Search Results for: Nuovo test rapido per distinguere le infezioni virali

Objectives
This study explores the drug use behaviour in the US general population in the early days of the COVID-19 pandemic with a focus on the relationship between sociopsychological factors, mobility restrictions from March to June 2020 and mental health conditions.

Design
A retrospective anonymous online survey representing a cross-section of the US population in 2020.

Setting
A qualified panel of 500 000 Qualtrics participants stratified by gender, race, age and geographical region to represent the US population.

Participants
3340 participants voluntarily consented to respond.

Measures
Outcome measure for illicit and non-medical use of prescription drugs based on the National Institute on Drug Abuse-Modified Alcohol, Smoking and Substance Involvement Screening Test Level-2 Substance Use for Adult Questionnaire and predictor measures include self-reports of mobility behaviours, demographics and mental states using psychometrically validated scales.

Results
2 tests showed that those who stayed home reported higher odds (p

Per la prevenzione del cancro dell’intestino

Per la prevenzione del cancro dell’intestino

Introduction
Endometriosis affects 10–15% of people assigned female at birth and can cause chronic pelvic pain and impair many domains of quality of life, such as fertility, mood and bladder, bowel and sexual function. Current treatments often fail, leading to recurrent pain and the need for reintervention. As endometriosis negatively affects many domains of life, a variety of non-pharmacological treatments modestly improve symptoms. To bundle these interventions into accessible packaging, our interdisciplinary team developed a novel endometriosis intervention titled ‘Peer-Empowered Endometriosis Pain Support (PEEPS)’, an 8-week integrative group care intervention. Here, we present the protocol for a pilot randomised controlled trial (RCT) to evaluate the effectiveness and implementation of PEEPS for people with endometriosis-associated pain refractory to surgical management. We hypothesise that patients who complete the PEEPS programme will show a greater decrease in pain interference in daily activities at intervention completion as compared with baseline than those in the education arm.

Methods and analysis
This is a hybrid type 1 effectiveness-implementation mixed-methods RCT in which 60 participants will be randomised using computer-generated random numbers stratified by group in the ratio 1:1 to PEEPS plus usual versus educational handout plus usual care. The primary outcome is change in pain interference from baseline to intervention completion. Secondary outcomes include change in pain interference from baseline to 6 months and 12 months postintervention, as well as change in other quality-of-life measures as measured by nine validated questionnaires from baseline to completion, 6 months and 12 months. Proctor et al’s Implementation Outcomes Framework will be used to evaluate acceptability, appropriateness and feasibility of PEEPS implementation, and the Consolidated Framework for Implementation Research will be used to guide the evaluation of barriers and facilitators of PEEPS at the patient and provider levels. Primary data analyses will follow the intention-to-treat principle. Descriptive statistics and two-sample t-tests for normally distributed values and Wilcoxon Rank-Sum test were performed for non-normally distributed values. Frequency analysis and Fisher’s exact or 2 tests will be used for categoric variables as appropriate. Longitudinal analysis of the primary and secondary outcomes will be conducted with a mixed-effects model to investigate the effect of PEEPS compared with education. Least square means (LSMs) and the corresponding 95% CIs at each timepoint, as well as LSM differences and 95% CIs between any post-baseline and baseline will be provided for the outcomes. ORs and 95% CIs will be calculated for categorical outcomes. Qualitative data will be collected in the form of open-ended feedback, focus groups with programme completers and semistructured interviews with participants who complete two or fewer sessions. The analysis will use an embedded design-experimental model in which quantitative and qualitative outcomes will occur concurrently with weight priority given to quantitative data.

Ethics and dissemination
This trial was approved by the Washington University in St. Louis Institutional Review Board (protocol 202402082) on 27 March 2024 and has low risk of harm to participants. All deidentified data from this project will be shared via Digital Commons@Becker. The findings of this study will be disseminated via scientific meetings and peer-reviewed journals. The results and conclusions will be summarised for patients and the public in common language using infographics to make the findings accessible. This pilot RCT will yield the effect size for PEEPS and generate implementation context and outcomes data to guide PEEPS application to real-world practice. If PEEPS proves to be effective, this study will inform adaptation and scaling to improve the lives of people with endometriosis through a non-hormonal, fertility-preserving approach.

Trial registration number
ClinicalTrials.gov; NCT06549985.

Introduction
Patients with knee osteoarthritis are at a higher risk of falls compared to healthy individuals, thereby increasing the likelihood of accidental injury. Resistance training is an important strategy for managing knee osteoarthritis. Although some studies suggest that blood flow restriction training combined with low-load resistance training (LL-BFRT) is a beneficial treatment approach, its effect on fall risk and balance function in patients with knee osteoarthritis remains unclear. We aim to conduct a randomised controlled trial to assess the effectiveness of combined training in reducing fall risk and improving function in patients with knee osteoarthritis.

Methods and analysis
We will conduct a single-blind pilot randomised controlled trial involving patients with knee osteoarthritis. 98 patients will be randomly assigned to either the LL-BFRT group or the low-load resistance training (LL-RT) group, with a 1:1 allocation ratio. Both groups will undergo a 4-week intervention. Follow-up assessments will be conducted at baseline, 4 weeks, 16 weeks, 28 weeks and 52 weeks. The primary outcome will be the measurement of the fall risk stability index and overall stability index using the Biodex Balance System. Secondary outcomes include the Numerical Rating Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the 30 s Chair Stand Test, proprioception testing, the Timed Up and Go Test, the Short Form-36 scores, compliance and adverse events. Intention-to-treat principles will be applied in data analysis.

Ethics and dissemination
This study has been approved by the Ethics Review Committee of the First Hospital of Quanzhou Affiliated Fujian Medical University (2024-K161). The results of the study will be disseminated through peer-reviewed publications.

Trial registration number
ChiCTR2400087829.

Introduction
Benzodiazepine receptor agonists (BZRA) deprescribing interventions are needed to tackle high BZRA use in the older population. This study aims to assess the feasibility of the D-PRESCRIBE intervention, adapted from Canada to the Belgian community setting. This pharmacist-led intervention comprises a patient educational brochure and a pharmacist-to-prescriber communication tool.

Methods and analysis
We will conduct a feasibility study of a cluster randomised controlled trial involving 8–10 community pharmacies (clusters) and aiming to recruit 56–80 patients (≥65 years). Intervention pharmacies will deliver the adapted D-PRESCRIBE intervention and control pharmacies, usual care. Patients will be blinded to group allocation. Quantitative data will be collected at baseline, 3 months and 6 months through patients’ and pharmacists’ questionnaires, aiming: (1) to test the feasibility of the intervention, (2) to test the feasibility of the study design needed for its evaluation and (3) to perform an exploratory cost-effectiveness analysis. Hence, data about implementation outcomes, mechanisms of impact (ie, mechanisms through which the intervention is supposed to be effective) and contextual factors will be gathered. Patient-centred outcomes will also be collected as they would be in a full cost-effectiveness trial. The feasibility of the study design will be assessed through participation rate, completeness of the data and a satisfaction survey, sent to participants after the 6-month data collection. Data will be analysed using descriptive statistics. To gain a deeper understanding of pharmacists and patients’ experience with the intervention, interviews will be conducted after the 6-month data collection and the Theoretical Domains Framework will be used as a deductive framework for analysis.

Ethics and dissemination
This study was approved by the Ethics Committee of CHU UCL Namur (NUB: B0392023000036). Participants will receive a summary of the results. Results will also be disseminated through the organisation of a local symposium and a peer-reviewed publication.

Trial registration number
NCT05929417.

Objectives
The COVID-19 pandemic highlighted the deterioration of nurses’ working conditions and a growing global nursing shortage. Little is known about the factors, strategies and interventions that could improve nurse retention in the peri- and post-COVID-19 period. An improved understanding of strategies that support and retain nurses will provide a foundation for developing informed approaches to sustaining the nursing workforce. The aim of this scoping review is to investigate and describe the (1) factors associated with nurse retention, (2) strategies to support nurse retention and (3) interventions that have been tested to support nurse retention, during and after the COVID-19 pandemic.

Design
Scoping review.

Data sources
This scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. MEDLINE, Embase, CINAHL and Scopus databases were searched on 17 April 2024. The search was limited to a publication date of ‘2019 to present’.

Eligibility criteria
Qualitative, quantitative, mixed-methods and grey literature studies of nurses (Registered Nurse (RN), Licenced Practical Nurse (LPN), Registered Practical Nurse (RPN), Publlic Health Nurse (PHN), including factors, strategies and/or interventions to support nurse retention in the peri- and post-COVID-19 period in English (or translated into English), were included. Systematic reviews, scoping reviews and meta-syntheses were excluded, but their reference lists were hand-screened for suitable studies.

Data extraction and synthesis
The following data items were extracted: title, journal, authors, year of publication, country of publication, setting, population (n=), factors that mitigate intent to leave (or other retention measure), strategies to address nurse retention, interventions that address nurse retention, tools that measure retention/turnover intention, retention rates and/or scores. Data were evaluated for quality and synthesised qualitatively to map the current available evidence.

Results
Our search identified 130 studies for inclusion in the analysis. The majority measured some aspect of nurse retention. A number of factors were identified as impacting nurse retention including nurse demographics, safe staffing and work environments, psychological well-being and COVID-19-specific impacts. Nurse retention strategies included ensuring safe flexible staffing and quality work environments, enhancing organisational mental health and wellness supports, improved leadership and communication, more professional development and mentorship opportunities, and better compensation and incentives. Only nine interventions that address nurse retention were identified.

Conclusions
Given the importance of nurse retention for a variety of key outcomes, it is imperative that nursing leadership, healthcare organisations and governments work to develop and test interventions that address nurse retention.

A causa delle infezioni da antibioticoresistenza occupati quasi 3 milioni di posti letto nel Paese

To the Editor Dr Lee and colleagues conducted a randomized, population-based trial in Taiwan to assess whether the addition of the Helicobacter pylori stool antigen (HPSA) test to the standard fecal immunochemical test (FIT) could reduce gastric cancer incidence and mortality. The study reported no significant differences between the 2 groups in gastric cancer incidence (0.032% vs 0.037%; P = .23) or mortality (0.015% vs 0.013%; P = .57). Several points merit further discussion.

To the Editor In a recent trial, there were no differences in gastric cancer incidence or mortality between the 2 treatment groups at a median follow-up of 5.7 years (IQR, 4.9-6.5 years). The progression time from early asymptomatic to symptomatic gastric cancer is unknown and may be longer than the follow-up time of the trial. Presentation of cumulative incidence curves would be helpful to further gauge the effect of the intervention. Furthermore, the study excluded 4 patients with gastric cancer diagnosed on endoscopy after trial entry. While H pylori eradication may not have affected the development of cancer in these patients, excluding them creates bias because the control group was not exposed to gastroscopy with early detection of prevalent cancers. We suggest a recalculation of screening effects including the 4 patients who were excluded. Additionally, we are interested to know if more than 1 H pylori stool test was offered (for example, with subsequent FIT), which would provide information about reinfection and subsequent cancer risk.

Objectives
To investigate the prevalence and factors of COVID-19 infection in children aged 0–6 years within Hunan Province following the deregulation of epidemic control.

Design
This is an observational study in epidemiology, using an on-site questionnaire survey to investigate the current status of COVID-19 infection and its influencing factors in children aged 0–6 years in Hunan Province from 16 February to 24 March 2023.

Setting
Multi-stage stratified sampling method was applied in this study. The regions were categorised as developed, medium and underdeveloped. One municipality was selected from each category. In each municipality, one district and one county were chosen for cluster sampling.

Participants
Children aged 0–6 years in Hunan Province.

Results
A total of 78 115 children aged 0–6 years were enrolled in this study, of 30 659 (39.2%) had a confirmed positive SARS-CoV-2 test result or related clinical symptoms. The majority of COVID-19 infections in children were of mild type (92.0%), and very few were severe and critical (0.4% and 0.1%). The majority (74.6%–88.7%) of children had minimal lifestyle behavioural changes after infected with COVID-19. Parents of the child working as a staff member (OR=0.654, 95% CI: 0.603, 0.709) and civil servant (OR=0.865, 95% CI: 0.794, 0.941), living in a rural area (OR=0.384, 95% CI: 0.369, 0.400) and no COVID-19 exposure (OR=0.108, 95% CI: 0.104, 0.113) were protective factors for COVID-19 infection in children.

Conclusion
Children experienced a large number of COVID-19 infections following the deregulation, fewer severe cases and fewer changes in lifestyle. Easing epidemic control measures in the later stage of the pandemic did not aggravate the consequences of the epidemic.

Introduction
Sexual minority women represent one of the highest-risk groups for hazardous drinking and comorbid mental health problems (eg, depression, anxiety). Research has identified cognitive (eg, expectations of rejection), affective (eg, emotion dysregulation) and behavioural (eg, avoidant coping) pathways through which minority stress (eg, stigma) places sexual minority women at disproportionate risk of hazardous drinking and comorbid depression/anxiety; yet no evidence-based interventions have been tested to address these pathways in this population. This article describes the design of Project EQuIP (Empowering Queer Identities in Psychotherapy), a randomised controlled trial of a transdiagnostic lesbian, gay, bisexual, transgender, queer (LGBTQ)-affirmative cognitive-behavioural therapy intervention (CBT) designed to improve minority stress coping and reduce sexual minority women’s hazardous drinking and mental health comorbidities.

Methods and analysis
This two-arm randomised controlled trial, funded by the National Institute on Alcohol Abuse and Alcoholism, has two objectives: (1) test the efficacy of 10 sessions of LGBTQ-affirmative CBT compared with 10 sessions of supportive counselling for sexual minority women in the community (anticipated n=450) who report hazardous alcohol use and meet criteria for a Diagnostic and Statistical Manual of Mental Disorders – 5 diagnosis of a depression or anxiety disorder and (2) examine psychosocial mechanisms and demographic factors as potential mediators and moderators, respectively, of the treatment-outcome relationship. This study’s primary outcome is change in the proportion of heavy drinking days. Secondary outcomes are changes in depressive and anxious symptoms.

Ethics and dissemination
The Yale University Human Subjects Committee reviewed and approved the research protocol. Results of this study will be disseminated to researchers and practitioners through peer-review publications and conference presentations, and directly to study participants.

Trial registration number
Registered on 17 August 2022 (ClinicalTrials.gov identifier: NCT05509166).

Introduction
Combining repetitive transcranial magnetic stimulation (rTMS) with robotic training could result in more significant improvements in motor function than either treatment alone. The efficacy of this combination may depend on the sequencing of the interventions. However, few studies have explored the possibility of interleaving or alternating between the two treatment modalities within a single session or over a shorter time frame. The objective of this study is to evaluate the efficacy of alternating rTMS and soft-hand rehabilitation robot therapy to enhance upper limb and hand function in patients with ischaemic stroke.

Methods and analysis
This multicentre study will be conducted as a single-blind, controlled, randomised trial, enrolling 132 post-stroke patients with a disease duration ranging from 1 week to 3 months. The study participants will be randomly assigned to group A (n=44), group B (n=44) and group C (n=44). All participants will undergo a 4-week neurological rehabilitation programme, which includes standardised physical and occupational therapy administered by experienced therapists. Group A will receive 10 Hz high-frequency rTMS (HF-rTMS) over the ipsilesional primary motor cortex (iM1) for 20 min, followed by 20 min of soft-hand rehabilitation robot training. Group B will receive 5 min of 10 Hz HF-rTMS over the iM1 followed by 5 min of soft-hand rehabilitation robot training, repeated four times. Group C will receive sham rTMS with other parameters identical to those of group A. The above treatments will be administered once daily, 5 days a week, for 4 weeks. The primary outcome measurement is the Fugl-Meyer assessment of upper extremity (FMA-UE). The secondary outcome measurements include the Hong Kong edition of Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK), the Modified Ashworth Scale (MAS), and the International Classification of Functioning, Disability and Health upper extremity entries (ICF-Upper Extremity Entries). Assessments will be conducted at baseline and after 4 weeks of treatment.

Ethics and dissemination
This study has been approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (2024-SR-515). The findings of this study will be spread through networks of scientists, professionals and the general public, as well as peer-reviewed scientific papers and presentations at pertinent conferences.

Trial registration number
ChiCTR2400089583.

This prospective multicenter study including individuals with hematuria evaluates the performance of a urinary DNA methylation test in identifying patients with high-grade or invasive bladder cancer.

Objectives
The aim of this study was to determine the prevalence of risky alcohol consumption and regular binge drinking, and their associated factors, in Spanish college students.

Design
A cross-sectional study was conducted.

Setting
This study took place at a private university in a northern region of Spain.

Participants
A total of 330 Spanish undergraduate university students enrolled in the 2022–2023 academic year voluntarily agreed to participate in this investigation.

Primary and secondary outcome measures
Data collection included sociodemographic information and health-related behaviours. The Alcohol Use Disorders Identification Test was used to assess alcohol consumption. Logistic regression models were used to identify independent predictors for risky alcohol consumption and regular binge drinking.

Results
40.0% of participants reported risky alcohol consumption, and 26.7% were classified as regular binge drinkers. Factors associated with risky alcohol consumption included smoking (OR=3.54, 95% CI 2.03 to 6.14) and problematic internet use (OR=2.10, 95% CI 1.24 to 3.53). Conversely, being older than 30 years was associated with a lower likelihood (OR=0.22, 95% CI 0.08 to 0.60). Regular binge drinking was associated with living outside the family home (OR=2.78, 95% CI 1.56 to 4.95), smoking (OR=3.53, 95% CI 1.94 to 6.40) and problematic internet use (OR=2.19, 95% CI 1.23 to 3.89). In contrast, being female (OR=0.50, 95% CI 0.27 to 0.94) and being over 30 years old (OR=0.28, 95% CI 0.10 to 0.86) were inversely associated.

Conclusions
Risky alcohol consumption and binge drinking are relatively common among Spanish university students. Interventions to promote responsible alcohol consumption among this population should be implemented in collaboration with other stakeholders.