Category: Nevin Manimala

Teach Learn Med. 2025 Aug 3:1-10. doi: 10.1080/10401334.2025.2538051. Online ahead of print.

ABSTRACT

There is a growing amount of literature on the benefits of using open-ended questions (OEQs) to assess knowledge in medical education. However, it is unknown how many US medical schools include OEQs in their assessment toolkits and how they are being used. The purpose of this study was to determine if OEQ assessments are an emerging trend in US medical education. We distributed an online survey to assessment leadership at all 156 US accredited allopathic medical schools between September 2022 and April 2024. Questions focused on the use or future interest of OEQs to assess medical knowledge in the pre-clerkship and clerkship curriculum. We calculated descriptive statistics for prevalence and use rates, and completed a conventional content analysis for open-ended comments. Seventy-eight US medical schools completed the survey (50% response rate). Forty schools (51%) reported using OEQs for medical knowledge assessment. OEQs were used during the pre-clerkship (28 schools), clerkship (two schools) or both parts of the curriculum (10 schools). On average, OEQs accounted for 20% of the pre-clerkship and 11% of the clerkship assessments at each school. Schools used OEQs to assess students’ understanding, assess certain types of knowledge, and develop students’ deeper learning. Representatives at schools not currently using OEQs reported considering using them in the future but expressed concerns about the amount of time needed to implement them. Numerous schools are using OEQs to assess medical knowledge, suggesting that this assessment format is feasible. Institutions can be innovative in their assessments by extending beyond multiple-choice questions and incorporating other question formats, such as OEQs, to fit their educational needs. This study provides a foundation for future research to explore the utility of OEQs and how to overcome the challenges of implementing OEQ assessments.

PMID:40753474 | DOI:10.1080/10401334.2025.2538051

J Fam Nurs. 2025 Aug 3:10748407251357216. doi: 10.1177/10748407251357216. Online ahead of print.

ABSTRACT

Having an infant requiring care in a neonatal intensive care unit (NICU) is challenging for parents. The aim was to investigate the effects of the Family Health Conversation (FamHC) model on self-reported mental health, family wellbeing, and family functioning in parents of infants requiring mechanical respiratory support during NICU care. This interventional study included 147 parents (72, intervention group; 75, control group). All participants received a study-specific questionnaire at three time points. The intervention trended toward positive effects on mental health, family wellbeing, and family functioning. However, all measurements showed considerable variation, and the estimated effects were not statistically significant at the 0.05 level. Regardless of the intervention, mental health symptoms decreased over time, whereas family wellbeing and functioning remained stable. To conclude, although the intervention trended favorable for all outcomes, no significant differences were observed between groups. Potential effects might be better identified using qualitative methodology or self-reporting measures in a larger sample.

PMID:40753473 | DOI:10.1177/10748407251357216

J Psychol. 2025 Aug 3:1-22. doi: 10.1080/00223980.2025.2534801. Online ahead of print.

ABSTRACT

This study examines a serial mediation framework to gain a deeper understanding of how social media use affects mental health. Many young people experience a sense of emotional overload from constant connectivity (i.e., digital stress), which may be one of the earliest signs of psychological strain, and the impact on self-concept clarity may further compound these effects. Thus, we examined how digital stress and self-concept clarity may serially mediate the relation between social media use and depressive symptoms. The study sample consisted of 995 Romanian participants aged 17 to 79 (M = 25.05, SD = 9.52; 63.22% female). Results suggested a positive association between digital stress and social media use and a negative association between self-concept clarity, digital stress, and depressive symptoms. Results also indicated a significant link between prolonged social media usage and digital stress, as well as a correlation between elevated digital stress levels and low self-concept clarity scores, which in turn, seemed to contribute to the development of depressive symptoms. However, the relation between digital stress and self-concept clarity did not fully account for the positive correlation between social media usage time and depressive symptoms. Thus, the mediation effect was incomplete, as the direct relationship between social media use and depressive symptoms persisted, remaining positive and statistically significant. We discuss these findings in terms of their practical implications for mitigating the effects of social media use on individuals’ mental health, with a focus on the relationship between digital stress and self-concept clarity.

PMID:40753470 | DOI:10.1080/00223980.2025.2534801

Ann Saudi Med. 2025 Jul-Aug;45(4):235-242. doi: 10.5144/0256-4947.2025.235. Epub 2025 Aug 7.

ABSTRACT

BACKGROUND: Pulmonary hemorrhage (PH) is a rare, life-threatening event characterized by bleeding into the airways and lung parenchyma.

OBJECTIVES: To explore the clinical characteristics of PH patients and investigate mortality-related risk factors, providing a holistic understanding of patient outcomes in this population.

DESIGN: A retrospective cohort study.

SETTINGS: The Pediatric Intensive Care Unit (PICU) at King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia.

PATIENTS AND METHODS: Pediatric patients with PH episodes (aged 1 month to 14 years) who were admitted from January 2014 to September 2019.

MAIN OUTCOMES MEASURES: Clinical characteristics, outcomes, and mortality-related risk factors.

SAMPLE SIZE: 80 children.

RESULTS: The cohort had a sex ratio of 1:1 and a median age of 24 months [interquartile range: 9-78]. Medical histories included bone marrow transplant (51.3%), oncology cases (40.0%), chemotherapy (61.3%), chest infection (86.3%), and immunosuppressant use (71.3%). Additionally, most patients (87.5%) had acute respiratory distress syndrome during the PH episode. The overall PICU mortality rate was 82.5% (66/80), and was associated with thrombocytopenia, sepsis, renal impairment, liver dysfunction, multiorgan dysfunction, and altered code status in univariable analysis (all P <.05). Multivariate analysis identified sepsis, multiorgan dysfunction, and altered code status as key predictors of PICU mortality (P <.05).

CONCLUSION: The high mortality rate reported emphasizes the need for tailored interventions and heightened vigilance, particularly in immunocompromised children. Future research will expand on these findings to refine current management protocols and further improve patient care in pediatric PH.

LIMITATIONS: Retrospective study, single-center.

PMID:40753460 | DOI:10.5144/0256-4947.2025.235

Ann Saudi Med. 2025 Jul-Aug;45(4):256-269. doi: 10.5144/0256-4947.2025.256. Epub 2025 Aug 7.

ABSTRACT

BACKGROUND: Stroke rehabilitation is a vital component of post-stroke care, and the length of stay (LOS) in hospitals and rehabilitation centers varies across healthcare systems. This systematic review and meta-analysis assessed LOS among stroke survivors in Arab countries.

METHODS: A comprehensive literature search identified studies reporting LOS in stroke rehabilitation. A comprehensive literature search from the inception until March 2025 identified studies reporting LOS in stroke rehabilitation.

RESULTS: A total of 18 publications (25 datasets) involving 12 690 individuals were included in the meta-analysis. The pooled mean LOS was 25.67 days [95% confidence interval (CI): 16.22-35.11]. Subgroup analyses showed a longer LOS in Saudi Arabia (37.03 days, 95% CI: 24.11-49.95) compared to other Arab countries (8.87 days, 95% CI: 4.90-12.84), and in rehabilitation centers (46.71 days, 95% CI: 33.18-60.24) compared to acute hospital settings (9.07 days, 95% CI: 5.27-12.86). LOS varies widely across Arab countries and care settings.

CONCLUSION: These findings highlight the need to examine whether differences in LOS are associated with functional recovery and healthcare efficiency. However, substantial heterogeneity across studies and a lack of outcome data limit the interpretability of the results.

PMID:40753459 | DOI:10.5144/0256-4947.2025.256

Ann Saudi Med. 2025 Jul-Aug;45(4):243-248. doi: 10.5144/0256-4947.2025.243. Epub 2025 Aug 7.

ABSTRACT

BACKGROUND: Three-dimensional (3D) high-definition (HD) laparoscopy is a promising tool in minimally invasive gynecologic surgery, offering enhanced depth perception and visualization. However, its role in total laparoscopic hysterectomy (TLH), particularly in patients with varying body mass index (BMI), remains underexplored.

OBJECTIVE: To evaluate the impact of 3D HD laparoscopy on surgical efficiency and patient outcomes in TLH, with a focus on BMI-related differences.

DESIGN AND SETTINGS: A single-center retrospective study.

PATIENTS AND METHODS: Sixty patients who underwent TLH were included: n=30 used 3D HD laparoscopy (Aesculap 3D EinsteinVision) and n=30 matched controls used 2D laparoscopy. Matching criteria included uterine weight and prior surgical history. Patients were stratified according to BMI (≤24.9, 25-29.9, ≥30.0 kg/m²).

MAIN OUTCOME MEASURES: Operative time, vault suturing time, blood loss, trocar site incisions, haemoglobin drop, and complication rates.

SAMPLE SIZE: 60 patients (30 in each group).

RESULTS: The 3D HD laparoscopy group demonstrated significant improvements across multiple outcomes. Trocar site incisions were significantly reduced in all BMI categories (P <.001). Vault suturing time was shorter in the 3D HD laparoscopy group (P =.002), and total operative time was reduced in overweight patients (P =.015). Obese patients in the 3D group had lower haemoglobin drop (P =.01) and reduced blood loss compared to 2D laparoscopy group (P =.017).

CONCLUSION: 3D HD laparoscopy enhances surgical efficiency in TLH, especially in patients with higher BMI, by minimizing trocar site incisions, reducing vault suturing times, and improving hemostasis-highlighting its value in overcoming challenges of minimally invasive gynecologic surgery.

LIMITATIONS: The study’s retrospective design and modest sample size limit generalizability.

PMID:40753458 | DOI:10.5144/0256-4947.2025.243

IISE Trans Occup Ergon Hum Factors. 2025 Aug 2:1-17. doi: 10.1080/24725838.2025.2539781. Online ahead of print.

ABSTRACT

OCCUPATIONAL APPLICATIONSAmong the three commonly used mathematical models for estimating overhead position from inclination data, the trigonometry model showed the most consistent alignment with in-lab motion capture data, with no statistically significant differences observed. Strong correlations were found between accelerometer-based wearable and inclination outputs during upright drilling and hammering tasks involving shoulder elevation above 150°. While no statistically significant differences were observed between observational and inclination-based estimates of overhead frequency, discrepancies were present in overhead duration estimates. These findings suggest that, with appropriate signal processing and modeling techniques, inclination data collected at the upper arm may offer a practical approach for estimating overhead exposures in field research. This method could support more refined monitoring and assessment of overhead work, potentially informing interventions aimed at reducing musculoskeletal strain and improving worker safety.

PMID:40753457 | DOI:10.1080/24725838.2025.2539781

BMC Med Educ. 2025 Aug 2;25(1):1141. doi: 10.1186/s12909-025-07689-4.

ABSTRACT

BACKGROUND: Medical training is a highly stressful environment for students. In previous studies, many instruments have been used to measure stress levels among medical students. However, these stress measurements are not specific tools for medical settings. This study aims to adapt the Medical Student Stressor Questionnaire (MSSQ) to Turkish, conduct validity and reliability studies, and provide a practical tool to evaluate medical school-related stressors of medical students in Turkey.

METHODS: All students studying at the (Manisa Celal Bayar University) School of Medicine were invited to the study. The data was collected between January-March 2024. The research was completed with 412 students. The MSSQ consists of 40 items and 6 subscales. The psychometric properties of the MSSQ were evaluated through tests for validity and reliability. Using RStudio version 1.3.1093 (R Studio, PBC) with the lavaan package, confirmatory factor analysis (CFA) with the “diagonally weighted least squares (DWLS)” estimator was conducted. Internal consistency was tested by Cronbach’s alpha coefficient and test-retest reliability was examined by intraclass correlation coefficient (ICC).

RESULTS: A total of 412 students participated in this study. The median (minimum-maximum) age of the students was found to be 20.00 (18.00-26.00) years. CFA was performed and the appropriate modification indices suggested by the model were added to the model. All 40 items loaded 0.38 or higher. The fit indices calculated as a result of the CFA were determined to be Root Mean Square Error of Approximation (RMSEA) = 0.060 (95% CI: 0.057-0.064)(p < 0.001), Comparative Fit Index (CFI) = 0.899 and Tucker-Lewis Index (TLI) = 0.888. The fit indices were at acceptable level. In the analyses conducted for the subscales, the Cronbach Alpha Coefficients were adequate.

CONCLUSION: In conclusion, this study has provided preliminary evidence for the validity and reliability of a Turkish version of the MSSQ. The six-factor structure was confirmed by CFA. We propose using the Turkish version of MSSQ to evaluate the stress level of medical students. Therefore, further research is needed to investigate the relationship between MSSQ and the other scales which used to measure stress.

PMID:40753444 | DOI:10.1186/s12909-025-07689-4

BMC Womens Health. 2025 Aug 2;25(1):383. doi: 10.1186/s12905-025-03757-5.

ABSTRACT

BACKGROUND: Menopause marks the cessation of menstrual cycles and brings significant changes to a woman’s body, including oral health alterations. While hormone replacement therapy (HRT) is commonly used to alleviate menopause symptoms, its impact on oral health, particularly periodontal conditions, has not been well studied in Saudi Arabia. Periodontitis, a disease that destroys the bone and soft tissue of the mouth, becomes more prevalent post-menopause. This study investigates the effect of HRT on periodontal health in post-menopausal women.

METHODOLOGY: A case-control study was conducted with 372 post-menopausal Saudi women from multiple healthcare facilities in Jeddah, Kingdom of Saudi Arabia. The study included 186 women with periodontitis (cases) and 186 women with healthy periodontium (controls). Periodontal health was assessed using the American Academy of Periodontology (AAP) 2017 classification and a validated questionnaire. Secondary objectives concerning periodontal parameters like Clinical attachment loss (CAL), saliva secretion rate, and bone loss were also measured in HRT users compared to non-users. Odds ratios (OR) and logistic regression were used for categorical data analysis, while t-tests and linear regression examined the relationship between numerical variables.

RESULTS: HRT use was significantly associated with a lower prevalence of periodontitis. The odds of having periodontitis were 3.2 times lower in HRT users compared to non-users (OR = 0.31, p < 0.05, 95% CI: 0.11-0.89). After adjusting for medical and demographic variables, HRT users had approximately six times lower odds of having periodontitis (OR = 0.17, p < 0.05, 95% CI: 0.04-0.81). However, HRT use did not significantly impact the severity of periodontitis once the disease was present. When secondary outcomes were measured, HRT usage had a significant association with decreased clinical attachment loss (Coef = -1.13, p < 0.05, 95% CI: (-2.26, -0.02)); however, this significance was lost after adjusting for medical and social variables. HRT usage did not have a significant effect on bone loss and saliva level, which were measured both as categorical and numerical variables.

CONCLUSION & RECOMMENDATIONS: HRT is associated with a lower prevalence of periodontitis but does not affect its severity. While collaborative care between dental and medical professionals is recommended, further research is needed to address study limitations and explore different HRT formulations and their impact on periodontal health.

PMID:40753442 | DOI:10.1186/s12905-025-03757-5

Trials. 2025 Aug 2;26(1):265. doi: 10.1186/s13063-025-08985-6.

ABSTRACT

BACKGROUND: High levels of trait anger and aggressive behavior are common and problematic phenomena in patients with borderline personality disorder (BPD). In BPD, patterns of reactive aggression often lead to functional impairment affecting important areas of life. Despite the high burden on individuals and their social environment, there are no specific, cost-effective treatments to reduce aggression in BPD. In previous studies, we and others have been able to infer specific biobehavioral mechanisms underlying patterns of reactive aggression in BPD that can be used as potential treatment targets. To address this, we developed a mechanism-based anti-aggression psychotherapy (MAAP) for the group setting that specifically targets the biobehavioral mechanisms underlying outward-directed aggression in BPD. A previously conducted proof-of-concept study had suggested beneficial effects for this neglected group of patients.

METHODS: In this multicenter, confirmatory, randomized-controlled-clinical-trial, MAAP, which consists of multifaceted, evidence-based treatment elements adapted from other sophisticated treatment programs such as Dialectical Behavior Therapy and Mentalization-Based Treatment, is tested for efficacy against a non-specific supportive psychotherapy (NSSP) program focusing on non-specific general factors of psychotherapy at seven different sites in Germany. Both treatment arms, based on one individual and 13 group therapeutic sessions (1.5 h per session, twice a week), are delivered over a period of 7-10 weeks. A total of N = 186 patients will be recruited, half of whom will be cluster-randomized to MAAP. Outcomes are assessed at baseline, immediately, and 4, 12, 20, and 24 weeks post-treatment using ecological momentary assessment, clinical interviews, questionnaires, and online tasks.

DISCUSSION: If proven superior, MAAP can be incorporated into standard psychiatric care, filling a critical gap in the current therapeutic landscape by offering a structured, cost-effective, and evidence-based treatment that directly targets the biobehavioral mechanisms underlying reactive aggression in BPD. By potentially improving clinical outcomes and reducing the burden of reactive aggression in BPD, MAAP could be beneficial for both individuals and their social environments. The study’s large, multicenter design enhances the generalizability of the results, making them more relevant for broader clinical applications.

TRIAL REGISTRATION: This study was registered in the German Clinical Trials Register DRKS (DRKS00031608) on 31.10.2023 ( https://drks.de/search/de/trial/DRKS00031608 ).

PMID:40753432 | DOI:10.1186/s13063-025-08985-6