Category: Nevin Manimala

Am J Drug Alcohol Abuse. 2026 Aug 5:1-8. doi: 10.1080/00952990.2026.2707638. Online ahead of print.

ABSTRACT

Background: Previous research indicates that workplace culture influences employees’ alcohol use. Given the unique environment of the restaurant industry, this study examined how cultural factors contribute to on-the-job alcohol use among food servers.Objective: The study aimed to contribute to the growing literature on alcohol use in restaurants by identifying, analyzing, and reporting themes explaining how workplace culture influences employee drinking behavior. Guided by three research questions, it examined the roles of organizational artifacts, espoused values, and basic assumptions on drinking behaviors in the workplace.Methods: A descriptive qualitative design was used to explore restaurant food servers’ perceptions of workplace influences on alcohol use. Data was collected on 12 semi-structured Zoom interviews and questionnaires completed by 88 participants recruited through a Facebook restaurant worker group. Interview data were analyzed using iterative thematic analysis in NVivo, while questionnaire data were summarized using descriptive statistics.Results: Findings showed that workplace artifacts such as alcohol-related branding, advertising, and social cues reinforce norms that encourage alcohol use. Despite formal zero-tolerance policies, inconsistent enforcement, peer influence, and managerial practices often normalize drinking at work. Underlying assumptions, including managerial tolerance and unwritten expectations, further sustain a workplace culture in which on-the-job alcohol use is accepted.Conclusions: Alcohol-related behaviors appear embedded in restaurant culture, with formal policies frequently contradicted by informal norms. The results highlight perceived alcohol availability and the role of passive leadership in enabling misuse. Strengthening alcohol policies, improving staff training, and increasing leadership accountability may help promote safer and more productive workplaces.

PMID:42555896 | DOI:10.1080/00952990.2026.2707638

Neurology. 2026 Sep 8;107(5):e218377. doi: 10.1212/WNL.0000000000218377. Epub 2026 Aug 5.

ABSTRACT

BACKGROUND AND OBJECTIVES: Patients with myasthenia gravis (MG) are frequently associated with other autoimmune diseases. However, the temporal relationship between autoimmune diseases and MG remains unclear. This study aimed to evaluate the rates and temporal patterns of autoimmune diseases during the 10 years preceding MG diagnosis.

METHODS: This retrospective population-based cohort study analyzed claims data from the Korean National Health Insurance Service between 2010 and 2021 and included individuals aged ≥20 years. MG was defined using the International Classification of Diseases, 10th Revision (ICD-10) code (G70.0) and Rare Intractable Disease registration (V012). Each MG case was matched with 10 controls by age, sex, and index year. Outcomes were autoimmune thyroid disease (AITD), systemic lupus erythematosus (SLE), seropositive rheumatoid arthritis (SRA), Sjögren syndrome (SjS), psoriasis, type 1 diabetes mellitus (T1DM), Crohn disease, and ulcerative colitis occurring during the 10 years before the index year. Rate ratios (RRs) and 95% CIs were estimated using Poisson regression models for 0-2, 2-5, and 5-10 years before the index year.

RESULTS: A total of 8,355 patients with MG and 83,550 matched controls were included. The mean age (SD) was 53.7 (16.0) years, and 44.1% were male. Patients with MG had a higher rate of any autoimmune disease during 10 years before diagnosis than controls (RR 2.12, 95% CI 1.97-2.28), with the highest rates in 0-2 years before diagnosis (RR 4.27, 95% CI 3.78-4.83). SLE (RR 4.87, 95% CI 2.71-8.77), SjS (RR 4.75, 95% CI 3.01-7.50), AITD (RR 3.66, 95% CI 3.29-4.07), and SRA (RR 2.45, 95% CI 1.89-3.19) showed the strongest associations. Psoriasis (RR 1.68, 95% CI 1.25-2.25) and T1DM (RR 2.03, 95% CI 1.52-2.71) were associated with MG only within 0-2 years before diagnosis, whereas Crohn disease and ulcerative colitis were not associated.

DISCUSSION: Autoimmune diseases were more frequent in the years preceding MG diagnosis than in controls, particularly within 2 years before diagnosis. Strong associations were observed for SLE, SjS, AITD, and SRA. However, these findings should be interpreted with caution because of limitations of administrative claims data.

PMID:42555884 | DOI:10.1212/WNL.0000000000218377

JMIR Mhealth Uhealth. 2026 Aug 5;14:e85658. doi: 10.2196/85658.

ABSTRACT

BACKGROUND: There is an urgent and critical need to support the mental health of health care providers, given high rates of stress and burnout. Although the issues are complex, digital access to information and support can help address the needs, as technology can facilitate on-demand links to private, customized resources, including peer support. Beyond Silence (McMaster University) is an evidence-informed mobile health platform co-designed with health care workers and grounded in prior evidence that mental health literacy and peer support can reduce stigma and facilitate earlier help-seeking.

OBJECTIVE: This study aimed to (1) explore how health care workers across diverse health care settings use the app and (2) identify opportunities and barriers to implementation.

METHODS: A multiple-case study framework, informed by the Consolidated Framework for Implementation Research (CFIR), was applied to capture 4 months of implementation across a purposive sample of 7 diverse Canadian health care organizations. Implementation within each organization was led by designated organizational champions who leveraged existing communication channels and standardized promotional materials to invite employees to voluntarily download and use the app. Implementation outcomes were assessed using app analytics (downloads and feature use) and semistructured baseline and follow-up interviews with organizational champions to explore contextual influences on uptake.

RESULTS: Approximately 1066 employees downloaded the app over the 4-month period, ranging from <2% to >45% of employees across the 7 organizations. Interviews with 28 organizational champions noted that there was good leadership support for the technology, aligning with their mission to address employee mental health. Barriers to use, however, included workplace culture surrounding mental health and help-seeking, lack of awareness about when and how to use the app, and infrastructure-related challenges, such as limited time and a lack of private spaces to download and use the technology.

CONCLUSIONS: Effective implementation is a precondition for positive outcomes; therefore, strategies are needed to optimize technology implementation. Recommendations include evaluating organizational readiness, building mental health literacy, creating a multimodal communication and implementation plan, addressing technology requirements, and embedding the technology into organizational policies and practices. This study highlights key challenges in the implementation of the Beyond Silence peer support platform for health care workers, including slow adoption linked to mental health stigma, competing demands, and limited frontline engagement. Addressing these barriers will require innovative, trust-building strategies to support meaningful uptake and sustained use.

PMID:42555844 | DOI:10.2196/85658

Clin J Oncol Nurs. 2026 Aug 3;30(4):275-282. doi: 10.1188/26.CJON.275-282.

ABSTRACT

BACKGROUND: Environmental services (EVS) workers in healthcare settings are at risk for exposure to hazardous drugs, including antineoplastic drugs, because of their role in cleaning, sanitizing, and disinfecting surfaces where patients have received these drugs. Personal protective equipment (PPE) is critical for minimizing exposure; because oncology nurses rely on EVS partners to maintain safe care environments, inconsistent PPE use has direct implications for team safety and oncology practice.

OBJECTIVES: This study aimed to assess PPE use among EVS workers in oncology and non-oncology settings, identify gaps between self-reported and observed PPE use, and explore factors influencing use.

METHODS: The team employed a mixed-methods approach, combining observational data with verbally administered questionnaire data. Twelve EVS workers from various units participated. Observations of PPE use and responses to adapted survey instruments provided insights into practices and perceptions.

FINDINGS: Results revealed discrepancies between self-reported and observed PPE use, and participants frequently overestimated use. Participants commonly wore gloves, but they underused gloves tested for use with hazardous drugs, particularly in oncology settings. The team identified training gaps as barriers to consistent PPE use, and social desirability bias may explain the discrepancy between self-reported and observed PPE use.

PMID:42555788 | DOI:10.1188/26.CJON.275-282

Clin J Oncol Nurs. 2026 Aug 3;30(4):270-274. doi: 10.1188/26.CJON.270-274.

ABSTRACT

Chemotherapy-induced neutropenia is a frequent complication in patients with cancer that can lead to severe outcomes like sepsis, hospitalizations, and treatment delays. A neutropenic sepsis care bundle was implemented in an.

PMID:42555784 | DOI:10.1188/26.CJON.270-274

Clin J Oncol Nurs. 2026 Aug 3;30(4):E67-E73. doi: 10.1188/26.CJON.E67-E73.

ABSTRACT

BACKGROUND: Palliative care (PC) is specialized health care that can improve quality of life for patients with cancer. However, PC tends to be underutilized or relegated to end-of-life care, limiting patients’ ability to benefit from patient-centered, goal-concordant care. Patients with pancreatic cancer, who are often diagnosed at an advanced stage and with high symptom burdens, could benefit from PC. A chart review conducted in 2022 at a southern New Jersey academic medical center and cancer center found that among 77 patients diagnosed with cancer, only 26 were referred to palliative care services. Of those referred, just 6 received referrals for goal-concordant care discussions; the remaining 20 were referred primarily for cancer-related pain and symptom management or hospice care.

OBJECTIVES: This pilot observational quality improvement study sought to increase PC referrals for patients with pancreatic cancer, and to determine whether the PC received was goal concordant.

METHODS: Patients (N = 19) received referrals to PC and completed pre- and postvisit surveys.

FINDINGS: All patients who completed the postvisit survey (N = 9) expressed satisfaction with care received from the PC team. However, there were significant delays from diagnosis to the PC visit. Nurses support oncology care and tend to be aware of patients’ needs; including nurses in discussions about PC may be a mechanism to increase referrals for this patient population.

PMID:42555779 | DOI:10.1188/26.CJON.E67-E73

Biomed Tech (Berl). 2026 Aug 6. doi: 10.1515/bmt-2026-0390. Online ahead of print.

ABSTRACT

OBJECTIVES: Self-etching primers have simplified the process of direct bonding of dental resins and orthodontic brackets. The aim of this study was to evaluate the cytotoxic impact of the leached components to L-929 fibroblast cultures.

METHODS: Transbond™ Plus self-etching primer (3M Unitek, 2724 South Peck Road, Monrovin CA 91016 USA) was applied to enamel pieces in three different conditions and the specimens were added to L-929 fibroblast cultures. The incubation time was 72 h and the cells were counted by flow cytometry. Statistics was carried out using descriptive and explorative data analyses.

RESULTS: In direct contact assays, the self-etching primer without bracket exhibited mild to moderate cytotoxicity. The application of primer, composite and bracket showed no relevant decrease of cell viability. After seven days, the cytotoxic effects had largely disappeared. Overall, the combination of self-etching primer, composite, bracket exhibits no significant cytotoxicity during the observation period.

CONCLUSIONS: When self-etching primers are used according to the recommended clinical protocols in orthodontics, the method is regarded as safe and the release of leachables seems to have no adverse clinical effect.

PMID:42555748 | DOI:10.1515/bmt-2026-0390

Indian J Med Res. 2026 Aug;164(2):203-219. doi: 10.25259/IJMR_3200_2025.

ABSTRACT

Background and objectives Despite substantial research on immunotherapy, its efficacy and safety in treating advanced non-small cell lung cancer (NSCLC) without identifiable driver mutations remain unclear. The objective of this review was to examine the efficacy and safety of immunotherapy, used as monotherapy or alongside chemotherapy, vs. chemotherapy alone in patients with advanced driver mutation-negative NSCLC. Methods A comprehensive literature search of PubMed, Embase, Scopus, and CENTRAL databases was conducted until December 2024. The protocol was registered in PROSPERO (CRD42024585050). Randomised controlled trials (RCTs) evaluating the efficacy and safety of immunotherapy, either as monotherapy or in combination with chemotherapy, compared with chemotherapy alone, were included. A random-effects meta-analysis was performed. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Results Twenty-three RCTs (n=14605 participants) were included. Immunotherapy (± chemotherapy) significantly improved overall survival [22 RCTs; 14,375 participants, hazard ratio (HR): 0.77; 95% Confidence interval (CI): 0.72-0.83] and progression-free survival (22 RCTs; 14,003 participants, HR: 0.67; 95% CI: 0.58-0.76) compared with chemotherapy alone. The objective response rate was also higher with immunotherapy (23 RCTs; 12,967 participants, RR 1.38, 95% CI: 1.24-1.54). No statistically significant differences were observed between the groups in terms of overall adverse event rates. Interpretation and conclusions Immunotherapy, whether administered alone or in combination with chemotherapy, provides significant survival benefits in patients with advanced driver mutation-negative NSCLC.

PMID:42555694 | DOI:10.25259/IJMR_3200_2025

Indian J Med Res. 2026 Aug;164(2):311-315. doi: 10.25259/IJMR_3672_2025.

ABSTRACT

Background and objectives Globally, measles cases remain above 10 million despite the introduction of two dose measles vaccination schedule since 2000. India reported 13220 cases during 2023-2024, ranking fourth globally. This raises concern regarding the effectiveness of the ongoing programme to achieve measles elimination. Tribal dominated regions in countries such as India needs particular attention due to their higher burden of childhood morbidity and mortality. This study aimed to estimate the proportion of children developing protective antibody levels following two doses of measles vaccine in a tribal location and to identify potential risk factors associated with non-response. Methods A tribal dominated region, the undivided Phulbani district of Odisha, India, was randomly selected. Using cluster sampling, 1375 Infants aged 8 months were enrolled from 30 tribal habitations and followed to document vaccination status. Blood samples (n=1185) were collected three months after the second measles vaccine dose, and their measles IgG antibody levels were quantified. Variables likely to influence antibody response were recorded and statistically evaluated. Results Two-dose measles vaccine coverage was 99.6%; however, 55.1% (n=653) of children demonstrated seropositivity (IgG titre ≥ 250 IU/L). Male gender was significantly associated with suboptimal antibody response. Age, nutritional status, interval between first and second vaccine doses, and vaccination logistics were not found to influence antibody response. Interpretation and conclusion This study provides the first evidence of suboptimal measles antibody response among children from a tribal area of Odisha, India, despite high vaccination coverage. There is a need to understand the immune persistence among such a vulnerable population, where measles control remains a challenge.

PMID:42555691 | DOI:10.25259/IJMR_3672_2025

Lang Speech Hear Serv Sch. 2026 Aug 5:1-16. doi: 10.1044/2026_LSHSS-25-00193. Online ahead of print.

ABSTRACT

PURPOSE: During the assessment process, speech-language pathologists (SLPs) have the opportunity to account for the involvement, thoughts, and views of children with speech sound disorders (SSDs). This is in alignment with the Convention on the Rights of the Child (CRC; UNICEF, n.d.; United Nations, 1989) including CRC Article 12 (Respect for children’s views), Article 13 (Sharing thoughts freely), and Article 23 (Children with disabilities), which affirms SLPs’ role to facilitate participation and consider perspectives. The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) offers a holistic framework that can guide assessment practices, including accounting for children’s views of their own speech. While previous research has been limited to theoretical application, the current study provides preliminary data regarding how American SLPs practically utilize the ICF framework in the evaluation of children with SSDs.

METHOD: An online survey was created using REDCap and disseminated to currently practicing SLPs across the United States. A total of 296 surveys were completed, and data were analyzed using descriptive and inferential statistics.

RESULTS: Over 50% of American SLPs were unfamiliar with the ICF, which was reflected in how they selected assessments of Body Functions more than Activities/Participation and Contextual Factors for children with SSDs. Furthermore, under 10% of SLPs included an assessment tool that measures a child’s communicative participation or self-reported attitudes.

CONCLUSIONS: Findings demonstrated a need for greater exposure to holistic assessment of children with SSDs in the United States. Recommendations extend to faculty and researchers to integrate the ICF framework in teaching and research to promote evidence-based assessment practices and patient-reported outcome measures to protect the CRC.

PMID:42554573 | DOI:10.1044/2026_LSHSS-25-00193