacy staff play in delivering harm reduction services for PWUD. Positioned at the intersection of accessibility and healthcare delivery, pharmacy staff are ideally situated to expand access to equitable care. To fully harness this potential, future research and practice should embed harm reduction as a core philosophy, extending beyond individual interventions to support the creation of person-centred, non-judgmental and low-barrier services.
Hypertension represents a major public health challenge globally, with a rising prevalence in China. This study aims to explore the factors shaping blood pressure (BP) control among hypertensive patients managed in community health centres (CHCs), with a particular emphasis on the association with age.
This was a population-based, observational study that used healthcare records from CHC in Shenzhen, covering the period from 1 January 2000 to 8 October 2024. Univariate and multivariate logistic regression analyses were employed to assess the independent associations of various factors with BP control rate. Additionally, the study evaluated the relationship between age and BP control across six distinct age subgroups.
The study included 1 073 914 participants who met the eligibility criteria, with 955 415 (88.97%) patients achieving BP control. The median baseline age was 55.9 (IQR 18–109) years. Individuals aged 45 years and above demonstrated better BP control rates (46–55, OR 1.053, 95% CI 1.020 to 1.087; 56–65, OR 1.246, 95% CI 1.205 to 1.289; 66–75, OR 2.183, 95% CI 2.103 to 2.265; >75, OR 2.159, 95% CI 2.060 to 2.262). Among young adults aged 18–35 years, increasing age was consistently associated with poorer BP control across most subgroups. For the middle-aged groups (36–45 and 46–65 years), age had little impact on BP control. In the 66–75 years age range, older age was linked to better BP control in some groups.
The association between age and BP control varied across age groups. Hypertension management strategies should be tailored to address the unique needs of different age groups, geographical regions and targeted populations.
Women with overweight or obesity tend to engage in low levels of exercise and face challenges in initiating and maintaining exercise throughout pregnancy.
This study aimed to evaluate the effectiveness of a peer-led walking and mobile health (mHealth) app intervention on self-efficacy and change in exercise behavior stage, based on the transtheoretical model (TTM), of women with overweight or obesity from pregnancy to one month postpartum.
The study was a randomized controlled trial with an experimental design. A total of 114 pregnant women (BMI ≥ 24 kg/m2 and gestation < 16 weeks) were recruited from prenatal clinics in Taiwan from July 2021 to May 2022. The intervention group (IG) received the peer-led walking program with mHealth support, while the control group (CG) received standard antenatal care. Follow-ups were conducted at 24–28 weeks (T2), 36–40 weeks (T3), and one month postpartum (T4).
The IG had significantly higher exercise self-efficacy scores from T1 to T3 compared to the CG. IG participants showed notable progress in exercise behavior stages, transitioning from the contemplation stage at T1 to preparation and action stages at T2 (χ 2 = 13.208, p < 0.01), with some reaching the maintenance stage by T3 (20.9%, χ 2 = 9.49, p < 0.05). In contrast, most of the CG participants remained at the contemplation stage throughout pregnancy to early postpartum.
The peer-led walking intervention with mHealth has the potential to enhance self-efficacy and promote sustained exercise behavior of women with overweight or obesity during and after pregnancy and is a valuable approach to establishing long-term exercise behavior.
ClinicalTrials.gov: NCT 05022680
Needling therapy may be a novel alternative therapeutic intervention for burn injuries and related complications. This scoping review aimed to comprehensively evaluate the evidence status of needling therapy for burns and their complications. Studies on needling therapy for burns and related complications were retrieved from inception to 1st June 2024. Nine databases (MEDLINE, Embase, CENTRAL, CNKI, CiNii, RISS, KISS, DBpia and OASIS) were searched without any language or study-type restrictions. The study design, details of the needling therapy, and results of needling for burn injuries (or related complications) were evaluated. Of the 1475 articles screened, 46 studies (comprising 16 experimental studies, 12 case studies, four observational studies, 13 randomised controlled trials, and one systematic review) were included in the final analysis. Most studies (71.7%) investigated the acute-phase burn wound healing process, while the remaining studies (28.3%) focused on the modulation of burn-related complications. Experimental studies demonstrated that needling therapy activates phases of the wound healing process including the inflammation, proliferation, and remodelling phases and modulates the cholinergic anti-inflammatory response in burn-related acute symptoms. Clinical studies exhibited a significant heterogeneity regarding treatment period, patient population, and needling type across different study designs. Experimental studies have primarily focused on the wound healing process itself, whereas clinical studies have investigated short-term outcomes related to burn complications, with great heterogeneity observed in the methods of needling employed. Further studies are required to strengthen research gaps between experimental and clinical research, with proper treatment and evaluation periods to demonstrate the effectiveness of needling therapy for burns and associated complications.
Trial Registration: INPLASY202450102
To explore community dwelling adults' lived experiences of participating in death café in Singapore.
A descriptive phenomenological study with Photovoice.
A purposive sample of community dwelling adults who participated in a community-based death café was recruited for this study. Data was collected through online individual semi-structured interviews. The Colaizzi's six-step descriptive phenomenological analysis was conducted for data analysis.
Twenty community dwelling adults who participated in a death café were recruited. Participants' experiences of the death café were expounded in four themes: appeals of attending death cafés, enabling features of death café, engaging in die-logues, and perceived impacts of death café on everyday lives. The participants were attracted to death cafés for various reasons including curiosity and grief. A comfortable environment, accompanied by open dialogues and refreshments, was credited as enablers for death conversations. Through these ‘die-logues’, the participants had a deeper understanding of death and began engaging in advance planning.
Death cafés provide a supportive environment for individuals to engage in death-related conversations that may not easily occur in daily life. By engaging in conversations about mortality within death cafés, participants are encouraged to take proactive steps towards advance planning.
Findings from this study can guide the development of community-based interventions by highlighting the essential components required for a death café tailored to the Asian context.
This study describes the community dwelling adults' lived experiences of participating in a death café. The findings from this study underscore the role of informal conversations about death as a tool to promote population health based palliative care initiatives such as overcoming death taboos and stimulating advance care planning among community dwelling adults.
The Consolidated Criteria for Reporting Qualitative Studies was used.
Community-dwelling adults participated in the interviews.
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.
by Fangfang Ruan, Kangwei Li, Kena Mi
Asthma is one of the major disease burdens in children. Ambient air pollution is associated with the prevalence and exacerbation of childhood asthma. Over recent decades, China has exhibited a persistent upward trajectory in pediatric asthma prevalence. This epidemiological trend necessitates a comprehensive evaluation of the health impacts associated with childhood asthma attributable to ambient air pollution exposure. This study selected PM2.5, NO2, and O3 as representative ambient air pollutants in China, and obtained exposure-response parameters required for health impact assessment through Meta-analysis. Then the study evaluated the health impacts of childhood asthma aged 0–14 years attributable to air pollution in 336 cities across China based on national real-time air quality monitoring data. Hypothetical scenarios were also constructed to predict the preventable childhood asthma disease burden under different air pollution control levels. The results showed that in 2019, air pollution caused 264,800–467,100 childhood asthma exacerbation cases and 622,800–1115,000 incident asthma cases among children, accounting for 7.1% − 12.5% and 31.4% − 56.2% of the total asthma children visits and incidence of childhood asthma in that year. The pollutant that has the greatest impact on childhood asthma is O3, followed by PM2.5 and NO2. The health impacts of the three pollutants were spatially distributed to be higher in the central and southern regions of China, and lower in the southwestern, northeastern, and northwestern regions. Chongqing was the city most affected by three types of pollutants. When pollutant concentrations comply with the WHO guidelines, up to 267,900 cases of childhood asthma exacerbations and 873,900 new-onset childhood asthma cases could be averted.Falls are among the most common adverse events in hospitals, causing significant harm to patients and increasing healthcare costs. In 2023, over 160 000 falls were reported in China, with 62.5% of hospitalised patients suffering fall-related injuries. Falls not only prolong hospital stays but also negatively impact nursing quality and healthcare system efficiency.
This study explored the lived experiences of nurse managers in preventing and managing inpatient falls in hospital settings and examined the contextual and managerial factors influencing fall prevention practices.
We conducted a qualitative study using a phenomenological approach to explore the lived experiences of nurse managers in managing inpatient falls. Semistructured interviews were conducted with 16 participants from a tertiary hospital in Shanghai. While data collection followed phenomenological principles to elicit rich experiential narratives, thematic analysis was guided by grounded theory coding techniques to inductively identify and categorise themes. NVivo 12 software was used for data management.
Six interrelated themes emerged, reflecting nurse managers’ experiences across the stages of patient admission, hospitalisation and discharge. At admission, participants emphasised the limitations of existing fall risk assessment tools and the need for multidisciplinary collaboration and intelligent technologies to achieve precise stratification. During hospitalisation, they described ongoing challenges in conducting dynamic reassessments, implementing personalised interventions, managing limited staffing and environmental constraints and promoting patient compliance through effective education. In the discharge phase, nurse managers reflected on the emotional and ethical tensions between ensuring patient safety and respecting autonomy, underscoring the importance of cultivating a strong safety culture and reinforcing nurses’ sense of responsibility. Collectively, these findings reveal that fall prevention is not merely a procedural task but a dynamic, interpretive process shaped by professional accountability, emotional strain and systemic limitations.
Nurse managers’ experiences reflect the complex interplay between managerial responsibility, cultural caregiving norms and organisational limitations in fall prevention. Strengthening multidisciplinary collaboration, integrating intelligent technologies and promoting a proactive safety culture are crucial for improving fall management. Policymakers should also consider China’s evolving caregiver-free ward initiatives to transition towards more nurse-led and patient-centred safety systems. Future research should further explore patient and family perspectives and evaluate strategies for sustainable cultural and structural change in fall prevention.
FreshRSS 