The impact of guideline-directed medical therapy (GDMT) has not fully translated to decreases in the disproportionate rates of hospitalization and lengths of stay in African Americans with congestive heart failure (CHF). GDMT is optimized by registered nurses (RNs) and their use of clinical information. Yet, there are no instruments for measuring the influence of clinical information use and nursing care. The study assessed an instrument’s ability to measure the influence of RN performance of social, technical, and socio-technical care tasks on length of stay in the CHF hospitalizations of African Americans.

A sample of 200 RNs, who cared for 5060 African Americans with 14,123 heart failure hospitalizations, were surveyed. Descriptive statistics, Cronbach’s alpha, and a generalized linear regression assessed the instrument’s reliability and predictive validity.

The Cronbach’s alpha was 0.95 (95% CI: 0.94–0.96). The corrected item-total correlations for the 22 items ranged from 0.44 to 0.80. For an increase of one to four points per item in a RN’s performance, the estimated reductions in the patient’s length of stay were 3.34% (6.11,0.5), 6.58% (11.84,1), 9.70% (17.22,1.49), and 12.72% (22.28,1.99), respectively (P = 0.004).

Increases in a RN’s performance of social, technical, and socio-technical care tasks were significantly associated with clinically meaningful decreases in their patients’ length of stay. The instrument has strong potential for addressing the disproportionate impact of CHF by measuring and tailoring interventions to optimize nursing care and the use of clinical information in the provision and receipt of GDMT.

The urban First Nations population in Australia is rapidly increasing. The health policy and research focus on urban First Nations Australians, however, is limited. To contribute to addressing this situation, The University of Queensland Poche Centre for Indigenous Health (UQ Poche Centre), a First Nations-led health research centre, is working closely with urban Aboriginal Community-Controlled Health Services (ACCHS) across Australia.

Our study examined urban ACCHSs stakeholders’ perspectives of the health and wellbeing of urban First Nations Australians and identified their priorities for a national Indigenous urban health research agenda.

Ten stakeholders were recruited for in-depth interviews from ACCHS that were members of the Research Alliance for Urban Community-Controlled Health Services (RAUCCHS), a partnership between the UQ Poche Centre and urban ACCHS focused on achieving equitable health outcomes for urban First Nations Australians. Six stakeholders identified as First Nations Australians. Interviews were audio-recorded and transcribed verbatim. Interview data were analysed using inductive thematic analysis.

Stakeholders highlighted a lack of research focused on the health of urban First Nations Australians. Specific priority areas they identified for an urban First Nations health research agenda were: evaluating the effectiveness and adaptability of Indigenous models of care, strengthening care pathways between ACCHS and specialist services, examining the intersection of cultural identity, racism and determinants of health, and greater investment in Indigenous research governance structures and processes.

There is a clear opportunity for researchers to engage with RAUCCHS members to establish a body of urban First Nations health research in Australia that responds to their research priorities.

Dignity is a crucial value in caring for nursing home residents. These residents are extremely vulnerable due to, among others, their physical, social, and mental health risks. These risk factors can undermine their sense of dignity and induce feelings of inferiority and even depression.

Dignity Therapy is a short, individualized psychotherapy aimed at decreasing the existential distress of patients with a terminal illness. It appeared to be successful in patients with incurable cancer and could be a valuable addition to the treatment of loss of dignity in nursing homes. We evaluated the feasibility of implementing Dignity Therapy in Dutch nursing homes and explored its potential effects on residents’ dignity, depression, and self-esteem.

A pre–post feasibility study was conducted in 2 nursing homes. Psychologists were trained to recruit residents and deliver Dignity Therapy. Standardized questionnaires were administered at baseline and follow-up to assess dignity, depressive symptoms, and self-esteem.

Psychologists were able to recruit and deliver the intervention to 36 residents. Participants generally evaluated the experience as pleasant and meaningful. No significant differences were found between pre- and post-measurements for dignity, depressive symptoms, and self-esteem. Regarding depressive symptoms, men and non-religious residents showed higher levels of depressive symptoms after the 8-week follow-up.

Dignity Therapy is feasible and acceptable for residents in Dutch nursing homes. Although no significant effects on dignity, depression, or self-esteem were detected, further research with larger samples and optimized implementation strategies is needed to understand the potential impact of Dignity Therapy in this setting.

This study aimed to evaluate patients with beta thalassaemia major using the cardiac electrophysiological index of balance, a new electrocardiography parameter, and to predict ventricular arrhythmias.

In this study, 60 beta thalassaemia major and 60 healthy children were included. All patients were evaluated with echocardiography. P-wave dispersion, repolarisation times, repolarisation dispersion times, and cardiac electrophysiological balance index were measured using 12-lead electrocardiography. Heart rate variability parameters were evaluated with a 24-hour Holter electrocardiography.

Left ventricular functions were similar between the groups. Although repolarisation times (QT, JT, and JTp) were significantly lower in the beta thalassaemia major group, heart rate-corrected repolarisation times were similar. Except for Tpe/QT, which is one of the repolarisation dispersion parameters, the other parameters were similar. The heart rate-corrected cardiac electrophysiological index of balance ratio was significantly higher in the beta thalassaemia major group. QRS duration and QRS-dispersion duration (QRS-d) were similar between the groups. There was a correlation between blood ferritin levels and LVmass-i, Tpe/QT, Tpe/QTc, QTc/QRS ratio, and QT, JT, and JTp values.

Patients with beta thalassaemia major are at high risk for ventricular arrhythmia due to a high QTc/QRS ratio, despite normal left ventricular systolic, diastolic, and autonomic function in the early period. We believe that there is a moderate correlation between blood ferritin levels and the QTc/QRS ratio and that the QTc/QRS ratio can provide important information for the follow-up and evaluation of patients with beta thalassaemia major.

Despite normal early ventricular function in the beta thalassaemia major group, they were at high risk of ventricular arrhythmias.

This study examined the relationship between food safety, food access, and nutritional status among earthquake victims in Kahramanmaraş and Hatay, Türkiye.

This descriptive, cross-sectional study was conducted face-to-face with 209 earthquake victims in 2023.

The median age was 42 years, and 52.6% were female. Among women, the perception of unhealthy food, inadequate mass feeding services, and dissatisfaction with meals increased the risk of food safety concerns. In men, those with an associate degree or higher were 20.7 times more likely to perceive food safety as inadequate, while the perception of unhealthy food raised this risk by 12.4 times. Lack of access to sufficient drinking water increased the risk of food inaccessibility by 2.6 times among women. In men, employment and dissatisfaction with meals increased this risk by 2.7 and 2.8 times, respectively. Both genders exhibited inadequate intake of water, energy, protein, polyunsaturated fats, fiber, folate, potassium, calcium, magnesium, iron, zinc, and several vitamins (P <0.05), while phosphorus and sodium levels were elevated (P <0.01).

Food safety and access issues were critical among earthquake victims, significantly impacting nutritional status. Findings emphasize the need for improved emergency food aid and distribution systems to mitigate post-disaster nutritional risks.

Reducing stigma and discrimination has been a priority in many national mental health policies for decades. Focusing efforts requires us to understand where this has the greatest impact on people with mental health problems. In 2024, we conducted a nationally representative survey that aimed to assess the burden of discrimination (as a product of frequency and impacts of experiences). Secondary aims were to quantify the types of discrimination experienced in different life domains and the sociodemographic and mental health problem characteristics of those experiencing higher burden.

Online surveys were completed by 6032 members of the general Australian community aged 18 years and over. The survey was carried out by the survey company The Social Research Centre, using their Life in Australia™ probability-based panel. Those who reported a mental health problem or scored high on the Kessler 6 measure of psychological distress (n = 2613) were asked about the past 12-month frequency and impact of their experiences of discrimination in a broad range of settings, including family, friends, workplaces and health services. The data were initially analysed using percent frequencies and 95% confidence intervals. A burden score was calculated for each domain, incorporating frequency and impact among those who reported discrimination experiences.

Overall, discrimination in social life was the most common (43.6% [95% CI 41.2, 45.9]), followed by discrimination from family (41.4% [95% CI 39.1, 43.7]) or in making or keeping friends (41.0% [95% CI 38.7, 43.3]). However, the highest burden was from discrimination in finding or keeping a job, in dating/intimate relationships, in housing (including renting or public housing) and in obtaining welfare benefits or disability pensions. The most common type of discrimination experience in the workplace and among friends, family and partners was of people lacking understanding of the impact of the person’s mental health problem. People aged 35–64 years were more likely than those aged 18–34 years to report higher burden in multiple domains; people with depression or attention-deficit/hyperactivity disorder also reported burden in more domains than people with anxiety or severe mental health conditions. Overall, 67.7% (95% CI 65.5, 69.9) agreed that stigma and discrimination was worse than the mental health problem itself.

Our study suggests that reducing the frequency and impact of discrimination in workplaces, welfare benefits and housing should be key targets for policy and practice. Improving the capacity of people in workplaces and intimate partners, families and friendship groups to better understand the impacts of mental health problems on individuals should also be a priority.

On September 17, 2024, a coordinated detonation of approximately 5,000 pager devices in Lebanon produced a large mass-casualty incident. Devices contained pentaerythritol tetranitrate (PETN). We report 5 pediatric patients transferred to a tertiary referral center for management of complex multisystem injuries.

We performed a brief report of 5 children (<12 years) referred to Baqiyatallah Hospital, Tehran. Demographics, injury pattern, surgical interventions, and short-term outcomes (up to 3 months) were abstracted from medical records. All patients received multidisciplinary care (ophthalmology, plastic surgery, orthopedics, otolaryngology, pediatrics, infectious disease).

Mean age was 9.2 years (range 5–11). All 5 children sustained ocular, facial, and hand injuries. Three eyes were auto-eviscerated, and 4 children underwent partial hand amputations. Multiple operative procedures were required per patient (ocular surgery, facial reconstruction, orthopedic fixation). Early outcomes were poor for vision and hand function in the majority; reconstructive planning and prosthetic rehabilitation were anticipated for longer-term care.

Close-range exposure to small PETN-containing devices produced a distinctive pediatric injury pattern dominated by severe ocular and upper-extremity trauma. These findings emphasize the need for pediatric-focused acute care algorithms and sustained rehabilitation resources after blast incidents.