Conectar
by Paula Becerra Fuello, Javier Lescure, Aaron Lackinger, María Sedeño Ráez, Jesús Gámiz Caro, Gonzalo Aranda Jiménez
This pilot study evaluates the feasibility and limitations of a multi-proxy approach for identifying potential indicators of horizontal positioning in cremated heads from archaeological, and to a lesser extent, forensic contexts. Two outdoor experimental cremations using fleshed and dry pig crania were conducted to evaluate the influence of pre-burning condition, vertical placement within the pyre and pyre dynamics on the expression of lateralised burning patterns. Combining macroscopic observations, fragmentation, colorimetric and Fourier-Transform Infrared Spectroscopy in Attenuated Total Reflectance (FTIR-ATR) mode, our preliminary observations suggest that lateralised differences in thermal exposure may be detectable under certain conditions. Significant differences (p-valueThis study aimed to investigate the associations of adolescents’ self-reported family financial stress, registry-based parental household income and parental education with adolescent anxiety and depression symptoms. Additionally, we adjust these associations for parental anxiety and depression symptoms and examine potential secular changes in these associations.
Family linkage study, using two cross-sectional population-based health studies, the Young-HUNT study and the HUNT study. Registry-based data from Statistics Norway (SSB).
Northern part of Trøndelag County, Norway.
Adolescent (aged 13–19 years) participating in The Young-HUNT3 Survey (2006–2008, n=8199) and The Young-HUNT4 Survey (2017–2019, n=8066) and their parents participating in The HUNT3 Survey (2006–2008, n=50 800) and the HUNT4 Survey (2017–2019, n=56 042).
Adolescent anxiety and depression symptoms were assessed by a short version of the Hopkins Symptom Checklist (HSCL), the five-item HSCL-5. Self-reported family financial stress was measured using a single-item question. Parental anxiety and depression were assessed by the 14-item Hospital Anxiety and Depression Rating Scale (total HADS score). Parental income and parental education were obtained from SSB. We use a multilevel mixed-effects generalised linear model.
Adolescents who perceived their family financial stress as worse than others reported a higher SCL-5 total score compared with those with self-perceived average financial stress. The relative differences ranged from 1.16 (95% CI 1.09 to 1.23) in boys to 1.24 (95% CI 1.17 to 1.31) in girls. In contrast, little or no association was found between parental registry-based income or educational level and adolescents’ mean SCL-5 total scores. Adjusting for parental HADS scores did not alter the estimates. With a few exceptions for girls, there was no evidence for a secular change in these associations.
Self-perceived family financial stress, but not registry-based parental income and education, was associated with elevated anxiety and depression symptom levels in adolescents, and findings were essentially the same in Young-HUNT3 and Young-HUNT4. These findings underscore the importance of incorporating multiple measures of socioeconomic status when investigating socioeconomic inequalities in adolescent mental health.
To identify values and preferences regarding smoking cessation interventions among adults with severe mental illness
Systematic review with best-fit framework synthesis
MEDLINE, EMBASE, Web of Science, CINAHL and Scopus from inception to 14 November 2025.
Studies with any design, in any clinical and geographical setting, reporting on adult (18+) current or past smokers with a diagnosis of schizophrenia, bipolar or mood disorder, including major depressive disorder or post-traumatic stress disorder. We selected all quantitative and qualitative findings regarding patients’ values and preferences, including beliefs, attitudes, behaviours and perceived barriers and facilitators, in relation to smoking cessation interventions.
Two reviewers independently screened studies. After a pilot to increase accuracy, data were extracted by one reviewer and verified by another. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used the best-fit framework synthesis methodology to synthesise the data.
Of 14 970 identified articles, 65 were included. Most studies were of moderate to high quality. Financial costs posed a significant barrier, while education and social support emerged as important facilitators. Patients preferred personal interactions with healthcare providers. Their motivation for cessation varied and was influenced by habits and perceived nicotine dependence. Health concerns and financial savings were primary drivers for reflective motivation. Beliefs regarding treatment varied. Although commonly used, scepticism about nicotine replacement therapy and concerns about the long-term safety of electronic delivery systems were reported. Overall, patients preferred personalised, flexible programmes and emphasised the need for tailored approaches. Digital interventions, especially mobile apps, that provide support, motivational content and relevant information, were perceived as appealing and helpful when sufficiently considering accessibility and usability aspects. Patients commonly perceived smoking as a coping mechanism for negative emotions. Developing new coping strategies and creating smoke-free environments were deemed to contribute to successful cessation.
Patient-centred care for people with severe mental illness should leverage behavioural and pharmacological strategies for smoking cessation. Flexibility, accessibility and ongoing support appeared important for addressing stress, withdrawal symptom interpretation and relapse vulnerability in this population.
CRD42022337933.
Worldwide, billions of children and young people live in areas affected by war. Suicide remains one of the three leading causes of death worldwide among people aged 15–29 years. However, little is known about the effect of war on suicidal behaviours in this group. This review aims to assess suicides, suicide attempts and suicidal ideation among children and young people exposed to war or armed conflict.
A scoping review of studies was conducted using Web of Science, PubMed, Embase and PsycINFO databases from their inception to 18 November 2025, without any restrictions on geographical location. We included only observational studies with full-text, peer-reviewed English articles reporting any suicides, suicide attempts and suicidal ideation of children and young people aged 0–24 years exposed to war. The quality of the included articles was assessed using the Quality Assessment with Diverse Studies. The protocol of the review was registered with the Open Science Framework on 29 March 2022 (https://osf.io/7kszh/).
Of the 3229 articles retrieved, 37 studies were eligible for review, providing data from 24 countries and covering a period of almost a hundred years (1921–2025). Most studies (>20) focused on conflicts ongoing during or until the 2000s, whereas only three focused on World War II. The reported outcomes were suicides (n=9), suicide attempts (n=15) and suicidal ideation (n=21). Included studies spanned six continents, from Latin America (n=5, Colombia only) to Europe (n=10). We assessed the suicide rates during and after wars. There was some evidence of a decrease in suicide rates during war, but no clear trend in suicide rates post-war was observed. The prevalence rates of suicide attempts and suicidal ideation varied widely, without uniformity in the definitions used. War-related trauma, mental health problems, substance abuse and exposure to suicide or suicide attempts were identified as risk factors, while protective factors included family and social support.
There is a need for more methodologically consistent and rigorous research on suicidal thoughts and behaviours in children and young people exposed to war or armed conflicts. Future research should identify mediator/moderating factors influencing suicidal behaviours and their links to mental health.
Care provided in people’s own homes (domiciliary care) is an increasingly important part of long-term care. There are various services, including home visits, live-in care and housing with care. Some people directly employ care staff, called personal assistants. Services vary in quality, price and availability, and there is currently little evidence of the value these services provide to the public purse and individuals. This study protocol presents planned research to fill this important gap.
This will be a cross-sectional study based on surveys of care recipients, their unpaid carers as well as formal care providers. In the first half of 2026, we will survey 1850 people accessing domiciliary care either through a homecare agency, a housing with care scheme or by directly employing personal assistants and 400 unpaid carers, all based in England. We will conduct a cost-effectiveness analysis taking a ‘production function’ approach and use quality of life as measured by the Adult Social Care Outcomes Toolkit as the main outcome of interest.
The study received ethical approval from the School of Social Sciences Staff Review Committee at the University of Kent on 20 May 2025 (reference 1195) and the Health Research Authority, London—Camberwell St Giles Research Ethics Committee on 28 October 2025 (reference 25/LO/0652). Implications around consent, data protection and confidentiality, risk and participant payment are discussed. In addition to academic outputs (eg, academic articles, conference presentations), we aim to coproduce news items and blogs with people with lived experience of accessing long-term care and jointly present findings at events aimed at the care sector. Moreover, we will offer participating care providers benchmarking briefs based on our findings.
To explore the influence of oral health-related knowledge, attitudes and practices on oral health risk-related behaviours of people in custodial settings.
Integrative review.
Scopus, ProQuest Central, Web of Science, Medline, CINAHL, Academic Search Complete, PsycINFO and Education Research Complete were searched in March 2024 and December 2025.
Studies reporting on any individuals in custodial settings, at least one oral health-related knowledge, attitude or practice and at least one oral health risk-related behaviour (either smoking, alcohol, illicit substances or sugar consumption). Data related to custodial population's oral health knowledge, attitudes, or practices and oral health risk-related behaviour were extracted, synthesised narratively and reported thematically.
Findings from the 26 studies reveal that people in custodial settings had a general lack of oral health knowledge, and oral health risk-related behaviours were prevalent. The most common risk-related behaviours reported were tobacco use and free sugar consumption. Oral health knowledge, attitudes and practices of this population were influenced by custodial healthcare systems and attitudes of dental professionals.
This review highlights the influence custodial healthcare and dental professionals have on the knowledge, attitudes, practices and risk-related behaviours of people in custodial settings. Oral health targeted interventions and strategies are required to improve oral health-related knowledge and attitudes thereby encouraging oral health practices among people in custodial settings.
This review will inform targeted oral health promotion programs that can improve oral health outcomes and experiences of this population.
People in custodial settings experience a disproportionate burden of oral diseases. This review underscores the need for proactive interventions and systemic reform to improve correctional healthcare experiences globally.
Preferred Reporting Items for Systematic Reviews and Meta-Analysis, Extension for Scoping Reviews (PRISMA-ScR) 2018.
No patient or public contribution.
Synthesises evidence on influencing factors contributing to poor oral health among people in custodial settings. Highlights impact of healthcare staff and custodial healthcare systems on population health. Highlights the necessity of oral health promotion programs to improve oral health knowledge and to promote oral health protective behaviours.
To demonstrate women’s preferences for three human papillomavirus (HPV) self-sampling devices.
Cross-sectional, programme-embedded paired comparative study with randomised sampling order within device pairs.
Organised cervical cancer screening programme in the Capital Region of Denmark.
1760 women eligible for cervical cancer screening (April 2024 to May 2025), assigned to one of three groups: (1) Evalyn versus FLOQSwab (n=518), (2) Evalyn versus SensiGrip (n=657) and (3) FLOQSwab versus SensiGrip (n=585).
Primary: device preference. Secondary: sampling-experience (self-reported). Data were assessed with ² tests for preference, logistic regression for predictor analysis and Wilcoxon signed-rank equivalence test with two one-sided test procedures to assess sampling experience.
Overall, 95.7% rated HPV self-sampling a positive experience and 87.3% preferred HPV self-sampling in future screening. SensiGrip was preferred significantly over FLOQSwab (p0.05) although Evalyn scored higher in sampling certainty. Sampling order influenced preference in Evalyn comparisons. Prior experience with self-sampling, screening history and subcohort membership did not significantly influence device preference.
Overall, participants rated self-sampling a positive experience. SensiGrip was preferred over FLOQSwab, while Evalyn demonstrated comparable overall acceptability to both alternative devices in the primary implementation-focused analysis. These findings suggest that device replacement would be acceptable from a screening participation perspective, particularly a shift from FLOQSwab to SensiGrip.
Socioeconomic inequalities exist in infectious diseases and sepsis in high-income countries. We investigated the association between income and mortality among patients with sepsis, overall and among those treated in the intensive care unit (ICU) versus general wards.
A retrospective register-based cohort study.
The Region of Southern Denmark (RSD).
All adult patients with an unplanned contact with a hospital in the RSD from 1 January 2016 to 20 March 2018. Patients with sepsis were identified based on the following criteria: (1) blood culture(s) performed within 48 hours of arrival, (2) antibiotic(s) administered within 48 hours of arrival, (3) a discharge diagnosis of infection and (4) a SOFA (Sequential Organ Failure Assessment) score of ≥2. The cohort was divided into quartiles according to household income.
Cox proportional hazards models were used to estimate the association between income groups and mortality. The primary outcome was 90-day mortality with 7-day and 365-day mortality as secondary outcomes. All outcomes were calculated overall and stratified by general ward treatment only and ICU admission.
We identified 7813 first-time visits with community-acquired sepsis, including 886 ICU admissions (11.3%). Among patients in the lowest income group, sepsis was associated with a HR of 1.16 (95% CI 1.01 to 1.34) for 90-day mortality compared with the highest income group. This association was particularly pronounced at 365-day follow-up: HR=1.24 (95% CI 1.10 to 1.39). No difference was observed in 7-day all-cause mortality, HR=1.13 (95% CI 0.89 to 1.45). The association was not observed among patients admitted to the ICU.
Low income was associated with increased mortality in patients with sepsis, particularly during long-term follow-up. The impact of income disparities was not observed among patient admitted to the ICU.
To describe how persons with diabetes experience learning about self-care, with a particular focus on foot self-care.
Narrative, semi-structured interviews were conducted with persons diagnosed with Type 1 or Type 2 diabetes. Participants were recruited through an advertisement in a diabetes association magazine and through convenience and snowball sampling. Eleven participants aged 53–87 were interviewed between December 2024 and April 2025. Interviews were audio-recorded, transcribed verbatim and analysed using a phenomenological hermeneutic approach.
Learning about foot self-care emerged as a gradual, lived process shaped by bodily experiences, social relationships and access to support. Three themes were identified: the social landscape of self-care, the being of the feet and taking knowledge into your own hands. Learning was influenced by encounters with healthcare professionals, informal support from relatives and personal experiences over time. Bodily symptoms acted as driving forces for learning and self-care actions. Understanding why self-care mattered was essential for motivation, while seeking and evaluating knowledge became a strategy for control and participation in care.
Learning about foot self-care among persons with diabetes is an embodied, relational and ongoing process. That develops through interaction among lived bodily experiences, social support and personal responsibility rather than through information alone.
Healthcare professionals must integrate persons' experience-based knowledge and support dialogue, reflection and shared learning to strengthen foot self-care practices.
The study addressed the limited understanding of how persons with diabetes learn foot self-care. The results showed that learning is shaped by lived experience, relationships and meaning-making. The findings are relevant for persons with diabetes and healthcare professionals involved in diabetes care.
The study adhered to the COREQ criteria.
No patient or public contribution.
Pilonidal sinus disease (PSD) is associated with substantial morbidity because of wound complications and recurrence after surgery. Adjunct laser hair removal (LHR) has been incorporated into postoperative management in some settings, but real-world outcomes in cohorts treated uniformly with LHR remain incompletely described. This study aimed to characterize postoperative outcomes after PSD surgery in a large integrated healthcare system in which adjunctive LHR was standard practice and to compare outcomes by surgical approach. We performed a retrospective descriptive cohort study of patients aged 14–89 years who underwent operative treatment of PSD with adjunctive LHR at Kaiser Permanente Northern California between 2012 and 2024. Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits. Outcomes were summarized as proportions overall and by surgical approach. Exploratory bivariable logistic regression examined associations between sex or body mass index (BMI) and outcomes. Multivariable modeling was not performed because of low event counts and sparse covariate distributions, which resulted in unstable models. Among 168 patients, the overall repeat procedure rate was 16.7%, the 30-day SSI rate was 14.4%, and 39.3% had at least one unplanned clinic visit. Patients treated with Bascom flap closure had fewer repeat procedures (10.4% vs. 20.8%) and fewer unplanned visits (33.8% vs. 43.6%) than those undergoing pilocystectomy, with similar SSI rates (14.9% vs. 14.0%). In exploratory analyses, sex and BMI were not significantly associated with outcomes in either surgical group. In this real-world cohort managed uniformly with adjunctive LHR, postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR. Controlled comparative studies are needed to determine the contribution of LHR to PSD outcomes.
by Jakob Brandstetter, Lea Goldstein, Tim Schreiber, Rupert Palme, Tobias Lindner, Markus Joksch, Bernd Krause, Brigitte Vollmar, Simone Kumstel
Pancreatic cancer is the third leading cause of cancer-related death, with a 5-year survival rate of only 10%. Preclinical studies remain essential for identifying novel therapeutic strategies, discovering biomarkers, and deepening the understanding of disease biology. The most frequent driver mutation in pancreatic cancer is the G12D mutation in the KRAS gene, present in approximately 90% of the tumors. A recent study demonstrated complete regression of KRAS-driven pancreatic cancer upon systemic ablation up- and downstream signaling proteins EGFR and C-RAF. Building on these findings, we investigated the therapeutic benefit of combining the EGFR inhibitor erlotinib with the novel pan-RAF inhibitor LXH-254. The anticancer effects of this combination were assessed in vitro in murine and human pancreatic cancer cell lines by evaluating cell proliferation, cell death and phosphorylation of key signaling proteins. Subsequent in vivo studies were performed in an orthotopic murine pancreatic cancer model and in genetically engineered KPC mice, using daily oral administration of LXH-254 (35 mg/kg) and erlotinib (75 mg/kg). While the treatment robustly inhibited MAPK signaling and caused significant anti-proliferative effects in vitro, it did not improve survival or reduce tumor burden in either in vivo model. hese results contrast with previous reports of efficacy from monotherapies in xenograft models, highlighting the limitations of current preclinical approaches. Our findings underscore the need to develop more effective pathway-targeted inhibitors, and preclinical models that predict clinical outcomes more accurately.Perioperative myocardial injury (PMI) is a common complication following non-cardiac, particularly thoracic, surgery and is associated with increased cardiovascular risk. Although guidelines recommend cardiac biomarker monitoring to detect PMI, its implementation in routine clinical practice remains limited.
To evaluate the combined use of high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting major adverse cardiovascular events (MACE) following elective thoracic surgery, and to determine whether NT-proBNP provides incremental prognostic value beyond hs-cTnI alone.
Multicentre observational cohort study.
Conducted between February 2021 and November 2023 in three Spanish tertiary hospitals.
Patients aged ≥45 years scheduled for elective thoracic surgery involving lung resection (pneumonectomy, lobectomy, bilobectomy or segmentectomy) under general anaesthesia. Exclusion criteria included urgent or non-thoracic surgery, active infection or sepsis and a history of severe heart failure (ejection fraction
Combined measurement of hs-cTnI and NT-proBNP at baseline (preoperatively) and at 24 and 48 hours postoperatively.
PMI was defined as hs-cTnI ≥45 ng/L at 24 and/or 48 hours or a ≥20% increase from baseline in patients with elevated preoperative concentrations.
Among 475 patients, PMI occurred in 11.8%. PMI had higher rates of prior stroke (12.5% vs 2.9%; p=0.004), smoking history (85.7% vs 64.0%; p=0.001) and severe renal dysfunction (7.1% vs 0.7%; p=0.001), with similar Revised Cardiac Risk Index distribution. Patients with PMI also had greater postoperative elevations of hs-cTnI and NT-proBNP (p
Combined hs-cTnI and NT-proBNP assessment improves perioperative cardiovascular risk stratification beyond ischaemia.
To evaluate the association between exposure to occupational biomechanical factors and the incidence of surgically treated osteoarthritis (OA) treated with arthroplasty in the hip and knee among male construction workers.
Longitudinal register-based cohort study.
Male construction workers (n=291 062) who participated in a national Swedish occupational health examination programme between 1971 and 1993, delivered through multiple primary-level nationwide occupational health centres.
Hip and knee arthroplasties performed due to OA from 1987 to 2019 were identified through linkage with the Swedish National Patient Register. Data on age, smoking habits, body mass index, job title and self-reported biomechanical exposures were collected during the health examinations. Occupational biomechanical workload was assessed using eight factors from a job-exposure matrix. Poisson regression was applied to estimate adjusted incidence rate ratios (IRRs) associated with each type of occupational biomechanical exposure.
The study included 10 336 cases of hip arthroplasties and 8926 cases of knee arthroplasties. All studied biomechanical risk factors were associated with an increased risk of knee OA requiring arthroplasty, especially for individuals exposed to static work in non-neutral lumbar postures (IRR 1.38, 95% CI 1.16 to 1.65) and those with a high frequency of kneeling (IRR 1.27, 95% CI 1.12 to 1.45). In contrast, only a few biomechanical factors were associated with an increased risk of hip OA requiring arthroplasty. Similar results were observed when alternative exposure measures, such as occupational group and self-reported exposure assessments, were employed.
Occupational workload was associated with an increased risk of knee arthroplasty due to OA, whereas the association for hip arthroplasty remains unclear.
To explore relatives' experiences of the circulatory death of a family member following out-of-hospital cardiac arrest and to explore their hypothetical perspectives on being asked to decide about organ donation in this situation. This study forms part of a broader initiative undertaken to assess the prerequisites for implementing uncontrolled donation after circulatory death in Sweden with a focus on ethical issues.
A qualitative design, using semi-structured interviews with open-ended questions.
Data were collected in Sweden between March 2024 and September 2024 and analysed using reflexive thematic analysis with an inductive, descriptive approach. Included were 13 bereaved relatives, four men and nine women.
The analysis generated three themes: ‘Fluctuating between hope and despair’, which describes relatives' experiences of their family member's sudden cardiac arrest; ‘Exposed to vulnerability’, concerning their experiences of death and their perspectives on reasoning about the deceased person's wishes regarding donation; and ‘Balancing a major life change’, which involves experiences of facilitators and barriers to dealing with the loss.
Awareness of the deceased family member's wishes regarding organ donation facilitates relatives' ability to support the deceased's known or presumed wishes. Compassionate and communicatively competent healthcare professionals influence relatives' capacity to reason about the deceased's wishes and cope with their experience of loss. Ensuring sufficient time for goodbyes and providing follow-up may facilitate emotional processing and should be considered when implementing uncontrolled donation after circulatory death.
Policies and clinical practice should ensure that relatives are adequately informed and supported in reasoning on their family members' wishes regarding organ donation. To achieve this, nurses and other healthcare professionals require training in compassionate and empathetic communication strategies. Such training is essential both for guiding relatives through reasoning about their family preferences and for providing emotional support during the grieving process.
What is already known? ○
Organ donation after sudden death in out-of-hospital cardiac arrest is a complex process that raises ethical issues concerning both the timing and the content of conversation with the deceased's relatives, as well as the relatives' capacity to reason about the deceased's wishes in the context of sudden death.
○Knowing the wishes of the deceased person, personal beliefs, and receiving clear, direct, and honest information from nurses and other healthcare professionals prepares relatives to reason about the deceased's known or presumed wishes regarding organ donation.
What were the main findings? ○
The quality of nurses' and healthcare professionals' communicative competence and their behaviours influence relatives' ability to reason and reflect on organ donation.
○Factors that facilitate family members' experiences of donation following out-of-hospital cardiac arrest and death include awareness of the deceased's wishes regarding organ donation, being able to see with their own eyes that their family member is dead, and having sufficient time to say farewell.
○Follow-up from health care services could have an impact on relatives' experiences and their processing of loss.
Where and on whom will the research have an impact? ○
This research has an impact on organ donation services, pre-hospital emergency care, and emergency department operations. It can assist nurses and physicians in planning ethical and family-centred care in cases of out-of-hospital sudden death and uncontrolled donation after circulatory death.
COREQ-checklist.
No patient or public involvement in design, conduct or reporting.
by Víctor Herrera, María Consuelo Miranda, Anyela Lozano-Parra, Diana Niño, Luis Ángel Villar, Rosa Margarita Gélvez Ramírez, Thomas Jaenisch, Laura Pezzi, Claudia Acevedo, Jürg Niederbacher
BackgroundZika virus (ZIKV) infection has been inconsistently associated with neurodevelopmental delay (ND). We aimed to compare the incidence of ND between ZIKV-exposed and ZIKV-unexposed children within the ZIKAlliance (ZA) cohort, in Colombia, assessed 2 years after birth (2018–2021).
MethodsWe performed a neurodevelopmental evaluation on normocephalic children (aged 40–72 months) from the ZIKAlliance cohort. Children were classified as ZIKV-exposed (maternal positive RT-qPCR or virus neutralization test – VNT) or unexposed (maternal negative IgG ELISA or VNT in paired antenatal samples). A trained psychologist, blinded to exposure status, administered the Denver Developmental Screening Test II (DDST-II). Children were considered at ND risk if they presented ≥1 delay or ≥2 cautions in one or more areas, within their age range in the DDST-II scale. Inconclusive initial tests were re-evaluated. Adjusted odds ratios were estimated using logistic regression.
ResultsWe analyzed conclusive DDST-II results from 153 children (mean age: 4.7 years; 53.8% male). Overall, 57.2% (n = 83) were classified as cases of ND. Children with ND were more likely to be male (61.4% versus 43.5%) and less likely to attend daycare or school (42.2% versus 11.3%) than children with normal development. After adjusting for child age, sex, household size, and education, the association between in utero ZIKV exposure and ND was not statistically significant (OR = 0.71; 95% CI: 0.32–1.59, p = 0.320). However, children attending daycare or school had a significantly lower risk of ND compared to those who stayed at home.
ConclusionsPrenatal ZIKV exposure was not associated with ND in this cohort of normocephalic preschool children. Instead, attending a community daycare or school emerged as a significant protective factor against developmental delays.
To assess the factors influencing dentists’ choice of restorative materials for posterior restorations, with a particular emphasis on the perceived influence of social media on patient preferences among general dental practitioners in Palestine.
Cross-sectional web-based survey.
A total of 550 general dentists practising in Palestine were invited between May and December 2023 through convenience and snowball sampling via social media platforms; 390 responded, and 350 complete responses were included in the final analysis.
No specific intervention was applied; this was an observational, questionnaire-based study.
Dentists’ selection of restorative materials (composite, amalgam or high-viscosity glass-ionomer cement (HVGIC)) for posterior restorations in relation to tooth type, patient age, oral hygiene, moisture control, financial status and social media influence.
Descriptive statistics, ² tests and multinomial logistic regression were used to examine associations and control for potential confounders.
Material selection varied significantly by tooth type (p
Patient-related factors were the main determinants of material selection, whereas practitioner demographics played a minimal role. HVGICs are preferred for paediatric and elderly patients because of their suitability for age-specific clinical needs. The influence of social media, assessed in this study as dentists’ perceptions rather than direct measures of patient behaviour, underscores its growing role in shaping dentists’ impressions of patient expectations and highlights the importance of evidence-based guidance and public education to support patient-centred, clinically appropriate restorative decisions.
To explore the meaning older Asian immigrants attribute to social isolation and loneliness, their management strategies, utilisation of resources and impact on health.
Systematic review of qualitative studies.
AgeLine, CINAHL, MEDLINE, ProQuest, PsycINFO, Scopus, and Web of Science databases were searched in September 2024.
Inclusion criteria: participants were Asian immigrants to Western countries aged 65 and over, community-living and experiencing social isolation and loneliness. Antonovsky's Sense of Coherence was used to frame the thematic analysis.
Ten papers were included and analysed deductively using elements of the sense of coherence framework: • Comprehensibility: Social isolation and loneliness are viewed as multifaceted, influenced by cultural and environmental dislocation, language barriers, intergenerational conflicts, deteriorating health and mobility, and socioeconomic challenges. • Manageability: included engaging in culture-specific community programs, family and ethnic community support and living within ethnic enclaves mitigated isolation and loneliness. • Meaningfulness: Strong family ties, active community involvement, spirituality, volunteerism, and cultural practices fostered resilience. However, accepting the changing values of their new world, living independently, and carving their own niche provided meaning to their transformed reality.
Older Asian immigrants experience social isolation and loneliness through a cultural lens, shaped by migration experiences, language barriers, and shifting family dynamics. Cultural roots, family ties, spirituality, community, acceptance, and independence enhance sense of coherence. Recognising the dynamic interplay between cultural identity, resilience, and adaptation is key to understanding their lived experience.
This review informs culturally sensitive interventions, guiding healthcare, community services, and policy to support social participation, mitigate loneliness through ethno-specific activities, and improve the quality of life for aging immigrant populations in Western countries.
The review was undertaken and reported using the PRISMA guidelines.
None.
PROSPERO (CRD42023425752)
by Josefine Lampinen, Håkan Littbrand, Ingeborg Nilsson, Annika Toots, Yngve Gustafson, Jerry Öhlin, Henrik Holmberg, Birgitta Olofsson, Anita Ericsson, Mia Conradsson
BackgroundTo meet the complex needs of adults with dementia, a team-based, individualized rehabilitation approach may be required. This randomized controlled pilot trial evaluated the feasibility of a person-centred multidimensional interdisciplinary rehabilitation program for older adults with dementia, in terms of follow-up and response rates, and potential short- and long-term effects in adults with dementia on social participation, loneliness, and mental health.
MethodsParticipants (mean age (SD) 78.7 (±6.6) years), were randomized to an intervention group (n = 31) or usual care (n = 30). The rehabilitation program consisted of a 20-week rehabilitation period and two follow-ups after 5 and 14 months. An interdisciplinary team performed assessments and interventions based on the individual’s goals. Assessors blinded to group allocation performed structured assessments at baseline and after 5, 12, 24, and 36 months.
ResultsInitially, response rates in participants with dementia were high for all assessments in the areas of social participation, loneliness, and mental health. Response rates after 12 months decreased, particularly for cognitively demanding questions with multiple-choice options in the area of social participation. Overall, there were few statistically significant differences between the groups in the outcomes over 36 months, but some of the findings seemed potentially clinically meaningful in favor of the intervention group: increased frequency of active recreation and organized social activities outside the home, as reported by both participants with dementia and caregivers or staff; as well as experienced more frequent visits to family and friends; and short-term reduction in depressive symptoms.
ConclusionsAssessments made of loneliness and mental health in this study over three years seemed feasible. It seemed cognitively demanding for participants with dementia to answer questions regarding social participation over time; therefore it seemed worthwhile to also ask informal caregivers or staff to avoid data loss. The positive findings noted during assessments and potential effects indicate that it is relevant to proceed further to an adequately powered RCT and conducted in additional geographical regions.
Trial registrationISRCTN – The UK’s Clinical Study Registry: http://www.isrctn.com/ISRCTN59155421
FreshRSS 