This paper describes the current status of research on disease distress in elderly type 2 diabetic patients at home and abroad, with a view to developing targeted interventions for diabetic patients, improving self-management behavioral ability and quality of life in elderly type 2 diabetic patients, and improving patients' glycemic control.Full article

Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a university in Metro Manila, Philippines, on the impact of SBL on their skills, emotional responses, and challenges encountered. A descriptive qualitative design was employed using purposive sampling of ten students who had participated in at least one SBL activity. Data were collected through semi-structured interviews and short written reflections and analyzed thematically following Braun and Clarke’s framework to capture nuanced experiences. Three major themes emerged from the analysis. First, students reported initial anxiety, nervousness, and stress during their early SBL experiences, which gradually transformed into confidence, adaptability, and resilience as they gained familiarity and competence. Second, SBL enhanced technical and cognitive skills such as clinical judgment, decision-making, teamwork, and patient-centered care, supporting students’ readiness for real-world practice. Third, students identified resource limitations, insufficient equipment, and time constraints as significant barriers to optimal learning, though these challenges also fostered creativity and perseverance. The findings demonstrate that SBL fosters technical competence, critical thinking, and professional growth but requires institutional support to address resource constraints and faculty development needs. This study underscores the importance of expanding SBL in Philippine nursing curricula to align with international best practices and to contribute to Sustainable Development Goals 3 (good health and well-being), 4 (quality education), and 5 (gender equality).Full article

VAP, or Ventilator Associated Pneumonia, is a type of pneumonia that arises in patients receiving mechanical ventilation. This condition is a serious complication and can lead to the patient's decline while on a mechanical ventilator, posing a significant risk for secondary complications if not addressed promptly. In particular, VAP is a prevalent issue in intensive care units, where the healthcare team works to prevent further deterioration of the patient. VAP is associated with a notably high mortality rate, particularly in individuals with weakened immune systems, as well as in younger and older populations. Extended intubation and prolonged sedation can contribute to the onset of VAP. The previous study had found that incidence of VAP accounts for 9 % to 27 % endotracheal intubated patients, whereas VAP has a mortality rate ranging from 25 % to 50 % [1-3]. VAP increased ICU and hospital length of stay, antibiotic consumption, and healthcare cost (Zhi Mao et al, 2016) [4]. While using the subglottic suctioning could prevent and help the intubated patient to decreased the development of VAP. The study shown by Smith et al (2021) [5] SSD is a technique employed to reduce micro aspiration of oropharyngeal secretions in patients with cuffed endotracheal airways. Aspiration of oropharyngeal secretions is the accepted cause of the majority of ventilator-associated pneumonia (VAP), a complication of invasive ventilation with high associated mortality. Another study by Rahul Gujadhur et al (2005) [6], subglottic suction has also been shown to delay the onset of VAP but no benefits in terms of ventilation time, hospital stay or mortality benefit have ever been shown. This investigation into subglottic suctioning may assist the healthcare team, particularly in the intensive care unit, in preventing the development of VAP and shortening the duration of ventilation for patients. The advantages of subglottic suctioning are often debated, particularly regarding its impact on the duration of intubation. However, recent research indicates that implementing subglottic suctioning within a time frame of fewer than three days could help reduce intubation duration and lead to improved patient recovery.Full article

This review explores the role of listening as a foundational component of communication and compassionate care in palliative settings. Drawing from ten scholarly articles published in 2025, the study examines how listening affects the experiences of patients, families, and healthcare providers. The findings emphasize that listening is not only a professional skill but a human act that reduces suffering, promotes dignity, and strengthens trust, especially where resources or standardized protocols are lacking. The review is organized into four main areas: the importance of listening in clinical decision making; its role in emotional support and team communication; its contribution to preserving patient dignity and comfort; and its impact on family involvement and closure. The study calls for future research to develop standardized tools for measuring listening in palliative care and to explore how cultural, economic, and technological contexts shape listening practices. Ultimately, the review concludes that listening must be at the heart of ethical, patient-centered care during the final stages of life.Full article

Effective infection control requires a close fit between the mask and face to minimize gaps. This study investigated whether surgical mask performance varies with face shape and mask size. Three facial models were 3D-printed using head-related transfer function data. Two mask sizes were tested on each model, and 3D measurements were taken at five facial points: the nose, cheeks, and chin to assess mask-to-face gaps. To simulate droplet emission, an aqueous sodium chloride solution was released from a pseudo-oral cavity in the models, and air leakage was measured using a mask-fitting tester. A two-way analysis of variance (ANOVA) was used to examine the effects of face and mask size on leakage. Small face models showed significantly higher leakage than medium and large ones (p < 0.001), and S-sized masks leaked more than M-sized masks regardless of face size (p = 0.038). Linear regression showed a positive correlation between chin gaps and leakage when using S-sized masks (p < 0.05). These results suggest that medium-sized masks offer better overall performance. However, for small faces, fit—especially at the chin, requires particular attention.Full article

This commentary letter was conducted to evaluate Wang et al.'s (2025) research study on the relationship between perceived staffing and quality of care among hospitals. The current study's findings show that the relationship between professional self-efficacy and job performance is mediated by work engagement. Life contentment influences work engagement, which is associated with enhanced job performance. However, involvement acts as a mediator between job performance and burnout, which could affect the quality of patient care. Staffing satisfaction and quality patient care are closely related, and it is essential for healthcare institutions to prioritize appropriate workforce levels and address the nursing shortage. However, there are still unanswered questions in this sector, such as researching nursing-specific care procedures, addressing data challenges, and understanding the connections between nursing practice and patient care outcomes. Future research should address the "black box" of nursing practice and address variations in the quality of patient care provided by nurses.Full article

Complexity Leadership Theory (CLT) is a new and revolutionary concept in addressing healthcare crises worldwide. Its relevance and applications were tested during the COVID-19 pandemic. However, no definite and encompassing research was done to apply it to nursing leadership. Thus, this study examines CLT integration into nursing leadership to address the challenges posed by the pandemic. Through a systematic review of literature from PubMed, Scopus, and Web of Science, relevant studies were analyzed to determine how complexity leadership theory was defined, conceptualized, and operationalized within nursing leadership context. The findings reveal that traditional hierarchical leadership models are insufficient in a dynamic crisis environment like the pandemic. Instead, CLT’s framework which encompasses adaptive, administrative, and enabling leadership facilitates innovation, resilience, and effective interprofessional collaboration. Nurse leaders employing these strategies are better positioned to manage resources limitation, foster shared decision-making, and implement technological advancements in rapidly changing healthcare settings. Overall, this study underscores the potential of complexity leadership theory to transform nursing leadership practices by promoting continuous learning and empowerment, thereby enhancing crisis response and preparedness for future pandemics.Full article

Smoking is a well-documented risk factor of cardiovascular diseases (CVD) and premature death. Previous studies have focused on smoking duration and total cigarette consumption, but a 2024 paper by Li et al. highlights the time between waking up and smoking the first cigarette as a risk factor of mortality, noting that smoking ≤5 minutes after waking is strongly linked to a higher risk of mortality and a higher chance of incident myocardial infarction or stroke, and may be a sign of nicotine dependence. Another study by Hu et al. (2024) states that early-morning smoking more strongly correlates with incident type 2 diabetes than total cigarette consumption, adding to preceding evidence that early-morning smoking is linked to type 2 diabetes and chronic obstructive pulmonary disease (COPD). The demonstrated association with adverse health outcomes and early-morning smoking suggests delayed time to first cigarette can be a useful target as part of smoking interventions. These findings indicate the necessity of public health policies targeting smoking behaviour in addition to cessation as a way to decrease the associated disease burden.Full article

Background: Maternal nutrition plays a crucial role in fetal brain development, with vitamin B12 being essential for neuronal myelination and cognitive function. The paper by Hrezova et al. entitled “Vitamin B12 Intake During Pregnancy Linked to Child Speech Development and Intelligence Quotient”, examines the association between maternal B12 intake and early childhood neurodevelopment. Methods: Using data from 5,151 mother-child pairs in the ELSPAC-CZ cohort, maternal B12 intake was assessed through dietary questionnaires, and child cognitive outcomes were evaluated at 18 months, 3 years, and 8 years. Multivariate adjustments were applied to control for potential confounders. Results: The research reports that higher maternal B12 intake was positively associated with improved language comprehension at 18 months (B=0.20,95% CI 0.06,0.34) and increased verbal IQ at 8 years (B=1.08,95% CI 0.09,2.08). However, no significant relationship was observed between maternal B12 intake and speech intelligibility at age 3 (OR=1.03,95% CI 0.99,1.07). Findings suggest B12’s role in early cognitive development but highlight gaps in its long-term effects. Conclusions: Ensuring adequate maternal B12 intake is vital for optimizing early neurodevelopment. Public health initiatives should promote B12 supplementation, especially for pregnant women at risk of deficiency. Further research with objective biomarkers is needed to clarify long-term effects.Full article

The commentary paper reviewed the above research study conducted by Wang et al. (2025), and the investigators examined the association between nurse staffing, job satisfaction, and work engagement, and how these variables impact the quality of care provision provided among the Chinese hospitals. Despite knowing that low staffing within the healthcare facilities is a global issue, Wang and colleagues believed that low staffing is negatively and significantly associated with nurse’s welfare and patient care outcome. This issue causes an increase in burnout and decreased retention of healthcare providers within the clinical setting. It is important to consider and focus on improving and fostering job satisfaction and work engagement among nurses to provide better quality care even within a low staffing environment. According to Wang and colleagues, low staffing outcomes could be mitigated by encouraging workplaces to create healthy and supportive environments for the engaged and satisfied nurses. These would result in better out among patients and increase job fulfilment and welfare among nurses.Full article