Conectar
by Sang Ah Lee, Jin-Myung Kim, Hye Eun Kwon, Youngmin Ko, Joo Hee Jung, Sung Shin, Young Hoon Kim, Sung-Han Kim, Hyunwook Kwon
PurposeOptimal perioperative antibiotic prophylaxis in kidney transplantation remains undefined despite routine antibiotic administration to prevent infections. In this retrospective observational cohort study with historical comparison, we compared the clinical efficacy of 6 days of ampicillin/sulbactam vs. a single dose of cefazolin.
Materials and methodsWe retrospectively analyzed 2322 kidney transplantation recipients at a single center, with the evaluation period spanning from 2015 through 2021. Patients were divided into 2 groups based on the perioperative antibiotic regimen received: 971 patients received ampicillin/sulbactam, and 1351 received cefazolin. This study focused on evaluating the impact of these regimens on postoperative infection incidence and the 6-month acute rejection (AR) rates.
ResultsThe cefazolin group exhibited a tendency toward higher urinary tract infection rates within 1 month after transplantation (3.4% vs. 2.2%, p= = 0.078). There were no significant differences in surgical site infections between the groups. The 6-month AR rates were significantly lower in the cefazolin group than in the ampicillin/sulbactam group (5.1% vs. 7.9%, p= = 0.009). Cefazolin was also confirmed to be significantly associated with reduced 6-month AR rates in the multivariable logistic regression analysis (odds ratio 0.63, 95% confidence interval [0.45-0.89], p= = 0.009).
ConclusionIn this study, we observed that a single dose of cefazolin as perioperative antibiotic prophylaxis may lead to higher rates of postoperative urinary tract infections, but it could potentially lower the incidence of acute rejection within six months.
by Yong Jae Lee, Nam Kyeong Kim, Kidong Kim, Chel Hun Choi, Keun Ho Lee, Jong-Min Lee, Kwang Beom Lee, Dong Hoon Suh, Sunghoon Kim, Min Kyu Kim, Seok Ju Seong, Myong Cheol Lim
ObjectiveTo identify the effect of fascial closure using barbed sutures on the incidence of incisional hernia in patients undergoing elective midline laparotomy for gynecological diseases.
MethodsIn this multicenter, non-blind randomized controlled trial conducted from February to December 2021, patients with a BMI 2 and aged >18 years, scheduled for midline laparotomy, were randomly assigned to receive either barbed (experimental) or non-barbed sutures (control) for fascial closure. The primary outcome was the cumulative incidence rate of incisional hernia up to 1-year post-surgery. Secondary outcomes included incisional hernia up to 2-years post-surgery, wound complications, and postoperative pain assessed by Brief Pain Inventory-Korean scores, and Numeric Rating Scale.
ResultsOut of 174 patients (experimental, 86; control, 88), 36 were excluded due to dropout or loss to follow-up, leaving 138 patients (experimental, 67; control, 71) included in the analysis. The groups were balanced in terms of cancer surgeries, mean wound length, and mean surgery time. The cumulative incidence rates of incisional hernia up to 1-year (0.0% vs. 1.4%; p > 0.999) and 2-years (0.0% vs. 3.4%, p = 0.496) post-surgery did not differ significantly between the experimental and control groups. Additionally, no significant differences were observed in the incidence of wound dehiscence 4 weeks post-surgery, cumulative incidences of wound dehiscence and wound infection up to 4 weeks post-surgery, or postoperative pain scores between the groups.
ConclusionsFascial closure using barbed sutures resulted in no cases of incisional hernia up to 2-years post-surgery, but did not demonstrate a significant reduction in incisional hernia rates compared with the non-barbed suture.
Trial registrationClinicalTrials.gov NCT04643197
To critically examine how male privilege operates within nursing leadership by applying sociological theories that highlight the paradox of men's advancement in a female-majority profession.
This position paper adopts a critical sociological lens to explore how gendered power structures continue to shape leadership in nursing.
Three interrelated sociological frameworks (tokenism, the glass escalator, and hegemonic masculinity) are applied to analyse how men, despite being numerically underrepresented, often reach leadership roles and hold institutional authority disproportionately. Literature from gender studies, nursing sociology, and workforce research is synthesised to trace patterns of privilege and exclusion.
The analysis demonstrates that male nurses often benefit from symbolic visibility, access to informal mentorship, and alignment with leadership norms that prioritise traits such as assertiveness and autonomy. Although some men encounter initial marginalisation, their minority status can enhance perceived legitimacy and accelerate advancement. However, these dynamics are not uniformly experienced. Intersections of race, sexuality, and citizenship significantly shape how male privilege is accessed and constrained.
Male privilege in nursing leadership is sustained by deeply rooted power structures. Addressing these disparities requires more than increasing male representation; it demands a redefinition of leadership values, and a critical review of the assumptions embedded in professional advancement.
Identifying the structural and cultural mechanisms that support male advancement can inform more equitable leadership development, guide inclusive policy design, and challenge taken-for-granted assumptions about competence and authority in nursing.
This study did not include patient or public involvement in its design, conduct, or reporting.
by Yoo Kyung Choi, Seok Hyun Son, Hong Seok Jang, In-Ho Kim, Sea-Won Lee, Soo-Yoon Sung
BackgroundRadiotherapy for locally advanced esophageal cancer can induce lymphopenia, potentially worsening outcomes. This study examines the association between clinical outcomes and the effective dose to the immune cells (EDIC), a measure of lymphocyte radiation exposure.
MethodsWe retrospectively analyzed 107 patients with locally advanced esophageal squamous cell carcinoma treated with definitive concurrent chemoradiotherapy (CCRT). The EDIC was calculated based on the mean lung dose, mean heart dose, and integral total body dose using established models. Patients were stratified into high (n = 42) and low (n = 65) effective dose to the immune cells (EDIC) groups using a cut-off value of 4.28 Gy. Survival outcomes, including overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFS), and distant metastasis-free survival (DMFS), were assessed.
ResultsThe 5-year OS and PFS rates were significantly lower in the high EDIC group than in the low EDIC group (51.9% vs. 66.6%, p = 0.043; 20.8% vs. 31.8%, p = 0.002, respectively). Multivariate analysis identified high EDIC as an independent predictor of poorer OS (hazard ratio (HR): 2.06, 95% confidence interval (CI): 1.1–3.86, p = 0.024) and PFS (HR: 1.7, 95% CI: 1.04–2.78, p = 0.034). Similarly, the 5-year LRFS and DMFS rates were significantly lower in the high EDIC group than in the low EDIC group (24.1% vs. 34.9%, p = 0.003; 29.0% vs. 44.0%, p = 0.018, respectively).
ConclusionA higher EDIC is an independent predictor of poor survival in patients with esophageal squamous cell carcinoma undergoing CCRT. Reducing radiation exposure to the immune system through optimized radiation planning and lymphocyte-sparing techniques may improve patient outcomes.
by Sunghoon Jeon, Keunho Kim, Cheolwon Choe, Juil Choi, Gun Lee, Chung-Do Lee, Hyeon-Jeong Moon, Jun-Gyu Park, Jin-kyung Kim, Namsoon Lee, Dongwoo Chang
Quick-soluble gelatin microparticles (QS-GMP) are emerging embolic agents under investigation for temporary vascular occlusion, offering reduced ischemic risk compared to permanent materials. The aim of this preclinical study was to evaluate the safety and efficacy of QS-GMP for transarterial embolization in a rabbit model of urinary bladder embolization. Twelve male New Zealand White rabbits underwent bilateral umbilical artery embolization using QS-GMP. Animals were assigned to four time-points (immediately, 3, 7, and 14 days post-embolization), with comprehensive assessments including clinical observations, hematologic and serum biochemical analysis, angiography, and histopathology. The procedure was technically feasible in all animals without intraoperative complications. Temporary hematuria and a transient decrease in body weight were observed post-procedure, both of which resolved spontaneously. Complete occlusion of the cranial vesical artery and absence of bladder wall perfusion were achieved immediately after embolization, followed by full recanalization at 3 days. Angiographic imaging at 7 and 14 days revealed transient hypervascularization of the bladder wall. Histopathological analysis showed marked edema, epithelial necrosis, and inflammatory infiltration at 3 and 7 days, with full urothelial regeneration observed at 14 days. No signs of ureteral or renal injury, or adverse systemic responses were detected. These findings suggest that QS-GMP may serve as a feasible option for temporary arterial occlusion in future veterinary lower urinary tract applications, although further long-term evaluation is warranted.by Yesung Lee, Woncheol Lee
Long working hours are increasingly recognized as a significant occupational hazard linked to various adverse health outcomes. This study aimed to assess how prolonged working hours relate to the subsequent development of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic and alcohol-associated liver disease (MetALD), based on a newly proposed classification system. We analyzed data from 117,354 Korean employees who underwent at least two abdominal ultrasound examinations between 2012 and 2023. Long working hours referred to a weekly workload of at least 60 hours. The primary outcome was the incidence of steatotic liver disease, categorized as MASLD or MetALD. A total of 28,361 new cases were identified over 627,094 person-years of follow-up. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Participants working ≥60 hours per week had a higher risk of developing MASLD (adjusted HR 1.17, 95% CI 1.03–1.32) and MASLD+MetALD (adjusted HR 1.18, 95% CI 1.05–1.33) compared with those working 35–59 hours per week. Subgroup analyses indicated that the association was especially pronounced among individuals aged ≤47 years and in men. These results suggest that prolonged working hours contribute to an increased risk of MASLD and MASLD+MetALD, particularly in younger and male populations, emphasizing the importance of occupational health interventions.High-intensity statin therapy is recommended as a first-line strategy for lowering low-density lipoprotein cholesterol (LDL-C) levels in patients with acute myocardial infarction (AMI). A combination of moderate-intensity statin and ezetimibe at an equivalent dose to high-intensity statin may achieve similar LDL-C reduction with fewer side effects. This study evaluates the long-term efficacy and safety of this approach, initiated following AMI, compared with high-intensity statin monotherapy.
The ROSUZET-AMI trial is a multicentre, prospective, open-label, randomised, non-inferiority trial. Patients with AMI who underwent percutaneous coronary intervention were randomised 1:1 to receive either moderate-intensity statin with ezetimibe (rosuvastatin 5 mg with ezetimibe 10 mg) or high-intensity statin monotherapy (rosuvastatin 20 mg). The primary endpoint is the composite of cardiovascular death, major coronary events (non-fatal myocardial infarction, documented unstable angina requiring hospitalisation and all coronary revascularisation events occurring at least 30 days after randomisation), or non-fatal stroke.
Ethics approval for this study was obtained from the Institutional Review Board of Seoul St. Mary’s Hospital (No. 2020-0424-0003). Informed consent is obtained from every participant before randomisation. The results of this study will be submitted for publication in international peer-reviewed journals, and the key findings will be presented at international scientific conferences.
To assess the association of normal systolic blood pressure maintenance (SBPmaintain) with coronary artery calcification (CAC) progression in non-diabetic and diabetic subjects at low to intermediate cardiovascular risk.
Retrospective cohort study with a mean follow-up of 3.3 years.
Data from the Korea Initiatives on Coronary Artery Calcification registry were analysed.
10 754 asymptomatic Korean adults (51.5±8.6 years; 84.5% male; 14.2% diabetes) were enrolled. Participants were divided into two groups: normal SBPmaintain (maintain (≥120 mmHg) at the time of follow-up CAC scan.
CAC progression was defined as a difference of ≥2.5 between the square roots () of the baseline and follow-up coronary artery calcium score (CACS) (transformed CACS). Annualised transformed CACS was defined as transformed CACS divided by the interscan period.
Compared with non-diabetics, the incidence of CAC progression was higher in diabetics (28.4% vs 47.3%, pmaintain was inversely associated with an annualised transformed CACS (β: –0.18, 95% CI: –0.25 to –0.12, pmaintain showed a lower risk of CAC progression than ≥elevated SBPmaintain in non-diabetics; however, this association was not observed in patients with diabetes.
Maintaining normal systolic blood pressure was associated with a significantly attenuated CAC progression, especially in clinical conditions without established diabetes.
This study retrospectively reviewed 46 patients undergoing transmetatarsal amputation (TMA) between January 2017 and January 2023 to evaluate complication rates within 6 months and assess the predictive value of the SINBAD classification for re-amputation risk. Patients were categorised based on re-amputation occurrence, and clinical and demographic data were collected. Each case was evaluated using the SINBAD scoring system, with logistic regression used to assess associations. Among the patients, 28 (60.9%) experienced no re-amputation, while 18 (39.1%) underwent re-amputation. Baseline demographics and laboratory findings did not significantly differ between groups. The mean SINBAD score was significantly higher in the re-amputation group (3.67 vs. 2.29; p < 0.001), with logistic regression identifying SINBAD score as an independent predictor (OR 6.76; 95% CI: 2.18–21.02; p < 0.001). A SINBAD score of ≥ 4 was associated with a re-amputation rate of 90.9%. In conclusion, the SINBAD classification proves to be a simple and effective tool for predicting re-amputation post-TMA, facilitating risk stratification and surgical planning for diabetic foot ulcer patients.
To identify a frame of reference for resident safety management in nursing homes.
Q-methodology.
This study was conducted using Q-methodology to identify shared perspectives about resident safety management among nursing home professionals. Data were collected from 13 May 2023, through 29 August 2023. Thirty-four professionals, including nurses, care workers, social workers and physical therapists, classified Q-samples into a normal distribution grid through Q-sorting. Data analysis was performed using the PQmethod programme. Q-factors were interpreted by integrating interview transcripts, demographic data and factor arrays that organised the analysis results.
The analysis included the Q-sort of 33 professionals, with an average age of 46.03 years and 6.53 years of nursing home experience, after excluding one individual who did not fit any Q-factor. Four Q factors explaining 63% of the total variance were identified: constructing individualised possible risk trajectories, utilising ingrained safety principles, creating supportive safety environments and coordinating safety principles with individual needs.
Understanding the diverse subjectivities of professionals can help develop strategies that promote collaboration among nursing home professionals and support preventive safety management practices.
The frame of reference derived from nursing home professionals' perspectives suggests a resident-tailored framework.
This study supports the development of interprofessional education tailored to the specific needs of nursing home settings by identifying shared perspectives among nursing home professionals. The findings highlight the need for clear guidelines to help professionals balance resident autonomy with safety and assess the impact of family involvement.
Reporting involved qualitative and quantitative approaches, in compliance with the MMAT criteria for mixed-method research.
No Patient or Public Contribution.
Endometriosis is a chronic condition affecting up to 11% of people presumed female at birth by the age of 44 years, characterised by the growth of tissue similar to the lining of the uterus on other organs. Endometriosis significantly impacts health-related quality of life (HRQoL) and imposes a substantial burden on both individuals and the healthcare system. International guidelines recommend the interdisciplinary management of endometriosis due to its significant biopsychosocial burden; however, research aimed at exploring psychological approaches for endometriosis is limited. This trial aims to evaluate the effectiveness of CodeEndo, an online co-designed interdisciplinary supportive care program, compared with a waitlist control (WLC), on HRQoL and biopsychosocial outcomes in people with a diagnosis of endometriosis.
A hybrid type 1 effectiveness and implementation randomised controlled trial (RCT) will be conducted. Eligible participants will be randomly allocated to either the CodeEndo program (n=176) or WLC group (n=176) for 8 weeks. The primary outcome will be HRQoL, and secondary outcomes will include psychological symptoms (anxiety, depression, stress), self-efficacy, menstrual, bladder and gastrointestinal symptoms, pain, fatigue, sleep, exercise, diet, symptom bothersomeness and physical and psychological well-being, measured at 8 weeks post-randomisation (T2) and 6-month follow-up (T3). Cost-effectiveness will also be examined. Longitudinal qualitative individual interviews (up to n=40) will be conducted with participants who complete the CodeEndo program to explore benefits, barriers and facilitators of ongoing use. Additionally, the CodeEndo program will undergo evaluation by a group of endometriosis healthcare providers, who will assess potential barriers and facilitators to its real-world implementation. Various process evaluation strategies will also be measured to inform future implementation. Data analyses will incorporate mixed-effects regression models on an intention-to-treat basis, cost-consequences and cost-utility, dietary and qualitative thematic analysis.
This protocol received ethics approval from Deakin University Research Ethics Committee (DUREC Ref: 2024-157). Dissemination is expected to include peer-reviewed journal articles, reports, conference presentations as well as websites or social media platforms of relevant chronic pain organisations. Participants will be sent a summary of trial results.
ACTRN12623000598684p.
To explore the influences of workplace bullying experiences, witnessing workplace bullying and bystander types on Speaking up for patient safety (SUPS) among hospital nurses.
Cross-sectional study.
A survey was conducted in September 2021 using a structured questionnaire about workplace bullying experiences, witnessing workplace bullying, bystander types, and SUPS. The questionnaire was administered to 200 bedside nurses from two tertiary university hospitals in South Korea.
One hundred and ninety-nine responses were analysed. A hierarchical regression model, incorporating organisational factors, workplace bullying experiences, witnessing workplace bullying, and bystander types explained approximately 44.0% of the variance in nurses' SUPS. Witnessing workplace bullying and the perpetrator-facilitating bystander negatively influenced SUPS, whereas victim-defending bystander had a positive influence on SUPS.
Findings suggest that witnessing workplace bullying and the bystander types of nurses working on patient care units are more impactful on nurses' SUPS than individual experiences of bullying. Notably, the victim-defending and perpetrator-facilitating bystander types were identified as key factors influencing SUPS.
Nurse managers should understand the roles of witnesses and bystanders working on a patient care unit, and how these roles may extend beyond traditional views of perpetrators and victims. Developing strategies to support and effectively manage witnesses and bystanders working on patient care units may promote positive SUPS behaviours among clinical nurses.
What problem did the study address?
Speaking up for patient safety (SUPS) in clinical settings is critical in maintaining and enhancing patient safety. However, a negative work environment, such as one that promotes workplace bullying may hinder nurses' willingness to engage in SUPS. Because many nurses involved in workplace bullying may be witnesses or bystanders rather than direct perpetrators or victims of such situations, this study explored the potential influences of workplace bullying, including the roles of witnesses and bystanders, on SUPS. What were the main findings?
SUPS was influenced more by witnessing workplace bullying and specific bystander types, namely victim-defending and perpetrator-facilitating bystanders, than by workplace bullying experiences. Where and on whom will the research have an impact?
These findings highlight the importance of addressing the roles of witnesses and bystanders in workplace bullying. Nurse managers should broaden their focus beyond perpetrators and victims to include the roles and views of all nursing staff within a department. By effectively managing witnesses and bystander types, they can foster an environment that enhances SUPS behaviours among nurses.
This study adhered to STROBE guidelines.
No Patient or Public Contribution.
by Dong Min Jung, Yong Jae Kwon, Yong Wan Cho, Jong Geol Baek, Dong Jae Jang, Yongdo Yun, Seok-Ho Lee, Gahee Son, Hyunjong Yoo, Min Cheol Han, Jin Sung Kim
Volumetric modulated arc therapy (VMAT) for lung cancer involves complex multileaf collimator (MLC) motion, which increases sensitivity to interplay effects with tumour motion. Current dynamic conformal arc methods address this issue but may limit the achievable dose distribution optimisation compared with standard VMAT. This study examined the clinical utility of a VMAT technique with monitor unit limits (VMATliMU) to mimic conformal arc delivery and reduce interplay effects while maintaining plan quality. VMATliMU was implemented by applying monitor unit limitations during VMAT reoptimisation to minimise MLC encroachment into target volumes. Using mesh-type reference computational phantom CT images, treatment plans were generated for a simulated stage I lung cancer case prescribed to 45 Gy in three fractions. VMATliMU, conventional VMAT, VMAT with leaf speed limitations, dynamic conformal arc therapy, and constant dynamic conformal arc therapy were compared. Plans were optimised for multiple isodose line prescriptions (50%, 60%, 70%, 80%, and 90%) to investigate the impact of dose distribution. Evaluation parameters included MLC positional accuracy using area difference ratios, dosimetric indices, gradient metrics, and organ-at-risk doses. VMATliMU prevented MLC encroachment into the internal target volume across 60%–90% isodose lines, showing superior MLC accuracy compared with other methods. At the challenging 50% isodose line, VMATliMU had 4.5 times less intrusion than VMAT with leaf speed limits. VMAT plans had better dosimetric indices than dynamic conformal arc plans. VMATliMU reduced monitor units by 5.1%–19.2% across prescriptions. All plans met the clinical dose constraints, with the aortic arch below tolerance and acceptable lung doses. VMATliMU combines VMAT’s dosimetric benefits with the dynamic conformal arcs’s simplicity, minimising MLC encroachment while maintaining plan quality. Reduced monitor units lower low-dose exposure, treatment time, and interplay effects. VMATliMU is usable in existing planners with monitor unit limits, offering a practical solution for lung stereotactic body radiation therapy.Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer mortality worldwide. Despite the organised CRC screening programme, the uptake rate of the population-based CRC screening was still low. Thus, we will conduct a randomised controlled trial in a community setting to evaluate the effectiveness of a theory-based chatbot in promoting CRC screening uptake.
A total of 500 eligible participants will be randomly assigned to a WhatsApp Messenger-initiated chatbot outreach group or a standard text reminder group at a ratio of 1:1. The intervention group will deliver Chinese culturally tailored education texts and videos developed based on the Health Belief Model and the Trans-Theoretical Model. The control group will deliver a standard text reminder of information about the Hong Kong organised CRC screening programme. In addition to the baseline assessment and postintervention assessment, all subjects will be followed up for 3 months and 6 months, respectively. The primary outcome will be the CRC screening uptake rate at the 3 month and 6 month follow-up. The secondary outcomes will be the intention to undergo CRC screening uptake, time interval to participate in and complete screening after recruitment, and reasons for not participating in screening at the 3 month and 6 month follow-up. Quantitative data will be analysed using Student’s t-test, Pearson’s 2 test or Fisher’s exact test. Qualitative data will be analysed by thematic analysis.
Ethical approval of this trial was granted by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (2022.614). Written informed consent will be obtained from study participants before enrolment. The findings will be disseminated through peer-reviewed journals.
The study was registered on clinicaltrials.gov (NCT06192862).
This study examined changes in health risk, daily activities and antipsychotic use after receiving Humanitude care for people with dementia.
Retrospective study design.
A total of 67 people with dementia were admitted to two municipal nursing hospitals and were receiving Humanitude care. Participants' medical records were collected at 5 time points: February 2023 (6 months before), May 2023 (3 months before), August 2023 (when over 70% of healthcare workers completed Level 1 Humanitude care training), November 2023 (3 months after) and February 2024 (6 months after). The changes were analysed using a generalised estimating equation model.
A statistically significant change in the fall risk group was observed in August 2023, November 2023 and February 2024, with 6%, 11% and 19% increases in the odds of moving to a lower-risk group, respectively, compared to February 2023. In the activities of daily living subscale, gargling showed significant changes in November 2023 and February 2024. This resulted in 62.7% and 58.7% increases in the odds of moving to the high-independence category, respectively. The number of antipsychotic agents used was significantly lower in February 2024 (3.82) compared to that in February 2023 (4.47), May 2023 (4.74) and August 2023 (4.6).
The results demonstrate that Humanitude care significantly contributes to reducing fall risk, improving gargling in activities of daily living and decreasing the number of antipsychotic agents in people with dementia.
Problem the study addresses: The impact of Humanitude care remains understudied. Main findings: Humanitude care helps in not only reducing health risks but also circumventing coercive pharmacological treatments. Impact on research: Humanitude care focuses on the dignity and autonomy of people with dementia.
This study was conducted following the Strengthening the Reporting of Observational Studies in Epidemiology.
No patient or public involvement.
Dementia notably increases fall risk in older adults, leading to major injuries and considerable concerns from health-care professionals. However, comprehensive evidence regarding the prevalence, incidence rate, and moderating factors of falls in institutional settings is limited. This study aimed to evaluate the prevalence, incidence rates, and moderating factors of falls among older adults with dementia in nursing homes and dementia-specialized care units.
A meta-analysis.
We searched CINAHL, PubMed, Embase, ProQuest, Scopus, Web of Science, and PsycINFO from database inception to April 30, 2024. Older adults with dementia in nursing homes or dementia-specialized care units were included. The pooled prevalence was analyzed using a generalized linear mixed model with random effects using R software. Incidence rates were reported per person-year using comprehensive meta-analysis software. Study quality was assessed using Hoy's criteria. Variations in the pooled prevalence of falls were explored through moderator analyses.
This meta-analysis included 21 studies involving 35,449 participants. The pooled prevalence of falls was 45.6%, with subtypes showing 39.2%, 35.2%, and 29.0% among Alzheimer's dementia, vascular dementia, and mixed dementia subtypes, respectively. Falls were more prevalent in dementia-specialized care units (53.0%) than in nursing homes (42.6%). The overall incidence rate was 3.61 per person-year, higher in dementia-specialized care units (5.80) than in nursing homes (3.17). Subgroup analyses revealed higher fall prevalence in women (70.0%) than in men (30.6%). Meta-regression indicated that comorbidities, including delirium, visual impairment, and arthritis, increased fall risk.
This meta-analysis revealed a high incidence of falls in nearly half of older adults with dementia, particularly among those in dementia specialized care units.
Healthcare professionals should prioritize regular fall risk assessments, tailored interventions, and environmental safety modifications, particularly in dementia-specialized care units, to reduce fall-related injuries and improve patient outcomes.
COVID-19 survivors may experience complex, distressing and persistent symptoms, referred to as long COVID, lasting months or years after diagnosis. More evidence is needed for effective long COVID screening and management.
To explore the clinical profile of long COVID and factors associated with its development.
A multicentre correlational study using a cross-sectional design.
Adults diagnosed with COVID-19 6–9 months earlier were recruited via social media and referrals from three facilities. Participants provided demographic data and assessed their symptoms and functional status using validated questionnaires. Data were analysed using descriptive statistics and binomial logistic regression.
Among 102 participants, 13%–30% reported significant impairments in cognitive, emotional and physical functioning. Over 10% experienced symptoms such as diarrhoea, sleep problems, dyspnoea, nausea, fatigue and pain. These impairments and symptoms were associated with acute symptom severity, chronic disease, overweight status, regular exercise and living without partners.
This study adds to the literature by examining long-term functional status and symptoms in omicron survivors using comprehensive, validated tools. The findings highlight the prevalence and clinical significance of long COVID symptoms, aiding in the identification of functional impairments requiring medical and nursing interventions.
Nurses should recognise these symptoms and educate survivors about potential challenges. Policies addressing long-term issues, including research, health services and education, are essential.
This study follows the STROBE guideline (Table S1).
Patients self-reported symptoms for this study.
ClinicalTrials.gov (NCT05303103)
FreshRSS 