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In 2022, the WHO conditionally recommended the use of treatment decision algorithms (TDAs) for treatment decision-making in children
Within the Decide-TB project (PACT ID: PACTR202407866544155, 23 July 2024), we aim to generate an individual-participant dataset (IPD) from prospective TB diagnostic accuracy cohorts (RaPaed-TB, UMOYA and two cohorts from TB-Speed). Using the IPD, we aim to: (1) assess the diagnostic accuracy of published TDAs using a set of consensus case definitions produced by the National Institute of Health as reference standard (confirmed and unconfirmed vs unlikely TB); (2) evaluate the added value of novel tools (including biomarkers and artificial intelligence-interpreted radiology) in the existing TDAs; (3) generate an artificial population, modelling the target population of children eligible for WHO-endorsed TDAs presenting at primary and secondary healthcare levels and assess the diagnostic accuracy of published TDAs and (4) identify clinical predictors of radiological disease severity in children from the study population of children with presumptive TB.
This study will externally validate the first data-driven WHO TDAs in a large, well-characterised and diverse paediatric IPD derived from four large paediatric cohorts of children investigated for TB. The study has received ethical clearance for sharing secondary deidentified data from the ethics committees of the parent studies (RaPaed-TB, UMOYA and TB Speed) and as the aims of this study were part of the parent studies’ protocols, a separate approval was not necessary. Study findings will be published in peer-reviewed journals and disseminated at local, regional and international scientific meetings and conferences. This database will serve as a catalyst for the assessment of the inclusion of novel tools and the generation of an artificial population to simulate the impact of novel diagnostic pathways for TB in children at lower levels of healthcare. TDAs have the potential to close the diagnostic gap in childhood TB. Further finetuning of the currently available algorithms will facilitate this and improve access to care.
Current diets which are commonly high in meat and ultra-processed foods are unhealthy and unsustainable and contribute significantly to climate change, environmental degradation and poor health outcomes. Transitioning to healthy and sustainable diets that are rich in plant-based foods and low in animal products could reduce environmental impacts and improve population health. Young Australian adults are a critical target group for dietary intervention as they are motivated towards climate action and have the lowest diet quality out of all adult age groups. As such, this study proposes a digital nutrition intervention to promote healthy and sustainable diets in this population group.
A 4-week pilot pre-post intervention will be conducted on the Deakin Wellbeing mobile application between July and August 2025. 32 young adults (18–25 years old; current student and/or staff at Deakin University; consume less than 260 g/week of legumes or 175 g/week nuts, living in Australia) will receive 4 weeks of the intervention to improve their adherence to a healthy and sustainable diet. Primary outcomes include feasibility (retention rate) and acceptability (engagement and user experience). Secondary outcomes include sustainable food literacy, legume and nut intakes, and adherence to a healthy and sustainable diet. Primary outcomes will be reported with descriptive statistics, while changes in secondary outcomes at each study time point will be measured using repeated measures Analysis of Variance, Friedman tests and McNemar’s tests.
Ethics approval to conduct the study was granted by the Deakin University Human Research Ethics Committee (2024/HE000163). A summary of findings will be disseminated to key stakeholders, for example, Deakin University Student Engagement groups, and will also be presented to the wider research community at conferences and via peer-reviewed publications. A summary of the results will be sent to all participants via email.
Australian New Zealand Clinical Trials Registry Registration ID: ACTRN12625000335493p, prospectively registered on 22 April 2025. Universal Trial Number: U1111-1319-0745.
Culture underpins social interaction between school health professionals and children. Both practice and research suggest that cultural variations, migration and intercultural interactions pose potential challenges in encounters between school health professionals and children and may relate to the health professionals’ understanding of their own culture as a factor in such encounters. Still, for the school health services (SHS), reviews collating existing research on school health professionals’ understanding of culture are lacking.
This review aims to identify, describe and analyse existing research on school health professionals’ (ie, school nurses, school social workers, school doctors and school psychologists) understanding of culture.
A scoping review of peer-reviewed and published scientific articles on school health professionals’ understanding of culture.
Articles published between 2013 and 2024 on culture, SHS and school nurses, school doctors, school social workers or school psychologists.
Searches were conducted in October 2023 and September 2024 in 10 databases. Two reviewers independently screened the article titles, abstracts and full texts for inclusion. Extracted data were analysed using descriptive statistics and qualitative content analysis. The qualitative content analysis focused on content related to theoretical considerations, key findings and conceptualisations of culture.
From 1784 screened articles, 100 articles were screened in full text and 21 articles fulfilled the eligibility criteria. After identifying two additional articles through manual searches, a total of 23 articles were included in the review. The findings show that the articles primarily applied a quantitative study design, focused on school psychologists and school nurses and were conducted in the USA and Nordic-Baltic area. Self-understanding was mainly studied using validated instruments, leaving the conceptualisation of culture to the researchers. Still, only about half of all the articles described the theoretical conceptualisation of culture. Studies of intercultural interaction focused on the challenges of encountering ‘diverse’ children and raised concerns about barriers and hindrances to the encounters.
This review shows that SHS professionals’ understanding of culture has mainly been studied within two SHS professions, within a narrow geographical sphere and without a theoretical stance on culture. Thus, more qualitative research, a clearer theoretical conceptualisation of culture and more research on SHS professionals’ practice and self-understanding are needed.
Persons diagnosed with anorexia nervosa (AN) may receive care in general psychiatric inpatient care (GPIC) for several reasons including severity of their condition, comorbidities and lack of access to specialised inpatient care. However, scant research has explored how this specific setting may impact persons with AN, either positively or negatively. Additionally, there is limited evidence regarding the most effective form of care for AN within GPIC. This integrative literature review provides a comprehensive overview of research focusing on care for AN in GPIC settings, shedding light on person-centred care and power within this specific context.
The review was conducted according to the methods of Whittemore and Knafl. We searched the academic databases PubMed, CINAHL and PsycInfo, with the latest search conducted in March 2025, in accordance with a specific search strategy and analysed the data using a constant comparison method. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for systematic reviews.
The synthesis revealed three perspectives of care for persons with AN in the context of GPIC: management of the symptoms, treatment of the patient and support for the person. Overall, the findings suggest that GPIC can aid in weight gain, but the impact on recovery is unclear.
Research indicates that GPIC possesses the biomedical knowledge necessary to save lives, but there is a lack of research focusing on the perspectives of persons with AN. This gap in understanding may affect treatment outcomes, the possibility of recovery and the personal experience of care for those with AN in this context.
CRD42023426095.
The study aimed to examine factors associated with the perceived feeling of safety and postoperative recovery in patients who have undergone orthopaedic day surgery under regional anaesthesia.
The design was quantitative, descriptive, and cross-sectional. The study participants comprised a consecutive sample (n = 209) of patients who underwent orthopaedic day surgery under regional anaesthesia.
A questionnaire was sent to the home addresses of the study population approximately 3 weeks postoperatively. The questionnaire included the Feeling Safe During Surgery Scale (FSS), the Swedish version of the post-discharge surgical recovery scale (S-PSR), and questions concerning background variables. Multivariate regression models were used to examine the association of different variables with both feeling safe and postoperative recovery.
The only factor associated with the feeling of safety was preoperative anxiety; higher levels of preoperative anxiety were associated with lower levels of perceived safety during surgery. The factors associated with postoperative recovery were the recovery process itself and the patient's feeling of safety. Higher levels of postoperative anxiety were associated with a lower level of postoperative recovery. Higher levels of perceived safety during surgery were associated with higher postoperative recovery.
The perceived feeling of safety in the perioperative period could not be explained by factors such as age, gender, or level of education. Based on the results of this study, postoperative recovery was associated with the perceived feeling of safety in the perioperative period. Anxiety in the perioperative period was associated with patients' perceived feeling of safety and their postoperative recovery. Thus, this study's results emphasise the importance of ensuring that people undergoing surgery feel safe to promote their recovery. Based on previous research, the nurse–patient relationship seems to be an important part of making patients feel safe, which ultimately affects their recovery.
This study examines the association between perceived feeling of safety in the perioperative period and patients' postoperative recovery after undergoing orthopaedic day surgery under regional anaesthesia. Previous research has shown that the nurse–patient relationship and patients' possibilities to participate in their care are important for them to feel safe. This study further emphasises the importance of fostering relationships in the perioperative period and making patients an active part in decision-making, as it may positively impact their recovery. Creating a feeling of safety for the patient should be prioritised, as it benefits their perioperative experience and postoperative recovery.
This research is reported in accordance with the STROBE guidelines.
No patient or public contribution.
To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.
The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.
Multiple-case study.
The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.
The cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.
Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.
Findings were reported using COREQ guidelines.
Patients were interviewed and contributed with data for this study.
This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.
To investigate fundamental care delivery regarding oral care in a surgical context, and to compare patients' self-reported oral health with registered nurse assessments.
A descriptive and comparative study, with a consecutive selection.
A patient oral health rating tool, including questions about performed oral care, was distributed to patients (n = 50), at four surgical wards in Sweden. The response rate was 72%. Oral health status was assessed by a registered nurse using the Revised Oral Assessment Guide (ROAG), and a comparison between patient and registered nurse assessment was performed by calculating Cohen's kappa coefficient and percentage agreement.
Patients (38%) reported severe oral symptoms, mostly dry lips and not an adequate amount of saliva, and 80% were not offered help with oral care. ROAG assessments revealed that 74% had problems with oral health. Almost half of the patients (48%) needed assistance with oral care but only 10% received help. Registered nurses assessed the patient's oral health as worse than the patient's self-assessment did.
There are deficiencies in fundamental care delivery regarding oral care in a surgical care context. Oral health assessments need to be performed by registered nurses. Routines for systematic oral assessments and for oral care need to be implemented by nurse managers to ensure that patients' fundamental care needs are fulfilled.
Oral health assessments need to be performed regularly by registered nurses since it is insufficient that patients self-assess their oral health. Nurse managers need to provide and implement routines for nurse assessments and oral care in surgical care contexts.
There are deficiencies in patients' oral health and oral care, and registered nurses need to perform oral health assessments. Nurse managers need to implement routines for registered nurse assessments and oral care.
Patients admitted to a surgical ward were included in the study after being screened for inclusion criteria. After participants signed informed consent, they filled in a questionnaire about oral health and oral care, and a registered nurse performed an oral health assessment.
This study was carried out according to the STROBE checklist.
FreshRSS 