Category: Nevin Manimala

Digit Health. 2025 Jul 20;11:20552076251357657. doi: 10.1177/20552076251357657. eCollection 2025 Jan-Dec.

ABSTRACT

OBJECTIVE: This study investigates the effects of developing and implementing an integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals under the deep integration of Internet technology. The goal is to provide practical references for addressing declining birth rate challenges and promoting the sustainable development of maternal and child specialty hospitals.

METHODS: Using a convenience sampling method, 100 pregnant and postpartum women from a tertiary maternal and child health hospital in Chengdu, China, were selected as the participants for this study. A random number table was used to assign the participants into the control group and the intervention group, with 50 participants in each group. The control group received conventional nursing care, while the intervention group was provided with an integrated service model for antepartum, intrapartum, and postpartum care, fully implemented with Internet technology. A comprehensive comparative analysis was conducted between the two groups across several key dimensions, including the number of return visits within 42 days postpartum: The actual number of return visits for checkups, treatments, or consultations due to various health issues during this period was recorded and compared; Postpartum complications within 42 days: The occurrence rates of common complications, such as postpartum infections, hemorrhage, and milk stasis, were meticulously documented and analyzed for both groups. Service satisfaction: A nursing satisfaction questionnaire was used to objectively and comprehensively assess the satisfaction levels of participants in both groups with the care they received. Willingness for postpartum follow-up visits: Differences in participants’ subjective willingness and proactive attitudes toward arranging subsequent postpartum visits were thoroughly examined. Psychological indicators: Using psychological assessment scales, the psychological status of the two groups was evaluated from the establishment of personal health records to postpartum follow-up, analyzing the psychological differences between the two groups.

RESULTS: Through systematic data collection, organization, and rigorous statistical analysis, the results revealed that the average number of return visits within 42 days postpartum was significantly lower in the intervention group (0.16 ± 0.42) compared to the control group (1.44 ± 1.11) (t = -7.630, P < .001). For service satisfaction, 84.00% (42/50) of participants in the intervention group were very satisfied, significantly higher than 52.00% (26/50) in the control group (χ² = 3.170, P = .001). The incidence of mastitis within 42 days postpartum was 2.00% (1/50) in the intervention group, markedly lower than 28.00% (14/50) in the control group (χ² = 2.670, P < .001). For willingness to seek follow-up visit, 96.00% (48/50) of participants in the intervention group stated they would return to the hospital if they had health issues, compared to 82.00% (41/50) in the control group (χ² = 5.010, P = .025). 92.00% (46/50) of participants in the intervention group were willing to choose our hospital for the newborn’s health checkup, significantly higher than 76.00% (38/50) in the control group (χ² = 61.060, P < .001). The 28 weeks GAD-7 scored lower in the intervention group (4.14 ± 0.73) than in the control group (5.27 ± 1.00) (t = -6.430, P < .001) and also lower in the intervention group than in the control group at admission (5.58 ± 1.40 vs. 7.29 ± 1.61; t = -5.630, P < .001). There was no significant difference in 28 weeks EPDS scores between two groups (9.02 ± 0.68 vs. 9.18 ± 0.78; t = -1.110, P = .270). The intervention group showed significantly lower EPDS scores at 42 days postpartum (7.84 ± 0.71 vs. 9.61 ± 1.84; t = -6.310, P < .001).

CONCLUSION: The integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals, based on the “Internet+” concept, effectively integrates Internet technology with critical processes in nursing services. This model precisely and efficiently addresses pregnant and postpartum women’s unique maternal and childcare needs at different physiological stages. It demonstrates significant advantages in optimizing medical resource allocation, improving the quality and efficiency of nursing services, and enhancing patients’ healthcare experiences and trust. The findings of this empirical study provide robust evidence for the model’s effectiveness in nursing care. The successful implementation of this innovative service model offers new perspectives and directions for transforming and upgrading maternal and child specialty hospitals in the face of declining birth rates and the associated challenges and opportunities. It holds significant value for broader application and promotion, with promising prospects for further development.

PMID:40693253 | PMC:PMC12277550 | DOI:10.1177/20552076251357657

J Clin Transl Res. 2024;10(4):229-236. doi: 10.36922/jctr.24.00022. Epub 2024 Aug 20.

ABSTRACT

BACKGROUND: Since 2020, the number of registered clinical trials has surged by over 30%, significantly increasing the demand for skilled coordinators. Despite this growth, a national shortage of qualified coordinators remains, driven by escalating responsibilities and workloads. Effective resource management is crucial for retention. While the Ontario Protocol Assessment Level (OPAL) helps quantify trial complexity, it overlooks key factors such as organizational structure and budget constraints that impact coordinator productivity. This project aims to refine the OPAL score by integrating it with longitudinal coordinator effort data, improving resource allocation, operational efficiency, and job satisfaction, thereby reducing burnout and turnover.

AIM: The aim of this study was to reduce burnout and turnover, ultimately contributing to the overall success of clinical trials.

METHODS: Actively enrolling interventional studies with corresponding coordinator effort tracking from June 1, 2022, to December 1, 2022, were included in the database. Protocols were graded using an adapted protocol assessment tool. Descriptive statistics compared protocol characteristics to the adapted assessment score and tracked coordinator hours, while Student’s t-test and univariate analysis evaluated differences in continuous variables. Linear regression analysis assessed the association between the adapted score and the coordinator effort.

RESULTS: Seven protocols were analyzed: five (71%) were federally funded, two (29%) were industry-sponsored; four (57%) were behavioral interventions, and three (43%) were drug studies. Significant differences were observed between industry-sponsored and federally funded studies (7.25 ± 1.77 vs. 6.45 ± 1.65; P < 0.0001) and between behavioral interventions and drug studies (6.88 ± 1.56 vs. 6.42 ± 1.91; P < 0.0001). Linear regression revealed the adapted OPAL score significantly predicted coordinator hours (β = 77.22; P = 0.01; R ² = 0.78).

CONCLUSION: The adapted protocol complexity scores predict coordinator effort, aiding in capacity assessment and objective project distribution.

RELEVANCE FOR PATIENTS: The findings from this project can inform more precise resource allocation, potentially leading to higher-quality studies and enhanced participant safety.

PMID:40693242 | PMC:PMC12279055 | DOI:10.36922/jctr.24.00022

J Natl Cancer Cent. 2025 May 3;5(3):330-345. doi: 10.1016/j.jncc.2025.03.001. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality. However, there remains a paucity of up-to-date statistical analyses that meticulously examine the global and national shifts in the epidemiology of genitourinary cancers. Our study aimed to provide a comprehensive understanding of the global distribution and progression of genitourinary cancers through analyses of the recently updated 2021 Global Burden of Disease (GBD) database.

METHODS: This study presented the incidence, mortality, disability-adjusted life years (DALYs), and their respective age-standardized rates for four genitourinary cancers (bladder, kidney, prostate, and testicular cancers) by sex, age, and location from 1990 to 2021. Estimates for these data were presented with their 95% uncertainty intervals (UIs). Estimated annual percentage changes (EAPCs) and Bayesian Age-Period-Cohort (BAPC) models were utilized to further quantify the temporal dynamics of age-standardized rates (ASRs) in genitourinary cancers. Countries and territories were categorized according to socio-demographic index (SDI) quintiles.

RESULTS: Globally, with the exception of a sustained decline in age-standardized incidence rates (ASIRs) for bladder cancer (EAPC = -0.36%), the ASIRs for kidney, prostate, and testicular cancers demonstrated an upward trend from 1990 to 2021 (EAPC = 0.53%, 0.20%, and 1.43%, respectively). In terms of geographical regions, High-income North America had the highest ASIRs for both bladder (13.98 per 100,000 persons [95% UI, 12.96 to 14.61]) and prostate (47.02 per 100,000 persons [95% UI, 44.47 to 49.04]) cancers. Southern Latin America recorded the highest ASIRs for kidney (13.44 per 100,000 persons [95% UI, 12.27 to 14.73]) and testicular (4.98 per 100,000 persons [95% UI, 4.33 to 5.72]) cancers. Additionally, Central Europe (1.25% [95% CI, 1.12% to 1.38%]), East Asia (2.40% [95% CI, 2.21% to 2.59%]), Eastern Europe (3.74% [95% CI, 3.55% to 3.92%]), and the Caribbean (5.52% [95% CI, 4.32% to 6.74%]) exhibited the highest EAPCs for bladder, kidney, prostate, and testicular cancers, respectively. Unlike the ASIRs, age-standardized mortality rates (ASMRs) and age-standardized DALYs rates (ASDRs) showed a downward trend over time in all types of genitourinary cancers. The disease burdens of bladder, kidney, and prostate cancers were primarily distributed among older men, while testicular cancer mainly occurred in young men. Smoking remained the primary risk factor for bladder cancer. Meanwhile, high fasting plasma glucose and high body-mass index exerted increasingly significant impacts on bladder and kidney cancers, respectively, during the study period. Projections to 2050 suggest that the global burdens of genitourinary cancers are expected to decline to varying degrees. However, regional disparities in genitourinary cancer burdens are projected to persist.

CONCLUSIONS: Although the results demonstrate a marginal decline in ASRs caused by genitourinary cancers, they still impose a considerable global burden and result in numerous deaths. Our study obtained and analyzed the latest epidemiological data of genitourinary cancers from the GBD 2021, offering valuable information for national healthcare professionals and policymakers to optimize resource allocation, manage costs more efficiently, and develop practical healthcare policies.

PMID:40693231 | PMC:PMC12276558 | DOI:10.1016/j.jncc.2025.03.001

Front Cardiovasc Med. 2025 Jul 7;12:1650098. doi: 10.3389/fcvm.2025.1650098. eCollection 2025.

ABSTRACT

[This corrects the article DOI: 10.3389/fcvm.2022.867944.].

PMID:40693227 | PMC:PMC12278736 | DOI:10.3389/fcvm.2025.1650098

Front Cardiovasc Med. 2025 Jul 7;12:1650107. doi: 10.3389/fcvm.2025.1650107. eCollection 2025.

ABSTRACT

[This corrects the article DOI: 10.3389/fcvm.2023.1191055.].

PMID:40693223 | PMC:PMC12278133 | DOI:10.3389/fcvm.2025.1650107

J Orthop Surg Res. 2025 Jul 21;20(1):684. doi: 10.1186/s13018-025-06088-1.

ABSTRACT

OBJECTIVE: This study aims to assess and compare the six-month postoperative clinical outcomes of Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS), unilateral biportal endoscopy (UBE), and percutaneous interlaminar endoscopic discectomy (PEID) for lumbar spinal stenosis (LSS). Additionally, muscle injury associated with these procedures is evaluated by analyzing changes in creatine kinase (CK) and C-reactive protein (CRP) levels.

METHODS: A total of 288 patients diagnosed with single-segment unilateral LSS and treated between January 2021 and June 2024 were included in this study. Patients were assigned to the AUSS group (n = 129), UBE group (n = 86), or PEID group (n = 73). Surgical parameters, including operative time, incision length, intraoperative blood loss, and postoperative facet joint preservation rate, were recorded. Clinical outcomes were assessed preoperatively and at 3 days, 3 months, and 6 months postoperatively using the Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), EQ-5D-5 L quality of life index, and the modified Macnab criteria. The extent of muscle injury was quantified through serum CK and CRP levels measured preoperatively and on postoperative days 1, 3, 5, and 7. Descriptive statistics and multiple comparison analyses were used to assess clinical parameters among the three groups. Longitudinal data were analyzed using a generalized mixed linear model.

RESULTS: The AUSS group demonstrated significantly shorter operative times and smaller incision lengths compared to the UBE and PEID groups (P < 0.001). Postoperative VAS scores decreased significantly in all three groups, with the greatest improvement observed in the AUSS group (P < 0.05). ODI and EQ-5D-5 L scores indicated superior postoperative quality of life in the AUSS group compared to the UBE and PEID groups (P < 0.05). However, no statistically significant differences were observed in the modified Macnab criteria outcomes or postoperative complication rates among the three groups (P > 0.05). The PEID group exhibited the lowest postoperative CK and CRP levels as well as the least intraoperative blood loss (P < 0.05), suggesting minimal muscle injury. The AUSS group showed lower muscle injury levels than the UBE group (P < 0.05).

CONCLUSION: Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS), unilateral biportal endoscopic (UBE) technique, and percutaneous endoscopic interlaminar discectomy (PEID) are all effective minimally invasive approaches for lumbar spinal stenosis (LSS). AUSS offers shorter operative time and better preservation of anatomical structures. PEID minimizes intraoperative tissue damage and reduces inflammatory response, while UBE balances visualization with operational flexibility. All three techniques demonstrate good short-term clinical outcomes. The surgical approach should be tailored to each patient’s symptoms and individualized needs. Although AUSS demonstrated certain intraoperative advantages, this study did not show that AUSS is superior to UBE or PEID in clinical efficacy or complication control. As a novel technique, AUSS may improve postoperative pain and quality of life, providing a valuable addition to the minimally invasive treatment options for lumbar spinal stenosis.

PMID:40691813 | DOI:10.1186/s13018-025-06088-1

BMC Nurs. 2025 Jul 21;24(1):951. doi: 10.1186/s12912-025-03595-8.

ABSTRACT

OBJECTIVE: This study explains the impact of organizational innovation climate on nurses’ innovation behavior in a tertiary specialized oncology hospital, while examining the chain mediation roles of achievement motivation and creative self-efficacy.

METHODS: In this online cross-sectional survey, 857 nurses from a tertiary specialized oncology hospital in Guangdong province, China were selected by convenience sampling method. SPSS Statistics v26.0 and AMOS v29.0 were used for data analysis. The reporting followed the STROBE checklist.

RESULTS: The nurses’ innovation behavior was below the medium level. Organizational innovation climate was significantly positively related to nurses’ innovation behavior, achievement motivation, and creative self-efficacy. Achievement motivation was positively correlated with both creative self-efficacy and nurses’ innovation behavior. Creative self-efficacy was positively correlated with nurses’ innovation behavior. Mediation analysis identified two pathways: creative self-efficacy independently mediated the relationship between organizational innovation climate and nurses’ innovation behavior, while achievement motivation and creative self-efficacy served as a chain mediator between the organizational innovation climate and nurses’ innovation behavior.

CONCLUSION: Our study highlights the critical role of organizational innovation climate in enhancing nurses’ innovation behavior in specialized oncology hospitals. Specifically, it demonstrates that achievement motivation and creative self-efficacy play a chain mediation role between organizational innovation climate and nurses’ innovation behavior. Healthcare administrators should prioritize constructing innovation-supportive climates, implement achievement motivation interventions, and strengthen creative self-efficacy development programs to systematically foster nurses’ innovation capabilities in oncology settings.

PMID:40691798 | DOI:10.1186/s12912-025-03595-8

BMC Public Health. 2025 Jul 21;25(1):2521. doi: 10.1186/s12889-025-21771-y.

ABSTRACT

BACKGROUND: The Integrated Management of Childhood Illnesss (IMCI) strategy has a lower coverage. The World Health Organization (WHO) introduced the concept of distance learning IMCI in 2014 to improve uptake of the strategy. This study was conducted to evaluate the effectiveness of a distance learning IMCI training compared with the standard IMCI training in the correct management of children presenting to primary health centers.

METHODS: This cluster randomized controlled trial with a 1:1 parallel design was conducted at 26 Basic Health Units (BHUs) in Pakistan. Healthcare workers in BHUs (n = 13) randomized to the intervention arm were trained as per the dIMCI protocols while those (n = 13) randomized to the control arm were trained as per the standard protocol. The trained heathcare workers were followed for around five months and were evaluated in the management of childhood illnesses at their respective health facilities. Correct management, the principal outcome, was defined based on a case being correctly assessed (proficiency score of ≥ 6 out of the total score of 10), classified (compared to the gold standard physician), treated (compared to the gold standard physician), and counseled (proficiency score of ≥ 5 out of the total score of 7). Descriptive statistics, binary logistic regression, and 95% confidence interval were calculated using Stata version 18 adjusted for the clusters. P-values < 0.05 were regarded as significant.

RESULTS: Under-five children presented to the two arms were mostly similar in gender, age, duration of consultation with the healthcare worker, and presenting complaints. On logistic regression, the dIMCI training was found to be a significant factor in the correct classification (OR = 1.77, 95% CI 1.22-2.58), correct counseling (OR = 6.11,95% CI 3.06 – 12.19), and the overall management of children (OR = 3.35, 95% CI 2.03 – 5.52) with strong evidence against the model hypothesis at this sample size. The dIMCI training showed weak evidence against the model hypothesis in the domains of correct assessment (OR = 1.84, 95% CI 0.99-3.40) and correct treatment (OR 1.46, 95% CI 0.92 – 2.31).

CONCLUSIONS: Health policymakers could consider the dIMCI an effective, feasible, and flexible alternative to standard IMCI training for scaling up the IMCI strategy.

TRIAL REGISTRATION: Registered with www.chictr.org.cn , under ChiCTR1900027201 on 05/11/2019.

PMID:40691783 | DOI:10.1186/s12889-025-21771-y

BMC Nurs. 2025 Jul 21;24(1):948. doi: 10.1186/s12912-025-03428-8.

ABSTRACT

BACKGROUND: Nurses are vital to healthcare systems, yet their psychological well-being remains underexplored despite its critical impact on professional performance and job satisfaction. Essential attributes such as self-esteem, psychological empowerment, and assertiveness play a crucial role in effective decision-making and advocacy. In Qatar, the National Health Strategy (2024-2030) emphasizes healthcare worker empowerment; however, research on the interplay of these psychological constructs among nurses is scarce.

AIM: This study aims to evaluate the levels of self-esteem, psychological empowerment, and assertiveness among nurses in Qatar and examine their interrelationships, particularly the mediating role of self-esteem between empowerment and assertiveness.

METHODOLOGY: A quasi-experimental one-group pre-posttest design was employed, focusing on baseline data from 144 registered nurses across Hamad Medical Corporation (HMC) facilities. Data were collected using validated tools, including the Rosenberg Self-Esteem Scale, Psychological Empowerment Scale, and the Rathus Assertiveness Schedule. Statistical analyses, including structural equation modeling and ANOVA, were conducted to identify relationships and demographic associations.

RESULTS: Findings indicated moderate levels of assertiveness (mean = 67.1 ± 10.9) and empowerment (mean = 51.1 ± 5.9), along with high self-esteem (mean = 27.1 ± 2.9). Empowerment significantly influenced assertiveness (β = 0.207, p = 0.009); however, self-esteem did not mediate this relationship. Significant demographic variations in self-esteem were observed, with higher levels reported among early-career nurses and general registered nurses, while assertiveness and empowerment remained consistent across demographic groups.

CONCLUSION: The study underscores the importance of fostering empowerment, self-esteem, and assertiveness among nurses through targeted interventions such as assertiveness training and supportive organizational policies. Future research should explore longitudinal changes in these psychological dynamics to enhance sustained professional development.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40691780 | DOI:10.1186/s12912-025-03428-8

Genome Biol Evol. 2025 Jul 3;17(7):evaf130. doi: 10.1093/gbe/evaf130.

ABSTRACT

Palms (family Arecaceae) are integral to understanding the evolution of tropical rainforests due to their long evolutionary history, high species richness, and hyper dominance in these ecosystems. Some palm genera, like Geonoma, are regionally and locally species-rich and abundant in Neotropical rainforests, but factors contributing to their divergence and ultimately their diversification remain poorly explored. A recent phylogenomic study identified the Geonoma undata complex, with high levels of genetic distinctiveness of different geographically proximal groups, describing it as a hyper-cryptic radiation. Here, we seek to disentangle the factors that contribute to genetic divergence in the G. undata cryptic species complex in the Northern Colombian Andes, where various forms ascribable to different taxonomic, morphological, and genetic groups exist. To address this, we pursued three main aims using nuclear single nucleotide polymorphisms distributed along over 4,000 genomic regions from 156 individuals. (i) We identified populations and used diversity metrics to understand evolutionary scenarios across pairwise comparisons of those populations. Geographically sympatric populations display evidence for allopatric selection that is likely explained by elevational segregation. (ii) Tajima’s D was used to infer broad genomic trends in selection and drift. In general, divergence between populations is enhanced by drift through population expansions. (iii) Lastly, we used outlier divergence and selection statistics to identify genes with outstanding divergence under significant positive selection. Two genes were identified that fit this description and are found to play functional roles in phenology, such as light response and flowering time.

PMID:40691772 | DOI:10.1093/gbe/evaf130