Category: Nevin Manimala

Scand J Caring Sci. 2025 Sep;39(3):e70115. doi: 10.1111/scs.70115.

ABSTRACT

BACKGROUND: The evaluation of nurses’ quality of care ensures that care is structured in a qualified manner.

AIMS: This study was conducted to determine the relationship between satisfaction with life in nurses and the quality of care provided by nurses.

METHODS: This descriptive and cross-sectional study included 515 nurses working in state hospitals in two provincial centres in Eastern Turkey. Data were collected using a personal information form, the Satisfaction with Life Scale, and the Caring Behaviours Inventory-24. Data analysis was performed using SPSS 25.0, AMOS 24.0, and G*Power 3.1 programmes.

RESULTS: Satisfaction with life was higher in females, married individuals, bachelor’s degree graduates, and nurses who willingly chose the profession. Working time had a significant relationship with the quality of care. The relationships between the scales were tested using structural equation modelling. All path coefficients were statistically significant (p < 0.05).

CONCLUSIONS: The mean scores of nurses’ satisfaction with life and quality of care were found to be at a moderate level. Furthermore, it was observed that as nurses’ satisfaction with life increased, their quality of care also improved. Based on these findings, it is recommended that health policies aimed at enhancing nurses’ life satisfaction be developed.

PMID:40947512 | DOI:10.1111/scs.70115

Scand J Caring Sci. 2025 Sep;39(3):e70115. doi: 10.1111/scs.70115.

ABSTRACT

BACKGROUND: The evaluation of nurses’ quality of care ensures that care is structured in a qualified manner.

AIMS: This study was conducted to determine the relationship between satisfaction with life in nurses and the quality of care provided by nurses.

METHODS: This descriptive and cross-sectional study included 515 nurses working in state hospitals in two provincial centres in Eastern Turkey. Data were collected using a personal information form, the Satisfaction with Life Scale, and the Caring Behaviours Inventory-24. Data analysis was performed using SPSS 25.0, AMOS 24.0, and G*Power 3.1 programmes.

RESULTS: Satisfaction with life was higher in females, married individuals, bachelor’s degree graduates, and nurses who willingly chose the profession. Working time had a significant relationship with the quality of care. The relationships between the scales were tested using structural equation modelling. All path coefficients were statistically significant (p < 0.05).

CONCLUSIONS: The mean scores of nurses’ satisfaction with life and quality of care were found to be at a moderate level. Furthermore, it was observed that as nurses’ satisfaction with life increased, their quality of care also improved. Based on these findings, it is recommended that health policies aimed at enhancing nurses’ life satisfaction be developed.

PMID:40947512 | DOI:10.1111/scs.70115

Health Serv Res. 2025 Sep 14:e70037. doi: 10.1111/1475-6773.70037. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the impact of increased Medicaid income eligibility during pregnancy on payment source for prenatal care and birth and on gestational age at birth (GAb).

STUDY SETTING AND DESIGN: We performed a quasi-experimental, difference-in-differences study comparing two increases in Medicaid income eligibility during pregnancy to two control states with data from 2007 to 2010: (Dyad 1) Ohio (expanded from 150% to 200% of the Federal Poverty level [FPL]) versus Pennsylvania and (Dyad 2) Wisconsin (185% to 250% FPL) versus Michigan. We performed multinomial logistic regression to assess the impact of increased Medicaid eligibility on the following key outcome variables: payment source for prenatal care and birth and GAb.

DATA SOURCES AND ANALYTIC SAMPLE: We utilized CDC Pregnancy Risk Assessment Monitoring System (PRAMS) data (2007-2010) and limited analysis to singleton, in-state live births. After re-weighting for PRAMS survey design, our analytical sample represented about 540,000 births.

PRINCIPAL FINDINGS: In the higher-income Wisconsin-Michigan dyad, increased Medicaid eligibility during pregnancy significantly increased exclusive Medicaid coverage for prenatal care (7.0%, 95% CI 2.9% to 11.1%) and birth (8.3%, 4.3% to 12.4%). Simultaneously, private insurance coverage dropped for prenatal care (-4.0%, -7.7% to -0.3%) and birth (-3.7%, -7.2% to -0.2%) while self-payment decreased only for birth (-1.8%, -3.5% to -0.2%). In the lower-income Ohio-Pennsylvania dyad, the only statistically significant effects on payment source were decreases in the likelihood of a payment source of other for prenatal care (-3.3%, -6.2% to -0.3%) and birth (-4.7%, -7.9% to -1.6%). There were no statistically significant effects on GAb across both dyads.

CONCLUSIONS: Increased Medicaid eligibility during pregnancy for individuals of higher income seems to improve utilization of exclusive Medicaid with diminished uninsurance but also less private insurance after accounting for indicators of socioeconomic advantage but has no clear impact on GAb. Medicaid policy should balance reducing uninsurance with directing scarce resources to high-risk individuals.

PMID:40947491 | DOI:10.1111/1475-6773.70037

Health Serv Res. 2025 Sep 14:e70037. doi: 10.1111/1475-6773.70037. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the impact of increased Medicaid income eligibility during pregnancy on payment source for prenatal care and birth and on gestational age at birth (GAb).

STUDY SETTING AND DESIGN: We performed a quasi-experimental, difference-in-differences study comparing two increases in Medicaid income eligibility during pregnancy to two control states with data from 2007 to 2010: (Dyad 1) Ohio (expanded from 150% to 200% of the Federal Poverty level [FPL]) versus Pennsylvania and (Dyad 2) Wisconsin (185% to 250% FPL) versus Michigan. We performed multinomial logistic regression to assess the impact of increased Medicaid eligibility on the following key outcome variables: payment source for prenatal care and birth and GAb.

DATA SOURCES AND ANALYTIC SAMPLE: We utilized CDC Pregnancy Risk Assessment Monitoring System (PRAMS) data (2007-2010) and limited analysis to singleton, in-state live births. After re-weighting for PRAMS survey design, our analytical sample represented about 540,000 births.

PRINCIPAL FINDINGS: In the higher-income Wisconsin-Michigan dyad, increased Medicaid eligibility during pregnancy significantly increased exclusive Medicaid coverage for prenatal care (7.0%, 95% CI 2.9% to 11.1%) and birth (8.3%, 4.3% to 12.4%). Simultaneously, private insurance coverage dropped for prenatal care (-4.0%, -7.7% to -0.3%) and birth (-3.7%, -7.2% to -0.2%) while self-payment decreased only for birth (-1.8%, -3.5% to -0.2%). In the lower-income Ohio-Pennsylvania dyad, the only statistically significant effects on payment source were decreases in the likelihood of a payment source of other for prenatal care (-3.3%, -6.2% to -0.3%) and birth (-4.7%, -7.9% to -1.6%). There were no statistically significant effects on GAb across both dyads.

CONCLUSIONS: Increased Medicaid eligibility during pregnancy for individuals of higher income seems to improve utilization of exclusive Medicaid with diminished uninsurance but also less private insurance after accounting for indicators of socioeconomic advantage but has no clear impact on GAb. Medicaid policy should balance reducing uninsurance with directing scarce resources to high-risk individuals.

PMID:40947491 | DOI:10.1111/1475-6773.70037

Pharm Stat. 2025 Sep-Oct;24(5):e70033. doi: 10.1002/pst.70033.

ABSTRACT

For toxicology studies, the validation of the concurrent control group by historical control data (HCD) has become requirements. This validation is usually done by historical control limits (HCL), which should cover the observations of the concurrent control with a predefined level of confidence. In many applications, HCL are applied to dichotomous data, for example, the number of rats with a tumor versus the number of rats without a tumor (carcinogenicity studies) or the number of cells with a micronucleus out of a total number of cells. Dichotomous HCD may be overdispersed and can be heavily right- (or left-) skewed, which is usually not taken into account in the practical applications of HCL. To overcome this problem, four different prediction intervals (two frequentist, two Bayesian), that can be applied to such data, are proposed. Based on comprehensive Monte-Carlo simulations, the coverage probabilities of the proposed prediction intervals were compared to heuristical HCL typically used in daily toxicological routine (historical range, limits of the np-chart, mean ± $$ pm $$ 2 SD). Our simulations reveal, that frequentist bootstrap calibrated prediction intervals control the type-1-error best, but, also prediction intervals calculated based on Bayesian generalized linear mixed models appear to be practically applicable. Contrary, all heuristics fail to control the type-1-error. The application of HCL is demonstrated based on a real life data set containing historical controls from long-term carcinogenicity studies run on behalf of the U.S. National Toxicology Program. The proposed frequentist prediction intervals are publicly available from the R package predint, whereas R code for the computation of the two Bayesian prediction intervals is provided via GitHub.

PMID:40947486 | DOI:10.1002/pst.70033

Pharm Stat. 2025 Sep-Oct;24(5):e70033. doi: 10.1002/pst.70033.

ABSTRACT

For toxicology studies, the validation of the concurrent control group by historical control data (HCD) has become requirements. This validation is usually done by historical control limits (HCL), which should cover the observations of the concurrent control with a predefined level of confidence. In many applications, HCL are applied to dichotomous data, for example, the number of rats with a tumor versus the number of rats without a tumor (carcinogenicity studies) or the number of cells with a micronucleus out of a total number of cells. Dichotomous HCD may be overdispersed and can be heavily right- (or left-) skewed, which is usually not taken into account in the practical applications of HCL. To overcome this problem, four different prediction intervals (two frequentist, two Bayesian), that can be applied to such data, are proposed. Based on comprehensive Monte-Carlo simulations, the coverage probabilities of the proposed prediction intervals were compared to heuristical HCL typically used in daily toxicological routine (historical range, limits of the np-chart, mean ± $$ pm $$ 2 SD). Our simulations reveal, that frequentist bootstrap calibrated prediction intervals control the type-1-error best, but, also prediction intervals calculated based on Bayesian generalized linear mixed models appear to be practically applicable. Contrary, all heuristics fail to control the type-1-error. The application of HCL is demonstrated based on a real life data set containing historical controls from long-term carcinogenicity studies run on behalf of the U.S. National Toxicology Program. The proposed frequentist prediction intervals are publicly available from the R package predint, whereas R code for the computation of the two Bayesian prediction intervals is provided via GitHub.

PMID:40947486 | DOI:10.1002/pst.70033

Eur J Med Res. 2025 Sep 15;30(1):845. doi: 10.1186/s40001-025-03170-6.

ABSTRACT

BACKGROUND: The lactate-to-albumin ratio (LAR) has emerged as a composite biomarker reflecting metabolic stress and nutritional status. This study aimed to evaluate the association between the LAR and 28 day mortality in hypertensive patients with atrial fibrillation (AF).

METHODS: We conducted a retrospective cohort study using the MIMIC-IV v3.1 database. Patients were screened for inclusion based on predefined criteria, resulting in a final cohort of 1087 eligible patients. Mortality within 28 days of ICU admission was the primary endpoint. Statistical analyses included LASSO regression and multivariate Cox regression, receiver operating characteristic (ROC) curve, and Kaplan‒Meier survival curve analyses.

RESULTS: The overall 28 day mortality rate was 22.8% (n = 248). Compared with survivors, nonsurvivors presented significantly higher LAR values (0.74 vs. 0.52, p < 0.001). Multivariate analyses indicated that the LAR was an independent predictor of 28-day mortality (HR 1.03, 95% CI 1.01-1.06, p < 0.05), even after adjusting for multiple clinical confounders. ROC analysis confirmed that the LAR had superior predictive ability (AUC 0.661) compared with other biomarkers. Kaplan‒Meier survival analysis revealed significant differences in mortality between the high- and low-LAR groups (HR 2.55, 95% CI 1.97-3.30, p < 0.05).

CONCLUSIONS: The LAR is an independent predictor of short-term mortality in hypertensive patients with AF. As a practical and easily applicable biomarker, the LAR holds significant potential for early risk stratification and tailored management in this high-risk population. Our findings underscore the importance of integrating LAR into clinical practice to optimize patient outcomes in critical care settings.

PMID:40947484 | DOI:10.1186/s40001-025-03170-6

Eur J Med Res. 2025 Sep 15;30(1):845. doi: 10.1186/s40001-025-03170-6.

ABSTRACT

BACKGROUND: The lactate-to-albumin ratio (LAR) has emerged as a composite biomarker reflecting metabolic stress and nutritional status. This study aimed to evaluate the association between the LAR and 28 day mortality in hypertensive patients with atrial fibrillation (AF).

METHODS: We conducted a retrospective cohort study using the MIMIC-IV v3.1 database. Patients were screened for inclusion based on predefined criteria, resulting in a final cohort of 1087 eligible patients. Mortality within 28 days of ICU admission was the primary endpoint. Statistical analyses included LASSO regression and multivariate Cox regression, receiver operating characteristic (ROC) curve, and Kaplan‒Meier survival curve analyses.

RESULTS: The overall 28 day mortality rate was 22.8% (n = 248). Compared with survivors, nonsurvivors presented significantly higher LAR values (0.74 vs. 0.52, p < 0.001). Multivariate analyses indicated that the LAR was an independent predictor of 28-day mortality (HR 1.03, 95% CI 1.01-1.06, p < 0.05), even after adjusting for multiple clinical confounders. ROC analysis confirmed that the LAR had superior predictive ability (AUC 0.661) compared with other biomarkers. Kaplan‒Meier survival analysis revealed significant differences in mortality between the high- and low-LAR groups (HR 2.55, 95% CI 1.97-3.30, p < 0.05).

CONCLUSIONS: The LAR is an independent predictor of short-term mortality in hypertensive patients with AF. As a practical and easily applicable biomarker, the LAR holds significant potential for early risk stratification and tailored management in this high-risk population. Our findings underscore the importance of integrating LAR into clinical practice to optimize patient outcomes in critical care settings.

PMID:40947484 | DOI:10.1186/s40001-025-03170-6

Int Urol Nephrol. 2025 Sep 14. doi: 10.1007/s11255-025-04780-z. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim is to investigate the correlation between renal maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), molecular kidney volume (MKV), and total kidney uptake (TKU), which are indicators of the PSMA kidney uptake pattern in ⁶⁸Ga-PSMA-11 PET/CT imaging and kidney function tests. We secondarily aim to investigate how accurately renal parameters obtained from ⁶⁸Ga-PSMA-11 PET/CT can provide information about the patient’s kidney functions.

METHODS: The study included 196 patients with prostate cancer who underwent ⁶⁸Ga-PSMA-11 PET/CT imaging for staging purposes. Semiquantitative analyses were performed on the kidneys in the PET/CT images, and renal SUVmax, SUVmean, MKV, TKU values, as well as anatomical kidney volume (CT-KV) from CT imaging, were calculated. The patients’ concurrent laboratory results, including eGFR, BUN, and creatinine levels, were recorded. Statistical analyses were performed using the SPSS 22 software. The Spearman test was used to determine the correlation between the parameters. The ANOVA test was used for intergroup comparisons, and the Tamhane test was used for post-hoc analyses.

RESULTS: When comparing eGFR, BUN, and creatinine values with PET/CT renal parameters, a significant correlation was found between eGFR and MKV (r = 0.397), TKU (r = 0.271), and CT-KV (r = 0.216). Similar correlations were also observed for BUN and creatinine. When patients were grouped based on eGFR values, Group 1 (eGFR > 90; normal) included 75 patients, Group 2 (eGFR: 89-60; mild reduction) included 98 patients, and Group 3 (eGFR: 59-30; moderate reduction) included 21 patients. Significant differences were observed between the groups in terms of TKU, MKV, and CT-KV. In post-hoc analyses, the most significant parameter was MKV.

CONCLUSION: ⁶⁸Ga-PSMA-11 PET/CT-derived renal parameters, particularly the molecular kidney volume (MKV), exhibit a significant positive correlation with renal function and demonstrate a significant decrease in patients with renal dysfunction compared to those with normal renal function.

PMID:40947457 | DOI:10.1007/s11255-025-04780-z