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Ayer — Octubre 2nd 2025Tus fuentes RSS

ColoCap: determining the diagnostic accuracy of colon capsule endoscopy compared with standard colonoscopy in patients at risk of colorectal disease - a study protocol

Por: Ibrahim · H. · Haritakis · M. · Ballantine · L. · McCormack · K. · Cotton · S. · Hudson · J. · Atkin · K. · Rogers · S. · Nixon · L. S. · Verghese · A. · Holmes · H. · Treweek · S. · MacLennan · G. · Dolwani · S. · Gardner · G. · Hurt · C. · Watson · A. · Turvill · J.
Background

Lower gastrointestinal symptoms attributed to colorectal disease are common. Early diagnosis of serious colorectal disease such as colorectal cancer (CRC), precancerous growths (polyps) and inflammation is important to ensure the best possible outcomes for a patient. The current ‘gold standard’ diagnostic test is colonoscopy. Colonoscopy is an invasive procedure. Some people struggle to cope with it and require intravenous sedation and/or analgesia. It is also resource-intensive, needing to be performed in specialist endoscopy units by a trained team. Across the UK, the demand for colonoscopy is outstripping capacity and the diagnosis of colorectal disease is being delayed. A colon capsule endoscope (CCE) is an alternative colorectal diagnostic. It is a ‘camera in a pill’ that can be swallowed and which passes through the gastrointestinal tract, obtaining visual images on the colon. There is now established experience of CCE in the UK. CCE might provide a less invasive method to diagnose colorectal disease if found to be accurate and effective and provide a means by which to increase the National Health Service (NHS) diagnostic capacity.

Aims and objectives

The aim of this study is to determine the diagnostic accuracy of CCE when compared with colonoscopy in representative and clinically meaningful cohorts of patients. An evaluation of the experiences of CCE for the patient and clinical team and an assessment of cost effectiveness will be undertaken.

Methods

We will undertake three research workstreams (WS). In WS1, we shall perform a paired (back-to-back) study. Each participant will swallow the CCE and then later on the same day they will have a colonoscopy. The study has been designed in collaboration with our Patient Advisory Group and as closely mirrors standard care as is possible. 973 participants will be recruited from three representative clinical contexts; suspected CRC, suspected inflammatory bowel disease and postpolypectomy surveillance. Up to 30 sites across the UK will be involved to maximise inclusivity. Measures of diagnostic accuracy will be reported along with CCE completion rates, number of colonoscopy procedures potentially prevented and adverse events, such as capsule retention. A nested substudy of intraobserver and interobserver agreement will be performed. WS2 will develop models of cost-effectiveness and WS3 will evaluate the patient and clinician experience, with reference to acceptability and choice.

Anticipated impact

The study findings will provide the evidence base to inform future colorectal diagnostic services.

Ethics and dissemination

The study has approval from the North East—Tyne and Wear South research ethics committee (REC reference 24/NE/0178, IRAS 331349). The findings will be disseminated to the NHS, National Institute for Health and Care Excellence, other clinical stakeholders and participants, patients and the public.

Trial registration number

ISRCTN16126290.

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Prevalence of postpartum family planning uptake and its association with spousal discussion, joint decision-making and partner approval: a systematic review and meta-analysis

Por: Khurram · J. · Lal · A. · Rahim · A. · Tikmani · S. S.
Objective

This systematic review examined the prevalence of postpartum family planning (PPFP) uptake and its association with spousal discussion and husband’s support.

Design

Systematic review and meta-analysis.

Data sources

A comprehensive literature search was conducted across PubMed (NLM), Scopus (Elsevier), Web of Science (Clarivate) and Cochrane Library (Wiley).

Eligibility criteria

The review included primary observational studies published in English between January 2014 and March 2024. Eligible studies reported prevalence and association between spousal discussion, support, approval or contraceptive use by the husband in PPFP within 12 months of childbirth.

Data extraction and synthesis

Two reviewers independently screened the articles, performed data extraction and assessed the risk of bias using the Newcastle-Ottawa Scale and Appraisal Tool for Cross-Sectional Studies. Discrepancies were resolved through consensus. Random-effects meta-analysis estimated pooled prevalence, and pooled ORs of log odds were reported for the association between spousal discussion and partner approval and PPFP uptake.

Results

Six cross-sectional studies involving 2856 postpartum women were included. The pooled prevalence of PPFP uptake was 35% (95% CI 19% to 52%). Meta-analysis showed that spousal discussion was associated with PPFP uptake (log OR=1.39 (95% CI 0.65 to 2.13), however, partner’s approval was not associated with PPFP uptake (log OR=1.49, 95% CI –0.08 to 3.06). Two studies assessed partner support, with one reporting a significant association (log OR: 1.45); joint decision-making was assessed in two studies but showed no significant association with PPFP.

Conclusions

In conclusion, the overall prevalence of PPFP uptake is low. Spousal discussion plays a critical role in enhancing PPFP uptake. These findings highlight the need for policy initiatives and programmatic interventions that promote couple communication for PPFP decision-making to improve reproductive health outcomes in low–middle-income countries.

PROSPERO registration number

CRD42024505801.

Evaluation of Nurses' Perceptions and Readiness for Artificial Intelligence Integration in Healthcare: A Cross‐Sectional Study in Turkey

ABSTRACT

Aim

To determine the perceptions and readiness of nurses regarding the integration of artificial intelligence (AI) into healthcare services.

Design

A descriptive cross-sectional study.

Methods

Data were collected from 388 nurses across Turkey using an online questionnaire designed to gather sociodemographic information, perceptions (measured by attitudes) and readiness (assessed by AI knowledge and confidence) toward artificial intelligence. Statistical analyses, including independent t-tests and ANOVA, were used to examine group differences. The study adhered to ethical principles and followed the STROBE Statement guidelines for cross-sectional research.

Results

Findings revealed that nurses' knowledge of AI in healthcare was generally limited, though many participants expressed optimism about its potential to improve efficiency, enhance patient care quality and alleviate nurse burnout. However, concerns about patient privacy and ethical challenges were identified as significant challenges to AI integration in healthcare settings.

Conclusion

The study underscores that while nurses recognise the potential benefits of AI, there is a significant need to address their limited knowledge and concerns regarding ethical and privacy issues. Educational initiatives and ethical frameworks are essential to facilitate AI's successful implementation in nursing practice.

Impact

This study emphasises the necessity of incorporating AI-related education into nursing curricula and highlights the importance of developing policies that mitigate ethical challenges, thereby preparing nurses for a future that integrates AI into patient-centred care.

Patient or Public Contribution

The study involved practicing nurses as participants to provide real-world insights into their perceptions and readiness for AI in healthcare, ensuring that findings reflect the practical implications of AI integration in clinical settings.

Work engagement and its association with emotional intelligence and demographic characteristics among nurses in Palestinian neonatal intensive care units

by Ibrahim Aqtam, Ahmad Ayed, Ahmad Batran, Moath Abu Ejheisheh, Riham H. Melhem, Mustafa Shouli

Introduction

Work engagement, defined as a positive, fulfilling, work-related state of mind characterized by vigor, dedication, and absorption, is crucial for nurse retention and quality of care in high-stress environments. Neonatal Intensive Care Units (NICUs) present unique emotional and psychological challenges for nurses, necessitating skills like emotional intelligence (EI) to enhance work engagement. This study investigates the association between EI, demographic factors, and work engagement among Palestinian NICU nurses.

Methods

A cross-sectional, descriptive correlational design was employed during February-April 2025. Of 230 nurses invited, 207 completed the survey (response rate = 90.2%) across 12 Palestinian NICUs using convenience sampling. Data analysis was conducted using descriptive statistics, Pearson’s correlation, and multiple linear regression via SPSS v26. Validated tools, the Schutte Self-Report Emotional Intelligence Test (SSEIT) and Utrecht Work Engagement Scale (UWES), were used.

Results

Emotional intelligence (EI) demonstrated a strong positive correlation with work engagement (r = 0.693, p B = 0.463, β = 0.535, p = 0.002), female gender (B = −2.250, β = −0.115, p = 0.017), and rotating shifts (B = 1.579, β = 0.105, p = 0.028) were significant predictors. EI was the strongest predictor (B = 0.358, β = 0.593, p M = 47.3 ± 5.8).

Discussion

The findings demonstrate strong associations between EI and engagement in high-stress NICU environments. Based on these findings, we propose implementing comprehensive EI training programs in nursing curricula, establishing mentorship programs to address age-related disparities, and developing gender-sensitive workplace policies to optimize work engagement and improve patient care quality.

Medication use patterns and polypharmacy among elderly in Iran: a cross-sectional study using national health insurance claims data

Por: Ataei · S. M.-N. · Golestani · A. · Khosravi · S. · Tabatabaei-Malazy · O. · Malekpour · M.-R. · Ebrahimpur · M. · Mirzadeh · F. S. · Shahali · Z. · Amini · M. R. · Effatpanah · M.
Objectives

Polypharmacy, defined as the concurrent use of multiple medications, is a growing concern among the elderly, especially in low-income and middle-income countries such as Iran. This study aims to explore the prevalence and patterns of polypharmacy among the elderly in Iran, using health insurance claims data to identify common drug classes and coprescribed medications, with a focus on informing policy decisions and improving medication management.

Design

Retrospective population-based observational study.

Setting

Nationwide data from the Iran Health Insurance Organization (IHIO) across 24 provinces.

Participants

1 876 527 individuals aged 65 years and older, insured by the IHIO from 2014 to 2017. Individuals with incomplete demographic information or lacking medication records in the database were excluded from the analysis.

Primary and secondary outcome measures

Prevalence and patterns of polypharmacy, demographic factors associated with polypharmacy, and common drug classes used. Medications were classified using the Anatomical Therapeutic Chemical system. Polypharmacy was defined as the use of five or more medications, with cumulative polypharmacy considering total drug use over time, and consecutive polypharmacy focusing on the frequency of monthly drug use. Logistic regression and association rule mining were applied to explore demographic factors and medication patterns associated with polypharmacy.

Results

Of the study population, 74.9% experienced cumulative polypharmacy over 6 months and 64.6% over 1 month, with 7.6% experiencing consecutive polypharmacy. Females and those aged 75–79 were more prone to polypharmacy. Systemic glucocorticoids were the most commonly used medications (50.02%), followed by HMG-CoA reductase inhibitors (42.73%) and platelet aggregation inhibitors (41.92%). Polypharmacy was most strongly associated with medications related to the alimentary tract and metabolism, cardiovascular system, nervous system and blood and blood-forming organs.

Conclusions

Polypharmacy is highly prevalent among the elderly in Iran, with significant variations by gender, age, insurance fund and region. The findings highlight the need for targeted interventions to manage polypharmacy and improve medication safety in this population.

Developing a pharmacist-led transition of care programme in the emergency department of a secondary care teaching hospital: a qualitative participatory co-design protocol

Por: Alhmoud · E. · Barazi · R. · Zakaria · A. · Andraous · L. · El Enany · R. · Thomas · B. · Abdulrouf · P. V. · Pathan · S. A. · Nazar · H. · Ibrahim · M. I. M. · Hadi · M. A.
Introduction

Transitions from the emergency department (ED) to home are high-risk periods for medication-related harm. Pharmacist-led interventions during this period may improve medication safety and care continuity, yet co-design approaches to develop such interventions remain underused. The aim of this study is to co-design a pharmacist-led transition of care programme for patients discharged from the ED.

Methods and analysis

This study will be conducted at a 371-bed secondary-care teaching hospital in Qatar and will follow two sequential phases using qualitative and participatory methods. Phase I will involve focus groups and semistructured interviews with key stakeholders (clinical pharmacists, physicians, nurses and patients or patient representatives). Phase II will consist of an intervention co-design workshop with decision makers (leaders, policymakers and representatives from Phase I). Participants will be recruited using purposive and snowball sampling. Interviews will be audio recorded and transcribed verbatim. Data will be analysed using an inductive-deductive approach, guided by the Theoretical Domains Framework, the Care Transitions Framework and the APEASE (Affordability, Practicability, Effectiveness/cost-effectiveness, Acceptability, Side-effects/safety, Equity) criteria for evaluation of intervention feasibility.

The anticipated outcome is a prototype intervention detailing target recipients, core components, workflow, implementation strategies and supporting tools. This prototype will be pilot-tested to assess feasibility and inform further refinement.

Ethics and dissemination

The study was approved by the Medical Research Centre of Hamad Medical Corporation-Qatar (MRC-01-24-699) and Qatar University Institutional Review Board (QU-IRB 009/2025-EM). Written informed consent will be obtained from all study participants prior to participation. Research findings will be disseminated through institutional stakeholder briefings, presentations at national and international scientific conferences and publication in peer-reviewed journals. Patient representatives will contribute throughout the intervention development process.

Exploring Resilience in Nursing: Multilevel Strategies for Enhancing Workplace Well‐Being

ABSTRACT

Aims

To explore how nurses working in a high-pressure academic healthcare setting in Saudi Arabia conceptualise, experience and sustain resilience in the face of professional stressors.

Design

A qualitative, descriptive phenomenological study.

Methods

Semi-structured interviews were conducted with 17 nurses from diverse clinical and academic backgrounds between March and May 2025. Data were analysed using reflexive thematic analysis, incorporating both inductive and interpretive approaches. Researcher reflexivity and methodological rigour were maintained throughout.

Results

Four major themes were identified: (1) Navigating Emotional Demands, which captured nurses' experiences of compassion fatigue and emotional resilience; (2) Support Systems and Collegial Ties, emphasising peer collaboration and mentorship; (3) Organisational Culture and Leadership, which highlighted the role of managerial support, workload policies and institutional climate; and (4) Adaptive Coping Strategies and Personal Development, including mindfulness, spirituality and continuous learning. These themes demonstrate the multilevel nature of resilience, shaped by personal attributes, interpersonal relationships and systemic factors.

Conclusion

Nurses develop resilience through an interplay of individual, relational and organisational strategies. Supportive leadership, collegial networks and opportunities for professional growth are critical in mitigating stress and preventing burnout. Findings underscore the need for culturally responsive, system-wide interventions that embed emotional safety, reflective practice and mentorship into healthcare settings. Future research should evaluate the impact of resilience-oriented policies on workforce retention and patient care outcomes.

Effect of a virtual reality program on patient comfort in the surgical intensive care unit of a French university hospital: study protocol for a monocentric, prospective, superiority, randomised controlled trial-ZION study

Por: Huette · P. · Malaquin · S. · Lefebvre · T. · Devos · C. · Ibrahima · A. · Daumin · C. · Coupez · A. · Josse · E. · Besserve · P. · Haye · G. · Bayart · G. · Guilbart · M. · Gibert · L. · Beyls · C. · Dupont · H. · Meynier · J. · Diouf · M. · Mahjoub · Y. · Abou-Arab · O.
Introduction

Admission to a surgical intensive care unit (ICU) following major surgery is associated with a number of discomforts, not only related to the disease itself but also to the care provided or the ICU environment itself (lights, sounds, pain, sleep deprivation, thirst, etc). This discomfort is real and can be associated with psychological consequences. We hypothesised that the use of immersive virtual reality (IVR) with HypnoVR is feasible and can help reduce discomfort in intensive care.

Methods and analysis

The ZION trial is a prospective, monocentric trial randomising 194 patients admitted to a surgical ICU after a major surgery. The inclusion criterion is patients admitted to a surgical ICU for at least 48 hours following major surgery (cardiac, thoracic or major abdominal surgery). Patients will be allocated to the intervention group (n=97) or the control group (n=97). In the intervention group, patients will receive IVR using HypnoVR two times a day during the ICU stay (2–5 days). In the control group, postoperative care will be conducted according to standard care without IVR. The primary endpoint will be the 18-item IPREA (Inconforts des Patients de REAnimation) questionnaire on the day of ICU discharge. The secondary endpoints will include intensity of discomfort symptoms (anxiety, pain, dyspnoea, thirst and sleep deprivation); the 18-Item IPREA Questionnaire assessed daily from randomisation to the V1 follow-up visit (ICU discharge); incidence of delirium; cumulative morphine consumption at ICU discharge; length of ICU stay and anxiety or depression at 1 month after discharge from intensive care and patient experience of device use.

Ethics and dissemination

Ethical approval was obtained from the institutional review board of the University Hospital of Amiens (Registration number ID: 2024-A01528-39) in January 2025.

Trial registration number

NCT06830369.

Prevalence of osteoporosis in prostate cancer survivor patients: a systematic review and meta-analysis protocol

Por: Ebrahimi · M. · Mohammadi · A. · Sarmadi · S. · Rahimnia · R. · Zare-Kaseb · A. · Reis · L. O. · Namazi Shabestari · A. · Aghamir · S. M. K.
Introduction

Osteoporosis is a skeletal condition with decreased bone mass and structural deterioration, increasing fracture vulnerability. Several studies have found a correlation between prostate cancer in men and an increased risk of osteoporosis. This study aims to determine the prevalence of osteoporosis in patients with prostate cancer.

Methods and analysis

The primary objective of this study will be to estimate the prevalence of osteoporosis in prostate cancer survivor patients. An extensive search will be conducted on PubMed, Scopus, Embase, Web of Science, CINAHL and ProQuest databases to ensure comprehensive coverage. The search will encompass the timeframe from 1 January 1994 to 24 September 2024. Furthermore, we will not impose any limitations on the language or geographical location of the published studies. In order to assess the potential bias in the included studies, the Joanna Briggs Institute critical appraisal checklist for prevalence studies will be employed. The analysis of data will be performed using STATA V.17. The prevalence of osteoporosis or osteopenia will be calculated for each study by dividing the number of participants with these conditions by the total number of patients diagnosed with prostate cancer. A subgroup analysis will examine prevalence regarding geographical location, age groups, ethnicity, definitions and measurements of osteoporosis or osteopenia, risk of bias in the included studies, type and duration of androgen deprivation therapy, and site of osteoporosis diagnosis. We will employ multiple methods to detect publication bias, including funnel plot analysis, Begg’s and Egger’s tests, and the Trim and Fill method. If we have enough data, we will conduct a sensitivity analysis using the leave-one-out-remove method.

Ethics and dissemination

No ethical approval or patient consent is required as this study synthesises only published aggregate data. Results will be disseminated via a peer-reviewed publication.

PROSPERO registration number

CRD42024600884.

Integrating artificial intelligence in community-based diabetes care programmes: enhancing inclusiveness, diversity, equity and accessibility a realist review protocol

Por: Hassan · S. · Ibrahim · S. · Bielecki · J. · Stanimirovic · A. · Mathew · S. · Hooey · R. · Bowen · J. M. · Rac · V. E.
Introduction

Marginalised populations—such as racialised groups, low-income individuals, newcomers and those in rural areas—disproportionately experience severe diabetes-related complications, including diabetic foot ulcers, retinopathy and amputations, due to systemic inequities and limited access to care. Although community-based programmes address cultural and accessibility barriers, their isolation from mainstream healthcare systems leads to fragmented care and missed opportunities for early intervention.

Artificial intelligence (AI)-powered technologies can enhance accessibility and personalisation, particularly for underserved populations. However, integrating AI into community settings remains underexplored, with socioethical concerns around inclusion, diversity, equity and accessibility requiring urgent attention.

This realist review aims to examine how, why and under what circumstances AI applications can be effectively integrated into community-based diabetic care for marginalised populations. The review will develop a programme theory to guide ethical, inclusive and effective AI implementation to ensure AI-driven innovations address health disparities and promote culturally sensitive, accessible care for all.

Methods and analysis

Using the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) extension for Reviews guidelines, this realist review will systematically search MEDLINE, Embase, CINAHL, Cochrane library, Google Scholar and Scopus, alongside grey literature. A two-stage screening process will identify eligible studies, and data extraction will use a developed tool. Synthesis will employ realist logic, analysing relationships between contexts (eg, organisational capacity), mechanisms (eg, AI functionalities) and outcomes (eg, reduced disparities).

Ethics and dissemination

Ethics approval is not required for conducting this realist review. Ethics approval will be obtained from the University of Toronto; however, following the completion of the realist review for patients and community members’ engagement to support knowledge mobilisation and dissemination to ensure practical application and reciprocity.

PROSPERO registration number

This protocol was registered at PROSPERO (CRD42025636284).

Perceptions of Gender Equity and Workplace Bias Among Nurses: Implications for Job Satisfaction and Career Progression

ABSTRACT

Background

Gender equity and workplace bias are critical factors influencing job satisfaction and career progression in healthcare. Despite global initiatives promoting equity, disparities persist within nursing, impacting organizational commitment and workforce retention.

Aim

This study investigates registered nurses' perceptions of gender equity and workplace bias and their impact on job satisfaction at King Khaled Hospital, Saudi Arabia.

Methods

A cross-sectional quantitative study design was employed, involving 246 randomly selected registered nurses. Data were collected using the gender equity in the Workplace Scale (GEWS), Workplace Gender Bias Scale (WGBS), and Job Satisfaction Survey (JSS). Descriptive statistics and Pearson correlation analyses were conducted using SPSS to assess gender differences and relationships between perceptions of equity, bias, and job satisfaction.

Results

The study revealed moderate agreement regarding gender equity in promotions (48.8%) and compensation (52%), indicating room for improvement in implementing equality policies. Workplace bias was perceived notably in stereotyping (50.8%) and differential treatment (60%), with female nurses reporting higher levels of bias. Job satisfaction was moderate, with 60% of participants expressing overall satisfaction and only 42% satisfied with promotional opportunities. Perceptions of gender equity positively correlated with job satisfaction (r = 0.65, p < 0.001), while workplace bias was inversely correlated (r = −0.54, p < 0.001).

Clinical Relevance

Persistent gender inequities and workplace biases negatively affect job satisfaction and career progression in nursing. Addressing these disparities through equitable organizational policies, diversity training, and inclusive leadership can enhance job satisfaction, improve retention, and foster a supportive work environment. These findings highlight the need for systemic reforms to promote workplace equity and well-being in healthcare organizations.

Applying Evidence to Improve Practice: Qualitative Insights Into Nurses' Experiences With Organizational Support for Mental Health Recovery

ABSTRACT

Background

The mental health and well-being of nurses are critical issues in health care, particularly following the increased stressors introduced by the COVID-19 pandemic. Nurses frequently experience burnout, stress, and emotional exhaustion due to systemic issues such as staffing shortages, heavy workloads, and limited access to mental health resources. These challenges not only affect nurses' well-being but also impact the quality of patient care. Organizational support plays a pivotal role in mitigating these issues, yet the lived experiences of nurses regarding such support remain underexplored.

Aim

This Study Aimed to Explore Nurses' Lived Experiences of Organizational Support and Its Impact on Their Mental Health Recovery, With a Focus on Identifying Actionable Strategies for Improvement.

Methods

A qualitative phenomenological approach was employed, using Interpretative Phenomenological Analysis (IPA) to gain deep insights into nurses' experiences. Twenty nurses from various healthcare facilities in the Asir region, Saudi Arabia, were recruited through purposive sampling. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis to identify recurring patterns and themes.

Results

Three main themes emerged: (1) Supportive Leadership, highlighting the critical role of empathetic and communicative leadership in fostering well-being; (2) Systemic Barriers, including staffing shortages, heavy workloads, and limited access to mental health resources; and (3) Workplace Wellness Culture, reflecting the influence of stigma, peer support, and the practicality of wellness programs on mental health recovery. These themes underscore the interconnected nature of leadership, systemic issues, and workplace culture in supporting nurses' mental health.

Linking Evidence to Action

The findings suggest several actionable strategies, including leadership training programs to foster empathy and communication, policies to address systemic barriers, tailored and accessible wellness programs, and initiatives to reduce mental health stigma. These interventions are essential for creating supportive environments that prioritize nurses' well-being and enhance their ability to deliver high-quality care.

Shaping the future of medical education: A cross-sectional study on ChatGPT attitude and usage among medical students in Sudan

by Weam Mohamed Meargni Ahmed, Malaz M. Abdalmotalib, Mohamed H. Elbadawi, Galia Tajelsir Fadulelmula Mohammed, Waad Mohamed Ibrahim Mohamed, Fatima Salih Babiker Mohammed, Hajar Saad Salih, Hiba Omer Yousif Mohamed

Background

Artificial intelligence (AI) is revolutionizing education globally, yet its adoption in medical education remains inadequately understood. ChatGPT, a generative AI tool, offers promising yet doubtful potential for enhancing academic and clinical training.

Methods

This study employed an analytical cross-sectional design, involving 1,443 Sudanese medical students who participated through an online, structured questionnaire. The questionnaire was designed to assess ChatGPT awareness, usage, and associated factors. Statistical analysis was performed using SPSS software to identify key determinants influencing ChatGPT awareness and usage among the participants.

Objective

This study investigates the levels of awareness, attitude, and usage of ChatGPT among Sudanese medical students, identifying key socio-demographic, economic, and institutional factors influencing its adoption.

Results

Among the participants, 65.8% were aware of ChatGPT, yet only 41.9% reported using it. Gender differences were statistically significant, with males demonstrating higher usage rates (p 300,000 SDGs) showed significantly greater usage (p  Conclusions

The findings underscore the urgent need for targeted interventions, including curriculum reform to integrate AI literacy, enhanced digital infrastructure, and gender-equity initiatives. Addressing these systemic gaps will scale up AI adoption in medical education. This study provides actionable insights for educators and policymakers, emphasizing the urgency of bridging socio-economic and institutional inequities to foster equitable access to AI tools in medical training.

Digital Bridges and Emotional Anchors: Nurses Facilitating Social Connectivity in Virtual Age‐Friendly Communities

ABSTRACT

Aim

To explore how nurses facilitate social connectivity among older adults in virtual age-friendly communities in Al-Ahsa, Saudi Arabia by serving as digital bridges and emotional anchors. Additionally, the study aimed to identify the factors that influence the effectiveness of nurse-led interventions in enhancing digital literacy and reducing social isolation among older adults.

Design

A qualitative study.

Method

Semi-structured interviews were conducted between June and August 2024 with 12 older adult participants and 10 nurse participants involved in virtual age-friendly community initiatives in Al-Ahsa, Saudi Arabia. Data were analysed using a hybrid approach that combined deductive thematic analysis—guided by socio-technical systems theory and relationship-centred care principles—with inductive analysis to identify key themes related to digital facilitation, emotional support and social connectivity.

Results

The findings indicate that nurse-led digital and emotional support significantly enhances older adults' digital literacy and emotional well-being, leading to improved social connectivity. Nurses acting as digital bridges provided essential technical guidance, while their role as emotional anchors offered empathetic support that mitigated feelings of isolation. However, challenges such as technical issues, resource limitations and cultural factors moderated the overall effectiveness of these interventions.

Conclusion

The study underscores the pivotal role of nurse-led interventions in promoting social connectivity among older adults in virtual settings. Future research should explore strategies to overcome technical and resource-related barriers and further integrate culturally sensitive approaches to optimise the benefits of digital health initiatives.

Implication for the Profession and/or Patient Care

Healthcare practitioners and policymakers should prioritise the implementation of nurse-led digital and emotional support programmes to reduce social isolation and improve the overall quality of life for older adults. Culturally tailored interventions are essential to address the unique needs of ageing populations in the digital era.

Reporting Method

The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Patient or Public Contribution

The insights obtained from older adult participants and nurses provided critical understanding of the dynamics and impact of digital and emotional support within virtual age-friendly communities.

Educational outcomes of emerging teaching methods in undergraduate nursing education: a systematic review and meta-analysis protocol

Por: AlMekkawi · M. · Al Maqbali · M. · ElKhalil · R. · Ibrahim · R. K. · Aldawsari · A. · Qatouni · F. · Sherif · M. · Pandarakutty · S. · Nalubega · S. · Arul Raj · A. R. · Hughes · C.
Introduction

Undergraduate nursing education is essential in preparing competent and compassionate healthcare professionals capable of addressing the complex challenges in today’s healthcare landscape. This protocol proposes a systematic review of the educational outcomes of virtual/augmented reality, flipped classrooms, team-based learning and gamification compared with traditional or didactic methods in undergraduate nursing education.

Methods and analysis

A systematic review protocol based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines will be conducted. Experimental and observational studies published from 2014 through 2024 will be identified by searching the electronic databases PubMed, Scopus, Embase, Web of Science and CINAHL that compare emerging with traditional or didactic teaching methods among undergraduate nursing students. Two reviewers will independently assess titles and abstracts to identify relevant studies based on eligibility criteria. Two additional reviewers will extract data from full-text articles that meet these criteria, evaluate the risk of bias and assess the quality of the selected studies. The meta-analysis will include effect size, heterogeneity, subgroup analyses and publication bias tests.

Ethics and dissemination

Ethics approval is not required. The publication will be in peer-reviewed journals and presented at national and international conferences.

PROSPERO registration number

CRD42024618288.

Therapeutic application of nano-encapsulated pomegranate peel extract attenuated DSS-induced colitis: Antioxidant and anti-inflammatory role and reduction of exaggerated response of endoplasmic reticulum stress

by Abdallah Tageldein Mansour, Safaa I. Khater, Hemmat M. Eissa, Helal F. Al-Harthi, Areej A. Eskandrani, Mohammed Ageeli Hakami, Wafa S. Alansari, Amirah Albaqami, Hanan M. Alharbi, Tarek Khamis, Doaa Ibrahim

The medicinal application of pomegranate peel extract enriched with polyphenols (PPE) as a therapeutic strategy for managing inflammatory bowel diseases (IBD) is still limited. Integrating pomegranate peel extract (PPE) into an effective nanocarrier system could enhance its mechanistic actions, potentially aiding in the remission of colitis. Therefore, this approach aimed to enhance PPE’s stability and bioavailability and investigate mitigating impact of pomegranate peel extract-loaded nanoparticles (PPE-NPs) in a colitis model. Colonic injury was induced by 5% dextran sulfate sodium (DSS) and efficacy of disease progression after oral administration of PPE-NPs for 14 days was assessed by evaluating clinical signs severity, antioxidant and inflammatory markers, expressions of endoplasmic reticulum associated genes and histopathological and immunostaining analysis in colonic tissues. Clinical signs and disease activity index were effectively reduced, and the levels of fecal calprotectin were decreased in groups treated with PPE-NPs compared to DSS group. The colitic group showed a significant increase (P IL-17, TNF-α, and IL-1β (increased up to 2.99, 4.36 and 4.90 respectively unlike PPE-NPsIII that recorded reduced levels of CRP, MPO and NO (8,96, 78.30 and 123 nmol/g tissue respectively) and much lower (P CHOP, JUNK, ATF6, BIP, and Elf-2) and immunostaining expression regulation of key markers regulating autophagy (Beclin-2) in this group. The histopathological changes in the colon were less severe in the PPE-NPs received groups (especially at the level of 150 mg/kg) compared to DSS group. Collectively, these findings suggest that the nanoencapsulation of PPE enhances its effectiveness in promoting recovery of colonic tissue damage and achieving remission of colitis.

Climate Anxiety and COPD: Unveiling Its Impact on Patients' Quality of Life Through a Multivariate Lens

ABSTRACT

Objective

To examine the impact of climate anxiety on the quality of life (QoL) of patients with COPD. It also explores how climate anxiety interacts with clinical factors, such as disease severity and comorbidities, to influence QoL.

Design

Cross-sectional.

Methods

A total of 270 COPD patients were recruited using a convenience sampling method. Data were collected through structured interviews and clinical assessments, incorporating the Climate Anxiety Scale, the St. George's Respiratory Questionnaire and the BODE Index. Hierarchical multiple regression analysis was performed to determine the predictors of QoL.

Results

The study found a statistically significant association between climate anxiety and both QoL (r = 0.81, p < 0.01) and COPD severity (r = 0.76, p < 0.01). COPD severity (B = 4.68, p < 0.01) and climate anxiety (B = 0.28, p < 0.01) were predictors of QoL. Among the covariates, former smokers, older patients and multiple comorbidities reported significantly worse QoL (B = 4.80, p = 0.03; B = 0.43, p < 0.01; B = 0.85, p = 0.02, respectively). Collectively all predictors explained 86% of the variance in QoL.

Conclusion

Climate anxiety significantly contributes to reduced QoL in COPD patients, beyond disease severity and demographic factors. Addressing psychological distress in COPD management is essential to improving patient outcomes.

Implications for Practice

Nurses should recognise climate anxiety as a key variable influencing COPD management. Incorporating climate anxiety screening into nursing assessments and providing targeted interventions can enhance patient support and improve overall COPD care.

Impact

Climate anxiety is an emerging concern in COPD. While previous research has focused on physical and clinical determinants of COPD-related QoL, climate anxiety remains underexplored. This study provides new evidence that climate anxiety is a predictor of poorer QoL, highlighting the need for holistic nursing interventions that address both physical and psychological health.

Reporting Method

This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

Patient or Public Contribution

Patients with COPD were involved in this study.

Relationship Between Health Literacy, Health Protective Behaviour, Quality of Life and Social Health in Older Adults Living in the Community

ABSTRACT

Aims

The aim of this study was to examine the relationship between health literacy, health protective behaviour, quality of life and social health in older adults living in the community.

Design

A cross-sectional study.

Method

This observational study was carried out by interviewing 600 older adult people living in a province in the South Marmara region of Turkey using a multi-stage cluster sampling method. The dependent variable of the study was social health perception, and multivariate linear regression analysis was used in the analyses. Reporting of the study followed the STROBE checklist.

Results

The social health of the participants is at a medium level. As a result of linear regression analysis, the social health score was found in those who have high school education or higher, those who live with their children and those who live alone to be significantly lower in those with poor general health perception. As age increases, health literacy increases, and quality of life decreases, the social health score decreases (p < 0.05).

Conclusion

In this context, steps should be taken to increase social harmony and social support for the older adult; the perceived environment should be improved, and environments that facilitate the lives of the older adult should be created.

Relevance to Clinical Practice

Determining the level of social health of the older adult and identifying the related factors is important in terms of improving the quality of services to be provided for the older adult. In this context, it is important for health professionals to take initiatives to improve the lifestyle, health literacy and quality of life of the older adult.

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