FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Safety and immunogenicity of rVSV{Delta}G-ZEBOV-GP vaccination when dosed concurrent with mRNA COVID-19 vaccine booster doses in healthy African adults (EbolaCov): protocol for a phase IV, single-centre, single-blinded, randomised controlled trial

Por: Gokani · K. · Taylor · A. · Packham · A. · Musabyimana · J. P. · Shema · H. · Mutabaruka · A. · Roche · S. · Takwoingi · Y. · Umuhoza · C. · Nyombayire · J. · Muvunyi · C. · Green · C.
Introduction

Ebola virus disease remains a significant public health concern. For protection from Ebola virus, the main target populations are epidemiologically identified and often include healthcare workers and refugees. These target populations are also routinely offered vaccines for other vaccine-preventable diseases. However, concomitant use of rVSVG-ZEBOV-GP with other vaccines is not recommended, given the absence of data regarding its reactogenicity and antigen-specific immunogenicity profile when co-administered. The EbolaCov trial aims to inform whether rVSVG-ZEBOV-GP can be administered concurrent to a Pfizer–BioNTech COVID-19 booster dose without an unacceptable increase in reactogenicity and/or loss of humoral immunogenicity to Ebola vaccine antigen.

Methods and analysis

This is a single-centre, randomised, single-blinded, vaccine safety and immunogenicity study in healthy adults living in Rwanda. Seventy-two participants will be randomised in a 1:1 ratio to two study groups, the first receiving rVSVG-ZEBOV-GP with a placebo, the second group receiving rVSVG-ZEBOV-GP concurrently with a Pfizer–BioNTech COVID-19 booster dose. The primary outcome measures are quantitative serum anti-glycoprotein (GP) antibody responses, as measured by ELISA, 28 days after vaccination, and frequency and severity of adverse events in the 7 days following vaccination. Secondary outcome measures include day 28 and day 180 serum anti-GP and serum SARS-CoV-2 anti-spike protein-specific geometric mean antibody titres.

Ethics and dissemination

This trial was approved by the Rwanda National Ethics Committee (reference 442/2024) and the University of Birmingham (reference ERN_2661-Jun2024). All participants were required to provide written informed consent in accordance with good clinical practice. Dissemination of results will be through conference presentations and peer-reviewed publications.

Trial registration number

Pan African Clinical Trials Registry (PACTR202407764378004) and ClinicalTrials.gov (NCT06587503)

Analysis of blood screening strategies and their efficacy among voluntary blood donors in a region of East China

by Yiming Jin, Rong Lu, Mingyuan Wang, Zihao Xu, Zhen Liu, Shuhong Xie, Yu Zhang

Objective

In this study, we aimed to analyze the blood screening detection strategies employed for voluntary blood donation in a specific region of East China and evaluate the efficacy of the blood safety detection system.

Donors and Methods

A total of 539,117 whole blood samples were collected from voluntary blood donors between January 2018 and July 2021, as well as in 2023 and 2024. The samples were screened for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibodies, human immunodeficiency virus antibodies/antigen (HIV Ab/Ag), and Treponema pallidum (TP) antibodies using enzyme-linked immunosorbent assay (ELISA). Alanine aminotransferase (ALT) levels were measured using a rapid method. Chemiluminescence immunoassay technology was used to detect five hepatitis B virus (HBV) markers. Polymerase chain reaction was employed to detect HBV DNA, HCV RNA, and HIV RNA. The reactivity rates of each marker were analyzed.

Results

The overall positivity rate for blood testing among donors in this region was 0.76% (4,078/539,117). The positivity rates for the individual markers were as follows: anti-TP (0.20%)> HBsAg (0.18%)> ALT (0.13%)> anti-HCV (0.085%)> nucleic acid testing (0.080%)> HIV antigen/anti-HIV (0.079%). No significant differences were observed (P > 0.05). Before 2023, the positivity rates for ALT and HBsAg exhibited occasional fluctuations, followed by a significant decline. Conversely, in 2024, a slight upward trend in the HIV positivity rate was noted.

Conclusion

The current multitiered blood screening and detection strategy in this region exhibits complementary advantages, ensuring effective blood safety. However, the observed slight upward trend in the HIV positivity rate among voluntary blood donors highlights the necessity for enhanced pre-donation counseling and risk assessment for key populations.

Development and pilot testing of a personalised decision aid for decision-making regarding fertility preservation in young female patients with cancer: a study protocol

Por: Jang · J. · Lee · E. M. · Chung · Y. K. · Lee · D. O. · Park · H. J. · Yim · G. W. · Lee · K. S. · Kim · J. H. · Ko · A. R. · Hong · J. H. · Kang · S.
Introduction

Infertility resulting from cancer treatment is known to be a major factor that reduces the quality of life of young cancer survivors. However, discussions and decision-making about fertility preservation before cancer treatment have been insufficient owing to barriers in the clinical field. In addition, selecting a fertility preservation option requires a complex decision-making process that considers not only medical information but also the patient’s values and preferences. Hence, an environment that more easily supports patient decision-making about fertility preservation needs to be created. Therefore, this protocol will develop and test a web-based decision aid (DA) for fertility preservation among young patients with cancer, considering patient preferences and values, evaluate acceptability and usability of the developed DA and assess its effectiveness.

Methods and analysis

This protocol outlines the development of a web-based DA for fertility preservation targeting females of reproductive age diagnosed with cancer. It includes alpha testing to evaluate the usability and acceptability of the DA, as well as beta testing to assess its effectiveness outside of clinical settings, both based on an online survey. The web-based DA for fertility preservation consists of three modules: 1) an information collection module, 2) an option suggestion module and 3) a value communication module. The information collection module collects information essential to select appropriate fertility preservation options. The option suggestion module returns all applicable fertility preservation options based on the patient’s characteristics, which are essential for determining the appropriate option, such as menarche status and desire for pregnancy. The value communication module provides information on the extent to which each fertility preservation option satisfies the patient’s values and preferences. After the development of the DA, a small group of young patients with cancer (n=10) and health providers (n=5) will be asked to use this web-based DA for fertility preservation and assess the acceptability and usability of this DA based on a survey (alpha-testing). By reflecting the feedback of acceptability and usability testing, the DA will be updated for improvement, and clinical field testing (beta-testing pilot trial) will be performed using the updated DA. Beta-testing will be conducted on young patients with cancer (aged 18–40 years) before they receive any curative cancer treatment (n=32). These patients with cancer will be randomly allocated to the DA group (intervention group) or the usual care group (control group). The DA group will use the web-based DA before treatment, and the control group will not have access to the web-based DA and will be asked to decide whether to consult a fertility preservation specialist. The primary outcome of the beta testing will be the level of decisional conflict, and the secondary outcomes will include knowledge, decision self-efficacy, decision readiness, depression severity, quality of life, counselling on fertility preservation and decision-making about fertility preservation. Outcomes, including decisional conflict, knowledge, decision self-efficacy, quality of life and depression severity, will be measured before the intervention (T0), 1 week after the intervention (T1) and 1 month after the intervention (T2). The readiness for decision-making will be assessed at T1 for the intervention group only. Counselling on fertility preservation and decision-making about fertility preservation will be assessed once after testing (T2) for both the intervention and control groups.

Ethics and dissemination

The study will be conducted in accordance with ethical standards and was approved by the Institutional Review Board at the National Cancer Centre, Korea (IRB No. NCC2024-0050). All study participants will provide written informed consent before participation. The results generated from this study will be presented at conferences or scientific meetings and disseminated through publication in a peer-reviewed journal.

Trial registration

NCT07038174 (beta-testing phase).

Prevalence, pathogenic bacteria, and risk factors associated with pediatric sepsis among under five children in a rural district hospital in Rwanda

by Patrick Orikiriza, Deogratius Ruhangaza, David S. Ayebare, Ezechiel Bizimana, Jean Baptiste Niyibizi, Irene Nshimiyimana, Louis Mujyuwisha, Abebe Bekele

Background

Pediatric sepsis poses a significant health challenge in Sub-Saharan Africa, with limited data on prevalence and pathogen profiles. This study determined the prevalence of pediatric sepsis, identified bacterial pathogens, and evaluated associated risk factors among children aged 1–59 months at Butaro Hospital, Rwanda.

Methods

A cross-sectional study was conducted from March 2022 to December 2022. The study included 114 children aged 1–59 months with suspected sepsis admitted to the pediatric ward at Butaro Hospital. Blood cultures were analyzed, and risk factors assessed using multiple logistic regression. Data were analyzed using Stata 17.

Results

Of 114 enrolled children, 60.5% (n = 69) had positive blood cultures (95% CI: 51.2–69.1). Among these 69 children, the majority were females, 70.0% (n = 35) (95% CI: 53.7–81.3) and below 6 months 68.1% (n = 15) (95% CI: 45.3–84.7). Pathogenic bacteria identified were Coagulase-Negative Staphylococci (CNS), 59.4% (n = 41) and Staphylococcus aureus, 40.6% (n = 28). Female gender (AOR = 2.4, 95% CI: 1.0–5.4, p = 0.045) and leukocytosis (AOR = 6.0, 95% CI: 2.0–20.2, p = 0.003) were the risk factors for sepsis.

Conclusions

The study reveals a high prevalence of sepsis among children under-five, especially females and less than 6 months with female gender and diagnosis with leukocytosis being a significant risk factor. Diagnostic strategies should focus on WBC counts to better manage at-risk children. These single-center study results however may not be broadly representative due to regional and resource differences, but they offer valuable insights for improving pediatric care in similar low-resource settings.

ExtraCECI: a community-based person-centred-enhanced care intervention to improve the quality of life and person-centred outcomes for people living with HIV/AIDS in Ghana--protocol for cluster randomised controlled trial

Por: Abboah-Offei · M. · Elsey · H. · Nkhoma · K. B. · Abboah-Offei · S. · Keding · A. · Fenty · J. · Yakimova · A. · Hewitt · C. · Dzansi · G. · Senoo-Dogbey · V. E. · Ayisi Addo · S. · Akazili · J. · Ayim · A. · Harding · R. · The ExtraCECI Project Team
Introduction

People living with HIV/AIDS (PLWHA) have complex physical, psychological, social and spiritual needs following diagnosis and poorer health-related quality of life than the general population. Holistic assessment and care delivery incorporating person-centred principles is required to address these needs. This protocol describes a cluster randomised controlled trial (cRCT) and process evaluation to evaluate the effectiveness of the extra community-based enhanced care intervention (ExtraCECI) to improve the quality of life and person-centred outcomes for PLWHA in Ghana.

Methods and analysis

This cRCT will randomly assign 26 recruited HIV clinics using 1:1 allocation to either ExtraCECI intervention or standard HIV care, with each clinic recruiting an average of 25 participants, that is, 650 in total. Eligible participants are adult PLWHA aged at least 18 years and in HIV care for at least 6 months, with cognitive ability to consent as guided by the Mental Capacity Act, clinically well to participate, attending an outpatient clinic. Healthcare professionals (HCP) at clinics randomised to the ExtraCECI intervention arm will receive training on person-centred care and holistic assessment of PLWHA in the domains of physical, psychological, social and spiritual well-being. PLWHA will be empowered to contribute to their care decisions including HCP using telehealth for ExtraCECI delivery with ongoing mentorship, while participants in the Standard HIV Care arm continue with usual care. The primary outcome is quality of life measured at the individual level using Medical Outcomes Study-HIV (MOS-HIV). The primary analysis will compare MOS-HIV total scores between groups using repeated measure linear mixed model and adjusting for important baseline characteristics (including stratification factors) and random effect of clinic. The incremental cost-effectiveness ratio will be used to estimate the cost-effectiveness of the ExtraCECI intervention, and a process evaluation will be conducted.

Ethics and dissemination

This protocol was approved by Edinburgh Napier University School of Health and Social Care Research Integrity Committee (REF: SHSC3681836) and the Ghana Health Service Ethics Review Committee (GHS-ERC:010/07/24). Results from this study whether positive or negative will be presented to participating sites, communities, at scientific conferences and published in peer-reviewed journals.

Trial registration number

ISRCTN77405303.

Mediating Role of Nurses' Perceived Professional Benefits Between ICU Nurses' Emotional Intelligence and Spiritual Care Competency: A Multicentre Cross‐Sectional Study

ABSTRACT

Aim

This study aims to investigate the levels of emotional intelligence, nurses' perceived professional benefits, and spiritual care competency among ICU nurses, explore the correlations among these three variables, and further analyse the mediating role of perceived professional benefits between emotional intelligence and spiritual care competency.

Study Design

A multicenter cross-sectional study was conducted following the STROBE guidelines.

Methods

From January to March 2024, 568 ICU nurses from seven tertiary hospitals in China completed an online questionnaire including demographic items, the Wong and Law Emotional Intelligence Scale, the Nurses' Perceived Professional Benefits Questionnaire, and the Spiritual Care Competency Scale. Data were analysed using SPSS 27.0 and Amos 27.0. Pearson correlation, structural equation modelling (SEM), and bootstrap analysis (5000 samples) were used to test associations and mediation effects.

Results

ICU nurses reported above-average scores in EI, NPPB, and SCC. EI was positively associated with both NPPB and SCC, and NPPB partially mediated the relationship between EI and SCC.

Conclusion

EI significantly contributes to ICU nurses' SCC both directly and indirectly through NPPB. These findings highlight the psychological mechanisms that support competency in spiritual care.

Impact

Nursing managers are encouraged to implement structured training programmes focusing on emotional regulation and professional value reinforcement, which may effectively enhance SCC and improve holistic care quality in ICU settings.

Patient or Public Contribution

Not applicable.

Impact of hypersexuality on spousal carers of patients with Parkinsons disease and frontotemporal dementia: a qualitative study

Por: Tayim · N. · Panicker · J. · Foley · J. · Selai · C. · El Sheikh · W. G.
Objectives

Hypersexuality involves an inability to control intense, recurring sexual impulses, resulting in repetitive sexual behaviours. It frequently manifests in patients with neurodegenerative disorders such as Parkinson’s disease (PD) and dementia. Using a qualitative approach, this study aims to explore the impact of hypersexuality on spousal carers of patients with PD and dementia.

Design

Qualitative study using semistructured interviews and thematic analysis.

Setting

This study was conducted in secondary care settings, including movement disorder and dementia clinics, as well as through patient support organisations. Participants were recruited from multiple centres across the UK. Interviews were conducted in a clinical research setting.

Participants

Eight spousal carers (five caring for patients with PD, three for patients with dementia) participated in the study. Participants were selected based on their role as primary carers and their experience managing hypersexuality in their partners.

Results

The thematic analysis identified 12 themes: manifestations, sexual practices, impact, control, emotional formulations, beliefs in causes of hypersexuality and attributions, relationship with the partner, dealing with hypersexuality, coping with hypersexuality, self-image, stigma and professional help-seeking. Hypersexuality altered patients’ sexual cognitions and behaviours, causing distress and strain on carers’ mental health and marital life. Carers struggled to cope with their partners’ hypersexuality, facing emotional burden and barriers to seeking professional help.

Conclusions

Hypersexuality significantly impacts spousal carers of patients with PD and dementia, affecting their emotional well-being and relationships. Healthcare professionals should recognise and address hypersexuality’s psychological and relational consequences. Psychoeducation, support groups and tailored interventions for patients and carers are recommended to alleviate emotional distress. Future research should explore the broader familial impact of hypersexuality and develop effective management strategies.

Clinical factors associated with multimorbidity, polypharmacy and medication regimen complexity among adults with hypertension: a multicentre cross-sectional study

Por: Yazie · T. S. · Mengistu · W. E. · Yimer · Y. S. · Dagnew · S. B. · Dagnew · F. N. · Moges · T. A. · Addis · G. T. · Belete · A. M.
Objectives

Factors associated with multimorbidity, polypharmacy and Medication Regimen Complexity Index (MRCI) may vary across countries. However, such data are lacking in the present study setting. This study aimed to identify factors associated with multimorbidity, polypharmacy and MRCI among adults living with hypertension in public hospitals of South Gondar Zone.

Design

Multicentred cross-sectional design

Setting

Public hospitals of Comprehensive Specialised and Primary Hospitals, Ethiopia.

Participants

Adults living with hypertension who had follow-up visits at outpatient clinics and were selected by systematic random sampling from 1 December 2021 to 28 February 2022.

Primary and secondary outcome measures

Medication regimen complexity was assessed using a 65-item medication regimen complexity tool. Sociodemographic data were collected through an interview, while polypharmacy and clinical characteristics were documented using a checklist. Data were entered into SPSS V.26 and analysed using STATA V.17. A binary logistic regression model was used to determine the AOR of factors associated with multimorbidity and polypharmacy. For factors influencing MRCI, an ordinal logistic regression was used.

Results

We found participants from Nefas Mewucha Hospital (AOR = 0.3, 95% CI 0.15 to 0.59) and Mekane Eyesus Hospital (AOR = 0.17, 95% CI 0.07 to 0.38), compared with Debre Tabor Comprehensive Specialised Hospital, polypharmacy (AOR = 5.52, 95% CI 1.49 to 20.39), medium (AOR = 19.76, 95% CI 5.86 to 66.56) and high MRCI (AOR = 120.32, 95% CI 33.12 to 437.07) were associated with multimorbidity. Multimorbidity (AOR = 25.4, 95% CI 7.48 to 86.23), controlled blood pressure (AOR = 0.43, 95% CI 0.19 to 0.92) and duration of hypertension therapy 5 years or more (AOR = 2.12, 95% CI 1.08 to 4.16) were associated with polypharmacy. Whereas controlled BP (AOR = 0.48, 95% CI 0.32 to 0.72) and multimorbidity (AOR = 14.55, 95% CI 9.00 to 23.52) were significantly associated with high MRCI. The prevalence of multimorbidity, high MRCI and polypharmacy was found in 46.1%, 35.22% and 12.29% of participants, respectively.

Conclusion

A considerable proportion of participants with hypertension experienced multimorbidity, polypharmacy and high medication complexity. Polypharmacy, primary hospital setting and high MRCI were independent variables associated with multimorbidity. On the other hand, multimorbidity and controlled BP were associated with polypharmacy and MRCI. Hypertension care should consider multimorbidity, polypharmacy and medication complexity.

Assessing statistical literacy in medical students and doctors: a single-centre, cross-sectional survey in South Korea

Por: Lee · S. Y. · Kim · S. · Kim · S. · Shin · Y. · Yim · J.-J. · Hwang · H. · Kwon · Y. · Kim · U.-N. · Do · Y. K.
Objective

Healthcare professionals must possess statistical literacy to provide evidence-based care and engage patients in decision-making. However, there have been concerns about healthcare professionals' inadequate understanding of health statistics. As an initial step in addressing the issue, we assessed the statistical literacy of medical students and doctors in South Korea by evaluating their comprehension of four statistical concepts: (a) single-event probability, (b) relative risk reduction, (c) positive predictive value and (d) 5-year survival rate.

Design

Cross-sectional survey study.

Setting

The survey was conducted from October 2018 to January 2019 in one medical school and its affiliated teaching hospital in Seoul, South Korea.

Participants

303 medical students from all six grades and 291 doctors from various specialties.

Primary and secondary outcome measures

The primary outcome measure was the correct answer rate for each question. The secondary outcome measure was the mean number of correct answers across the four statistical literacy questions, calculated for each individual.

Results

The correct answer rates for basic numeracy questions were close to 100%. Regarding statistical literacy, 95.5% and 83.2% of the participants accurately understood single-event probability and relative risk reduction, respectively. However, only 49.3% and 49.2% of the participants accurately understood the positive predictive value and 5-year survival rate, respectively. The correct answer rates for the question about the 5-year survival rate differed significantly between students (40.9%) and doctors (57.7%) (p

Conclusions

Medical students and doctors have weaker statistical literacy than their basic numeracy. Therefore, it is essential to implement medical education and professional development programmes that focus on improving their statistical literacy. These programmes should specifically address measures of medical test accuracy and the distinction between a 5-year survival rate and mortality.

Trace metals and their human health risks in sesame seeds from the main cultivation areas of Ethiopia

by Bewketu Mehari, Tarekegn Fentie Yimer, Tihitna Beletkachew, Eyob Alem, Worku Negash, Mengistu Mulu, Dereje Yenealem, Ayalnesh Miretie

Sesame (Sesamum indicum L.) is a major oilseed crop globally, and white sesame is a key contributor to the foreign exchange earnings of Ethiopia. The main production districts of white sesame in Ethiopia are Humera, Metema, Tegedie, Mirab-Armachiho and Tachi-Armaciho. This study assessed the levels of trace metals (Fe, Cu, Zn, Mn and Ni) in white sesame seeds from these regions and evaluated the associated health risks to consumers. A total of 53 samples were collected from 19 farmer villages across the five districts. Homogenized samples from each village were analyzed using the acid digestion method followed by flame atomic absorption spectroscopy (FAAS). The limit of detection of the method ranged from 0.75 to 865 mg/kg, and the limit of quantitation ranged from 2.55 to 28.8 mg/kg for the different elements analyzed. The recovery of the method was in the range of 90.9‒99.6%. The results showed trace metal levels ranging from 164 ± 6 to 381 ± 4 mg/kg for Fe, 94.0 ± 1.9 to 126 ± 0.8 mg/kg for Zn, 11.8 ± 0.4 to 14.2 ± 0.4 mg/kg for Cu, 11.9 ± 0.9 to 15.0 ± 0.7 mg/kg for Mn and 16.2 ± 1.1 to 21.0 ± 1.2 mg/kg for Ni across the production districts. One-way ANOVA revealed significant differences (p

Factors associated with the uptake and utilisation of diabetic retinopathy screening services in sub-Saharan Africa: A scoping review

by Iheanyi Oby Nwaoha, Albain Ayime Balibuno, Nuha Ibrahim

Introduction

Diabetic Retinopathy (DR) is a microvascular complication of chronic Diabetes that can lead to visual impairment if left untreated. While concerted efforts have been made to develop screening modalities to facilitate the early detection of Diabetic Retinopathy in sub-Saharan Africa, little is known about the factors impacting the optimal use of these screening services. This paper aims to identify and highlight factors associated with the access of Diabetic Retinopathy screening services from patient and service provider perspectives.

Methodology

This scoping review was conducted using the Arksey and O’Malley (2005) framework. A comprehensive search of peer-reviewed articles and grey literature was conducted from May 2023 to June 2023. Electronic databases searched include Medline, Embase, PubMed, CINAHL Complete, APA PsycINFO, Web of Science, and African Journal Online (AJOL). Two reviewers independently screened the retrieved records for eligibility, and relevant data was extracted from the included studies. A descriptive overview of key findings was provided, and the 5As conceptual framework of access to healthcare was used to map the identified factors.

Results

The search strategy yielded 873 records. Of those, 19 studies met the criteria for inclusion. Health literacy and duration of Diabetes were reported in 12 and 9 studies as the most common factors associated with DR screening services access. Similarly, age at onset and inadequate referral by healthcare providers were cited as significant determinants of DR screening access in 7 studies, respectively.

Conclusion

The 5As framework of access to healthcare aids our understanding of factors associated with the access of DR screening from patient and service provider standpoints. To address these issues, there is a need for more research on this topic to design effective DR screening services in the region.

Positive Coping Style and Family Resilience of Caregivers of COPD Patients: The Chain Mediating Roles of Caregiver Burden and Resilience

ABSTRACT

Aims

To investigate the association between positive coping style and family resilience, considering the mediating factors of burden and individual resilience within caregivers of chronic obstructive pulmonary disease (COPD) patients.

Design

A cross-sectional survey.

Methods

A total of, 204 caregivers of COPD patients were recruited using convenient sampling from April 2023 to May 2024 to investigate general information, family resilience, individual resilience, caregiver burden and positive coping styles on caregivers of COPD patients. Influencing factors were primarily identified using Mann–whitney U test and Kruskal–Wallis H test. Spearman correlation analysis was used to explore the correlation between family resilience, positive coping, caregiver burden and resilience. Linear regression was used to analyse the influencing factors of family resilience of caregiver. Structural equation modelling was used to detect the mediating effects of caregiver burden and resilience.

Reporting Method

The STROBE checklist was followed.

Results

The family resilience of caregivers was positively correlated with positive coping styles and individual resilience, and negatively correlated with caregiver burden. The family resilience of caregivers increased with the improvement positive coping style and individual resilience, and decreased with the increase of caregiver burden. Caregiver burden and resilience played the chain mediating roles between positive coping style and family resilience.

Conclusion

Family caregivers of COPD patient with higher education levels also have higher family resilience. Higher positive coping style may lead to higher family resilience of caregivers of COPD patients by reducing caregiver burden and promoting resilience.

Relevance to Clinical Practice

There are individual differences in the level of family resilience of caregivers of COPD patients, and nurses can provide personalised interventions to different family caregivers by understanding their characteristics and needs. Nurses can improve the family resilience of caregivers by guiding them to adopt positive coping styles, reducing burdens and promoting resilience.

Patient or Public Contribution

This study was conducted with the participation of caregivers of COPD patients who contributed data by completing study questionnaires.

Comparing the effectiveness of peer‐led healthy aging interventions on depression and quality of life in community‐dwelling older adults: A systematic review and network meta‐analysis

Abstract

Background

Healthy aging has become increasingly important owing to the rapidly growing population of older adults globally, and results from the complex interplay of multiple characteristics such as depression and quality of life. Several countries have included peer-led interventions in their health policies to promote healthy aging. Given the growing evidence for these interventions, determining their comparative effectiveness is vital and warranted.

Aim

The aim of this study was to examine the relative effectiveness of peer-led interventions on the depression and quality of life of community-dwelling older adults.

Methods

A systematic review and network meta-analyses were performed. The meta-analysis was performed using random-effects models. Additionally, subgroup, meta-regression, and frequentist network meta-analyses were conducted. The protocol was registered with PROSPERO (CRD 42023492659).

Results

Twelve studies with depression outcomes and 11 studies with quality-of-life outcomes were included. The effect sizes for depression and quality of life were moderate and small, respectively. For depression, face-to-face interactions and intervention duration were moderating factors. For quality of life, intervention provider was a moderating factor. The combined peer–nurse intervention was shown to have a large effect on quality of life, whereas interventions provided by professionals other than nurses or provided only by peers had a small effect. A ranking analysis found that the most effective intervention for increasing quality of life was the simultaneous involvement of both healthcare professionals and peers. The provision of education and exercise interventions showed a higher ranking than goal setting in the leading group.

Linking Evidence to Action

The peer-led interventions were sufficient for depression. The effectiveness for improving quality of life may increase when involving both peers and healthcare professionals, particularly nurses. Nursing and health policymakers could establish distinct strategies depending on whether the goal of peer-led interventions is to improve quality of life or alleviate depression for older adults.

Effectiveness of Integrated Care for Older Pepole (ICOPE) in Improving Intrinsic Capacity in Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Objective

Conduct a systematic review of existing studies on intrinsic capacity (IC) and a meta-analysis of studies to assess the overall effectiveness of ICOPE in improving IC in older adults.

Methods

Ten databases were systematically searched from inception to November 8, 2023, and the search was last updated on January 2, 2024. Randomised controlled trials (RCTs) were included. The main outcomes were IC (cognition, psychological, sensory, vitality and locomotion).

Results

The results showed ICOPE had a significant effect in improving cognitive function (SMD = 0.36; 95% CI, 0.17 to 0.56, p < 0.001, 12 RCTs, 7926 participants) and depressive symptoms (SMD = −0.70; 95% CI, −0.96 to −0.43, p < 0.001, 26 RCTs, 11,034 participants), but there was no statistically significant difference in improving locomotion (SMD = 0.16; 95% CI, −0.03 to 0.34, p = 0.098, 3 RCTs, 1580 participants). Meta-regression analysis shows that intervention duration should be paid attention to when the source of heterogeneity is discussed on the cognition.

Conclusion

The results suggest that ICOPE may be a potentially effective approach to help improve the IC in older adults, showing significant potential for improving cognitive function and reducing depressive symptoms in particular.

Implications for the Profession and/or Patient Care

ICOPE is expected to provide effective strategies to enhance issues such as IC and may be an innovative way to improve the overall health of older adults. This result provides strong support for geriatric nursing practice and encourages the adoption of ICOPE as a viable nursing approach to promote healthy ageing.

Long-term survival outcomes of endoscopic therapy vs. surgical resection in patients with cardia gastrointestinal stromal tumor

by Qiong Wu, Jun Jiang, Zhuofan Li, Xin Ling, Zhenguo Qiao, Yimin Ma

The ideal surgical approach for treating cardia gastrointestinal stromal tumor (GIST) is not clearly established. This study aimed to assess the long-term survival results among patients who received endoscopic therapy (ET) or surgical resection (SR) for cardia GIST. Cardia GIST patients from 2000 to 2019 were selected from the surveillance, epidemiology, and end result (SEER) database. Multiple imputation (MI) was applied to handle missing data, and propensity score matching (PSM) was carried out to mitigate selection bias during comparisons. Demographic and clinical characteristics’ effects on overall survival (OS) and cancer-specific survival (CSS) were assessed using Kaplan-Meier analyses and multivariate Cox proportional hazard models. A total of 330 patients with cardia GIST were enrolled, including 47 (14.2%) patients with ET and 283 (85.8%) patients with SR. The 5-year OS and CSS rates in the ET and SR groups were comparable [before PSM, (OS) (76.1% vs. 81.2%, P = 0.722), (CSS) (95.0% vs. 89.3%, P = 0.186); after PSM, (OS) (75.4% vs. 85.4%, P = 0.540), (CSS) (94.9% vs. 92.0%, P = 0.099)]. Moreover, there was no significant difference between ET and SR in terms of long-term OS (hazard ratio [HR] 0.735, 95% confidence interval [CI] 0.422–1.282) and CSS (HR 1.560, 95% CI 0.543–4.481). Our study found no significant disparity in long-term survival outcomes between ET and SR in cardia GIST patients, implying that ET could be a valid surgical strategy for treating cardia GIST.

Effectiveness of integrated care for older adults‐based interventions on depressive symptoms: A systematic review and meta‐analysis

Abstract

Aim

To pool existing studies to assess the overall effectiveness of integrated care for older adults (ICOPE)-based interventions in improving depressive symptoms in older adults.

Design

A systematic review and meta-analysis.

Data Sources

Ten databases were systematically searched from inception to 15 July 2023 and the search was last updated on 2 September 2023.

Methods

Standardized mean difference (SMD) was calculated using random effects models. RoB 2 and GRADEpro GDT were used to assess the methodological quality and confidence in the cumulative evidence. Funnel plots, egger's test and begg's test were used to analyse publication bias. Sensitivity, subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity.

Results

The results of 18 studies showed ICOPE-based interventions had a significant effect on improving depressive symptoms (SMD = −.84; 95% CI, −1.20 to −.3647; p < .001; 18 RCTs, 5010 participants; very low-quality evidence). Subgroup analysis showed the intervention group was characterized by mean age (70–80 years old), intervention duration between 6 to 12 months, gender (female <50%), non-frail older adults, depressed older adults and mixed integration appeared to be more effective. Sensitivity analysis found the results to be robust.

Conclusion

ICOPE-based interventions may be a potentially effective alternative approach to reduce depressive symptoms in the older adults.

Implications for the Profession and/or Patient Care

Healthcare professionals are expected to use ICOPE as one of the interventions for depressive symptoms in older adults, and this ICOPE could provide more comprehensive care services for older adults to reduce depressive symptoms.

Impact

ICOPE-based interventions may be a potentially effective alternative approach to reduce depressive symptoms in the older adults. ICOPE-based interventions had a significant effect on reducing depressive symptoms in the older adults. The intervention group characterized by mean age of older adults, intervention duration, gender ratio, health condition and integration types may influence the effect size.

Reporting Method

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Patient or Public Contribution

No Patient or Public Contribution.

The effect of work readiness on work well‐being for newly graduated nurses: The mediating role of emotional labor and psychological capital

Abstract

Objective

To investigate the relationship between work readiness and work well-being for newly graduated nurses and the mediating role of emotional labor and psychological capital in this relationship.

Methods

A cross-sectional survey was conducted in mainland China. A total of 478 newly graduated nurses completed the Work Readiness Scale, Emotional Labour Scale, Psychological Capital Questionnaire, and Work Well-being Scale. Descriptive statistical methods, Pearson correlation analysis, and a structural equation model were used to analyze the available data.

Results

Newly graduated nurses' work readiness was significantly positively correlated with work well-being (r = 0.21, p < 0.01), deep acting (r = 0.11, p < 0.05), and psychological capital (r = 0.18, p < 0.01). Emotional labor and psychological capital partially mediated the relationship between work readiness and work well-being. Additionally, emotional labor and psychological capital had a chain-mediating effect on the association.

Conclusions and Clinical Relevance

Work readiness not only affects newly graduated nurses' work well-being directly but also indirectly through emotional labor and psychological capital. These results provide theoretical support and guidance for the study and improvement of newly graduated nurses' work well-being and emphasize the importance of intervention measures to improve work readiness and psychological capital and the adoption of deep-acting emotional-labor strategies.

Development of a supportive care framework for breast cancer survivor's unmet needs: A modified Delphi study

Abstract

Aim

To establish a supportive care framework for addressing unmet needs among breast cancer survivors, providing practical guidance for healthcare providers to assess and manage these needs, ultimately enhancing the health outcomes and quality of life of breast cancer survivors.

Design

We conducted a two-round Delphi survey to gather expert opinions regarding the unmet needs supportive care framework for breast cancer survivors.

Methods

Initial framework identification and inquiry questionnaire creation was achieved via literature search and expert group discussions, which included 15 experts from nursing practice, clinical medicine, nursing management and nursing education was conducted using a Delphi survey. To establish consensus, a two-round Delphi poll was done, using criteria based on the mean (≥4.0), coefficient of variation (CV < 0.25) and percentage for entire score (≥20%).

Results

Experts reached a consensus, leading to six care modules, and 28 care entries: Tumour Detection Support (three care entries), Management of Complications of Antitumor Therapy (seven care entries), Healthy Lifestyle Management (five care entries), Sexual and Fertility Support (four care entries), Psychosocial Support (four care entries) and Resource and Linkage Support (five care entries).

Conclusion

To address breast cancer survivors' unmet needs, a supportive framework was developed to actively enhance their health outcomes. However, further refinement and feasibility testing using mobile devices or artificial intelligence are required.

Implications for the Profession and Patient Care

This pioneering framework prioritises addressing unmet needs and equips healthcare providers to assess and manage these needs effectively, facilitating the implementation of programs aimed at improving the well-being of breast cancer survivors.

Reporting Method

This study was guided by a modified guideline for the Conducting and Reporting of Delphi Studies (CREDES) (Palliative Medicine, 31(8), 684, 2017).

Patient or Public Contribution

No Patient or Public Contribution.

Trial and protocol registration

The Delphi study methodology does not require registration.

Exploration of machine learning models for surgical incision healing assessment based on thermal imaging: A feasibility study

Abstract

In this study, we explored the use of thermal imaging technology combined with computer vision techniques for assessing surgical incision healing. We processed 1189 thermal images, annotated by experts to define incision boundaries and healing statuses. Using these images, we developed a machine learning model based on YOLOV8, which automates the recognition of incision areas, lesion segmentation and healing classification. The dataset was divided into training, testing and validation sets in a 7:2:1 ratio. Our results show high accuracy rates in incision location recognition, lesion segmentation and healing classification, indicating the model's effectiveness as a precise and automated diagnostic tool for surgical incision healing assessment. Conclusively, our thermal image-based machine learning model demonstrates excellent performance in wound assessment, paving the way for its clinical application in intelligent and standardized wound management.

❌