Search Results (712)

Background: Incontinence is a widespread and socially taboo phenomenon worldwide. Incontinence, with its various manifestations, is one of the most common illnesses in outpatient medical care and represents a serious health problem for those affected of all ages. As part of the second update of the German expert standard published in 2024 on continence promotion, a systematic literature review was conducted to identify, appraise, and synthesize current evidence on nursing interventions to promote urinary and fecal continence. The expert standard does not provide a gradation of recommendations, but rather that the criteria depicted in the standard have the highest possible recommendation character in the sense of the best available knowledge. The aim of this article is to present the examination of available evidence within the context of the second update of the expert standard. Methodology: A systematic literature review was conducted between September and December 2022 with additional guideline research in December 2023 in Medline (via PubMed), CINAHL (via EBSCO), and the Cochrane Library, using predefined inclusion and exclusion criteria. Additional guideline databases and organizational websites were searched manually. The review process and reporting were guided by PRISMA 2020 reporting standards. Eligible studies included qualitative, quantitative, and guideline publications in English or German published since 2012. Study selection, data extraction, and critical appraisal were conducted independently by two reviewers. Results: Of 2850 initial records, 60 studies met the inclusion criteria and were included in the review. The majority were systematic reviews and evidence-based guidelines. The central literature-based results of the expert standard are presented based on the steps of the nursing process. The findings were thematically synthesized along the steps of the nursing process and informed key nursing interventions for continence promotion and compensation, including assessment, patient education, pelvic floor training, and selection of continence aids. Discussion: There are a variety of evidence-based interventions that can be used to deal with urinary and/or fecal incontinence and the tasks that professional nurses take on in promoting continence are complex. Patients and their relatives want information and advice on treatment options, reliable contacts and individual support offers to make informed decisions. Full article

Background/Objectives: Promoting access to palliative care education at all levels and in diverse contexts is essential. In Brazil, however, despite progress, awareness remains limited. The Last Aid approach provides accessible ways for the public to engage in discussions about serious illness, death, dying, and grief, while also suggesting practical actions to support. The present study aimed to investigate whether Last Aid Courses are accepted and contribute to increasing knowledge and awareness of Palliative Care to different settings in Brazil. Design/Methods: To obtain more in-depth views, a mixed methods approach was chosen, and participants from all Last Aid Courses offered in Brazil between March and November 2024 were invited to respond to a mixed qualitative–quantitative questionnaire provided after the course. Results: Thirty-two courses were offered, with 343 participants. Most of the Last Aid Courses participants came from the general public (53.2%), followed by health students (28.1%). 98.8% of all respondents indicated they had acquired new knowledge. Qualitative analysis identified four themes: death as part of life, communication about dying, dignity and respect for patients’ wishes, and the need for palliative care education. Participants highlighted autonomy, compassion, and dialogue as essential, reinforcing the urgency of expanding public education. Conclusions: The course implementation in Brazil showed positive results, indicating its potential to raise awareness about the topic, regardless of the context. Full article

The Laplace equation is an important partial differential equation, typically used to describe the properties of steady-state distributions or passive fields in physical phenomena. Its Cauchy problem is one of the classic, serious, ill-posed problems, characterized by the fact that minor disturbances in the data can lead to significant errors in the solution and lack stability. Secondly, the determination of the parameters of the classical Laplace equation is difficult to adapt to the requirements of complex applications. For this purpose, in this paper, the Laplace equation with uncertain parameters is defined, and the uncertainty is represented by fuzzy numbers. In the case of granular differentiability, it is transformed into a granular differential equation, proving its serious ill-posedness. To overcome the ill-posedness, the Fourier regularization method is used to stabilize the numerical solution, and the stability estimation and error analysis between the regularization solution and the exact solution are given. Finally, numerical examples are given to illustrate the effectiveness and practicability of this method. Full article

Background and Objectives: Thrombophilia is a prothrombotic disorder that increases the risk of blood clotting and can pose serious health problems. It is considered a condition of gene–gene or gene–environment interactions. Variation in the prevalence of thrombophilia mutations and their interaction among populations necessitates localized genetic assessments. However, population-based genetic data remains limited for developing effective preventive strategies. Materials and Methods: This cross-sectional observational study was conducted over five years (2020–2024) at a tertiary university hospital in Northern Greece. A total of 2961 individuals aged 18–85 years (mean: 50.5) were registered based on family or medical history of venous thromboembolism (VTE) or clinical symptoms of VTE. The final analysis included 2078 participants comprising 1143 males (55%) and 935 females (45%), who met all the inclusion criteria. Inclusion criteria were absence of acute illness or malignancy, informed consent, and an adequate DNA quantity for genotyping, whereas excluded criteria included incomplete laboratory data, active inflammatory or malignant disease, and cognitive or psychiatric conditions. Peripheral blood samples were collected in 2 mL K₃-EDTA tubes, and genomic DNA was analyzed using real-time polymerase chain reaction (PCR) with melting curve analysis and hybridization probes (LightMix^® in vitro diagnostics, TIB MolBiol, Berlin, Germany). Five thrombophilia-related polymorphisms, Factor V Leiden (F5 G1691A), prothrombin (F2 G20210A), methylenetetrahydrofolate reductase (MTHFR C677T and MTHFR A1298C), and Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G, were examined for allele and genotype frequencies, Hardy–Weinberg equilibrium testing, pairwise linkage disequilibrium (D′ and r²), and power analysis. For subjects tested for Factor V Leiden (n = 1476), the activated protein C resistance (APC) ratio was additionally evaluated using the ACL TOP 750 analyzer. Results: Allele frequencies were 7.3% for FV Leiden and 3.7% for FII. The PAI-1 allele was distributed at 44%, while the MTHFR (C677T and A1298C) alleles were each present at 33%. Significant linkage disequilibrium was identified between MTHFR (C677T and A1298C) and between MTHFR A1298C and PAI-1. No evolutionary pressure or demographic bias was found in the Hardy–Weinberg equilibrium. The APC ratio demonstrated a high sensitivity (99.2%) and specificity (96.6%), indicating that it may serve as a reliable screening method. Conclusions: Our findings highlight informative patterns in the genetic predisposition to thrombophilia, which may help develop rule-based strategies for implementing thromboprophylaxis guidelines and personalized medical interventions. Full article

Caregivers of a child with a serious medical condition are often confronted with difficult and stressful medical information. While they commonly seek out health-related information to better care for their child and help with their decision-making, sometimes caregivers engage in healthcare information avoidance. Healthcare information avoidance is the decision to prevent or delay the acquisition of available, but potentially unwanted, health-related information. We begin by defining the construct of healthcare information avoidance and exploring key theoretical frameworks that illuminate its underlying mechanisms including emotion regulation theory, attentional and cognitive models, approach-avoidance coping strategies, and dispositional theories. A lack of validated measures to assess caregiver healthcare information avoidance was noted as contributing to the dearth of empirical work in this area. Common areas of caregiver healthcare information avoidance were identified at various points throughout the pediatric palliative care illness trajectory. The review concludes with directions for future research and practical recommendations for clinical care, highlighting the importance of identifying the occurrence and reasons for caregiver information avoidance as well as optimizing approaches to information provision. Full article

Multidrug resistance has also been accompanied by the prolonged use of antibiotics that makes complications in treatment. Biofilm in pathogenic bacteria is the most serious challenge linked with chronic illnesses and also contributes to virulence and drug resistance. Several bacterial pathogens employ the Quorum-sensing (QS) mechanism to coordinate their collective behaviors like bioluminescence, virulence, and biofilm formation. Therefore, agents that inhibit or interfere with bacterial QS and biofilm formation are emerging as a new class of next-generation antibacterial. Recently, nanoparticles have been employed to improve the efficacy of existing antibacterial agents. In the present study, gold nanocrystals were synthesized by using Koelreuteria paniculata (KP) leaf extract. Synthesized nanocrystals were characterized by a face-centered cubic structure of ~20 nm by XRD, FTIR, Zeta sizer, and TEM. Biogenic Gold nanocrystals (BGNCs) exhibited extended QS inhibition in bio-indicator strains Chromobacterium violaceum and Pseudomonas aeruginosa biosensor strains. BGNCs strongly suppressed QS-controlled violacein production in C. violaceum CV026, and elastase, protease, pyocyanin, alginate, and biofilm formation in P. aeruginosa (PA01). In addition, BGNCs notably suppressed the relative expression of PA01 quorum sensing, biofilm-forming, and virulence-regulating genes, as quantified by qRT-PCR. As a result of the broad-spectrum suppression of QS and biofilm by BGNCs, it is anticipated that these nontoxic bioactive nanocrystals can be employed as surface sterilization agents in nosocomial infections. Full article

Acute pancreatitis (AP) is an inflammatory disorder of the pancreas that can lead to serious systemic complications. Its clinical presentation varies widely, ranging from mild, self-limiting symptoms to severe, life-threatening illness. Currently, there are no specific therapies approved for the treatment of AP, and management primarily relies on supportive care. However, a growing number of clinical trials have evaluated the translational potential of effective therapies derived from experimental models and have identified promising pharmacological agents that may help ameliorate disease severity. Alongside pharmacological approaches, nutritional management of AP has been gaining increasing attention. Evidence supports the use of enteral nutrition over parenteral feeding, as it is associated with a lower risk of necrotic infections, multiple organ dysfunction, mortality, and other associated complications of AP. In this review, we summarize the therapeutic potential of pharmacological and dietary/nutritional interventions, including naturally occurring bioactive compounds, for AP in the context of its molecular pathology, with the aim of supporting improved clinical decision-making, enhancing patient outcomes, and informing future research directions. Full article

Staphylococcus aureus (S. aureus) is one of the most common hospital-acquired pathogens and poses a serious threat to patients with weakened immune systems. Transmission can occur through foodborne illness, skin infections, abscess formation, and bloodstream invasion. The most severe complication arises when S. aureus infects the heart, leading to valve damage and potentially progressing to heart failure. In addition, many strains have developed strong resistance to conventional antibiotic therapies, making treatment increasingly difficult. These challenges highlight the importance of early detection for effective prevention and management. This research focuses on the development of a polymer composite incorporating hydroxyproline for the preparation of molecularly imprinted polymers (MIPs) designed for the rapid detection of S. aureus. The sensing platform, based on electrochemical principles, enabled sensitive and efficient analysis of bacterial samples. The sensor exhibited a broad analytical range, detecting S. aureus from 1 to 10,000 CFU/mL, with a detection limit as low as 1.031 CFU/mL. Selectivity testing against Pseudomonas aeruginosa, Candida albicans, and Escherichia coli confirmed high specificity toward S. aureus. These findings highlight the potential of this MIP-based electrochemical sensor as a reliable tool for rapid bacterial detection in clinical and environmental settings. Full article

Over the past five decades, the emergence and re-emergence of multiple flaviviruses have triggered significant global outbreaks, posing serious threats to public health. Among them, West Nile virus (WNV) is a major cause of mosquito-borne illness, typically presenting as an acute systemic febrile disease and, in some cases, progressing to the central nervous system involvement. No specific antiviral therapies or effective vaccines are available for WNV infections. In this context, antimicrobial peptides (AMPs) with antiviral properties—known as antiviral peptides (AVPs)—have gained attention as potential therapeutic agents due to their ability to interfere with various stages of the viral life cycle. Two frog-derived melittin-like peptides, AR-23 and RV-23, were synthesized and purified, and their hemolytic activity was assessed on human erythrocytes. Antiviral activity against WNV was evaluated in Vero cells using cytopathic effect reduction assays and real-time PCR quantification of viral RNA. Time-of-addition experiments were conducted to explore the stage of viral inhibition. In silico molecular docking studies were performed to examine interactions between the peptides and the viral E glycoprotein. Both peptides displayed strong antiviral effects during the early phases of infection, likely through direct interaction with viral particles and disruption of virus–host interactions. Compared with melittin, AR-23 and RV-23 showed greater efficacy and lower cytotoxicity, highlighting their potential as promising therapeutic candidates for flavivirus infections. Full article

Background/Objectives: Legacy planning should respect te care preferences of people facing serious illness and integrate palliative care (PC). Legacy creation with the guidance of health professionals in PC assumes a therapeutic nature and aims to respond to the psychospiritual needs of patients and their families. To date, research on professional experiences to create legacy in PC remains scarce. Therefore, this study sought to explore the experiences of PC professionals in legacy creation with the ill person and their family during EoL care. Methods: A descriptive qualitative study was performed through in-person semi-structured interviews with PC professionals from Portugal. Data collection was conducted from February to May 2025. Transcripts from the interviews were thematically analyzed with qualitative data management software WebQDA. The study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. Results: Sixteen PC professionals participated in the study. Most participants were nurses (n = 8), followed by six physicians and two psychologists. The mean age of participants was 44.93 ± 10.46 years. Data analysis yielded three themes: (1) the worth of legacy in EoL; (2) enablers of legacy-building process; and (3) challenges of legacy-building process. Conclusions: Legacy is a meaningful resource that gives professionals the opportunity to connect with patients and their families, and to enact value-concordant person-centered care. By providing a greater grasp of legacy construction, our findings may help healthcare providers better understand how to provide dying patients and their families with dignity-conserving care. Full article

Background: Occupational accidents, injuries, and illnesses are serious problems for organizations. Workplace sleepiness is a major issue that affects occupational safety and productivity. Workplace sleepiness is influenced by sleep, diet, and blood glucose levels, but the causal relationship is unclear. This scoping review aimed to investigate the factors affecting work productivity, with a particular focus on the impact of sleepiness caused by food intake and blood glucose level on productivity. Methods: PubMed, and Web of Science were used to search terms, such as “workplace,” “sleepiness or postprandial hypoglycemia,” “productivity,” and “measurement.” The following studies were included: (1) those with working hours evaluations; (2) that excluded patients with diabetes, heart diseases, or other diseases; (3) that excluded patients with mental illness; (4) that did not limit the evaluation of sleepiness at work to sleep only; (5) with publications after 2014; and (6) that were research articles. Results: The search yielded 521 articles. Nine papers met the inclusion criteria. Six studies assessed blood glucose levels, six assessed sleepiness, and one simultaneously assessed blood glucose and sleepiness. The Karolinska Sleepiness Scale (KSS) is the most frequently used sleep measure. Most studies have assessed the effects of controlled diets. Although some studies have used continuous glucometers, their evaluation of blood glucose levels has been limited. The extracted literature also included mild exercise and control of environmental illumination as a countermeasure against sleepiness. Conclusions: Although few studies have analyzed the causes and countermeasures of sleepiness in the workplace, sleepiness affects work productivity, diet affects sleepiness, and several methods for suppressing sleepiness have been researched. However, a few studies have directly evaluated the effects of blood glucose fluctuations and sleepiness on work productivity. These results suggest that further research into the relationship between sleepiness at work and related biological signals and blood glucose fluctuations will be important in understanding the causes, as it will form the basis for measures to improve work productivity. Full article

Background: Sepsis is a common and serious complication in pediatric hematology oncology (PHO) patients. The Endothelial Activation and Stress Index (EASIX) score offers a potentially accessible tool for risk stratification in septic patients. Our objective was to evaluate the association of the EASIX score with adverse clinical outcomes among septic PHO patients. Methods: A retrospective review was conducted for all PHO patients admitted to the intensive care unit (ICU) with sepsis from July 2022 to December 2024. Results: A total of 53 patients with 65 sepsis events were included in this analysis. The median age was 14.9 [IQR 9.9] y and the most common disease was hematologic malignancy. In our cohort, 60% needed vasopressors, 36% required invasive mechanical ventilation, and 22% underwent renal replacement therapy (RRT). Log2-EASIX > 2.5 was associated with higher vasopressor requirements (87% versus 45% in the low log2-EASIX group, p = 0.001) and an increased need for RRT (39% versus 12%, p = 0.024). Septic PHO patients with log2-EASIX > 2.5 were 6.9 times more likely to require vasopressor support [(95% CI 1.7–27.8) p = 0.007]. In addition, PHO patients with log2-EASIX > 2.5 had a longer ICU stay (7 d versus 2 d in the low log2-EASIX group, p = 0.024) and an extended overall hospitalization (33 d versus 25 d, p = 0.029). Conclusions: A higher EASIX score was associated with adverse outcomes in critically ill septic PHO patients. Our findings suggest that the EASIX score can be used as a tool for identifying septic patients at an increased risk of clinical deterioration and poor outcomes. Prospective studies in larger cohorts are warranted to validate and expand upon these findings. Full article

Salmonella presents serious risks to human health, causing about 150,000 deaths per year through the consumption of contaminated food, especially chicken eggs. Consequently, risk of salmonellosis from chicken eggs is of significant interest to the Saudi Food and Drug Authority (SFDA). Models that predict the risk of salmonellosis from chicken eggs are valuable tools for protecting public health. After a review of existing models, the SFDA selected the Poultry Food Assess Risk Model (PFARM) for the purpose of evaluating its ability to assess the risk and severity of salmonellosis for a small cohort of chicken egg consumers in Riyadh, Saudi Arabia, as a proof-of-concept and pilot study. The PFARM was selected because it uses novel methods to consider more risk factors for salmonellosis than other models, such as growth potential and zoonotic potential of Salmonella, buffering capacity of the meal, and consumer behavior, health, and immunity. The SFDA examined chicken eggs from retail stores in Riyadh for Salmonella contamination and surveyed 125 consumers to obtain data for simulating how they store, prepare, and consume eggs at home, and their resistance to salmonellosis. The prevalence of Salmonella in chicken eggs at retail was 7% (7/100). The isolated Salmonella serotypes were Cerro (n = 4), Enteritidis, Stanley, and Winston. Salmonella’s mean number (growth units) per contaminated egg was 1.58 log₁₀ (range: 0 to 3.08 log₁₀). The mean category for consumer survey results ranged from 1.1 (very low risk) for meal preparation time to 3.7 (high risk) for home storage time with 34.4% of consumers having low resistance to salmonellosis. Per 100,000 egg meals, the PFARM predicted 88 infections, two illnesses, and no hospitalizations or deaths. The consumers who became ill were exposed to Salmonella Enteritidis, had moderate resistance to salmonellosis but high-risk behaviors for egg storage (temperature abuse), meal preparation (poor hygiene), and consumption (undercooked eggs). These results showed that the studied chicken eggs posed a low risk and severity of salmonellosis for the surveyed consumer cohort in Riyadh, Saudi Arabia, and that the PFARM was fit-for-purpose. The next step is to improve the PFARM and apply it more broadly in Saudi Arabia to better define the problem and its control. Full article

The alarming rise in foodborne illnesses, particularly those associated with microbial contamination in meat products, presents a serious challenge to global food safety. Among these microbial threats, Pseudomonas aeruginosa (P. aeruginosa) poses a critical threat due to its biofilm-forming capability and prevalence in contaminated beef, highlighting its effective real-time detection. Herein, we report the fabrication of a novel electrochemical aptasensor based on multimetal perovskite (FeCoCuNiO) doped with urea-derived graphitic carbon nitride (g-C₃N₄), synthesized via a sol–gel combustion method. The FeCoCuNiO-g-C₃N₄ nanocomposite was then coated onto a graphitic pencil electrode and functionalized with a DNA-based aptamer specific towards P. aeruginosa. The resulting aptasensor exhibited a low detection limit of 3.03 CFU mL⁻¹ with high selectivity and sensitivity, and was successfully applied to real-time detection of P. aeruginosa in food samples. To the best of our knowledge, this work presents the first FeCoCuNiO-g-C₃N₄-based aptasensor for bacterial detection, offering a promising platform for food safety assurance and public health protection. Full article

Background: Individuals with serious mental illness (SMI) die significantly earlier and experience disproportionately higher rates of physical health issues compared with non-SMI groups. Despite advances in care, this mortality gap persists. One factor that contributes to this discrepancy is inadequate access to healthcare, as individuals with SMI are less likely to receive appropriate medical care. Methods: To better understand this, we completed a narrative review synthesizing existing literature on common barriers to care faced by the SMI community. We reviewed 34 articles and identified three primary barriers to receiving healthcare. Results: These included structural and logistical barriers (geographic location, access to technology and internet, disjointed medical and mental healthcare); intrapersonal- and patient-level barriers (symptoms and psychological impact of SMI, lack of awareness or prioritization of medical issues, medical mistrust, and limited health literacy); and provider- and system-level barriers (lack of knowledge or support for integrated care, lack of knowledge of SMI, stigma, and diagnostic overshadowing). Conclusions: We argue that addressing these issues requires a reorientation toward person-centered approaches that prioritize continuity, integration, and dignity in care for individuals with SMI, and we offer specific recommendations in service of these aims. Full article