Conectar
by Sadia Akter, Md. Nazid Bin Ibrahim, Zimam Mahmud, Sonia Tamanna, Md. Shakhawat Hossain Shawon, Farzana Ansari, Md. Zakir Hossain Howlader
Acute myocardial infarction (AMI) remains a leading cause of cardiovascular morbidity and mortality worldwide. Emerging evidence highlights vitamin D as a critical determinant of cardiovascular health. The CYP2R1 gene encodes the key 25-hydroxylase enzyme responsible for converting vitamin D to its principal circulating metabolite, 25-hydroxyvitamin D. However, the influence of CYP2R1 polymorphisms on AMI susceptibility, particularly within South Asian populations, has not been well characterized. This study investigates the association of two CYP2R1 variants, rs2060793 and rs12794714, with AMI risk and their relationship with serum vitamin D levels in a Bangladeshi cohort. A total of 502 participants comprising 251 AMI patients and 251 age- and sex-matched controls were analyzed. Genomic DNA was extracted and genotyped using PCR-RFLP, while serum 25-hydroxyvitamin D3 levels were quantified by HPLC. AMI patients exhibited markedly lower vitamin D concentrations (23.92 ± 0.94 ng/mL) than controls (30.3 ± 0.86 ng/mL; p p = 0.0064). The dominant model (TC + CC vs. TT) further confirmed this relationship (OR = 2.53, 95% CI: 1.39–4.61, p = 0.0016). In contrast, rs12794714 showed no significant association with AMI in this population. Stratified analysis indicated that rs2060793 was significantly linked to AMI in males but not females, while both variants were associated with increased risk in individuals aged ≤60 years, but not in those >60 years. Bioinformatic and molecular docking analyses (RegulomeDB, JASPAR, HADDOCK 2.4, DNAproDB) further demonstrated potential regulatory effects of these variants on CYP2R1 function. Collectively, our findings reveal a novel association between CYP2R1 rs2060793 and vitamin D deficiency with AMI risk in the Bangladeshi population, underscoring the interplay of genetic and metabolic determinants in the molecular pathogenesis of AMI.Long COVID is a complex, multisystem chronic condition that may persist or fluctuate for months to years after SARS-CoV-2 infection. Despite emerging international research, significant gaps remain in understanding the full breadth of long COVID’s impacts in Australia. No study has yet prospectively examined these multidimensional impacts using a culturally appropriate, user-validated toolkit. Our study aims to characterise symptom profiles, functional outcomes and psychological, social, financial and behavioural impacts of long COVID in Australian adults; identify factors associated with recovery trajectories; and validate a set of measures to support research and clinical care.
This national, multi-site, longitudinal prospective cohort study comprises three phases: (1) survey selection and user-testing; (2) psychometric validation; and (3) a longitudinal cohort study. Survey selection was informed by literature review, Australian parliament inquiry reports and international recommendations, and refined through iterative user-testing and expert review. A total of 1000 participants aged ≥18 years from diverse cultural backgrounds with ongoing symptoms following COVID-19 infection will be divided into three cohorts based on time since infection. Surveys will be administered at seven time points over 24 months, with optional follow-up to 36 months. Data linkage to state and national health datasets will enable an objective assessment of healthcare utilisation and associated costs. Psychometric properties of the tools will be evaluated using baseline responses from the initial 300 participants, including assessments of structural/construct validity, convergent validity, known-groups validity, cross-validity, internal reliability, responsiveness and test–retest reliability. Other data analyses will include descriptive statistics, repeated-measures analysis of variance, linear mixed-effects modelling and multivariable regression models.
Ethics approval was obtained from The St Vincent’s Hospital Melbourne Human Research Ethics Committee (HREC) (112108/2024/PID00364) and RMIT University HREC (28124). Research findings will be disseminated at conferences and in peer-reviewed publications.
Australian New Zealand Clinical Trials Registry (ACTRN12625001415493).
Inadequate emergence is a common postoperative complication in elderly patients following major abdominal surgery. This study was designed to determine its incidence, identify associated risk factors and characterise its clinical subtypes within this high-risk cohort.
This prospective single-centre cohort study was conducted at a comprehensive specialised tertiary care hospital in Northwest Ethiopia. Consecutive patients aged 65 years and older scheduled for elective major abdominal surgery under general anaesthesia were enrolled.
The primary outcome was the proportion of patients experiencing inadequate emergence.
A total of 388 patients were analysed. Inadequate emergence occurred in 21.9% of participants (95% CI 14.3% to 31.6%), with hypoactive emergence observed in 10.7% and emergence delirium in 11.2%. Multivariable logistic regression identified several independent predictors, including advanced age (adjusted OR (AOR)=1.9; 95% CI 1.5 to 8.2), preoperative anxiety (AOR=2.7; 95% CI 1.2 to 7.2), prolonged preoperative fasting (AOR=2.1; 95% CI 1.8 to 9.1), non-ketofol-based induction (AOR=3.4; 95% CI 1.6 to 6.3), absence of abdominal field block (AOR=4.2; 95% CI 4.0 to 9.6), substantial intraoperative blood loss (>1000 mL; AOR=1.9; 95% CI 1.2 to 7.6), postoperative nausea and vomiting requiring antiemetics (AOR=2.2; 95% CI 2.1 to 7.1) and presence of an indwelling urinary catheter (AOR=2.4; 95% CI 1.8 to 7.9).
Inadequate emergence occurred in approximately one in five elderly patients undergoing elective major abdominal surgery. Independent predictors included advanced age, major intraoperative blood loss, postoperative nausea/vomiting requiring antiemetics, non-ketofol-based induction, preoperative anxiety, absence of abdominal field block, presence of an indwelling urinary catheter and prolonged preoperative fasting.
by Mequanent Dessie Bitewa, Thomas Kidanemariam Yewodiaw, Aysheshim Asnake Abneh, Mikias Getahun Molla, Mulat Belay Simegn, Tadele Sinishaw Jemere, Mequannt Alemu Endayehu, Aysheshim Belaineh Haimanot, Werkneh Melkie Tilahun, Atirsaw Assefa Melikamu, Tadele Derbew Kassie
BackgroundCervical cancer is preventable, yet it remains a leading cause of cancer death in women. About 90% of cases and 94% of deaths occur in low- and middle-income countries (LMICs). Limited access to screening drives high incidence and mortality. Screening is central to secondary prevention and global elimination efforts.
ObjectiveThis study aimed to assess determinants of cervical cancer screening among women aged 30–49 years in low- and middle-income countries: a multilevel analysis.
MethodsA cross-sectional study used nationally representative data from 148,605 weighted women aged 30–49 years in 20 LMICs (2019–2024). Multilevel logistic regression identified factors associated with cervical cancer screening while accounting for cluster-level variation. Statistical significance was set at p Result
Overall cervical cancer screening uptake was 14.03% (95% CI: 13.63–14.45%), ranging from 0.92% in Mauritania to 42.98% in Zambia. Higher screening was associated with older age 40–49 years (AOR = 1.48; 95% CI: 1.41–1.54), occupation (AOR = 1.15; 95% CI: 1.10–1.21), contraceptive use (AOR = 1.38; 95% CI: 1.31–1.44), recent health-facility visit (AOR = 1.93; 95% CI: 1.84–2.02), prior abortion (AOR = 1.28; 95% CI: 1.22–1.34), female-headed households (AOR = 1.11; 95% CI: 1.05–1.18), high community education (AOR = 1.63; 95% CI: 1.49–1.79), and high media exposure (AOR = 2.54; 95% CI: 2.30–2.80). Lower uptake was observed among individuals in high-poverty communities (AOR = 0.63; 95% CI: 0.57–0.68), higher parity (1–4 birth) (AOR = 0.86; 95% CI: 0.78–0.94); (five or more births) (AOR=0.66 95% CI: 59–0.73), and those residing in rural areas (AOR = 0.89; 95% CI: 0.82–0.97).
ConclusionCervical cancer screening uptake in LMICs is far below the WHO 2030 target, with wide country disparities. Socio-demographic factors, health-facility contact, and community education increase uptake, while poverty and geographic barriers reduce it. Integrating screening into routine reproductive and maternal care, strengthening community and media education, and addressing structural barriers to access are essential to improving coverage.
by Nadieh Abdallah, Ahed Almahdi, Diana Shella, Rasha Al-Masri, Iyad Maqboul, Mohammad Jaber, Ramzi Shawahna
This study was conducted to assess the incidence and types of complications and mortality following liver biopsy, and to identify independently associated factors that can inform clinical practice in a resource‑limited healthcare system. A retrospective multicenter study was conducted across six major hospitals between January 2020 and December 2025. Medical records of 218 patients undergoing percutaneous and laparoscopic liver biopsies were reviewed. Demographic, clinical, laboratory, procedural, and outcome variables were extracted using a validated data collection form. Inferential analyses were conducted using chi‑square, Fisher’s exact, and Mann‑Whitney U tests, while multivariate logistic regression models were employed to identify factors independently associated with complications and mortality. The most common types of complications were infection (n = 7, 3.2%) and hemorrhage (n = 6, 2.8%), followed by pulmonary complications (n = 4, 1.8%), metabolic disturbances (n = 3, 1.4%), and acute kidney injury (n = 2, 0.9%). Mortality was recorded in 6 patients (2.8%). Higher pre-operative white blood cell count was independently associated with infections (OR: 1.28, 95% CI: 1.02–1.62, p = 0.036). Older age was independently associated with mortality (OR: 1.07 per year increase, 95% CI: 1.01–1.15, p = 0.035). Hemorrhage and pulmonary complications were more frequent after laparoscopic biopsy and under general anesthesia, although these associations did not remain significant in adjusted models. This study provides the first systematic evidence on liver biopsy safety in Palestine, a resource‑limited healthcare system, thereby filling a critical gap in the regional literature. The study identified pre-operative increases in white blood cell count as a predictor of infection and older age as a predictor of mortality. These simple, pragmatic markers can guide monitoring and risk stratification in constrained environments, offering actionable insights for clinicians and policymakers. Future studies should be conducted to evaluate whether these markers can help reduce complications and mortality.To present the process of establishing a Doctor of Nursing Practice (DNP) policy analysis project option at one nursing school, offering examples of diverse student and graduate analyses to guide other institutions.
Nurses are skilled patient advocates, and their advocacy forms a crucial foundation for influencing health policy. This, in turn, enhances population health and addresses health disparities, particularly for vulnerable groups. DNP students are educated to use innovative methods to integrate current evidence to inform practice and policy, yet some nursing schools lack resources to support comprehensive DNP policy analysis projects.
The article presents a case example of how one institution developed a pathway and instructional support to formally offer DNP students the option to perform a DNP policy analysis project.
Essential elements to support students' successful completion of a DNP policy analysis project include adequate faculty expertise in health policy and a structured institutional framework. Residency activities must deepen a student's understanding and knowledge about policy and the health problem trying to be solved with policy. Clear documentation of these unique residency activities is crucial. There is a strong emphasis on the need for clear communication and guidance between programme faculty, programme mentors and students. DNP policy analysis projects enrich students' knowledge, skills and networks, fostering future policy leaders and facilitating collaboration with clinical experts across diverse research fields.
Nurturing DNP students completing policy analysis projects is vital for translating evidence into practice, developing future nurse policy leaders and ensuring health equity and access to quality healthcare.
DNP policy projects can positively influence nursing practice and policy. Expanding upon previous DNP students' policy analysis projects also provides a unique opportunity to build and broaden nursing's impact on policy development.
To explore (a) the associations between individual social responsibility and the public intention to use violence against nurses; and (b) the relationship between individual social responsibility, personal variables and the public's intention to employ violence against nurses.
Workplace violence against nurses is a significant widespread occupational health issue. To date, no reference has been found to the association between personality traits such as individual social responsibility and the public's intention to use violence against nurses.
A cross-sectional survey design with a convenience sample of 667 Israeli participants from among the public. A structured self-report questionnaire was distributed, including socioeconomic variables, individual social responsibility and responses to four vignettes describing incidents of violence directed at nurses. Multiple linear regressions were calculated for intention to employ violence, with demographic variables and individual social responsibility as independent variables. The STROBE checklist for cross-sectional studies was used for reporting.
Negative correlations were found between individual social responsibility and the intention to employ violence against nurses. Gender, having witnessed physical violence and individual social responsibility explained 19% of the variance in the intention to employ violence against nurses. Demographic variables and having witnessed verbal or physical violence were found to moderate the association between individual social responsibility and the intention to employ violence against nurses.
Witnessing a violent incident in a healthcare setting is a risk factor for the intention to employ violence against nurses. Our findings point to the role of individual social responsibility as one of the strategies to help reduce violent events.
Educating and promoting values of social responsibility among the public can reduce incidents of violence in healthcare settings, thus contributing to the safety and quality of care provided.
The public contributed via study participation.
To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.
An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).
Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.
Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.
There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.
Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.
This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.
This study adheres to the STROBE guidelines for reporting observational studies.
In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.
To synthesise evidence on wearable devices for continuous vital signs monitoring in adult hospital inpatients, focusing on clinical effectiveness, nursing perspectives, workflow impact, patient experience and resource implications.
Scoping review.
Joanna Briggs Institute methodology reported using PRISMA-ScR guidelines.
Six databases (CINAHL, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane), Scite.ai, and hand searching for studies published between January 2015 and November 2025. Data were synthesised using reflexive thematic analysis.
Sixty-seven studies from 19 countries were included. Four integrative themes were identified. (1) Enhancing clinical safety through continuous monitoring: wearable devices consistently enable earlier recognition of physiological deterioration; however, downstream outcomes such as length of stay and transfers to intensive care units were mixed and context dependent. (2) Transforming nursing practice and workflow integration highlighted improved situational awareness and potential efficiency gains, alongside challenges related to alarm overload, parallel documentation and implementation workload. (3) Patient experience of wearable monitoring: most patients reported reassurance and perceived safety, though experiences reflected a tension between monitoring as care and monitoring as surveillance; discomfort, anxiety, and privacy considerations were infrequently examined. (4) Economic and organisational consequences: potential system value was suggested through workforce efficiencies, but economic benefits were largely inferred, with infrastructure and training costs often underreported.
Wearable continuous monitoring technologies show clear potential to support nursing observations enabling improved early detection of deterioration. Realising these benefits depends on effective integration into workflows, robust governance, and sustained nursing leadership rather than technological capability alone. Significant evidence gaps remain regarding long-term outcomes, economic evaluation, and large-scale implementation.
Wearable devices for continuous vital signs monitoring have the potential to transform inpatient surveillance by enabling earlier recognition of physiological deterioration and enhancing nurses' situational awareness. This scoping review synthesises international evidence demonstrating that, although wearable monitoring can improve patient safety and workflow efficiency, its impact depends on effective integration into nursing practice, governance structures, and organisational preparedness. Continuous monitoring also introduces new challenges including alert fatigue, data interpretation, and workflow redesigns, highlighting the vital role of nursing leadership in digital health implementation. The review also identifies critical evidence gaps, particularly concerning long-term clinical outcomes, patient experience, and cost-effectiveness, providing priorities for future research and policy to promote safe, ethical, and sustainable adoption.
None.
Doctoral research in nursing is central to advancing scientific knowledge, strengthening professional identity, and informing evidence-based practice, education, and health policy. Analyzing the thematic content of doctoral theses offers insight into research priorities and national variations in nursing scholarship. Yet, no systematic cross-country analysis has examined the thematic focus of such work.
To explore and describe the diversity and scope of doctoral nursing research themes across eight countries in the Sigma Europe Region, identifying key areas of scholarly focus and shared priorities.
A document-based qualitative study using reflexive thematic analysis, as outlined by Braun and Clarke, to examine patterns of meaning within thesis summaries.
The study included doctoral nursing thesis summaries defended between January 2020 and December 2023, sourced from national and institutional repositories in eight countries of the Sigma Europe Region. A total of 15 repositories (4 national, 11 institutional) were systematically searched, and additional summaries were obtained via direct contact with universities offering doctoral nursing programmes.
Data were collected between September 2024 and February 2025 using predefined inclusion and exclusion criteria. In total, 431 eligible thesis summaries were analyzed following Braun and Clarke's six-phase framework, supported by MAXQDA software for data management and coding.
Thematic analysis identified three overarching domains: (1) foundations of nursing practice and care philosophy, (2) systemic and organizational dimensions of nursing, and (3) clinical innovation and public health impact. Ten interrelated themes emerged, including holistic and patient-centred care; emotional, psychological, and quality-of-life dimensions; communication in healthcare; workforce challenges; transforming nursing practice; maternal, neonatal and pediatric health; digital and virtual health innovations; public health and chronic disease management; and disease management, caregiving, and outcomes. Cross-cutting elements such as cultural sensitivity and resilience spanned multiple themes.
This cross-national synthesis demonstrates the breadth and depth of doctoral nursing research in the Sigma Europe Region. Findings highlight nursing's pivotal role in addressing healthcare needs through innovative, person-centred, and evidence-informed solutions, and underscore the value of international collaboration in shaping resilient, equitable, and future-ready healthcare systems.
Drug-related problems (DRPs), which encompass medication errors (MEs), adverse drug reactions and adverse drug events (ADEs), represent significant challenges in healthcare settings. While medication safety has been extensively studied in hospitals and primary care settings leading to development of improvement strategies, there is limited understanding of these issues within prison healthcare environments. This knowledge gap is concerning given that prisoners often have complex medication needs due to higher rates of chronic physical and mental ill health and substance use disorders compared with the general population. Time in prison presents an opportunity to provide treatment for this socially disadvantaged group, making it an important setting to optimise medication management. This scoping review aimed to understand the nature and frequency of medication safety incidents, their contributory factors and evaluate strategies for enhancing medication safety within prison healthcare environments, where unique institutional constraints and security requirements may impact safe medication use.
This study conducted a systematic search across six databases to appraise the published literature from 2000 to 2023 (Embase, Medline, PsycINFO, CINAHL Plus, Cochrane and Web of Science), with reporting according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review guidelines. Data extraction was completed by one author, with validation of a sample by the other authors. The review included quantitative, qualitative and mixed-methods studies examining DRPs in prison healthcare.
The review included 42 studies on medication safety in prison healthcare, comprising epidemiological perspectives (52.4%, n=22/42), aetiological exploration of DRPs (45.2%, n=19/42) and intervention evaluation (11.9%, n=5/42). Studies were predominantly from the USA (30.9%, n=13/42) and the UK (26.1%, n=11/42). Most studies focused on infectious disease management (52.3%, n=22/42), particularly HIV treatments (42.8%, n=18/42), followed by mental health medications (23.8%, n=10/42). Non-adherence emerged as the most commonly studied DRP, reported in both epidemiological (68.1%, n=15/22) and aetiological studies (68.4%, n=13/19). Contributing factors included medication delivery problems, psychosocial factors, accessibility challenges and conflicts between healthcare delivery and security requirements. Five intervention studies were identified, with two from the USA (40%, n=2/5). These interventions included those addressing medication non-adherence (40%, n=2/5) and potentially inappropriate prescribing (20%, n=1/5), and highlighted the potential efficacy of multidisciplinary and pharmacist-led approaches in addressing medication safety challenges within prison healthcare settings.
This represents the first comprehensive study to present a narrative report on the existing evidence regarding the epidemiology, aetiology and interventions for medication safety events in prison healthcare. While intervention studies demonstrate promising findings from multidisciplinary and pharmacist-led initiatives, further evidence is needed to address DRPs beyond medication non-adherence, guided by a deeper understanding of their contributory factors. Future studies should target preventable MEs and ADEs, as well as wider health conditions to broaden our understanding of prison-specific contributory factors to develop targeted interventions for this vulnerable population.
To examine the impact of delays in intensive care unit (ICU) admission on patient outcomes, specifically clinical deterioration and mortality among patients transferred from the emergency department (ED) or general wards following acute deterioration in an Australian public hospital.
This prospective cohort study was conducted over a 12-month period (15 April 2022–14 April 2023) in a 209-bed regional hospital. It included adult patients (aged ≥ 18 years) admitted to the ICU from ED or general wards following acute deterioration. Primary outcomes measured were duration of delay in ICU admission, ICU and hospital mortality and changes in Sequential Organ Failure Assessment (SOFA) scores over time to assess organ dysfunction and progression.
A total of 403 patients were included. Of these, 276 (68.5%) experienced delays in ICU admission, ranging from 25 min to 347.25 h (median: 7.13 h). Delayed ICU admission was associated with increased mortality. Each one-point increase in the highest recorded SOFA score was linked to a 7.5% rise in mortality odds, while each one-point increase in the initial or 24-h SOFA score corresponded to a 6.8% increase.
Delayed ICU admission was significantly associated with increased mortality, particularly in patients with elevated SOFA scores, indicating worsening organ dysfunction and clinical instability.
These findings highlight the urgent need for improved triage systems, early warning protocols and streamlined escalation pathways to expedite ICU transfers for deteriorating patients. Timely intervention is essential to reduce harm and improve outcomes.
This study reinforces the clinical risks of delayed ICU admission and supports timely escalation of care in emergency and ward settings across Australian public hospitals.
Conducted in accordance with STROBE guidelines.
No direct patient or public involvement. The study used routinely collected clinical data to evaluate systemic and clinical outcomes.
The cover image is based on the article Moisture-Responsive Friction Adaptability: Rethinking the Conventional Skin Silicone Interfaces in Pressure Injury Prevention Dressing Designs by Amit Gefen et al., https://doi.org/10.1111/iwj.70860.
The cover image is based on the article Moisture-Responsive Friction Adaptability: Rethinking the Conventional Skin Silicone Interfaces in Pressure Injury Prevention Dressing Designs by Amit Gefen et al., https://doi.org/10.1111/iwj.70860.
Losses of functional reserve across multiple physiological systems have been identified in frail patients, yet the exact aetiology of frailty remains unclear. Although strongly associated with chronological age, frailty often develops at a younger age in patients with organ failure. Frailty is prevalent in patients with kidney failure; however, individuals experience improvements in physical frailty measures following kidney transplantation. This makes younger patients with kidney failure a unique population for studying both the accelerated onset of frailty and its reversal. This research project aims to test the hypothesis that frailty secondary to organ failure and age-related frailty are associated with similar molecular and physiological measures.
This longitudinal study will recruit 150 patients in three groups. Group A (kidney transplant recipients aged ≥40 years; n=50) and Group B (patients aged ≥40 years active on the kidney transplant waitlist; n=50) will comprise younger adults with frailty from organ failure. Group C (adults aged ≥65 years (or ≥55 years for Aboriginal and Torres Strait Islander patients); n=50) will comprise older community dwellers. The primary outcome is the Frailty Index (FI). Secondary outcomes include the change in FI over time, and at baseline when considering various clinical metadata, immune parameters, kidney function and nutrition intake which will be measured at baseline and 12-month time points. Longitudinal changes in frailty will be analysed using linear mixed models with multiple testing corrections for false discovery rates.
Endocrine profiles and metabolomics, measures of immune function and microcirculatory dysfunction, will be measured by liquid chromatography-mass spectrometry and/or gas chromatography-mass spectrometry. The gut microbiome will be sequenced via shotgun metagenomics (Illumina NextSeq500, 150 bp paired-end, 3Gbp/sample). Circulating cell-free DNA/mitochondrial DNA will be quantified through droplet digital PCR. Microcirculation will be assessed via sublingual dark field videomicroscopy with glycocalyx markers measured by ELISA.
This study will be conducted with all stipulations of this protocol, and the conditions of the ethics committee approval. Ethical principles have their origin in the Declaration of Helsinki, all Australian and local regulations and in the spirit of the standard of Good Clinical Practice (as defined by the International Conference on Harmonisation). Organs/tissues will be sourced ethically and will not be sourced from executed prisoners or prisoners of conscience or other vulnerable groups.
Ethics approval was received by the Metro South Health Research Ethics Committee (HREC/2023/QMS/95392) and ratified by the University of Queensland.
Results will be disseminated through peer-reviewed publications, academic conferences, participant newsletters and health organisation collaboration.
This study evaluated the frictional properties of the skin-contact interfaces of two multilayer prophylactic dressings under simulated perspiration conditions. The tested dressings were identical except for the skin-contact interface, which was either silicone-made or Hydrofiber-made, that is, AQUACEL Hydrofiber Technology. Using a standardised tribological ‘sled test’ setup and a skin-mimicking polymer substrate, we measured the static and kinetic coefficients of friction for each dressing interface type at varying moisture levels. The dressing with the Hydrofiber interface consistently demonstrated significantly lower static and kinetic coefficients of friction compared to the silicone-based dressing, across all moisture conditions. The Hydrofiber interface exhibited a sharp coefficient of friction reduction with minimal (5%) moisture accumulation, mimicking overnight perspiration under thermoneutral conditions. This dressing maintained the low coefficient of friction levels at a steady level of approximately 0.2 until full saturation. In contrast, the silicone interface retained high (> 1) coefficients of friction regardless of moisture. These findings highlight an important biomechanical advantage of Hydrofiber skin-contact materials in reducing frictional forces at the skin-dressing interface, especially in moisture-prone body areas, in a pressure injury prevention context. Friction-responsive skin-contacting dressing materials with low coefficients of friction, which remain low while they become moist due to perspiration accumulation, should be preferred for preventative dressings.
For adolescents living with higher body weight, changing lifestyle behaviours can be met with challenges due to psychosocial factors, such as mental health and emotional challenges. Few behavioural interventions have included skill development to manage these mental health and emotional challenges.
The feasibility of a dialectical behavioural therapy (DBT)–enhanced lifestyle intervention will be evaluated through a pilot randomised controlled trial. We will recruit 90 adolescents aged 14–17 years with a body mass index Z-score >1.4 and mild-to-moderate depressive symptoms to participate with a caregiver in the trial. Adolescents will be randomised 2:2:1 to one of the three study arms: (A) behavioural lifestyle intervention with DBT skills training, (B) behavioural lifestyle intervention alone (ie, without DBT skills training) or (C) control. The interventions will include two sessions weekly for 16 weeks that include (1) one modified DBT skills training with two facilitators, supervised by a clinical psychologist, combined with one behavioural lifestyle session delivered by a dietitian and/or a kinesiologist and (2) two behavioural lifestyle sessions alone. DBT skills training will consist of teaching mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness and walking the middle path modules. Behavioural sessions will be guided by evidence-based practices for goal setting, dietary counselling, improving sleep, reducing screen time and structured physical activity. The main outcomes are enrolment rates, adherence to the intervention and retention rates for follow-up measurements. The secondary outcome will be changes in the quality of life (Pediatric Quality of Life Inventory) and daily physical activity levels between baseline and immediately post-intervention. Adolescents will participate in a focus group incorporating photo elicitation to explore satisfaction, acceptability and perceived benefits of the study arms.
This study has received ethical approval from the University of Manitoba’s Biomedical Research Ethics Committee (HS24295-H2020:427), Hamilton Health Sciences & McMaster University (HiREB 18159) and The Conjoint Health Research Ethics Board (CHREB), University of Calgary (REB24-1084). Results will be disseminated through publication in peer-reviewed journals and be relevant to researchers and clinicians involved in paediatrics and paediatric weight management.
The Optimising older People’s Transition from acute care Into residential aged care through Multidisciplinary Assessment and Liaison (OPTIMAL) trial is a multisite hybrid type II stepped wedge randomised controlled trial with an embedded process evaluation that aims to evaluate the effectiveness of implementing a bundle of evidence-based interventions to provide systematic support to older adults being discharged from hospital to residential aged care (RAC) homes for the first time. The trial is based on evidence from models of care used internationally to improve the quality of care transitions and addresses a need to provide evidence of transferability and effectiveness of these models in the Australian context. The embedded process evaluation will assess the acceptability, appropriateness, feasibility, adoption and fidelity of the OPTIMAL intervention, as well as the mechanisms of impact.
The OPTIMAL trial will be implemented across the three metropolitan local health networks (LHNs) in South Australia. The process evaluation will be conducted in parallel with the main trial and is theoretically informed by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) implementation framework, which theorises that the implementation success of OPTIMAL is determined by the facilitation of the intervention with the intended recipients in their inner and outer contextual setting. The process evaluation will employ a mixed methods approach. Qualitative and quantitative data will be collected through baseline context mapping of LHNs, interviews with key LHN and RAC stakeholders, online survey of clinical teams, fortnightly check-in forms, and activity logs and field notes maintained by the nurse facilitator in each LHN. Data will be mapped and reported based on the i-PARIHS framework.
Ethical approval for the OPTIMAL trial was obtained from the Southern Adelaide Clinical Human Research Ethics Committee (approval 2023/HRE00111), and the relevant governance approvals were obtained for each participating LHN. Ethical approval includes a waiver of the requirement for consent for routinely collected patient data. Study findings will be disseminated via journal publications, presentations at conferences, stakeholder discussions, consumer forums and advocacy to key decision makers to support knowledge translation.
Australia New Zealand Clinical Trial Registry, ACTRN12624001008516, registered 20 August 2024.
Recent research indicates that around 8% of older people living in prison have signs or symptoms of dementia or mild cognitive impairment (MCI), yet the care they receive is not equivalent to care in the community and this means their needs may not be met. We co-developed an intervention specifically for older people living in prison with dementia/MCI (Dementia and Mild Cognitive Impairment in prison care pathway and training package–DECISION). To date, this has not been implemented or evaluated. This paper presents our protocol for a study to assess the feasibility and acceptability of DECISION.
This is a non-randomised, realist-informed mixed-methods feasibility study with integrated process evaluation, which will take place in two prisons in England. The intervention was codeveloped with experts with lived experience. Participants will include older people living in prison, staff working in prison and peer supporters. We will assess the feasibility and acceptability of the intervention (eg, numbers eligible; rates of recruitment and retention), and the evaluation design (eg, completion rates of standardised outcome measures). Methods will include semistructured, realist-informed interviews; an audit to assess implementation fidelity; focused ethnography; training questionnaires; and collection of resource use data. We will refine the DECISION programme theory using realist-informed methods to examine and refine how contexts and mechanisms interact to produce the intervention’s outcomes.
This study received a favourable ethical opinion from the Wales REC 3 Research Ethics Committee in January 2025 (reference number 24/WA/0323). HMPPS National Research Committee approval was also granted in January 2025 (reference number 2024-1451). Findings will be disseminated through a range of avenues, including stakeholder engagement events, open-access papers, conference presentations, evidence briefings for commissioners, providers and practitioners, and newsletters for service users.
Effective thermal management at the skin-dressing interface is essential in pressure injury prevention by means of prophylactic dressings. This study quantified the thermal conductivity of AQUACEL Hydrofiber Technology (AHT, hydrofiber) and polyurethane foam dressing materials under normothermic (32°C) and febrile (40°C) conditions across increasing moisture levels. Using a validated custom heat-flow meter system, dry hydrofiber exhibited significantly greater thermal conductivity than the polyurethane foam (0.43 ± 0.01 vs. 0.20 ± 0.01 W/m K at 32°C; p < 0.001). Upon hydration at 32°C, thermal conductivity values increased nonlinearly for both materials but to a much greater extent for the hydrofiber. At 15% moisture, the hydrofiber reached 4.73 ± 0.12 W/m K compared to the polyurethane foam at 1.03 ± 0.02 W/m K. At 40°C, hydrofiber achieved 3.39 ± 0.19 W/m K with only 10% moisture, indicating a temperature-responsive biphasic transformation. Overall, hydrofiber demonstrated a fivefold greater thermal conductivity response to moisture than the polyurethane foam. These findings highlight critical, material-dependent differences in heat dissipation under clinically relevant conditions. The superior moisture-responsive thermal conductivity of hydrofiber highlights its potential to improve heat dissipation at the skin-dressing interface under clinically relevant conditions and thereby mitigate local heat accumulation, contributing to skin protection. Thermal conductivity and thermal adaptability studies should be integrated into dressing efficacy research and be used for selection criteria for pressure injury prevention programs alongside mechanical and absorptive performance.
The aim of this study was to assess the prevalence of poor sleep quality and its determinants in people with schizophrenia in Northwest Ethiopia.
Institutional-based cross-sectional study design.
University of Gondar, Comprehensive and Specialized Hospital, Gondar, Ethiopia.
A total of 405 people with schizophrenia attending outpatient treatment at University of Gondar, Comprehensive and Specialized Hospital were recruited in this study employing systematic random sampling technique from 1 April to 30 May 2024.
An interviewer-administered questionnaire and chart review were used to collect the data. Pittsburgh Sleep Quality Index, Clinical Global Impression-Schizophrenia Scale, Glasgow Antipsychotic Side-Effects Scale, Medication Adherence Report Scale and Oslo Social Support Scale were used. A binary logistic regression was employed to measure the association of poor sleep quality and its determinants and variables with a p value of
The overall prevalence of poor sleep quality in people with schizophrenia was found to be 58.3% with a 95% CI 53.38 to 63. Age less than 45 years (adjusted OR (AOR)=2.1, 95% CI 1.2 to 3.7), poor and moderate social support (AOR=10, 95% CI 5.7 to 17.8 and AOR=4.7, 95% CI 2.5 to 8.8), poor medication adherence (AOR=1.9, 95% CI 1.8 to 3.1) and a family history of mental illness (AOR=1.9, 95% CI 1.2 to 3.3) were significantly associated with poor sleep quality in this study.
This study revealed that around six in 10 people with schizophrenia experience poor sleep quality. Therefore, healthcare providers should routinely screen people with schizophrenia for sleep and consider targeted interventions to achieve the ultimate goal of treatment process.
FreshRSS 