The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL) is designed to measure quality of life (QoL) in cancer patients receiving palliative care. The aim of this study was to translate and validate an Urdu version of the questionnaire, which was previously lacking.

Following formal approval from the EORTC, the QLQ-C15-PAL was translated into Urdu. Patients admitted under the palliative care service at a tertiary care center in Karachi, Pakistan, were enrolled in this cross-sectional study, and the Urdu QLQ-C15-PAL and the Edmonton Symptom Assessment Scale (ESAS) forms were administered. Performance status was assessed using the Palliative Performance Scale (PPS). Cronbach’s alpha and Pearson correlation coefficients were determined to gauge reliability and validity. Concurrent and known-group validity were tested using ESAS responses and PPS assessments.

One hundred patients with varying primary cancer sites were included. Cronbach’s alpha for the overall questionnaire was 0.86 and was >0.8 for all subscales except fatigue, where it was 0.697. All correlations to indicate convergent validity had coefficients >0.8 and 87% of correlations between “unrelated” domains were weak, indicating discriminant validity. Known group validity was established and improved QoL was observed in the high PPS (>40) subgroup of patients across multiple domains. However, concurrent validity was not strongly established.

The Urdu QLQ-C15-PAL is a reliable and valid tool to measure QoL in cancer patients who speak Urdu. However, replication of our results in other settings is warranted.

Early identification of patients colonized with multidrug-resistant organisms (MDROs) facilitates infection control interventions. We assessed a Public Health Risk Model’s ability to predict carbapenem-resistant Enterobacterales and other MDROs.

We retrospectively analyzed a medical intensive care unit patient cohort screened at time of admission for MDRO carriage (1/2017–1/2018). Encounters were linked to Illinois Hospital Discharge Data and assigned a public health risk model probability score. We compared the model’s performance to traditional screening strategies that use variables locally available to clinicians at time of admission (i.e., transfer from other hospital, tracheostomy, gastrostomy, pressure ulcer). Model discrimination was evaluated by quantifying the area under the curve (AUC). For each approach, we assessed sensitivity, specificity, and number needed to screen (NNS) to detect one MDRO carrier.

Model probability calculation was successful in 1237/1250 (98.9%) admissions. The model identified carbapenem-resistant Enterobacterales colonization well (AUC 0.82) and generalized to predict colonization with other healthcare-associated MDROs, including carbapenem-resistant Pseudomonas aeruginosa (AUC 0.82) and vancomycin-resistant enterococci (AUC 0.76). The model did not predict MDROs with known local community reservoirs, i.e., third-generation cephalosporin-resistant Enterobacterales (AUC 0.61) and methicillin-resistant Staphylococcus aureus (AUC 0.59). At the same NNS, the model had higher sensitivity compared to use of traditional screening strategies (68% versus 41%).

A risk model using patient-level healthcare exposure data from a state public health dataset identified critically ill patients likely to harbor healthcare-associated MDROs at the time of admission.

There is currently no established normative data for cardiopulmonary exercise parameters in the semi-supine position. There is conflicting data regarding the impact of a semi-supine body position on the semi-supine recumbent ergometer on cardiopulmonary exercise parameters. The goal of the current study was to match semi-supine recumbent ergometer tests completed in children/adolescents with those completed on the cycle ergometer and treadmill to identify differences in cardiopulmonary exercise parameters between devices.

Maximal semi-supine recumbent ergometer tests were matched by demographics (age, race/ethnicity, sex, height, weight, and body mass index) to tests completed on the cycle ergometer and treadmill. Groups were compared with two-sample T-tests for numeric variables and Fisher’s exact tests for categorical variables.

There was no difference in demographics between groups. Peak cardiopulmonary exercise parameters (watts, oxygen consumption, heart rate, blood pressure, oxygen saturation, minute ventilation, respiratory exchange ratio, respiratory rate, and anaerobic threshold) were unchanged between semi-supine recumbent ergometer and cycle ergometer, but the ventilatory equivalent of carbon dioxide was higher on the cycle ergometer versus semi-supine recumbent ergometer. Anaerobic threshold, peak oxygen consumption, and peak minute ventilation were lower on the semi-supine recumbent ergometer than on the treadmill.

The uniformity in nearly all cardiopulmonary exercise parameters between the semi-supine recumbent ergometer and cycle ergometer suggests that normative data for the cycle ergometer are a reasonable surrogate for normative data on the semi-supine recumbent ergometer until semi-supine recumbent ergometer-specific normative data are developed.

Acute Palliative and Supportive Care Units (APSCUs) provide unique and tailored care to patients with advanced chronic illness. In an APSCU, patients receive intensive palliative care while remaining in an acute care hospital setting. This allows for physical and psychological suffering to be aggressively treated by a dedicated interdisciplinary team. In the case of our patient, the APSCU changed the trajectory of his expected outcome of in-hospital death to a successful discharge home.

We report the case of a patient with advanced colon cancer who suffered cardiac arrest in the emergency department and was expected to die soon after transition to comfort-oriented care.

After terminal extubation, our patient continued to have agitated delirium and was transferred to our APSCU for aggressive symptom control. He stabilized and progressively became more responsive, prompting a change in his plan of care with a goal of discharge home with hospice. The APSCU’s interdisciplinary team was able to adapt to the patient’s unexpected clinical improvement and provide him and his family with the medical, psychosocial, and spiritual expertise to prepare him for a successful discharge home, where he ultimately died 6 weeks later.

The case report demonstrates that an APSCU, with its skilled interdisciplinary team in the acute care hospital, is an ideal setting to provide patient-centered care for seriously ill patients and their families.

This study aims to elucidate the ethical dilemmas faced by pre-hospital emergency medical service personnel during disaster triage, with a specific focus on the Kahramanmaraş Earthquakes, and to document their experiences.

This phenomenological study employed semi-structured interviews with 29 pre-hospital emergency medical service workers who served during the first 72 hours of the Kahramanmaraş Earthquakes to gather qualitative data. Purposeful sampling was used for face-to-face interviews, and MAXQDA20 was utilized for content analysis.

The main themes encompassed problems related to disaster management organization, environmental factors, and individual factors. Environmental factors, such as coordination deficiencies at the scene, jurisdictional confusion, security concerns, and seasonal conditions, as well as personal factors including education and experience, were pivotal in the occurrence of ethical dilemmas in disaster triage.

Pre-hospital emergency medical services personnel affected by the disaster faced more ethical dilemmas. The presence of many affected children had a profound emotional impact on participants, leading to more frequent ethical dilemmas, particularly in the application of black code protocols.

We analysed cardiac MRI and catheterisation variables during pre-Fontan evaluations for associations with major adverse cardiac events including Fontan takedown, mechanical circulatory support, heart transplantation, or death.

In this single-centre retrospective study, we gathered pre-operative MRI and catheterisation data for all patients who underwent Fontan operation at Children’s Medical Center, Dallas, from April 2017 to November 2022. Patients were grouped according to the presence or absence of adverse events, and MRI and catheterisation parameters were compared between groups. We used the Mann–Whitney U Test for non-parametric data, Student’s T-test for parametric continuous variables, and Fisher’s Exact Test for categorical variables.

Of the 119 combined evaluations, 81 proceeded with Fontan palliation. Adverse events were recorded in 10% of patients (n = 8). One had a Fontan takedown, one underwent transplant, one required mechanical circulatory support, and five died in a median 21-month follow-up. Factors significantly associated with adverse events included heterotaxy syndrome (p = 0.04), higher combined pulmonary vascular resistance (p = 0.03), and moderate-severe (≥30%) atrioventricular valve regurgitation (p = 0.046). While combined pulmonary vascular resistance calculated from both catheterisation and MRI data predicted outcome, pulmonary vascular resistance calculated using data solely from catheterisation showed no discriminative ability.

Post-Fontan major adverse cardiac events were associated with heterotaxy syndrome, higher combined pulmonary vascular resistance, and moderate-severe atrioventricular valve regurgitation identified on pre-Fontan MRI and catheterisation. Combined pulmonary vascular resistance using transpulmonary gradient from catheterisation data and effective pulmonary blood flow from MRI data may help predict outcome.

Investigating the relationship between behavioural addictions and mental health is essential due to their impact on well-being and the significant barriers they create to achieving lasting recovery. The aim of the study was to examine the prevalence of food addiction, problematic internet use, and internet gaming disorder among 866 high school students (grades 9–12) in Turkey, Bingöl and their associated with impulsivity, emotional regulation, depression, anxiety, and stress.

The sample was selected using a convenience sampling approach. Data were collected via online questionnaires using validated scales and analysed with SPSS package programme.

The prevalence of food addiction was 6.9%, problematic internet use 14.3%, and internet gaming disorder 0.9%. Problematic internet use relatively high prevalence likely reflects adolescents’ increased exposure to digital devices. Mental health factors were found to be significantly related to behavioural addictions: depression, anxiety, and stress predicted food addiction; depression and stress predicted problematic internet use, and anxiety was linked to internet gaming disorder.

This study contributes to the literature by examining multiple behavioural addictions and their common risk factors simultaneously and provides a comprehensive perspective. It is also one of the rare studies examining food addiction with other behavioural addictions. More research is needed to develop better intervention programmes and policies in the issue.

Cognitive fatigability (CF), which refers to a decline in performance during sustained cognitive effort, can significantly impact people with multiple sclerosis (PwMS). This study examined the unmet needs related to perceived CF in PwMS.

One hundred PwMS completed a survey assessing factors known to contribute to CF. Participants indicated whether each factor, including CF itself, was disruptive and whether adequate support was available to address these concerns. A factor identified as disruptive and insufficiently addressed was considered an unmet need (Need Index [NI] ≥50%).

Group-level analysis revealed no significant unmet needs, although fatigue (NI = 30.23), CF (NI = 22.96) and physical activity (NI = 19.55) were more frequently reported. Individual-level analyses revealed that unmet needs varied by community setting (rural vs urban) and socioeconomic status (SES) (lower vs higher SES), with rural participants and those with lower SES reporting higher rates of unmet needs. In addition, PwMS who indicated CF was an unmet need reported more difficulties across most contributory factors, including sleep quality, fatigue, cognitive impairment, depression and contextual factors. The presence of fatigue and CF combined contributed to greater unmet needs across various domains, especially fatigue, CF and cognitive impairment, compared to fatigue alone.

Participants from rural and low socioeconomic backgrounds were more likely to have unmet needs. Notably, 36% of participants (N = 33) reported unmet needs related to perceived CF. The findings highlight the importance of tailoring future interventions to address identified needs more adequately.