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Abstract: Children undergoing cancer treatment face repeated, prolonged hospitalisations carrying substantial risks of psychological distress, social isolation, and impaired development. Volunteers offering structured non-medical activities are widely employed to complement professional psychosocial care in paediatric oncology settings, yet empirical evidence examining their role specifically—as distinct from professionally delivered psychosocial interventions—remains sparse. This narrative review, conducted in accordance with SANRA criteria and drawing on a structured search of PubMed, PsycINFO, and Google Scholar (2000–2025), supplemented by a targeted verification search in July 2026, synthesises the theoretical and preliminary empirical basis for volunteer involvement, critically evaluates associated clinical risks, and proposes evidence-informed recommendations for paediatric oncology clinical practice. Three theoretical frameworks provide the conceptual grounding for volunteer activities: developmental psychological models (Piaget; Erikson), stress and coping theory (Lazarus and Folkman), and the biopsychosocial model (Engel). Indirect empirical evidence—derived predominantly from professionally delivered interventions—supports short-term benefits of structured distraction, play, and social activities on procedural anxiety, pain experience, and sense of social inclusion; the sole study examining volunteer-facilitated activities specifically in paediatric oncology reported meaningful reductions in distress and high family satisfaction. Eight categories of clinical risk are identified, including physical and psychological overload, erosion of child autonomy, suppression of authentic emotional expression, and inadequate coordination with healthcare staff. Six practice recommendations are proposed, centred on a working definition of the volunteer role, mandatory pre-access training, genuine individualisation including cultural adaptation, multidisciplinary-team-led coordination, and structured programme evaluation. Volunteer involvement can meaningfully complement professional psychosocial care when delivered within a structured, supervised, and multidisciplinary-team-coordinated framework. The paediatric oncology team occupies a pivotal role in realising the potential benefits while safeguarding children from associated risks. Prospective research employing standardised volunteer programme definitions and validated child-reported outcome measures is urgently needed to build an evidence base commensurate with the clinical importance of this practice.
Keywords: paediatric oncology, hospitalised children, volunteers, psychosocial support, cancer nursing, play interventions, distraction, clinical recommendations
Published in DiRROS: 06.08.2026; Views: 202; Downloads: 139
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Abstract: We put into perspective the knowledge about white sharks (Carcharodon carcharias) in the Mediterranean Sea to identify if the northwestern part is an area of interest and the most efficient methodologies to highlight the presence of the species. We have compiled the main peer-reviewed works, officials’ reports and theses, both worldwide and more specifically in the Mediterranean. We focused on studies that allow us to define a more precise framework to search the species. In the Mediterranean, a particular link has been highlighted with bluefin tuna (Thunnus thynnus). The northwestern Mediterranean Sea has unique characteristics compared to other parts of the sea regarding primary productivity, surface temperature, presence of tuna, and is bordered by two white sharks’ hotspots. We list methodologies for detecting the species worldwide, including BRUVS and environmental DNA. We also make recommendations for field studies.
Keywords: white sharks, Mediterranean, distribution, diet, recommendations
Published in DiRROS: 10.07.2026; Views: 161; Downloads: 154
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Abstract: Neuroendocrine tumors of the appendix, formerly known as carcinoid tumors, represent a rare entity. They are slow-growing tumors, characterized by an indolent clinical course. In pediatric patients, the 5-year overall survival is estimated to be 100% and the event-free survival slightly less than 100%, with only one reported case of local relapse to date. Nevertheless, a proportion of these patients still undergo a second surgery, mostly represented by right hemicolectomy with mesenteric lymphadenectomy, in consideration of the presence of certain risk factors (size >1.5 or 2 cm; tumors of the appendiceal base with or without suspicious residuals, mesoappendiceal invasion, lymphovascular invasion, serosal breach). This approach represents an overtreatment of patients with a benign clinical course regardless of the presence of risk factors and/or whether a second surgery is performed. National recommendations for diagnosis, treatment, and follow-up of neuroendocrine tumors of the appendix in pediatric age are available in France, Italy, and Germany, but international consensus is lacking. This review presents the internationally harmonized recommendations for the diagnosis and treatment of neuroendocrine tumors of the appendix in children and adolescents, established by the European Cooperative Study Group for Pediatric Rare Tumors group.
Keywords: appendiceal neuroendocrine tumors, pediatric oncology, diagnostic and therapeutic recommendations
Published in DiRROS: 09.04.2026; Views: 407; Downloads: 436
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Abstract: Scope: This European Society of Clinical Microbiology and Infectious Diseases guideline provides evidence-based recommendations to support a selection of appropriate antibiotic use practices for patients seen in the emergency department (ED) and guidance for their implementation. The topics addressed in this guideline are (a) Do biomarkers or rapid pathogen tests improve antibiotic prescribing and/or clinical outcomes? (b) Does taking blood cultures in common infectious syndromes improve antibiotic prescribing and/or clinical outcomes? (c) Does watchful waiting without antibacterial therapy or with delayed antibiotic prescribing reduce antibiotic prescribing without worsening clinical outcomes in patients with specific infectious syndromes? (d) Do structured culture follow-up programs in patients discharged from the ED with cultures pending improve antibiotic prescribing? Methods: An expert panel was convened by European Society of Clinical Microbiology and Infectious Diseases and the guideline chair. The panel selected in consensus the four most relevant antimicrobial stewardship topics according to pre-defined relevance criteria. For each main question for the four topics, a systematic review was performed, including randomized controlled trials and observational studies. Both clinical outcomes and stewardship process outcomes related to antibiotic use were deemed relevant. The literature searches were conducted between May 2021 and March 2022. In April 2022, the panel members were formally asked to suggest additional studies that were not identified in the initial searches. Data were summarized in a meta-analysis if possible or otherwise summarized narratively. The certainty of the evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation criteria. The guideline panel reviewed the evidence per topic critically appraising the evidence and formulated recommendations through a consensus-based process. The strength of the recommendations was classified as strong or weak. To substantiate the implementation process, implementation trials or observational studies describing facilitators/barriers for implementation were identified from the same searches and were summarized narratively. Recommendations: The recommendations on the use of biomarkers and rapid pathogen diagnostic tests focus on the initiation of antibiotics in patients admitted through the ED. Their effect on the discontinuation or de-escalation of antibiotics during hospital stay was not reported, neither was their effect on hospital infection prevention and control practices. The recommendations on watchful waiting (i.e. withholding antibiotics with some form of follow-up) focus on specific infectious syndromes for which the primary care literature was also included. The recommendations on blood cultures focus on the indication in three common infectious syndromes in the ED explicitly excluding patients with sepsis or septic shock. Most recommendations are based on very low and low certainty of evidence, leading to weak recommendations or, when no evidence was available, to best practice statements. Implementation of these recommendations needs to be adapted to the specific settings and circumstances of the ED. The scarcity of high-quality studies in the area of antimicrobial stewardship in the ED highlights the need for future research in this field.
Keywords: antimicrobial stewardship, blood cultures, culture follow-up, diagnostic tests, emergency department, guideline, implementation, rapid tests, recommendations, watchful waiting
Published in DiRROS: 09.03.2026; Views: 582; Downloads: 746
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Abstract: This study critically examines the challenges faced by the Kosovo Albanian diaspora in investing in their home country. Despite being a significant economic asset, particularly through substantial remittances that contribute to the national GDP, the diaspora encounters various barriers to effective investment. Based on 53 biographical interviews (2014–2016) with migrants in Switzerland and Germany, as well as 23 interviews with key informants, including officials, trade union representatives, and civil society actors, the study highlights the absence of adequate incentive packages to support diaspora driven investments in Kosovo. The research addresses both individual and policy levels, offering recommendations aimed at enhancing the impact of diaspora financial initiatives.
Keywords: diaspora investments, Kosovo Albanian, remittances, economic development, policy recommendations, qualitative research, Kosovo
Published in DiRROS: 10.02.2026; Views: 809; Downloads: 435
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