Category: Nevin Manimala

BMC Emerg Med. 2025 Apr 5;25(1):51. doi: 10.1186/s12873-025-01210-2.

ABSTRACT

INTRODUCTION: Workplace bullying among nurses working in emergency departments is a serious issue that can significantly impact their job stress levels. One of the most important sources of stress in every person’s life is their job. This study aimed to determine the relationship between workplace bullying and job stress among nurses in emergency departments.

METHODS: This cross-sectional study was conducted in the emergency departments of hospitals affiliated with Kurdistan University of Medical Sciences in 2023 in Iran. A total of 211 nurses were selected based on inclusion criteria using a census method. Data collection tools included a demographic information form, the Negative Acts Questionnaire for workplace bullying, and the Nursing Job Stress Questionnaire. Data were analyzed using descriptive and inferential statistics (P < 0.05).

FINDINGS: The findings showed that the mean scores for job stress and workplace bullying in nurses were 127.87 ± 34.30 and 56.47 ± 21.58, respectively, both at moderate levels. Furthermore, the results indicated a significant relationship between nurses’ job stress in all dimensions and workplace bullying (P < 0.05).

CONCLUSION: Considering the average levels of bullying in the work environment and occupational stress of nurses and the existence of a significant statistical relationship between these two variables, the results of this research can help nursing managers to plan effectively to reduce bullying in the workplace and occupational stress of nurses.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40188351 | DOI:10.1186/s12873-025-01210-2

BMC Nurs. 2025 Apr 5;24(1):377. doi: 10.1186/s12912-025-03054-4.

ABSTRACT

AIM AND OBJECTIVES: This study aims to evaluate the impact of individualized nursing care, grounded in Meleis’ Transition Theory, on maternal role performance and parental self-efficacy in primiparous women.

BACKGROUND: Research indicates that care practices informed by theoretical frameworks, particularly those focused on the transition to motherhood, can positively influence women’s adaptation to their new maternal roles.

DESIGN: A randomized, single-blind controlled trial was conducted with women meeting the inclusion criteria. Results were reported following the CONSORT 2010 guidelines. The study was registered with ClinicalTrials.gov under registration number NCT05866588.

METHODS: A total of 99 primiparous women participated in the study, with 49 in the experimental group and 50 in the control group. The experimental group received nursing care based on Meleis’ Transition Theory, which included 8 educational and counseling sessions-4 prior to birth and 4 after-spanning from the 28th-32nd week of pregnancy through the 4th month postpartum. Data were collected using the Personal Information Form, the Being a Parent for the First Time Scale, and the Parental Self-Efficacy Scale. Statistical analyses included t-tests, chi-square tests, Mann-Whitney U tests, and regression analysis.

RESULTS: The nursing care provided to the experimental group led to statistically significant improvements in maternal role satisfaction, perceptions of life changes, and parental self-efficacy compared to the control group (p < 0.05).

CONCLUSIONS: Nursing care based on Meleis’ Transition Theory enhanced maternal role satisfaction, increased parental self-efficacy, and improved maternal adaptation in primiparous women. It is recommended that nurses apply Transition Theory to support a healthy transition to motherhood in this population.

RELEVANCE TO CLINICAL PRACTICE: This study provides evidence for the effectiveness of individualized nursing care in facilitating a healthy transition to the maternal role and offers valuable insights for the nursing literature.

TRIAL REGISTRATION: Clinical Trial Registry NCT05866588 [Registration date 2023/05/01 (Retrospectively registered)].

PMID:40188345 | DOI:10.1186/s12912-025-03054-4

Health Qual Life Outcomes. 2025 Apr 5;23(1):33. doi: 10.1186/s12955-025-02356-0.

ABSTRACT

BACKGROUND: To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care Homes’ Adoption (DACHA) study, we assessed the discriminant construct validity of QoL measures, using hypothesis testing to assess the factors associated with QoL.

METHODS: Care home records for 679 residents aged over 65 from 34 care homes were available that had been linked to health records and care home provider data. In addition to data on demographics, level of needs and impairment, proxy report measures of social care-, capability- and health-related QoL of participants were completed (ASCOT-Proxy-Resident, ICECAP-O, EQ-5D-5L Proxy 2). Discriminant construct validity was assessed through testing hypotheses developed from previous research and QoL measure constructs. Multilevel regression models were analysed to understand how QoL was influenced by personal characteristics (e.g. sex, levels of functional and cognitive ability), care home level factors (type of home, level of quality) and resident use of health services (potentially avoidable emergency hospital admissions). Multiple imputation was used to address missing data.

RESULTS: All three QoL measures had acceptable construct validity and captured different aspects of QoL, indicated by different factors explaining variation in each measure. All three measures were negatively associated with levels of cognitive impairment, whilst ICECAP-O and EQ-5D-5L Proxy 2 were negatively associated with low levels of functional ability. ASCOT-Proxy-Resident was positively associated with aspects of quality and care effectiveness at both resident- and care home-level.

CONCLUSION: The study found acceptable construct validity for ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L Proxy 2 in care homes, with findings suggesting the three are complementary measures based on different constructs. The study has also provided evidence to support the inclusion of these QoL measures in any future MDS.

PMID:40188343 | DOI:10.1186/s12955-025-02356-0

BMC Public Health. 2025 Apr 5;25(1):1288. doi: 10.1186/s12889-025-22527-4.

ABSTRACT

BACKGROUND: Pregnancy in individuals with diabetes and/or hypertension, especially when undiagnosed, untreated, or uncontrolled, can result in severe consequences, including maternal and child mortality. Contraception is crucial for the management of pregnancy in individuals with diabetes and/or hypertension. However, the decision-making and experiences related to contraception use among this population in low- and middle-income countries are poorly understood. This study aims to explore the barriers to contraception use among sexually active men and women living with diabetes and/or hypertension.

METHODS: We conducted a qualitative study using the empirical phenomenological approach. We interviewed participants diagnosed with diabetes and/or hypertension, as well as stakeholders involved in providing care to individuals living with at least one of these two conditions and family planning service providers. Semi-structured interview guides were used, and data were collected through four focus group discussions, four in-depth interviews, and ten key informant interviews. All interviews were transcribed and analysed thematically.

RESULTS: People living with diabetes and/or hypertension encounter misunderstandings and various barriers when it comes to using contraception. These experiences were categorised into four main themes and nine sub-themes. The themes identified were: (i) lack of awareness/inadequate knowledge and misunderstanding, (ii) social and religious beliefs, (iii) barriers to available and affordable contraceptives, and (iv) lack of coordination between facilities providing family planning services and treatment and management for diabetes and/or hypertension.

CONCLUSION: Findings provide a comprehensive understanding of the complexities and considerations involved in contraceptive use-related decision-making among individuals with diabetes and/or hypertension. These findings can be used in policymaking and programme development to promote contraceptive use and improve the reproductive health outcomes of this population.

PMID:40188336 | DOI:10.1186/s12889-025-22527-4

BMC Public Health. 2025 Apr 5;25(1):1289. doi: 10.1186/s12889-025-22126-3.

ABSTRACT

BACKGROUND: There is growing evidence that exposure to particulate matter (PM) is associated with impaired cognitive function. However, limited studies have specifically examined the relationship between PM exposure and domain-specific cognitive function.

METHODS: This study involved 2,668 female participants from the Lifestyle and Healthy Aging of Chinese Square Dancer Study. Global cognitive function was assessed using a composite Z-score derived from four tests: the Auditory Verbal Learning Test (AVLT), Verbal Fluency Test (VFT), Digit Symbol Substitution Test (DSST), and Trail Making Test-B (TMT-B). These tests evaluated specific cognitive subdomains: memory (AVLT), language (VFT), attention (DSST), and executive function (TMT-B). PM concentrations were estimated using a Random Forest (RF) model, which calculated the average concentrations over 1-year and 3-year periods at a high grid resolution of 1 × 1 km. Mixed linear regression was employed to explore the association between PM exposure and cognitive function.

RESULTS: After adjusting for basic socio-demographic factors, a 10 mg/m³ increase in 3-year exposure to PM₁₀ was significantly associated with a decrease in the DSST score by -0.05 (95% confidence interval [CI]: -0.11, 0) and an increase in the TMT-B score by 0.05 (95% CI: 0.01, 0.1). When further adjusting for gaseous pollutants (SO₂, NO₂, and O₃), even stronger associations were observed between 3-year exposure to either PM_2.5 or PM₁₀ and performance in both global cognition and specific cognitive subdomains. Specifically, in the DSST subdomain, a 10 µg/m³ increase in 1-year PM₁₀ exposure was associated with a decrease in the score by -0.10 (95% CI: -0.15, -0.04). Age-stratified analyses further indicated that older participants were consistently more vulnerable to PM exposure. Notably, 3-year exposure to both PM_2.5 and PM₁₀ was linked to declines in DSST scores across both middle-aged and older age groups.

CONCLUSION: Ambient PM exposure was significantly associated with performance in global cognitive function and specific cognitive domains among Chinese females. Female populations over 65 years old were more susceptible to the adverse effects of PM_2.5 and PM₁₀. Among the four subdomains, the DSST showed the strongest association with PM exposure, even at earlier ages, suggesting that impaired attention may serve as an early warning sign of cognitive decline.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40188325 | DOI:10.1186/s12889-025-22126-3

BMC Med Res Methodol. 2025 Apr 5;25(1):89. doi: 10.1186/s12874-025-02527-z.

ABSTRACT

BACKGROUND: Traditional statistical methods assume normally distributed continuous variables, making them unsuitable for analysis of prevalence proportions. To address this problem, two commonly utilized variance-stabilizing transformations (logit and Freeman-Tukey) are empirically evaluated in this study to provide clarity on the optimal choice among these transforms for researchers.

METHODS: Simulated datasets were created using multiple Monte Carlo simulations, with varying input parameters to examine transformation estimator performance under varying scenarios. Additionally, the research delved into how sample size and proportion influenced the variability of the Freeman-Tukey transform. Performance was evaluated for both single prevalence proportions (coverage, interval width and variation over sample size) as well as for meta-analysis of prevalence (absolute mean deviation of pooled proportions, coverage and interval width).

RESULTS: For extreme proportions we found that the Freeman-Tukey transform provides better coverage and narrower intervals compared to the logit transformation, and for non-extreme proportions, both transformations demonstrated similar performance in terms of single proportions. The variability of Freeman-Tukey transformed proportions with sample size is only seen when the range of proportions under scrutiny are very small (~ 0.005), and the variability of the Freeman-Tukey transform’s value occurs in the third decimal place (0.007). In meta-analysis, the Freeman-Tukey transformation consistently showed lower absolute deviation from the population parameter, with narrower confidence intervals, and improved coverage compared to the same meta-analyses using the logit transformation.

CONCLUSION: The results suggest that the Freeman-Tukey transform is to be preferred over the logit transformation in the meta-analysis of prevalence.

PMID:40188320 | DOI:10.1186/s12874-025-02527-z

Insights Imaging. 2025 Apr 5;16(1):83. doi: 10.1186/s13244-025-01957-z.

ABSTRACT

OBJECTIVES: To compare imaging differences between bleeding and non-bleeding angiomyolipoma with respect to the proportion and attenuation of the angiomyogenic component and the occurrence and size of aneurysms.

MATERIALS AND METHODS: CT scans and angiographies preceding 58 consecutive embolisations at two institutions from 1999 to 2018 were analysed retrospectively. Tumour volume was measured by contouring the angiomyolipoma on CT scans. The partial volume of the angiomyogenic component (blood vessels and smooth muscle relative to fatty tissue) was derived using attenuation threshold values measured in Hounsfield Units.

RESULTS: Bleeding angiomyolipoma exhibited a significantly higher proportion of angiomyogenic component (23%) than non-bleeding angiomyolipoma (8%) (p = 0.042). Angiomyolipoma with 0-5% angiomyogenic component had a lower risk of bleeding compared to those with ≥ 5% angiomyogenic component (13% vs 42%). Mean attenuation values of angiomyogenic components did not differ between bleeders and non-bleeders. Aneurysms were observed in 24% of angiomyolipoma during angiography. No statistically significant association was found between the occurrence of aneurysms and bleeding, neither when all aneurysms were included nor when only aneurysms ≥ 5 mm were considered. Tuberous sclerosis patients had larger tumours (11.4 cm vs 6.0 cm), but no significant difference in bleeding was observed (p = 0.53).

CONCLUSIONS: A higher proportion of the angiomyogenic component in bleeding renal angiomyolipoma suggests a possible association with bleeding. Angiomyolipoma with less than 5% angiomyogenic components may represent a subgroup with a reduced risk of bleeding. Our findings do not confirm the widely accepted assumption that aneurysms significantly increase the risk of bleeding.

CRITICAL RELEVANCE STATEMENT: Measuring the angiomyogenic component in renal angiomyolipoma could help address current knowledge gaps and aid in the more efficient selection of patients for therapeutic interventions.

KEY POINTS: Identifying risk factors for bleeding beyond tumour size is important. Very low angiomyogenic component tumours may have reduced bleeding risk. The presence of aneurysms may not significantly increase bleeding risk. Reporting angiomyogenic proportion on CT may aid in treatment decisions.

PMID:40188309 | DOI:10.1186/s13244-025-01957-z

Tech Coloproctol. 2025 Apr 5;29(1):93. doi: 10.1007/s10151-025-03135-1.

ABSTRACT

BACKGROUND: Surgical site infections (SSI) are the most common complication after stoma closure. Circular skin closure (CSC) has been proposed to reduce SSI with comparable or even better outcomes than conventional primary sutures (PS). The aim of this meta-analysis is to compare circular with primary skin closure in stoma closure.

METHOD: A systematic review of the literature was performed for articles published between January 2010 and June 2023, including all randomized control trials (RCT) on wound infection of adult patients following stoma reversal. The primary outcome was 30-day SSI; secondary outcomes were operative time, length of stay, and incisional hernia.

RESULTS: Eight RCTs were identified that included a total of 606 patients undergoing stoma closure surgery. Four percent of patients in the CSC group developed SSI, compared to 27% of patients undergoing PS. The 30-day SSI rate was lower after the circular skin closure (OR 0.11, 95% CI 0.06-0.21; p < 0.00001, I² = 0%). There was no difference in the operative time (99.2 vs 103.5 min; MD – 0.17, 95% CI – 0.37, 0.03; p = 0.10), length of stay (7.1 vs 7.7 days; MD – 0.34, 95% CI – 0.55, – 0.12; p = 0.002), and incisional hernia rate (2% vs 4%; OR 0.61, 95% CI 0.23, 1.60; p = 0.31).

CONCLUSION: CSC is associated with lower SSI rate and should be preferred to linear skin closure technique after stoma closure surgery.

PMID:40188299 | DOI:10.1007/s10151-025-03135-1

Ann Surg Oncol. 2025 Apr 5. doi: 10.1245/s10434-025-17176-1. Online ahead of print.

ABSTRACT

BACKGROUND: Statistical cure, defined as achieving life expectancy comparable with that of disease-free individuals, has not been specifically investigated in hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC), which accounts for more than 50% of the global HCC burden. This study aimed to develop a cure model for HBV-HCC after hepatectomy using matched HBV carriers and the general population as reference groups.

METHODS: From a Chinese multicenter database, HBV-HCC patients who underwent curative-intent hepatectomy were retrospectively reviewed. Independent prognostic factors were identified through Cox regression. A spline-based cure model was applied using two reference populations: matched Chinese HBV carriers (from Shanghai Center for Disease Control and Prevention) and the general population (from the National Bureau of Statistics).

RESULTS: The study analyzed 740 HBV-HCC patients. The following eight independent risk factors were identified: preoperative high viral load (hazard ratio [HR] 1.27), Child-Pugh grade (HR 1.21 and 1.43), multiple tumors (HR 1.70), tumor size greater than 5.0 cm (HR 1.47), macrovascular invasion (HR 3.33), microvascular invasion (HR 1.25), intraoperative blood transfusion (HR 1.21), and postoperative HBV reactivation (HR 1.89). The overall cure probability was 21.2% versus that for HBV carriers and 11.1% versus that for the general population. Risk stratification identified distinct groups relative to HBV carriers. Low risk (64.2%) showed an initial cure rate of 30.3% and achieved a 95% cure probability by 8.6 years, whereas high risk (10.5%) showed negligible cure probability.

CONCLUSIONS: This first HBV-HCC-specific cure model demonstrated that statistical cure is achievable for a subset of patients after hepatectomy. Risk stratification identifies patients with varying cure probabilities, providing valuable guidance for personalized treatment strategies and surveillance protocols.

PMID:40188279 | DOI:10.1245/s10434-025-17176-1

Eur Arch Otorhinolaryngol. 2025 Apr 5. doi: 10.1007/s00405-025-09346-4. Online ahead of print.

ABSTRACT

PURPOSE: Vibrant Soundbridge (VSB) is an active middle ear implant that serves as a solution for people unable to use conventional hearing aids properly. Surgical techniques for VSB implantation have progressively advanced, improving its outcomes. Traditionally, VSB processor activation transpires around four weeks after the surgery to provide enough healing; however, contemporary practices in cochlear implant and bone-anchored hearing device activations indicate reduced waiting times. The purpose of this research is to explore the feasibility, safety, and advantages of early VSB activation.

METHODS: This prospective study was conducted in two phases. In phase one, the patients only attempt using the device on the first business day after surgery and then return in 4 weeks for a complete and standard fitting and device use. In the second phase, participants had a thorough fitting and began using the device on a regular basis the first working day after surgery. Feasibility, safety, and audiological results were assessed throughout both phases.

RESULTS: Early activation was successfully achieved in all patients in the early group without significant complications. When comparing the audiological examination and fitting parameters between the initial session the day after surgery and the one-month follow-up, there was no statistically significant change.

CONCLUSION: The study emphasizes the possibility for early VSB activation, which might minimize wait times and enhance patient satisfaction without compromising device function. Further study is required to validate these results in broader groups and investigate long-term consequences.

PMID:40188275 | DOI:10.1007/s00405-025-09346-4