Cancer has impacted patients’ quality of life (QoL). Qigong, a type of mind-body exercise, has been adopted by some patients with cancer to improve their QoL. However, various lengthy questionnaires were used to assess Qigong’s effects which made data synthesis difficult. Therefore, a simplified Qigong QoL Questionnaire (3Q instrument) has been developed to assess cancer patients’ QoL when they practise Qigong. This study aims to validate this instrument and contribute to the standardisation and simplification of the outcome measures for the studies on Qigong.

A total of 173 patients with cancer practising Qigong in Australia and China will be recruited to evaluate QoL using the 3Q instrument and Functional Assessment of Cancer Therapy–General (FACT-G) questionnaire. SPSS Statistics V.29 software will be used for data analyses. Exploratory factor analysis will be conducted to identify the factor structures of the 3Q instrument. The internal consistency of the 3Q instrument will be evaluated by Cronbach’s alpha. Test–retest reliabilities will be confirmed by intraclass correlations. Content validity will be assessed by the Spearman’s correlation coefficient. Construct validity will be established through confirmatory factor analysis. Criterion validity will be assessed against FACT-G, and Spearman’s correlation coefficient will be adopted to calculate their correlations.

This study has been approved by the RMIT University Human Research Ethics Committee (HREC26229). The findings from the present study will be submitted to peer-reviewed journals for publication and/or presented at conferences.

Mental health issues such as depression and anxiety are highly and disproportionally prevalent among university students. Beyond the academic rigour, stressors imposed by a new environment result in them being vulnerable to the onset and manifestation of mental health symptomatology. Leveraging smartphones and wearables for digital phenotyping capabilities is an innovative approach for monitoring and intervening in the mental health conditions of university students. This provides a unique opportunity to collect and identify digital and behavioural biomarkers, subsequently enabling the development of predictive models to identify university students at risk.

This study—Brightline—will employ an observational study design over a 6-month period, recruiting 500 students from a major public university in Singapore. Passive data collection will occur continuously throughout the monitoring period through a wearable device (Fitbit Charge 6) and smartphone sensors via the Brightline app, which uses a digital phenotyping data collection platform. Active data collection will consist of self-report questionnaires to be completed at the beginning of the study and follow-up assessments at 1, 3 and 6 months after. The passive and active data collected will be analysed to identify the digital biomarkers associated with depression, anxiety, stress, loneliness and affect among university students. Predictive models of these mental health issues will also be developed.

This study was approved by the Nanyang Technological University Institutional Review Board (IRB-2023-894). Findings from this study will be published in peer-reviewed journals and presented at academic conferences.

NCT06770075.

The development of simple tools to identify individuals at high risk of coronary heart disease (CHD) would enable rapid implementation of preventive measures. This study was designed to construct predictive models and scoring systems for CHD using monocyte count and its ratio to high-density lipoprotein cholesterol (HDL-C) (MHR).

Population-based prospective cohort study.

The Shanghai Suburban Adult Cohort and Biobank (SSACB).

This prospective study included 44 013 CHD-free participants of the SSACB. The Songjiang subcohort served as the training set, in which three predictive models and corresponding scoring systems were developed with monocyte count or MHR using stepwise Cox regression. The models and algorithms were tested internally using 10-fold cross-validation and externally in the Jiading subcohort. Discriminations were assessed based on area under the curve (AUC) values, while calibrations were evaluated using the Hosmer-Lemeshow goodness-of-fit test.

During a mean follow-up period of 4.8 years, 883 CHD events occurred, with an incidence of 415.7/100 000. Monocyte count and MHR were significantly associated with the risk of CHD. The constructed model incorporating monocyte count (Model 2) achieved AUC values of 0.746 (0.726, 0.766) for 4-year CHD prediction in the training set, 0.746 (0.690, 0.796) in the cross-validation, and 0.717 (0.674, 0.761) in the external validation, comparable to the models including HDL-C (model 1) or MHR (model 3). Calibration plots demonstrated good agreement between predicted and actual probabilities. Similar results were observed for the corresponding scoring algorithms.

The monocyte-based model is a simple, low-cost and well-calibrated risk-stratification tool for CHD. However, the declined discrimination in external validation indicates limited generalisability. Prospective multicentre validation and recalibration are therefore warranted before clinical adoption.

Although lung cancer in never smokers (LCNSs) accounts for an estimated 25% of all lung cancer cases, the temporal trends in LCNS incidence and its broader epidemiological patterns remain poorly understood. Our study examines the temporal trends in LCNS incidence and analyses key epidemiological characteristics, specifically, the trends in mortality rates, survival rates and changes in age at onset to illuminate the reasons for temporal trends in LCNS incidence.

Retrospective population-based cohort study.

Regional electronic health record (EHR) database linked to the cancer registry in eastern China.

A total of 1 080 317 adults who have never smoked were included, among whom 4061 incident lung cancer cases were identified between 1 January 2009 and 31 December 2020.

The temporal trends in LCNS incidence in a large population-based dynamic cohort were estimated, overall and separately by sex, age group and histological types. The broader epidemiological patterns of LCNS, such as trends in mortality rates, survival rates and changes in age at onset, were analysed.

From 2009 through 2020, the incidence of LCNS among men increased significantly from 9.51 to 43.4 per 100 000 (average annual percentage change (AAPC) 10.51%; 95% CI (6.88% to 14.26%)) whereas a sharper increase was observed among women from 3.57 to 51.68 per 100 000 (AAPC 22.39%; 95% CI (18.36% to 26.55%)). The 2-year survival of LCNS improved from 39% in 2010 to 64% in 2018 for men, and from 57% in 2009 to 86% in 2020 for women, while the mortality from LCNS remained stable from 2014 through 2020 (men: AAPC –1.77%; 95% CI (–8.95% to 5.97%); women: AAPC 2.19%; 95% CI (–4.09% to 8.89%)). The increasing trend in LCNS incidence was observed across most of the age groups except the elderly population aged ≥85 years in both sexes and the men aged 45–54 years, but the increase was most evident in the younger population aged

There is a substantial increase in LCNS incidence, especially among women and young populations. However, the reason for these observed trends remains unclear and warrants investigation.

This study aimed to examine the reproductive concerns and their influencing factors among adolescents and young adults with acute leukaemia and to explore the relationship between reproductive concerns and patients’ quality of life.

A cross-sectional study.

The haematology departments of four tertiary-level hospitals in Hunan province, China.

Convenience sampling method was used to recruit 233 adolescents and young adults with acute leukaemia, from June 2024 to December 2024.

The primary outcome was assessed using the Chinese version of the Reproductive Concerns After Cancer and the secondary outcome was measured by the 12-item Short Form Health Survey.

Adolescents and young adults with acute leukaemia had a mean reproductive concerns score of 55.57±7.57, a quality of life physical component summary (PCS) score of 38.54±8.58 and a mental component summary (MCS) score of 39.84±8.78. Univariate analysis showed significant differences in reproductive concerns based on fertility status, place of residence, education level, fertility counselling and family history of acute leukaemia (p

Adolescents and young adults with acute leukaemia exhibited moderately high levels of reproductive concerns, particularly those who had no children, had a low education level, resided in rural areas, had a family history of acute leukaemia or had received fertility counselling. Therefore, we suggest that healthcare providers prioritise addressing reproductive concerns in high-risk patients by offering tailored, high-quality and continuous fertility counselling and psychological support. Strengthening these strategies can help alleviate reproductive concerns and improve both mental health and overall quality of life in this population.

To enhance nursing students’ critical thinking abilities, numerous educators have explored alternative teaching methods. While meta-analyses have confirmed that various approaches are effective in developing critical thinking, consensus regarding their comparative effectiveness remains elusive. Furthermore, few investigations have directly contrasted the outcomes across these methods, highlighting the necessity to undertake a comprehensive evaluation of their impact on nursing students’ critical thinking skills. Accordingly, this study aims to assess the effects of six teaching methods on nursing students’ critical thinking abilities.

A comprehensive literature search will be carried out up to May 2025 across various databases, such as PubMed, Embase, The Cochrane Library, Web of Science, OVID, CNKI, Wanfang Database and the China Biological Literature Database (CBM). The search strategy will specifically target randomised controlled trials meeting predefined inclusion criteria. Two independent reviewers will screen the selected studies and extract pertinent data. The methodological quality of the included studies will be assessed using the Cochrane risk of bias tool. A network meta-analysis will then be performed using Stata software, incorporating the following analytical components: heterogeneity, network evidence diagrams, publication bias plots, league tables, forest plots, subgroup analyses or meta-regression and sensitivity analyses. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system will be leveraged to appraise the overall quality of evidence related to critical thinking abilities across all compared interventions.

No formal research ethics approval is required. The results will be submitted to a peer-reviewed journal for publication.

CRD42024618735.

Cohort studies of ageing and cognitive decline typically do not begin fielding comprehensive cognitive assessments until older adulthood. However, for identifying preventable dementia risk factors, there is strong value in beginning at earlier ages. The case is especially compelling in sub-Saharan Africa, where the number of older individuals is expected to triple in the next three decades, and where risk factors may operate more intensively at earlier ages. This study reports on the adaptation and validity of the Harmonised Cognitive Assessment Protocol (HCAP) approach in the Kenya Life Panel Survey (KLPS), collected among middle-aged respondents.

To evaluate the validity of the HCAP approach in Kenya, this study assesses model fit statistics from confirmatory factor analyses (CFA) and tests measurement invariance by respondent characteristics.

Both rural and urban areas in Kenya.

A sample of n=5878 individuals from the KLPS, who have been surveyed regularly since they were schoolchildren in the 1990s. The HCAP assessment was administered in 2023 at an average age of 37 years (10–90 range 34 to 41).

For each individual, the CFA generates a general cognitive performance score, and cognitive performance scores for five distinct domains, including memory, executive functioning, language, orientation to time and place, and visuospatial functioning.

Fit of the models to the data was adequate for general cognitive performance (root mean squared error of approximation (RMSEA)=0.03; comparative fit index (CFI)=0.94; standardised root mean residual (SRMR)=0.05), language (RMSEA=0.02; CFI=0.95; SRMR=0.05) and good for memory (RMSEA=0.05; CFI=0.99; SRMR=0.02) and executive functioning (RMSEA=0.03; CFI=0.98; SRMR=0.03). The CFA indicate that the factor structure is consistent with findings from other countries and that reliability for the general cognitive performance score was high. Statistical models also suggest invariance at the scalar level for leading demographic (gender, age) and socioeconomic (education, occupational complexity) characteristics.

This study demonstrates that the cognitive functioning of mid-age Kenyans appears to be well captured by the adapted protocol. While there is a moderate decline in cognitive performance among older individuals, this relationship appears to be mediated by education, indicating that this KLPS HCAP provides a valuable baseline for studying future cognitive decline.

Diagnosis in the early stages of dementia can lead to successful delay in associated cognitive decline. However, up to 76% of Australians diagnosed with dementia have already advanced beyond the early stage of disease. BrainTrack is an evidence-based mobile application (app) designed in Australia to promote brain health self-awareness, self-determination to promote help-seeking and, ultimately, a timelier dementia diagnosis. We will evaluate user experience, implementation and social return-on-investment outcomes of BrainTrack and will report dementia-related concerns, dementia literacy, knowledge, stigma and motivation for behaviour change and explore their associations with demographic characteristics.

A multimethods, concurrent, two-study observational design will be used. Study 1 will evaluate BrainTrack user experience and implementation outcomes, changes in users’ dementia literacy, dementia knowledge, perceptions of dementia-related stigma and help-seeking at five time points (baseline, 1, 3, 6 and 12 months). People residing in all states and territories of Australia will be recruited to the study via the BrainTrack app. Data collection will occur online and through teleconferencing. Approximately 1000 participants will complete all five surveys. Google Analytics data will measure adoption. App usage data will identify app use patterns. A sample of continuing app users (~n=80) and those who cease app use within 6 months (~n=20) will be interviewed to obtain in-depth information about their app use and help-seeking experience. Dementia Australia Helpline data will quantify help-seeking calls triggered by BrainTrack use. In Study 1, longitudinal outcomes will be analysed using mixed models. The economic and social value of BrainTrack will be assessed using social return on investment analysis. In Study 2, general practitioners (~n=20) currently practising in Australia will participate in semi-structured interviews conducted via online teleconferencing. Interviews will elicit perceptions of the usefulness of BrainTrack for initiating and facilitating discussions with patients about cognition and dementia. Qualitative data will be analysed thematically, followed by deductive analysis guided by the Theoretical Domains Framework.

This study has received Human Research Ethics Committee approval from Deakin University Human Research Ethics Committee (Study 1: HREC Reference Number 2022–220) and Deakin University Human Ethics Advisory Group, Faculty of Health (Study 2: Reference Number 202_2022). Informed consent will be obtained prior to participation, either verbally for interviews or online for surveys. Study findings will be published in peer-reviewed journals and communicated to key stakeholders.

The nursing profession has undergone significant evolution over the past century, shifting from a role traditionally viewed as an auxiliary to physicians to one of autonomous healthcare professionals equipped with specialised skills and expertise. This shift is driven by the increasing recognition of the importance of evidence-based practice in enhancing patient outcomes and advancing the field of nursing. Consequently, nursing research has emerged as a critical priority in the profession. This study seeks to explore the nursing research landscape in Malaysia, where data remain limited, by examining trends before, during and after the COVID-19 pandemic.

This scoping review will be conducted following the Arksey and O'Malley framework, using four electronic databases: PubMed, Scopus and CINAHL for journal articles published between 2015 and 2024, and Web of Science for conference proceedings from the same period.

The findings from this scoping review will provide an overview of the nursing research landscape in the Malaysian context, offering insights that could guide the future advancement of nursing research in the country. The results will be disseminated through submission to a peer-reviewed scientific journal for publication. Ethical approval is not required for this scoping review, as it involves the synthesis of data from available published literature.

Teenage pregnancy remains a critical global health issue, particularly in low- and middle-income countries. The intergenerational transmission of teenage pregnancy underscores the need for targeted interventions. Existing research on intergenerational approaches is fragmented, with varying methodologies and outcomes. This scoping review seeks to address this gap by answering the following research questions: What are the available intergenerational interventions for teenage pregnancy, and what are the associated risks and protective factors for early and late teenage pregnancy?

This study does not involve primary data collection and therefore does not require ethical approval. The review will be conducted in five stages: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting the results. A comprehensive search of electronic databases, grey literature and relevant organisational websites will be conducted for literature published between 2014 and 2024. Data will be extracted using a standardised form and synthesised narratively. Stakeholder consultation will be conducted to refine findings and ensure relevance. The findings will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) extension for Scoping Reviews guidelines. The results will be presented through narrative synthesis, with tables and charts used to summarise key information.

As the review is based on publicly available data, ethical approval is not required. Ethical clearance will be sought for stakeholder consultations, if necessary. Findings will be disseminated through peer-reviewed publications, conferences, policy briefs and shared openly on the Open Science Framework (OSF). This protocol is registered in the OSF (https://doi.org/10.17605/OSF.IO/CM9WK).