FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

European Registry of Next Generation Imaging in Advanced Prostate Cancer (RING): protocol for an international, prospective registry study

Por: Chernysheva · D. · Fanti · S. · Bjartell · A. · Afferi · L. · Breda · A. · Palou · J. · Padhani · A. R. · Sanguedolce · F.
Introduction

Next-generation imaging (NGI), particularly with prostate-specific membrane antigen positron emission tomography (PSMA PET) tracers, enables earlier and more accurate detection of metastases. However, conventional imaging (CT and bone scan) remains more affordable and widely accessible and was the standard used in most pivotal trials that established current survival outcomes. As PSMA PET becomes more widely adopted, a stage migration effect is emerging. However, key uncertainties persist regarding the actual proportional employment of NGI in clinical practice, main indications for its use and the mid-term and long-term effects of an NGI-driven treatment pathway. Furthermore, when or whether CI alone might remain enough informative for the treatment decision-making is still unclear.

Methods and analysis

The European Registry of Next-Generation Imaging in Advanced Prostate Cancer is a non-profit, non-interventional, multi-centre, international, prospective, investigator-initiated registry that is intended to collect real-world data on how patients with prostate cancer at risk of harbouring metastasis (high-risk at initial diagnosis, or after primary treatment) are managed according to the type of imaging used for the systemic work-up. The registry is conducted in two phases: (1) cross-sectional analysis of imaging choices and their effect on clinical decision-making and (2) longitudinal follow-up evaluating survival outcomes such as progression-free survival (PFS), disease-specific survival (DSS) and skeletal-related events (SSEs). Statistical analyses will include descriptive analysis of demographic and clinical variables, comparative analysis between different imaging pathways, survival and prognostic analyses using Kaplan–Meier tests. The expected minimum sample size of the registry is 600 patients, and the planned follow-up duration is 24 months for the longitudinal follow-up.

Ethics and dissemination

The study protocol was approved by the ethics committee of Fundació Puigvert (#C2024/30), and ethics approval is required at all participating sites. All patients will provide written informed consent. The results will be disseminated widely and transparently to maximise their effect on clinical practice, research and patient care through peer-reviewed publications, presentations at international conferences as well as through patient advocacy groups and relevant patient websites.

Trial registration number

NCT06866782.

In the shadow of Graves disease: a qualitative interview study of patients experiences conducted at a secondary referral centre in Sweden

Por: Lindo · A. · Alsen · S. · Fors · A. · Filipsson Nyström · H.
Objective

Graves’ disease (GD) is the most common form of hyperthyroidism in Sweden with an incidence of 21/100 000 individuals, the majority of whom are women of working age. GD can be overwhelming for the affected patient. A way to improve health outcomes is to better understand patients’ experiences of their illness. We therefore aimed to explore patients’ experiences of GD during the initial phase of the disease.

Design

A qualitative study based on semistructured interviews was conducted and analysed using qualitative content analysis, following Graneheim and Lundman’s description of the method.

Setting

The study was carried out within specialised care at the secondary level in a Swedish healthcare context.

Participants

15 patients (12 women and 3 men; aged 29–74 years) within the first 3 months after GD diagnosis were included in the study.

Results

Being affected by GD means facing a range of new and often incomprehensible symptoms contributing to an experience of change in one’s personality. In contact with healthcare, they experienced challenges such as an overwhelming amount of information, a lack of energy, and feelings of being a burden. These factors were described as having a negative impact on daily life, well-being, and psychological and psychosocial functioning. The participants highlighted the need to be listened to, to receive tailored information, to have continuous contact, and to have fatigue and other symptoms more thoroughly addressed.

Conclusion

The findings indicate that symptoms have a significant impact on patients with GD, influencing their care experience, information processing, decision-making abilities, and daily functioning. The application of person-centred care can be one way to support patients with GD, as it facilitates a collaborative approach and enhances the comprehension of each patient’s needs and resources. By acknowledging the patient’s experiences, situation, and expectations, as well as the comprehensive impact of the disease, and by modifying support strategies, patient well-being and health outcomes may be significantly improved.

Randomised controlled trial to assess the efficiency and effectiveness of remote care compared with in-clinic care for adult cochlear implant recipients in the first 12 months after activation: a protocol of the INSPIRE study

Por: Quaranta · N. · Murri · A. · Denys · S. · Verhaert · N. · Huinck · W. · Townsend · J. · Swinnen · F. · Dhooge · I. · de Klerk · A. · Mehta · D. · Brotto · D. · Craddock · L. · Hoskam · G. · Schou · I. M. · McBride · M. E. · Campbell-Bell · C.
Introduction

Post-surgical care following cochlear implantation is a pivotal part of the rehabilitation journey for cochlear implant (CI) recipients. However, frequent in-clinic visits, particularly in the first year following CI activation, can place a significant burden on CI recipients. Moreover, the growing number of CI recipients may pose a challenge for CI clinics to provide consistent and lifelong care. Cochlear Remote Care is a platform that enables the delivery of post-surgical care through remote hearing assessments and remote video appointments, offering an opportunity to enhance clinic efficiency, eliminate geographical barriers, reduce financial burdens and provide flexible post-surgical options. The primary objective of this study is to compare self-reported hearing ability in daily life among CI recipients who receive post-surgical care through Remote Care with those receiving routine in-clinic care during the first year following CI activation. Additionally, the study will assess the time and costs associated with these care models for both the clinic and patients.

Methods and analysis

This multi-centre randomised controlled trial is set to be conducted across 11 clinics in the United Kingdom, Italy, the Netherlands, Belgium and Australia, with an anticipated sample size of 148 participants. All participants will be adults with post-lingual deafness and unilateral CIs. Following baseline measurements at 3 months post-activation, participants will be randomly assigned to either in-clinic visits or Remote Care appointments. At six and 12 months after activation, participants will complete a comprehensive battery of audiometric tests and questionnaires on patient-reported outcomes, usability and resource utilisation.

Ethics and dissemination

Ethics approval has been obtained for each clinical site. Study findings will be disseminated widely through peer-reviewed publications, lay language summaries and conference presentations.

Trial registration number

NCT05552118.

Determining the indirect costs of suicide in Sweden: a national population-based cross-sectional study, 2010-2019

Por: Wikström · D. · Nystrand · C. · Hadlaczky · G. · Gedin · F.
Objectives

Globally, more than 700 000 people commit suicide annually. In Sweden, the yearly incidence ranges between 1000 and 1500 people, which is higher than the global average. The aim of this study is to estimate the economic burden related to indirect costs that suicide has imposed on Swedish society between 2010 and 2019.

Design

National population-based cross-sectional study.

Participants and setting

All suicides in Sweden between 2010 and 2019, using data from the Swedish National Cause of Death Registry.

Outcomes

Indirect costs associated with suicides, estimated using the human capital approach, including productivity loss over 1-year and lifetime horizons.

Results

Between 2010 and 2019, 1406 to 1591 suicides occurred annually in Sweden, resulting in approximately 26 500 productive life years lost each year. In 2019, the productivity loss due to suicides was estimated at 44 million over a 1-year horizon and 935 million over a lifetime horizon. The corresponding per-person costs were 37 000 and 778 000, respectively.

Conclusions

This study provides valuable insights into the economic burden of suicide on Swedish society. It underlines the potential economic benefits of effective suicide prevention, aligning with previous research highlighting the substantial returns—both monetary and in terms of human well-being—that successful prevention strategies can yield.

Health economic assessment of the Landes public service 'Vivre a Domicile (VIVADOM) (Living at Home) based on personalised care for frail older adults with human support and digital solutions (telecare, tablet, home automation and connected objects): a Ma

Por: Sawadogo · A. R. · Gayot · C. · Nys · J. F. · Le Goff-Pronost · M. · Tchalla · A.
Introduction

Preventing loss of autonomy has become a public health issue due to the increase in healthcare costs associated with ageing. It has become even more pressing with the arrival of the baby-boomer generation. This has given rise to several initiatives. This is the background to the VIVADOM project. The project provides a complete kit for older adults aged 60 years and over living at home. First, the kit includes a technological package (telecare, light path and digital tablet). Then, these older adults benefit from personalised human support provided by postal workers trained in gerontology. The aim of this study will be to carry out a health economic assessment (HEA) of the VIVADOM project as part of the prevention of frailty and/or dependency (by comparing beneficiaries of the complete kit with non-beneficiaries). The comparator will be the fact of not benefiting from the complete kit. In addition, the efficiency of the project in preventing falls and cognitive problems will be studied. We will calculate three incremental cost-effectiveness ratios (ICER) for these three issues.

Methods and analysis

The economic model used will be the Markov model. Transition probabilities, average costs and average quality-adjusted life year (QALY) will be calculated for the two groups being compared. The ICER will be obtained by dividing the difference in average costs by the difference in average QALYs. Finally, ICERs will be compared with willingness-to-pay (WTP) to assess the efficiency of the system. Thus, the VIVADOM project will be efficient when these ICERs are lower than the WTP. Univariate and probabilistic sensitivity analysis will be carried out to ensure the robustness of the analysis results.

Ethics and dissemination

The HEA of the VIVADOM project has been approved by the research unit of the University of Limoges in France. The results will be published in a peer-reviewed journal and presented at relevant national and international conferences.

Effects of mental health interventions given at youth-friendly health services and integrated youth services: a systematic review protocol

Por: Andersen · M. · Lostelius · P. V. · Bring · A. · Ring · L. · Nystrand · C. · Olsson · E. M. G.
Introduction

Although poor mental health among young people has been increasing in the past decades, many young people are reluctant to use traditional mental healthcare. To cater to the needs of young people, various youth-friendly treatment options have been developed. These include the youth-friendly health service (YFHS) standards put forth by the WHO in 2012 and the integrated youth services (IYS) for mental health developed in certain countries globally. However, no synthesis of the effect of these services on youth mental health has been conducted. The aim of the proposed study is to conduct a systematic review of the effect of mental health treatments conducted within YFHS and IYS clinics. The primary research question is what effect mental health interventions given at ‘youth-friendly’ clinics for treating mental health, such as IYS and YFHS, have on the mental health and quality of life (QoL) of young people?

Methods and analysis

A preliminary search for other reviews on the topic was conducted during the first half of 2024, after which a protocol of the present study was registered in PROSPERO. In May 2024, a search was carried out in the PubMed, PsycINFO, CINAHL and Web of Science databases, which gave references for 12 738 papers to be screened for inclusion in the review, and a follow-up search was carried out in April 2025, yielding a further 2182 references. For inclusion, studies must have participants between 12 and 25 years of age; interventions be given at clinics designed to be ‘youth-friendly’ or given at an IYS; control condition, if any, consisting of standard care or waiting list; outcomes must be mental health symptomology or QoL. To be included, studies must be published from 2012 and onwards. Screening of titles and abstracts in the initial search was carried out independently by two reviewers. Screening of studies found in the follow-up search and in the reference lists of included articles will be carried out in the same way. Data analysis of the initial search was conducted in the latter half of 2024, while final data analysis including the results from the follow-up search is ongoing. The Cochrane risk of bias assessment tools will be used to assess bias of included articles, and certainty of the evidence will be evaluated according to the GRADE methodology. A meta-analysis of the results will be performed if a sufficient amount of homogenous data is found; otherwise, a synthesis without meta-analysis will be conducted.

Ethics and dissemination

The proposed review may form a valuable synthesis of the state of the art of treatment options catering to young people. Investigating the effectiveness of YFHS or IYS in treating young people’s mental health may inform future directions for development and research. The present study does not need ethical approval, since only previously published, ethically approved data are used in the current study. The findings of the study will be disseminated through submissions to peer-reviewed journals and international conferences, as well as disseminated within the Swedish YFHS community.

PROSPERO registration details

ID nr CRD42024528687.

Navigating Hepatitis C care: Knowledge gaps and access barriers among young women who inject drugs in rural Appalachia

by Cheyenne R. Wagi, Renee McDowell, Anyssa Wright, Kathleen L. Egan, Christina S. Meade, April M. Young, Madison N. Enderle, Angela T. Estadt, Kathryn E. Lancaster

Background

Hepatitis C virus (HCV) and injection drug use among young women are dramatically rising in the rural United States. From 2004 to 2017, heroin use among non-pregnant women increased 22.4% biennially, mirroring increases in HCV cases, especially among younger populations. Young women who inject drugs (YWID, ages 18–35) face elevated HCV risk due to biological, behavioral, and socio-cultural factors. Barriers to HCV testing and treatment services further delay diagnoses, fuel transmission, and limit access to harm reduction services. This study applies the Theoretical Domains Framework (TDF) to identify factors influencing HCV testing and treatment among YWID in rural Appalachia Ohio.

Methods

We conducted in-depth interviews with YWID (n = 30) in 2023 to understand their HCV testing and treatment experiences in rural Appalachia Ohio. Interviews were transcribed, inductively coded, and analyzed using grounded theory. Identified themes were mapped onto the TDF domains.

Results

Key TDF domains influencing HCV care included knowledge, beliefs about consequences, and intentions. While YWID knew where to get tested, they expressed uncertainty about treatment value and access while actively using drugs. Social influences, stigma, and mistreatment by healthcare providers created barriers to treatment. Environmental context and resources, such as transportation, also influenced access to care.

Conclusions

YWID in rural Appalachia face barriers to HCV care, such as gaps in knowledge about HCV treatment, which is compounded by gendered stigma, and logistical challenges. Rapidly changing treatment restrictions led to misinformation about treatment access. These gaps highlight the need for interventions specifically designed to address YWID lived experiences.

The Relevance of Sustainability and the Climate Crisis to the Nursing Profession and Nursing Education: A Literature Review

ABSTRACT

Introduction

The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations.

Design

A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded.

Methods

A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed.

Results

The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience.

Conclusion

This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges.

Clinical Relevance

Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically, taking a leadership role includes both acting as a knowledge multiplier and increasing the health literacy of the general population.

❌