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To map and synthesise the main recommendations for arterial blood gas (ABG) collection in intensive care units (ICUs).
A scoping review was conducted according to the PRISMA-ScR Checklist, supported with The PAGER framework and guided by the Joanna Briggs Institute methodology to ensure methodological rigour and analytical comprehensiveness.
Data collection was conducted from February to April 2024. The data sources included: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PubMed Central, Scientific Electronic Library Online (SciELO), Web of Science (WoS), SCOPUS, Science Direct, Virtual Health Library (VHL), Excerpta Medica database (Embase), CAPES Thesis and Dissertation Catalogue, Brazilian Digital Library of Theses and Dissertations (BDTD), Scientific Open Access Repository of Portugal (RCAAP), Theses Canada and the Oswaldo Cruz Foundation (Fiocruz) repository.
Key findings recommend the radial artery as the preferred puncture site, an insertion angle of 30° to 45°, the use of 1 or 3 mL syringes and 20G or 23G gauge needles. Transport and storage at room temperature are advised. Cryoanalgesia and subcutaneous analgesia methods were found to be effective for pain management.
The review highlights the best practices for arterial blood gas collection in critical care. The synthesized evidence strengthens clinical practice, informs guidelines for intensive care nursing and promotes safer, higher-quality care for critically ill patients.
The evidence-based recommendations identified can enhance nursing care related to arterial blood gas collection. Adherence to these practices promotes safer, more humanised and evidence-based care during the procedure.
The report of this study followed the PRISMA-ScR Checklist.
There was no patient or public involvement in this scoping review.
by Lauren H. Baker, Terun Desai, Jonathan Sinclair, Amy V. Wells
ObjectivesTo monitor sleep patterns of elite swimmers and explore sleep as a potential risk factor for upper respiratory symptoms (URS) alongside salivary Immunoglobulin A (IgA) in elite swimmers, over an 8-month competitive season.
DesignSecondary analysis of an 8-month longitudinal study in elite international swimmers leading into either the Commonwealth Games 2018 or Swim Cup Eindhoven.
MethodsFourteen elite swimmers (age ± SD = 19.9 ± 0.8 years, height = 178.9 ± 6.3 cm, and mass = 75.0 ± 7.7 kg) were recruited. Self-reported sleep quality, URS data and salivary IgA was obtained weekly on a standardised day. Quantitative sleep parameters were measured using wrist-worn actigraphy four times for two-week bouts; during low, moderate, high training loads and once leading into competition.
ResultsSwimmers waking fatigued was positively associated with frequency (p Conclusions
Perceived fatigue on waking was significantly associated with both frequency and severity of URS, and inversely associated with mucosal immunity (salivary IgA), providing novel insight into the relationship between sleep, fatigue and illness in this cohort. Although causality cannot be established, the high prevalence of inadequate sleep shown in elite swimmers highlights the importance of individual sleep monitoring to support recovery and inform strategies aimed at illness prevention.
by Ana Laura Januário Lelis, Leandro Aparecido Ferreira da Silva, Daniel Moretto Casali, Tiago Leiva, Murilo Chuba Rodrigues, José Paulo Roman Barroso, Pedro Veloso Facury Lasmar, Camila Lisboa Tomaz, Anabelle Jorge Barbosa, Camila Cesario Fernandes Sartini, Johnny Maciel de Souza, Danilo Domingues Millen
This study evaluated the effects of increasing narasin doses on ruminal fermentation, nutrient digestibility, ruminal pH stability, papillae histology, and microbial composition in Angus cattle fed feedlot diets. Three rumen-cannulated Angus steers (average body weight: 680 kg) were assigned to a 3 × 3 Latin square design and received diets containing 13, 20, or 27-ppm of narasin. Each experimental period consisted of 14 days of adaptation followed by seven days of sampling. Ruminal degradability was assessed on days 15–17, apparent digestibility on days 15–19, continuous ruminal pH on days 19–20, and samples for short-chain fatty acids (SCFA), microbiota, and ruminal histology were collected on days 20 and 21. Ruminal degradability was not affected by narasin dose. Digestibility of acid detergent fiber (ADF) was significantly influenced, with the greatest values observed at 27-ppm (P = 0.01). Increasing narasin doses improved ruminal pH stability, as indicated by a linear increase in minimum pH (P = 0.01) and a reduction in the duration of pH below 5.6 (P = 0.10). At 13 ppm, SCFA production, particularly acetate and propionate, increased (P P P = 0.02), and butyrate (P P P = 0.03). Narasin supplementation altered ruminal microbial composition, increasing the relative abundance of Lachnospiraceae and Isotricha while reducing lactic acid–producing bacteria. In terms of ruminal morphology, supplementation with 20-ppm of narasin increased the keratin layer thickness of ruminal papillae (P = 0.02), suggesting enhanced epithelial development. Overall, narasin supplementation modulated ruminal function and microbial ecology, with doses between 13 and 20-ppm providing the most favorable balance between fermentative efficiency and ruminal health in feedlot cattle.To examine the contexts and mechanisms that enable compassionate mentorship in healthcare, in order to generate evidence-informed insights for fostering healthier, more sustainable work environments.
A rapid realist review.
Systematic searches were conducted in Ovid MEDLINE (1946–December 2024), Embase (1974–December 2024) and CINAHL (1981–December 2024). Additional sources included Google Scholar searches, reference list scanning and grey literature (e.g., practice guidelines, policy briefs, professional reports). The review was conducted between August 2024 and July 2025.
Realist review methods were applied to answer the question: What works, for whom, under what circumstances and why? The review proceeded in four stages: defining scope and research questions with an expert panel; iterative searching and screening; data extraction and synthesis into context–mechanism–outcome configurations (CMOCs); and development of a programme theory.
Twenty-two documents were included, spanning nursing, medicine, allied health and interdisciplinary contexts. Six CMOCs were identified, encompassing the following themes: (1) relationship compatibility; (2) vulnerability and self-exploration; (3) growth through untapped strengths; (4) anti-oppression and equity; (5) mentors' pride and confidence; and (6) culture of mentorship. The resulting programme theory conceptualises compassionate mentorship as a dynamic, multi-level process with cumulative impacts on individual well-being, professional development and organisational culture.
Compassionate mentorship represents not only a relational practice but also a structural intervention for healthier workplaces. Programmes should prioritise compatibility, cultivate psychological safety, invest in mentee growth, embed equity, recognise mentor contributions and institutionalise mentorship culture.
These strategies offer actionable pathways to strengthen workforce resilience, retention and sustainability.
One co-author is a retired nurse, ethicist and person with lived experience in the healthcare system. This co-author was integral to this project, serving on the scientific steering committee from project conceptualisation and funding application through study conduct and publication.
by Claudia Jaramillo-Mazo, Daniel Bravo, Diego Fernando Villanueva-Mejía, Javier Correa-Alvarez
Cadmium (Cd), a toxic heavy metal found in agricultural landscapes worldwide, has been pointed out in cropped soils with Theobroma cacao L., as one of the main contaminants that translocate into plant tissues. Among the factors linked to cadmium translocation into plants, the role of soil bacterial communities in chemical transformation in soils has been poorly investigated. Overall, soil bacterial communities are shaped by diverse environmental and anthropogenic factors that influence crop yield and health. Cadmium alters soil microbial communities and increases the risk to human health through plant uptake. Although the impacts of cadmium on soil bacteria have been studied in other crops, there is limited information on cacao. Thus, this study aimed to assess the responses of soil bacterial communities in cacao farms to cadmium exposure, both natural and spiked. A total of 225 rhizosphere soil samples were collected from 16 plots across five cacao farms in two Colombian departments. The complementary approaches used were: (i) 16S rDNA amplicon sequencing to assess the composition of the bacterial community in soils with natural Cd concentrations, and (ii) isothermal microcalorimetry (IMC) to measure the temporal metabolic responses of bacteria to Cd in closed systems for 80 hours at 25 °C. The findings suggest that nearly 28% of the bacterial community responds to high cadmium concentrations in soils, both in natural and experimental conditions. Field-based observations revealed that Cd-responsive taxa detected under natural soil conditions included several unculturable bacterial groups, whereas laboratory experiments with Cd spiking predominantly selected for previously characterized cadmium-tolerant bacteria (CdtB). Significant variation in natural Cd-bacterial community composition and Cd-related metabolic activity was observed across the farms. Moreover, Cd-responsive bacterial taxa exhibited increased abundance during Cd spikes. As expected, contrasting patterns were revealed by the activity-response measured by IMC and taxonomic analyses of 16S rRNA gene sequences.To evaluate the effectiveness of early administration of excitatory amino acid (EAA) inhibitors on long-term neurological outcomes in adults with acute moderate to severe traumatic brain injury (TBI).
Systematic review and meta-analysis of randomised controlled trials (RCTs).
MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, WHO International Clinical Trials Registry Platform and ClinicalTrials.gov from inception to January 2026.
RCTs comparing EAA inhibitors with placebo, standard care or any other interventions were included. Trials enrolled adult patients (≥18 years) with moderate to severe TBI (Glasgow Coma Scale score ≤12) receiving the intervention within the acute phase of care (first week).
Pairs of reviewers independently screened trials, extracted data, assessed the risk of bias (RoB) with the Cochrane RoB tool 2 and graded the certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Random effects models were used for all effect measures and trial sequential analyses (TSA) were performed for each outcome.
The primary outcome was long-term neurological function at 6 months (or the nearest earlier time point), assessed with the Glasgow Outcome Scale (GOS) or extended version (GOS-E), using the classical definitions of an unfavourable outcome (GOS 1–3 or GOS-E 1–4).
28 trials enrolling 4238 patients were included. Early administration of EAA inhibitors was not associated with reduced unfavourable neurological outcomes (relative risk 0.93 (95% CI (0.84 to 1.03); I²=40%; 15 trials, n=3613, moderate certainty). No statistically significant difference was observed based on EAA inhibitor type, timing or duration of administration, RoB or TBI severity. Mortality, intensive care unit lengths of stay and mean intracranial pressure were not statistically different between groups, but hospital length of stay was reduced in the EAA inhibitors group. The early use of EAA inhibitors was not associated with adverse events (low certainty). TSA showed insufficient power for the primary outcome.
In adults with moderate to severe TBI, the early administration of EAA inhibitors was not associated with a reduction of unfavourable neurological outcomes. Further high-quality and adequately powered RCTs are required to clarify their role in TBI management.
CRD42025635527.
Chronic diseases are a major global health burden, contributing to morbidity, mortality and healthcare costs. Self-care is essential for effective disease management, with health literacy (HL) and digital health literacy (eHL) playing a role in enabling individuals to engage in health-promoting behaviours. However, the relationship between HL and self-care remains inconclusive, necessitating further investigation to clarify its impact.
To synthesise evidence on the association between HL and self-care in chronic diseases and identify mediating and moderating factors influencing this relationship.
A systematic search was conducted across PubMed, CINAHL, PsycINFO, Embase, Web of Science and Cochrane CENTRAL, supplemented by manual reference checks and author correspondence.
This systematic review and meta-analysis followed PRISMA guidelines, including observational studies and RCTs assessing HL and self-care. Meta-analyses were performed using Fisher's Z transformation. Risk of bias was assessed using ROBINS-E and certainty of evidence was evaluated through GRADE.
A total of 138 studies were included, with 52 meta-analysed. Higher HL was associated with improved self-care behaviours, including medication adherence, disease monitoring and lifestyle modifications across chronic diseases, including type 2 diabetes, heart failure, hypertension, chronic kidney disease, asthma, coronary artery disease, arthritis and COPD. Psychological (self-efficacy, empowerment), cognitive (disease knowledge, decision-making) and social (healthcare communication, social support) factors mediated this relationship, while distress and depression moderated it. Meta-analysis revealed a moderate positive association between HL and self-care (r = 0.29, 95% CI: 0.26–0.31, p < 0.001). Subgroup analyses showed consistent positive effects across conditions. No significant publication bias was detected (Egger's test, p = 0.294). Risk of bias was high in 62 studies, while certainty of evidence ranged from very low to moderate.
HL positively influences self-care in chronic diseases, with its impact shaped by multiple mediators and moderators. Future interventions should integrate tailored education, digital tools and mental health support to enhance HL effectiveness.
PROSPERO (CRD42024488061, registered 20.01.2024).
To investigate what works when using Patient-Reported Outcome Measures (PROMs), for whom, in what contexts, and why in four Value-Based Healthcare (VBHC) programmes.
Realist evaluation.
Evaluation of Heart Failure, Parkinson's Disease, Epilepsy and Cataract surgery programmes using data from a scoping review, documentary analysis, questionnaires, quantitative routinely collected data and semi-structured interviews with staff, patients and carers (July 2022–August 2023). Programme theories and logic models were developed, tested and refined.
We conducted 105 interviews (67 patients, 21 carers and 17 staff) and collected data from 230 patients (66 Epilepsy, 140 Heart Failure and 24 Parkinson's Disease) and 14 staff via questionnaires. Clinicians used PROMs data to regularly monitor patients with Heart Failure and Epilepsy, which resulted in better triage and tailoring treatment, prioritisation of access based on the urgency of need, and facilitation of referral to relevant professionals. In Heart Failure, this further resulted in a more efficient provision of care and better use of resources, care closer to home, improved health outcomes (e.g., better symptom management) and service redesign. The same was not observed in Epilepsy, as patients who required mental health treatment had to be referred, but they were not always able to access specialist services. PROMs were discontinued in Cataract surgery services mainly due to the lack of integrated IT systems, which caused an increased workload and staff resistance. In Parkinson's Disease, patients were asked to complete PROMs even though the information was not consistently being used.
Findings challenge the orthodoxy that implementing PROMs is universally good and brings about real improvements in patient outcomes in a VBHC context. PROMs are generally ill-suited for long-term use with patients in routine care without further adaptation. Greater staff and patient involvement are imperative to enhance the acceptability and relevance of the programmes.
Patient-Reported Outcome Measures can improve care when embedded in well-supported systems. Implementation must be realistic, involve staff and patients, and be underpinned by clear leadership and robust digital infrastructure. Co-designed patient-facing tools can improve accessibility and engagement.
What problem did the study address? There is limited evidence on how Patient-Reported Outcome Measures function across different routine healthcare contexts. What were the main findings? Patient-Reported Outcome Measures improved care in Heart Failure but not in other services, largely due to contextual barriers. Where and on whom will the research have an impact? Findings are relevant for clinicians, service designers, and policymakers seeking to implement meaningful person-centred outcome measurement in long-term conditions.
We adhered to Realist and Meta-narrative Evidence Syntheses: Evolving Standards II guidance and to the Guidance for Reporting Involvement of Patients and the Public.
The study was developed alongside a wide range of patient and public stakeholders involved in the Aneurin Bevan University Health Board Value-Based Healthcare programme, third sector and specific individuals and groups representing the four included services (i.e., St. David's Hospice Care, British Heart Foundation, Digital Communities Wales, Epilepsy Action, Digital Communities Wales, Parkinson's UK Cymru, Race Equality First, Aneurin Bevan Community Health Council, Value- Based Healthcare Patient Reference Group and Wales Council of the Blind). A total of 10 virtual meetings were strategically planned to address gaps, assist in the interpretation of findings, and ensure that outcomes were pertinent and accessible to the specific needs and circumstances of under-represented or vulnerable groups.
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.
A discussion paper outlining guidance for nurse engagement in food equity efforts.
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.
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.
No patient or public contribution.
To investigate factors influencing the implementation of advanced practice nursing roles within healthcare organisations in seven European countries from the perspective of advanced practice nurses.
A cross-sectional survey was conducted between September 2021 and December 2022, involving advanced practice nurses from Belgium, Finland, Germany, Iceland, Ireland, Spain and the Netherlands. The countries were selected to represent different stages of implementing advanced practice nursing roles, from emerging to well-established.
A self-administered questionnaire was used to address five domains: patient care, practice patterns, policy and legal, educational and workforce-related factors. Descriptive statistics, chi-squared tests and correspondence analysis were employed to identify patterns and country-specific differences across these domains of implementation factors.
A total of 491 advanced practice nurses participated in the study. While almost three-quarters of the participants indicated satisfaction with their job, the study highlighted multifaceted factors influencing the implementation of advanced practice nursing roles across countries. The Netherlands, Ireland and Belgium reported mainly facilitators, whereas Finland, Iceland and Germany noted barriers or a lack of knowledge. Spain mostly reported neutral or moderate positions. Key challenges included role ambiguity, interprofessional collaboration gaps, limited managerial support, workload imbalances, limited mentorship and underutilised competencies. Results also indicated that advanced practice nurses are partially hindered by operating in isolation from other professions.
The findings emphasise the need for robust organisational support, interprofessional collaboration and clear role definitions to facilitate the integration of advanced practice nursing roles. Addressing professional isolation through networking and mentorship is crucial to sustaining the advanced practice nursing workforce.
Policy should prioritise support for advanced practice nursing, including structured mentoring and networking opportunities. Further research on advanced practice nurses' well-being and long-term role sustainability in Europe is recommended.
What problem did the study address? What were the main findings? Where and on whom will the research have an impact?
This study reported factors influencing advanced practice nurse role implementation across seven European countries with different levels of role development. Key challenges included role ambiguity, interprofessional collaboration gaps and limited support. The findings can guide healthcare managers and policymakers on the key factors to consider when integrating advanced practice nursing roles into their teams.
To explore why parents consent to or decline organ donation after their child's death and identify the factors that influence their decision-making.
Mixed-methods analysis of routinely collected quantitative and qualitative data from 594 cases in the United Kingdom between 2018 and 2024.
Quantitative analysis of clinical and demographic variables of potential donors, including regression analyses examining associations with parental consent. Qualitative content analysis and frequency counts of anonymised clinical notes of parental discussions and decision-making. Integration of quantitative and qualitative findings on similar phenomena of interest.
For each additional life-year of the child, the odds of parental consent increased by 6%; the odds of consent among white families were five times higher than those of non-white families; and the odds of consent for donation after brainstem death were 1.78 times higher than those for donation after circulatory death. Parental non-support was influenced by the perception that organ donation prolonged or altered end-of-life care, cultural and religious beliefs and the need for surgery. Factors facilitating consent included altruism, creating a positive legacy, and prior knowledge of organ donation. Parents fell into four decision groups: those who immediately consented, hesitated but consented, hesitated but declined and immediately declined.
This study provides new insights and theories about which parents are more likely to consent to paediatric organ donation. Findings highlight a range of factors that shape parental decisions and the need for approaches tailored to the varied concerns and complexities that parents face in navigating end-of-life care for their child. Developing specific support strategies that acknowledge contextual, religious and procedural concerns may enhance consent rates and facilitate a more bespoke family-centred approach to paediatric organ donation and palliative care. Other countries achieve better paediatric consent rates, suggesting there is potential to further improve policy and practice, underpinned by a programme of research.
What is already known: Internationally, there is a shortage of organs for paediatric transplants, and parental consent is the limiting factor in most high-income countries. Paediatric organ donation is unique from adults, and there is limited research into why parents consent to or decline organ donation for their child. What this paper adds: This analysis identified a range of interconnected factors that could positively or negatively influence parental consent decisions, with emotional, logistical, procedural and religious factors acting as critical barriers to consent. Additionally, parents were categorised into four decision-making groups that have distinct decision-making patterns and characteristics. Implications for practice and policy: These findings provide a foundation for better understanding why parents choose not to consent to organ donation for their child, which can begin to inform the development of policies and practices that better create the conditions for consent and a more family-centred approach in paediatric end-of-life care.
This study highlights critical factors predicting and shaping parental decisions and indicates a need for approaches tailored to the emotional and logistical complexities that parents face. Specific support strategies that acknowledge contextual, religious and procedural concerns may facilitate a more bespoke family-centred approach to paediatric end-of-life care and enhance organ donation consent rates.
What problem did the study address? Internationally, there is a shortage of organs available for children in need of transplants. Parental consent for paediatric organ donation is a limiting factor in most high-income countries. The emotive nature of a child's death makes paediatric organ donation complex and unique, and there is limited research on the factors influencing parental decision-making and the reasons parents choose to consent to or decline organ donation after their child's death. What were the main findings? We identified a range of interconnected factors that could positively or negatively influence parental consent decisions, with emotional, logistical, procedural and religious factors acting as critical barriers to consent. For the first time, parents have been categorised into four decision-making groups that have distinct decision-making patterns and characteristics. A novel and prevalent factor that negatively impacted consent was that organ donation prolonged or altered end-of-life care, often due to organ donation being raised after plans had been made for end-of-life care. This highlights the need for health systems to adopt proactive and timely approaches to integrating paediatric organ donation with care pathways. This study also identified that parents were 1.78 times more likely to consent to organ donation via a donation by brain death pathway compared to a donation by circulatory death pathway. Where and on whom will the research have an impact? This is the largest study of paediatric organ donation outside of the United States (where the healthcare system is predominantly for-profit and therefore a different model and context compared to the United Kingdom) and provides new insights and understandings that can assist Specialist Nurses in Organ Donation, clinical teams and palliative care specialists in tailoring their approach to end-of-life care to achieve the best consent outcome for each child, their parents and wider family. Findings provide a valuable foundation for the development of future research and developments in policy and practice in the United Kingdom and countries with similar health systems. Findings also include generalisable insights that can be utilised internationally, irrespective of the health system.
This study adhered to the Good Reporting of a Mixed-Methods Study (GRAMMS) reporting standards.
Patients or the public were not involved in this study.
This study aims to describe current nurse prescribing practices in the absence of a legal framework, evaluate healthcare providers' preferred prescribing models, and their perceptions of the impact of nurse prescribing in Belgian hospitals.
Multicentre quantitative, cross-sectional survey.
Between December 2022 and April 2023, healthcare providers from seven Flemish hospitals completed an online survey after being presented with a short explanatory video on independent and supplementary nurse prescribing. The survey assessed demographics, current practices, expected impact and preferred prescribing models.
Of the 303 respondents, 86% were nurses, 10% were medical doctors and 4% were pharmacists.
Independent nurse prescribing or deprescribing of medications was reported by 75% in their current work context. Nurse prescribing was observed weekly or daily by 48%, primarily for initiating new medications. Overall, 44% preferred independent nurse prescribing over no prescribing.
Despite the absence of a legal framework, nurses in Belgian hospitals regularly prescribe medications. Most healthcare providers positively perceive the expected impact of nurse prescribing.
There is an urgent need for legal and institutional frameworks that acknowledge existing practices, define responsibilities and support safe and effective care. Structured policies could improve interprofessional collaboration, clarify clinical accountability and ensure consistent training for nurse prescribers.
This study addressed the widespread but informal practice of nurse prescribing in the absence of legal regulation in Belgium. It found that a majority of healthcare providers observed nurse prescribing in clinical practice and preferred formalised prescribing models. These insights can support health authorities, healthcare decision-makers and educators in designing regulations, implementation strategies and curricula aligned with clinical practice.
The authors adhered to the STROBE reporting checklist for cross-sectional studies.
This study did not include patient or public involvement in its design, conduct, analysis or reporting.
To assess the feasibility and acceptability of a group-based intervention for addressing fear of childbirth in multiparous women.
Single-arm non-randomised feasibility trial with a convergent mixed methods design.
The intervention, conducted at a central maternity hospital and led by a psychiatric nurse and a midwife, included three prenatal and one postnatal face-to-face group sessions, supplemented by a phone call. Quantitative measures were gathered via self-report questionnaires at baseline, before birth, and post-intervention. Exit interviews were conducted with participants and interventionists. Additional data included records from recruiting midwives, the primary investigator, and diaries filled out by the interventionists after each session. Primary outcomes assessed included recruitment, adherence, acceptability, and fidelity. Secondary outcomes included fear of childbirth, anxiety, depression, and childbirth experience.
The intervention was feasible and acceptable. Recruitment and adherence aligned with pre-study expectations. Indicative results suggested potential improvement in fear of childbirth and helped secure a positive childbirth experience, particularly through peer discussions and the birthing class.
While the intervention is considered feasible and acceptable, it requires further refinement before proceeding to a multicentre randomised controlled pilot trial.
The group-based intervention may have potential in reducing fear of childbirth and enhancing the childbirth experience for multiparous women. These women may particularly benefit from peer support and childbirth classes.
Rising fear of childbirth can adversely affect mothers, families, and society. Existing interventions often target primiparous women, neglecting multiparous women. This study evaluated a novel group-based intervention for fear of childbirth in multiparous women in Finland. Findings confirmed its feasibility and acceptability, with preliminary results showing a positive impact on fear of childbirth. Further research is needed to validate these findings. This research has implications for multiparous women and the healthcare professionals supporting them.
The study adhered to CONSORT extension guidelines for reporting randomised pilot and feasibility trials (Supplementary file 1) and the TIDieR checklist (Supplementary file 2).
Limited patient and public involvement was incorporated, focusing on the development of the intervention.
Trial Registration: clinicaltrials.gov: NCT05766202
To translate, culturally adapt and validate the Italian version of Fundamentals of Care Framework and the Fundamentals of Care Practice Process.
Qualitative tool validation study.
The study followed internationally recommended procedures, including forward–backward translation, expert committee review, content validation through cognitive interviews and face validity testing with nurses and nursing students. Data were collected between January and October 2023.
Key terms were culturally and linguistically adapted to enhance clarity and contextual relevance, with changes informed by expert feedback. Content validation confirmed conceptual equivalence, and face validity testing demonstrated that Italian versions were perceived as clear, appropriate and applicable across clinical and educational settings.
Cultural adaptation of theoretical frameworks is essential for ensuring their relevance and usability in local contexts. The Italian versions of the Fundamentals of Care Framework and the Fundamentals of Care Practice Process will provide a robust, evidence-based foundation for person-centred care across education, research and clinical practice.
By making these tools accessible in Italian, this study supports the integration of fundamentals of care into national nursing education and practice, promoting international consistency in person-centred care. It lays the groundwork for curriculum reform, clinical implementation and global collaboration in nursing.
Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
This study did not involve any patient or public contribution.
ClinicalTrials.gov identifier: NCT05177627
The cover image is based on the article Moisture-Responsive Friction Adaptability: Rethinking the Conventional Skin Silicone Interfaces in Pressure Injury Prevention Dressing Designs by Amit Gefen et al., https://doi.org/10.1111/iwj.70860.
The cover image is based on the article Moisture-Responsive Friction Adaptability: Rethinking the Conventional Skin Silicone Interfaces in Pressure Injury Prevention Dressing Designs by Amit Gefen et al., https://doi.org/10.1111/iwj.70860.
The feature cover image is based on the article Intent to treat analysis of the Primary and Secondary Outcomes for the XXX intact fish skin graft for deep diabetic foot wounds trial by John Lantis et al., https://doi.org/10.1111/iwj.70847.
The feature cover image is based on the article Intent to treat analysis of the Primary and Secondary Outcomes for the XXX intact fish skin graft for deep diabetic foot wounds trial by John Lantis et al., https://doi.org/10.1111/iwj.70847.
To describe prescription patterns, dosing and persistence of guideline-directed medical therapy (GDMT) among patients with heart failure with reduced ejection fraction in Singapore, and to identify factors associated with the use of quadruple therapy (ACE inhibitor (ACEi)/angiotensin II receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), β-blocker, mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter-2 (SGLT2) inhibitor).
Retrospective, observational cohort study.
Secondary and tertiary care settings across seven public hospitals in Singapore.
3999 adults hospitalised from 2020 to 2022 with a first heart failure-related admission and left ventricular ejection fraction ≤40%. Patients with absolute contraindications to specific GDMT classes were excluded from eligibility calculations.
Primary outcomes were the proportions of eligible patients prescribed each GDMT class and quadruple therapy at discharge. Secondary outcomes were 6-month prescription patterns, dose attainment and predictors of quadruple therapy use.
Among eligible patients, 80%–99% met criteria for each GDMT drug class, yet only 29% received quadruple therapy at discharge in 2022. Prescription rates for ACEi/ARB/ARNI (67%), beta-blockers (89%), MRAs (40%), and SGLT2 inhibitors (46%) remained suboptimal despite high eligibility. At discharge, over 90% of patients on ACEi/ARB/ARNI and beta-blockers received ≤50% of target doses. By 6 months, prescription rates declined by 16% for ACEi/ARB/ARNI, 26% for beta-blockers and 7% for MRAs, while SGLT2 inhibitor use increased. Older age (OR 0.97, 95% CI 0.96 to 0.98) and chronic kidney disease stage 3a–4 (OR 0.65 to 0.04) were associated with lower odds of receiving quadruple therapy, while significant institutional variation was observed.
Despite high eligibility, uptake and optimisation of GDMT remain poor in Singapore, with substantial treatment gaps driven by underprescription, inadequate dosing and discontinuation. Interventions targeting clinician awareness, postdischarge support and institutional practice variation may improve adherence to guideline-recommended therapy.
To assess the nutritional status and identify associated factors among children under 5 years residing in Ward 10 of Bhimdatta Municipality, Kanchanpur District, Sudurpashchim Province, Nepal.
Community-based cross-sectional study.
Ward 10 of Bhimdatta Municipality, the second-largest ward by population within the municipality.
A total of 248 children aged 6–59 months were selected using simple random sampling from a list of eligible children compiled through the local vitamin A supplementation programme. Children who were ill for more than 7 days, had physical deformities or whose mothers were illiterate were excluded. Data were collected between 2 January and 25 May 2024.
Nutritional status was assessed using anthropometric indicators—height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight)—according to WHO Child Growth Standards. Measurements were taken using a ShorrBoard to the nearest 0.1 cm, and WHO Anthro V.3.1.0 was used to generate Z-scores. Data were analysed using EpiData V.3.1 and SPSS V.20. Descriptive statistics were computed, and 2 tests identified candidate variables for multinomial logistic regression to determine factors associated with nutritional status.
The study found that 35.08% of children under 5 years in Ward 10 were affected by some form of under-nutrition. A significant association was observed between under-nutrition and exclusive breastfeeding practices (p2 tests.
Under-nutrition remains a major public health concern among children under 5 years in Bhimdatta Municipality. Interventions focusing on promoting exclusive breastfeeding, improving maternal education and strengthening household food security are recommended to enhance child nutritional outcomes.
FreshRSS 