In a rapidly evolving world shaped by digital transformation, digital technologies are increasingly being used in healthcare. To use them effectively, nursing staff, patients and their caregivers need the appropriate skills. To date, digital literacy in general, digital skills and (digital) technologies have played a minor role in German nursing curricula. In addition, little is known about the use of technology in nursing education and about effective ways to enhance digital competence. This scoping review aims to identify current literature on innovative and experiential-based teaching and learning methods for developing competence in technology and digitalisation for nurses and informal caregivers, as well as digital technologies that are being used in this educational context.

This scoping review, which will be designed and conceptualised using the Joanna Briggs Institute methodology for conducting scoping reviews, will take place from April 2025 to January 2026. The search will be conducted on the databases CINAHL, Emcare, Embase, Medline and ERIC. Screening and extraction will be peer reviewed and follow predefined criteria, as well as opportunities for free-text responses. The extracted data will be analysed using absolute and relative frequencies. Free-text responses will be analysed using qualitative content Analysis.

As an ethics vote is not required to conduct a scoping review, this will not be obtained. The results will be disseminated via open access publication in a peer-reviewed journal and through presentations at conferences.

This study aimed to describe the epidemiology, outcomes and costs of four immune-mediated inflammatory rheumatic diseases (IMIRDs)—systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS)—in Brazil’s public and private healthcare systems from 2018 to 2022.

Retrospective observational study.

The study was conducted across hospital and outpatient levels of care in Brazil, based on nationwide data representing the public (Department of Informatics of the Unified Health System—DATASUS) and private (National Supplementary Health Agency—ANS) healthcare sectors.

The study analysed data from four distinct systems: 609 427 patients from the public Outpatient Information System (SIA), 32 119 patients from the public Hospital Information System (SIH), 19 083 deaths from the public Mortality Information System (SIM) and 11 846 hospitalisations from the private healthcare system (ANS).

RA had the highest incidence, ranging from 19.9 to 24.9 per 100 000, while SLE remained stable (6.3–6.7 per 100 000). Prevalence increased for all diseases: RA rose from 95.7 to 136.8, SLE from 23.4 to 38.9, AS from 15.0 to 23.6 and PsA from 10.8 to 17.4 per 100 000. SLE had the highest hospitalisation (7.2%) and lethality rates (8.7%), along with the highest average outpatient cost (US$440.9 per patient). In the private system, RA and SLE accounted for the most hospitalisations (36.3% each). SLE had the highest proportion of emergency hospitalisations (70.5%), while PsA had the highest proportion of elective hospitalisations (61.8%).

RA had the highest prevalence and incidence rates among the studied IMIRDs, while SLE was associated with the highest lethality, outpatient costs and emergency hospitalisations. The rising prevalence of these diseases highlights their growing burden on Brazil’s healthcare systems.

NCT06698900.

Neurodevelopmental disabilities (NDs) affect early communication, social engagement and parent-child interactions. Children with NDs often struggle with prelinguistic skills, such as maintaining eye contact and using gestures, which are essential for language development. Parenting behaviour plays a key role in fostering these abilities, and early interventions involving parents can enhance socio-communicative and linguistic outcomes. The present multicentred randomised controlled trial evaluates the effectiveness of a parent-involved speech therapy intervention in improving early socio-communicative skills in children with NDs.

Sixty children with NDs aged 6 months to 5 years will be randomly assigned to either the intervention group (IG, n=30), receiving a parent-involved speech therapy intervention focused on socio-communicative skills, or the control group (CG, n=30), receiving care-as-usual speech therapy. Participants will be recruited from eight rehabilitation centres in Lombardy, Italy. Both interventions will last 8 weeks, with weekly 45 min sessions led by trained speech therapists. Primary outcomes include early communication and intersubjective skills and parenting behaviour, assessed at baseline (T0) and post-intervention (T2—2 months from enrolment). Socio-cognitive skills and socio-emotional development will be considered as secondary outcomes. Feasibility and potential confounders (eg, parental stress) will be measured and controlled between groups.

The study has received formal approval by the deputed ethical committee for all eight participant centres (Comitato Etico Lombardia 2 – Protocol n. R1916/24 – L2-109). Results of the main trial and of the exploratory aims will be submitted for publication in peer-reviewed journals and international conferences.

NCT06666777.

To determine whether postponing daily medical rounds to provide additional preparation time for residents reduces round duration and alters time allocation during rounds, with the hypothesis that increased preparation leads to more efficient rounds without reducing patient contact.

Time and motion study with a before-and-after comparison.

Internal medicine division of Lausanne University Hospital, a Swiss tertiary teaching hospital.

75 residents; 60% women; mean age of 29.6 years and 3.0 years of training.

In 2017, the daily work schedule was reorganised by postponing rounds from 09:00 to 10:00 and moving educational sessions to the afternoon, thereby freeing 90 min to prepare patient cases before rounds.

The primary outcome was the duration of rounds and the proportion thereof spent with patients, using computer systems or in discussion with colleagues. Secondary outcomes included the detailed distribution of resident activities during the officially scheduled round period, particularly time dedicated to supervision, teaching and administrative tasks.

Round duration decreased from 142 min per shift (95% CI 128 to 156) in 2015 to 112 min (95% CI 101 to 124) in 2018 (p=0.001). The proportion of round time spent directly with patients remained stable at 47%. Computer use during rounds decreased from 43% to 32% (p

Postponing rounds to allow more preparation time was associated with shorter, possibly more efficient rounds, reduced computer use in patient presence and increased supervision and teaching.

ISRCTN69703381, https://doi.org/10.1186/ISRCTN69703381 (registration date: 24 April 2018).

Progressive supranuclear palsy (PSP) is a devastating neurodegenerative disease characterised by cognitive, behavioural and motor problems. Motor symptoms are highly disabling, while cognitive and behavioural changes have a major impact on carer burden, quality of life and prognosis. Apathy and impulsivity are very common, often coexistent in PSP, and negatively predict survival. In preclinical models and other diseases, apathy and impulsivity are associated with noradrenergic deficits, which can be severe in PSP.

Noradrenaline for Progressive Supranuclear Palsy Syndromes trial is a randomised, double-blind, placebo-controlled, crossover design, Phase IIb clinical trial to evaluate the efficacy and safety of oral atomoxetine for the treatment of cognitive and behavioural changes in PSP. Participants receive atomoxetine 40 mg (10 mg/mL oral solution) once daily or a matched placebo solution, in random order, each for 8 weeks. An ‘informant’, who knows the patient with PSP well, is co-recruited to complete some of the trial outcome measures. Participants remain in the trial for 22 weeks after randomisation. The primary objectives are to assess (1) safety and tolerability and (2) efficacy versus placebo on challenging behaviours as reported in a subscale of the Cambridge Behavioural Inventory. Secondary and exploratory measures relate to cognition, the PSP Rating Scale, mood and potential baseline predictors of individual response to atomoxetine computed from imaging, genetic and cognitive measures at baseline.

The trial was approved by the South Central-Oxford B Research Ethics Committee (REC) and the Medicines and Healthcare products Regulatory Agency (REC reference: 20/SC/0416). Dissemination will include publication in peer-reviewed journals, presentations at academic and public conferences and engagement with patients, the public, policymakers and practitioners.

ISRCTN99462035; DOI: https://doi.org/10.1186/ISRCTN99462035; EudraCT (European Union Drug Regulating Authorities Clinical Trials Database)/CTIS (Clinical Trial Information System) number: 2019-004472-19; IRAS (Integrated Research Application System) number: 272063; Secondary identifying numbers: CPMS (Central Portfolio Management System) 44441.