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Fania (Fanny) Kaplan and the attempted assassination of Vladimir Lenin: ophthalmologic considerations
No full textPurpose: Fania (Fanny) Kaplan (1890–1918), who was reportedly visually impaired, confessed to the attempted assassination of Soviet leader Vladimir Lenin (1870–1924) in 1918 by shooting him with a pistol. The precise nature of her visual loss is unknown and raises doubts about whether she had sufficient visual function to perform the act. Methods: Historical documents were reviewed. Results: The cause of Kaplan's visual loss is uncertain but occurred following a bomb blast in 1906. If the explosion was the cause, then she most likely had bilateral closed‐globe, blast‐related injuries, perhaps with additional functional visual loss. She reportedly received treatment at a medical centre in Kharkov (now Kharkiv), then led by the prominent ophthalmologist Leonard Girshman (1839–1921). An informal estimate of the minimum visual acuity required to shoot an adult at 10 feet (3 m) with a pistol is approximately 1.2 logMAR (Snellen equivalent 20/320 or 6/96). Conclusions: Based on available historical documents, Kaplan's visual function was most likely sufficient to carry out the assassination attempt, although her visual impairment may have contributed to the attempt being unsuccessful.</p
Characterizing Sedentary Behaviour in Residents with Intellectual Disability in Community Living Arrangements
No full textNo description supplied</p
Excessive daytime sleepiness is independently associated with dehydration among older adults
No full textBackground: Excessive daytime sleepiness (EDS) is common in older adults and may contribute to reduced oral intake, potentially increasing the risk of dehydration, which has been linked to adverse health outcomes. We aimed to investigate whether EDS is associated with elevated plasma osmolarity (Posm) in a geriatric population.Methods: In this cross-sectional study, 1,335 adults aged ≥ 65 years attending a geriatric outpatient clinic were assessed. Participants were classified as having EDS (Epworth Sleepiness Scale ≥ 11) or non-EDS. Plasma osmolarity was estimated using a validated formula, with thresholds of > 295 mmol/L for dehydration and > 300 mmol/L for overt dehydration. Clinical, laboratory, and demographic data were collected. Associations between EDS and dehydration were analyzed using univariate and multivariate logistic regression, adjusting for age, sex, comorbidities, and medication use.Results: EDS was present in 24% of participants. Plasma osmolarity exceeded 295 mmol/L in 56% and 300 mmol/L in 23% of participants. Patients with EDS were older and had higher prevalence of chronic kidney disease, dementia, and polypharmacy. In multivariate analysis, independent predictors of Posm > 300 mmol/L included diabetes mellitus (OR 4.41), chronic kidney disease (OR 5.32), serum sodium (OR 1.76), and EDS (OR 1.51, p = 0.027). EDS was not independently associated with Posm > 295 mmol/L.Conclusions: In older adults, EDS is independently associated with overt dehydration. Routine assessment of daytime sleepiness may serve as a simple, non-invasive marker to identify individuals potentially at risk, enabling timely hydration interventions and potentially improving health outcomes in aging populations.</p
Disproportionate increase of extreme obesity among older people: data from the English longitudinal study of ageing
No full textBackground: The global rise in obesity increasingly includes extreme forms, notably BMI ≥ 50 kg/m², which present disproportionate health risks, especially among older adults. Despite this, most epidemiological research aggregates all obesity (BMI ≥ 30 kg/m²), potentially underestimating the burden of extreme obesity. Understanding trends in this subgroup is critical for targeted public health and clinical responses.Methods: We analyzed data from the English Longitudinal Study of Ageing (ELSA) across four waves (2004–2005 to 2016–2017). Data were analysed on the entire population and also for those aged ≥ 65 years. BMI was calculated from measured or self-reported height and weight and classified using WHO standards. Poisson regression with robust error variance was used to assess trends across BMI categories, adjusting for age and sex.Results: Extreme obesity (BMI 50–59.9 kg/m²) increased by 50% over the 12-year period, and for the first time, individuals with BMI ≥ 60 kg/m² were observed in 2016–2017. Among older adults, mild obesity (BMI 30–39.9 kg/m²) declined slightly, while class II obesity (BMI 40–49.9 kg/m²) rose significantly. However, no individuals aged ≥ 65 years were recorded in the ≥ 60 kg/m² category. Though absolute numbers remain small, the upward trend is clear and clinically significant.Conclusions: Extreme obesity is rising disproportionately, including among older adults, and requires urgent recognition as a distinct public health challenge. Healthcare systems must adapt to the complex needs of this population, including appropriate medical infrastructure, specialized care pathways, and enhanced clinical guidelines. Ongoing surveillance and tailored interventions are essential to address this growing burden.</p
Effect of Exposure to Asynchronous Virtual Clinical Environments on Actual/Perceived Competence in Drug Dosage Calculation: A Pilot Study
No full textIntroduction: Nursing students are expected to be ‘practice ready’ on qualifying. This includes safe medication
administration. This pilot study investigates the relationship between exposure duration to asynchronous virtual
drug dosage calculation scenarios and nursing student actual and perceived competence.Methodology design
planned for larger scale main study was tested and piloted.
Methods: A randomised quasi-experimental research design (pre- and post-test) was used. Purposive sampling
was used to recruit six groups of second/third-year pre-registration undergraduate nursing students from six sites
(UK and Canada). Students were randomly assigned to four groups of different exposure to the safeMedicate®
COVID-19 education module.
Results: Student actual competence increased across all four groups, and their perceived competence mirrored
this. There wasno clear dose-response relationship demonstrated.
Conclusion: Valuable insights into the effects of asynchronous virtual learning on drug dosage calculation
competence among nursing students were generated. Improvement in actual and perceived competence was
found, but no clear dose-response relationship. Further research on a larger scale is needed to explore the impact
of instructional design, feedback, and interaction on learning outcomes.</p
Developing a counselling and psychotherapy competency framework for addictions: a systematic review
No full textBackground: Adults with addictions may turn to professional counsellors and psychotherapists for help. Addictions work comprises a specialist counselling skillset. This article summarises the literature review and analysis that underpins the British Association for Counselling and Psychotherapy's (BACP) Addictions Competence Framework.Aims: This study aimed to identify the specialist knowledge, skills and experience associated with effective counselling for adults seeking help with addictions, whether active or in recovery. Materials and Methods: We systematically reviewed empirical research and wider literature. The EBSCO database was searched following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, using a range of search terms and appropriate inclusion and exclusion criteria. Relevant data were extracted, reviewed and thematically synthesised. Results: Forty‐seven relevant articles were identified. Five superordinate themes were developed: (1) specialist addiction knowledge; (2) assessment and treatment planning; (3) training, supervision and professional practice; (4) client‐focused approach; (5) specific therapeutic techniques. Findings from this study indicate that addictions counselling work is enhanced when therapists have knowledge of different addiction models and are able to offer suitable interventions for the pre‐treatment phase, relapse prevention and for supporting the recovery process. Discussion: Effective therapy adopts an integrative, client‐focused approach that fosters safety and collaboration. It focuses on managing cravings/urges, addressing emotional concerns and helping clients challenge self‐defeating thoughts and beliefs. Techniques associated with effective addictions counselling include psychoeducation, motivational interviewing and mindfulness‐based strategies. Delivery style is characterised by empathy and a non‐confrontational stance. Conclusion: This review identifies specialist knowledge, skills and experience associated with effective counselling for adults seeking help with addictions and provides evidence to underpin the BACP's Addictions Competence Framework.</p
Vertical farming of hardy nursery stock: LED-driven propagation strategies compared with industry practice
No full textHardy nursery stock production relies on the propagation of semi-hardwood or hardwood cuttings, yet rooting success is often inconsistent due to species-specific constraints and environmental variability. This study examined how vertical farming systems influences early propagation traits in three evergreen woody ornamentals—
Elaeagnus × ebbingei
,
Pittosporum tenuifolium
, and
Euonymus japonicus
—representing varying rooting difficulty. Cuttings were propagated under ambient light (control) or two light-emitting diode (LED) treatments differing in red-to-blue ratio and intensity (7:1 at 100 μmol m
-
² s
-
¹; 9:1 at 140 μmol m
-
² s
-
¹). Fresh shoot weight, fresh root weight, and chlorophyll content were measured, and trait stability assessed via coefficients of variation.
E. japonicus
achieved highest biomass under the 7:1 ratio, while
E. × ebbingei
and
P. tenuifolium
performed best under ambient light. Chlorophyll declined under LEDs in all species but remained most stable in
E. japonicus
. Variability analysis indicated chlorophyll as the most stable trait, shoot biomass moderately variable, and root biomass the most plastic. Principal component analysis indicated that chlorophyll and biomass traits were regulated independently, suggesting that rooting responses were more closely associated with carbon allocation processes than with pigment stability. These results demonstrate that species-specific responses shape propagation outcomes, and tailored LED strategies can enhance rooting uniformity and efficiency.</p
Delivering palliative care in mental health nursing settings: a systematic review
No full textRationale: Palliative care can provide comfort, alleviate suffering, and improve quality of life; however, access to palliative care for people with mental illnesses at the end of their lives is extremely poor. As the need for palliative care is expected to rise significantly in the future, palliative care must be considered a global health priority.Aim: To examine the provision of palliative care within mental health settings and explore the factors that influence the experience of patients receiving palliative care in these settings.Method: This systematic review draws on peer-reviewed qualitative, quantitative and mixed-methods primary studies, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered online. A total number of 61,782 studies was identified after a comprehensive search of five academic databases. After rigorous screening, only nine studies met inclusion criteria and were selected.Results: Thematic analysis identifies three major themes and three subthemes: access to palliative care, advance decisions and treatment, and care in palliative care settings (palliative care settings, palliative care professionals and palliative care/medical interventions).Conclusion: Access to palliative care for people with complex mental illness is very low when compared to the general population. Advance care planning should be initiated early in the development of palliative care needs, rather than at the point of mental illness diagnosis.Recommendations: Although care for people with complex mental illness is complex while dying, conversations around palliative care need to be as part of a therapeutic relationship and engagement. Also, palliative care staff have an important role in communicating end-of-life planning to patients' families and carers.</p
Collagen supplementation for skin and musculoskeletal health: an umbrella review of meta-analyses on elasticity, hydration, and structural outcome
No full textCollagen is a protein with multiple roles within the human body, such as supporting fibroblast formation in the dermis, replacing dead skin cells, protecting organs, giving structure, strength and elasticity to the skin, and a primary role in blood clotting. The aim of the present study was to carry out an umbrella review with integrated meta-analyses to capture the breadth of health outcomes associated with collagen supplementation intake. This umbrella review of systematic reviews includes a search of the use of collagen in PubMed, Embase, Scopus, and Web of Science until March 2025. The effect size for each health outcome was calculated using standardized mean differences, relative risks, or odds ratios, along with their corresponding 95% CIs. Separate meta-analyses were conducted for each outcome and pooled effect sizes were calculated using the inverse variance method under a random-effects model. Meta-regression analyses were conducted to explore potential sources of heterogeneity, and the grading of evidence was carried out using the GRADE. Among 573 papers, 16 systematic reviews for a total of 113 RCTs and 7983 patients were included. In relation to skin, musculoskeletal health, and osteoarthritis conditions, collagen supplementation was consistently associated with favorable outcomes. Regarding oral health and cardiometabolic parameters, the impact of collagen supplementation yielded mixed results. Collagen supplementation demonstrates consistent and clinically meaningful benefits for dermal, bone, and muscular health.</p
A Qualitative Study on the Experiences of Adult Females with Late Diagnosis of ASD and ADHD in the UK
No full textBackground: Adult females with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are frequently underdiagnosed due to gender bias, overlapping symptoms, and limited awareness among healthcare professionals. The scarcity of research on this subject—particularly in the UK context—underscores the need for further investigation. Accordingly, the aim of this study was to explore the lived experiences of adult females receiving a late diagnosis of ASD and/or ADHD and to identify key barriers within the UK diagnostic pathway. This study addresses a critical knowledge gap by examining the factors contributing to delayed diagnosis within the United Kingdom. Study Design and Method: The study employed a qualitative approach, utilising an anonymous online questionnaire survey comprising nine open-ended questions. Responses were obtained from 52 UK-based females aged 35–65 years who had either received or were awaiting a diagnosis of ASD and/or ADHD. Data were analysed thematically within a constructivist framework. Findings: The analysis revealed three overarching themes: (i) limited understanding and lack of empathy among healthcare professionals, (ii) insufficient post-diagnostic support, with most participants reporting no follow-up care, and (iii) a complex, protracted diagnostic process, often involving waiting periods exceeding three years. Gender bias and frequent misdiagnosis were recurrent issues, contributing to significant psychological distress. These findings underscore the need for systemic reforms and align closely with gaps identified in the existing literature. Conclusions: The findings emphasise the urgent need for gender-sensitive diagnostic frameworks, enhanced professional training, and a person-centred approach to care. Key recommendations include shortening diagnostic waiting times, strengthening healthcare professionals’ knowledge base, and ensuring equitable and consistent post-diagnostic support.</p
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