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In this study, we aimed to clarify the effects of breakfast intervention on autonomic nerve function in healthcare workers who skip breakfast. This cross-sectional, interventional study was conducted between January 2020 and December 2021. All participants were full-time healthcare workers who completed a self-administered questionnaire on fatigue and subjective symptoms and underwent noninvasive autonomic nerve function tests. "Skippers" were defined as individuals who ate breakfast <4 times per week, and "eaters" were those who ate breakfast >4 times per week. We introduced a cereal, Frugra (Calbee, Inc.), to skippers who opted for the breakfast intervention. Subsequently, they completed the questionnaire again and repeated the autonomic nerve function tests. Among 196 participants (age [mean±SD]: 29.8±7.8 y; 177 women and 19 men), 120 were categorized as skippers and 76 as eaters. In the skipper group, more participants were nurses, lived alone, and worked the night shift than in the eater group. The Chalder Fatigue Scale (CFS) score in the skipper group was higher than that in the eater group, although not significantly. Regarding autonomic nerve function, no significant differences were observed between the groups. In 50 skippers who opted for the breakfast intervention, the CFS score significantly decreased after 4 wk. Log low frequency and log coefficient of component variance total power significantly increased, whereas log high frequency increased, but not significantly, after the intervention. In conclusion, for healthcare workers who were breakfast skippers, the consumption of breakfast cereal reduced their fatigue level and improved their autonomic nervous system activity.
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http://dx.doi.org/10.3177/jnsv.70.380 | DOI Listing |
JAMA Netw Open
September 2025
Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City.
Importance: Advances in diagnostics have enabled the detection of more gastrointestinal pathogens, but misuse of diagnostics can lead to inappropriate antibiotic use and excess financial burdens. Ensuring appropriate use of diagnostics is crucial for optimizing patient care and promoting stewardship of health care resources.
Objective: To elicit parents' and clinicians' perspectives on expectations for care of pediatric diarrhea with a focus on diagnostic testing and to evaluate the potential for an electronic clinical decision support tool (ECDST) to improve appropriate use of diagnostics.
JAMA Netw Open
September 2025
Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada.
Importance: Caregivers of community-dwelling older adults play a protective role in emergency department (ED) care transitions. When the demands of caregiving result in caregiver burden, ED returns can ensue.
Objective: To develop models describing whether caregiver burden is associated with ED revisits and hospital admissions up to 30 days after discharge from an initial ED visit.
Hernia
September 2025
Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, Herlev, DK-2730, Denmark.
Purpose: Primary ventral hernia repair is a common elective procedure; however, mesh placement practices vary widely, and there is limited evidence to guide optimal placement. This international study examined surgeons' preferences and considerations regarding mesh placement in elective primary ventral hernia repair.
Methods: We conducted an international cross-sectional survey targeting surgeons experienced in primary ventral hernia repair.
Eur J Trauma Emerg Surg
September 2025
French Military Medical Service Academy - École du Val-de-Grâce, Paris, France.
Background: Delivering intensive care in conflict zones and other resource-limited settings presents unique clinical, logistical, and ethical challenges. These contexts, characterized by disrupted infrastructure, limited personnel, and prolonged field care, require adapted strategies to ensure critical care delivery under resource-limited settings.
Objective: This scoping review aims to identify and characterize medical innovations developed or implemented in recent conflicts that may be relevant and transposable to intensive care units operating in other resource-limited settings.
Eur J Trauma Emerg Surg
September 2025
Emergency Medical Services of Karlovy Vary Region, Zavodni 390/98C, Karlovy Vary, 36006, Czech Republic.
Background And Importance: In the Czech Republic, paramedics are required to consult a physician before administering intravenous opioids, which may delay effective prehospital pain management. As paramedic competencies expand in Europe, it is important to evaluate the safety and efficacy of independent opioid administration in prehospital emergency care settings.
Objectives: To assess the safety and effectiveness of intravenous sufentanil administered independently by trained paramedics compared to administration following remote physician consultation in adult trauma patients.