Category: Statistics

BMC Public Health. 2026 Jan 12. doi: 10.1186/s12889-026-26188-9. Online ahead of print.

ABSTRACT

BACKGROUND: Much of the burden of non-communicable disease in high-income countries is attributable to harmful engagement with health behaviours. Evidence suggests that these behaviours may be better understood, and more amenable to intervention, if analysed as clusters of behaviours rather than individual behaviours. To date, research on the clustering of health behaviours has focused on the consequences of multi-engagement as opposed to the potential shared antecedent or contemporaneous processes. Moreover, adolescence is a critical period for the development of health behaviours, yet there remain more studies on the clustering of health behaviours in adulthood, when patterns of behaviour are likely already crystallised.

METHODS: Drawing from a nationally representative longitudinal dataset of young people living in the Republic of Ireland, latent- class analysis was used to identified clusters of the health behaviours: diet quality, levels of physical activity, screentime, tobacco smoking and underage alcohol consumption, for the first time in this context. We theorised potential social determinants for engagement with the distinct clusters of behaviours and evaluated these theories empirically using multinominal logistic regression.

RESULTS: Our findings indicate that, what are typically termed, ‘lifestyle’ behaviours (diet, physical activity and screentime) tend to co-occur rather than appear in isolation. These lifestyle behaviours appear to be relatively independent of tobacco smoking and underage alcohol consumption, which we term ‘substance use.’ We demonstrate that the experience of periodic, but mostly persistent poverty (approx. nine years), is associated with membership of clusters characterised by lifestyle behaviours, while reporting oppositional values is distinctly associated with membership of clusters characterised by substance use.

CONCLUSIONS: Our results support the much-established relationship between income poverty and harmful health behaviours related to lifestyle that is evidenced when looking at these behaviours individually and thereby provides further empirical evidence for the theories on ‘fundamental causes’ of health inequalities and the ‘social exclusion framework.’ We find an association between oppositional values and substance use behaviours, and furthermore that oppositional values tend to be highest among the income poorest adolescents. We highlight a concurrent influence for substance use in adolescence, which is also relevant for addressing inequalities in health behaviour engagement.

PMID:41526895 | DOI:10.1186/s12889-026-26188-9

BMC Pulm Med. 2026 Jan 13. doi: 10.1186/s12890-026-04102-8. Online ahead of print.

NO ABSTRACT

PMID:41526889 | DOI:10.1186/s12890-026-04102-8

BMC Health Serv Res. 2026 Jan 12. doi: 10.1186/s12913-025-13977-y. Online ahead of print.

NO ABSTRACT

PMID:41526882 | DOI:10.1186/s12913-025-13977-y

BMC Health Serv Res. 2026 Jan 12. doi: 10.1186/s12913-025-13943-8. Online ahead of print.

ABSTRACT

BACKGROUND: Depression and anxiety disorders are the leading causes of work disability in most developed countries. Psychotherapies are evidence-based treatments for these disorders, but evidence of the psychotherapy effects on changes in work disability remains limited. This study examined changes in work disability in patients receiving psychotherapy and matched controls and their associations with employee and employer-related factors.

METHODS: We used register-based data from Terveystalo Plc., Finland’s largest occupational health service provider, linked with national registers (Statistics Finland, Social Insurance Institution). The study included patients who received primary care-level psychotherapy (N = 3,912) between 2018 and 2021, matched with controls (N = 11,733) using propensity scores. Group-based trajectory modelling identified work disability patterns based on three-month means of mental health-related sickness absence day intervals. Multinomial logistic regression assessed associations between sickness absence trajectory membership and baseline sociodemographic, clinical, and employer characteristics.

RESULTS: Three distinct work disability trajectory groups emerged: a group including those employees with a highly increasing level of work disability (6% of the population), ranging from 17 to 1 day of work disability and those with a slightly increasing (7% of the population) level of work disability ranging from 5 to 1 days of work disability. In both groups, the level of work disability peaked around psychotherapy onset and decreased after it. The third group, stable low (87% of the population), included those with nearly no work disability throughout the study. In multinomial regression models, history of mental disorders, related sickness absences, and somatic and psychiatric comorbidity were associated with the likelihood of belonging to either of the adverse work disability trajectory groups.

CONCLUSIONS: Psychotherapy may decrease long-term work disability, especially among individuals with a high level of baseline work disability. Those with a previous mental disorder burden and related work disability require special attention to enable timely treatment to prevent prolonged work disability.

PMID:41526875 | DOI:10.1186/s12913-025-13943-8

BMC Oral Health. 2026 Jan 12. doi: 10.1186/s12903-026-07662-7. Online ahead of print.

ABSTRACT

BACKGROUND: The early and accurate diagnosis and management of common orofacial conditions is essential for effective dental care. However, junior dentists often lack confidence and practical skills in this area. This study aimed to assess the impact of an educational lecture on dental interns’ competency in diagnosing and managing prevalent orofacial diseases.

METHODS: This study was conducted among dental interns at King Abdulaziz University, Saudi Arabia. A total of 161 newly graduated interns were invited to participate. An evidence-based, one-hour interactive online lecture involving common orofacial conditions was delivered by a certified oral medicine consultant. Participants completed a validated 40-item questionnaire at three time points: before the lecture, immediately after the lecture, and two months after the lecture. The questionnaire was designed to assess diagnostic and management skills using 20 clinical scenarios. Diagnostic competency score was based on the percentage of correct responses to 20 diagnostic multiple-choice questions (MCQs), and a management competency score was based on the percentage of correct responses to 20 management MCQs. Descriptive statistics and weighted kappa analyses were conducted by employing SPSS^®, with significance set at p < 0.05.

RESULTS: Among the 161 participants, 91 interns (56.5%) completed all the stages. Following the intervention, overall competency scores significantly increased (from 78% at baseline to 91% immediately after the lecture), with a relative improvement of approximately 13% being observed (p < 0.001); moreover, the scores remained 8.5% higher than those at baseline at the two-month evaluation. Diagnostic accuracy demonstrated a notable improvement of 12.5% (p < 0.001) following the intervention and remained higher than baseline at follow-up. The greatest improvement in the diagnosis was observed for herpes labialis (+ 53.1%), irritational fibroma (+ 32.1%), and leukoedema/morsicatio buccarum (+ 20%). Management competency improved by 13.5% (p < 0.001) immediately after the lecture, followed by a decrease of 6% at the two-month follow-up. The greatest improvement was observed in the management of recurrent aphthous stomatitis (+ 36.6%). No significant differences were observed in terms of sex or grade point average (GPA).

CONCLUSION: The educational lecture significantly enhanced the ability of dental interns to diagnose and manage common orofacial conditions. Given the importance of timely diagnosis and appropriate management in reducing the severity of common oral lesions, the findings of this study provide valuable insights. The results suggest that such targeted educational interventions should be integrated into continuing dental education programs to enhance clinical competence among practitioners.

PMID:41526874 | DOI:10.1186/s12903-026-07662-7

BMC Pediatr. 2026 Jan 12. doi: 10.1186/s12887-025-06496-6. Online ahead of print.

ABSTRACT

BACKGROUND: Iron deficiency (ID) is a common nutritional disorder and a leading cause of anemia worldwide, particularly affecting children with congenital heart defects (CHD). Despite its clinical importance, data on the prevalence of ID in pediatric CHD patients, especially in low- and middle-income countries, remain limited. This study aimed to assess the prevalence of iron deficiency and anemia in Vietnamese children with CHD before and after surgical repair, and to identify associated risk factors.

METHODS: We conducted a cross-sectional observational study at the University Medical Center in Ho Chi Minh City, Vietnam, from January to September 2023. A total of 151 children with CHD were included: 81 preoperative and 70 postoperative patients. Children with confounding conditions or recent iron supplementation were excluded. Iron deficiency was defined using both the British Society for Haematology (BSH) and the AHA/ACC/HFSA criteria. Hematological and biochemical parameters were measured, and logistic regression was used to explore associations between clinical characteristics and iron deficiency.

RESULTS: Preoperative iron deficiency was observed in 46.9% of patients using BSH criteria and 87.7% using AHA criteria. Postoperative prevalence decreased to 34.3% and 75.7%, respectively. Cyanotic patients had significantly higher red blood cell indices and lower ferritin and transferrin saturation compared to acyanotic patients preoperatively; these differences were no longer observed after surgery. Anemia prevalence was relatively low, with mostly mild cases (16% preoperative and 11.4% postoperative). Univariate analysis identified age under five years and lower preoperative weight as risk factors for iron deficiency; however, these associations were not statistically significant in multivariate models.

CONCLUSIONS: Iron deficiency is highly prevalent among Vietnamese children with CHD, particularly before surgical repair, and persists in a substantial proportion even after surgery. The findings highlight the need for routine screening and targeted nutritional interventions throughout the perioperative period to improve long-term outcomes in this vulnerable population.

TRIAL REGISTRATION: Not applicable.

PMID:41526873 | DOI:10.1186/s12887-025-06496-6

BMC Pregnancy Childbirth. 2026 Jan 12. doi: 10.1186/s12884-026-08640-1. Online ahead of print.

ABSTRACT

INTRODUCTION: This study investigated inflammation-related co-morbidities in women with gastroesophageal reflux (GER) and poor gestational outcomes.

METHODS: A retrospective cohort of 17 women with GER and 207 without GER who were admitted to a pre-conceptional counseling program was analyzed. All patients were evaluated for the presence of risk factors associated with obstetric complications and poor gestational outcomes, including hereditary thrombophilia, methylenetetrahydrofolate reductase (MTHFR) polymorphisms, type 2 diabetes mellitus, chronic inflammatory diseases, and autoimmune disorders.

RESULTS: GER was present in 7.59% (17/224) of women, and 35.3% (6/17) of GER-positive cases had gastritis and/or chronic peptic ulcer disease. Chronic inflammatory and autoimmune diseases were significantly more frequent in women with GER (p = 0.001 and p = 0.002, respectively). There was also a statistically significant difference in the distribution of MTHFR 677CC, -CT, and -TT genotypes in terms of the presence of GER (p = 0.036). A higher frequency of the MTHFR 677TT genotype was observed in women with GER.

CONCLUSIONS: Presence of GER may be indicative of inflammation-associated “placenta-related obstetric complications” and poor gestational outcomes in subsequent pregnancies.

PMID:41526858 | DOI:10.1186/s12884-026-08640-1

BMC Pregnancy Childbirth. 2026 Jan 13. doi: 10.1186/s12884-025-08594-w. Online ahead of print.

ABSTRACT

BACKGROUND: Vaginal Birth After Cesarean is a clinical measure that can reduce repeated cesarean deliveries, improve perinatal outcomes and shorten hospital stays. However, successful practice of Vaginal Birth After Cesarean remains restricted in the Middle East due to limited regional-specific guidelines. This study aimed to identify the predictors and maternal and neonatal outcomes of failed Vaginal Birth After Cesarean among a group of Middle Eastern women.

METHODS: A retrospective case-control design was conducted between January 2023 and February 2024 across three hospitals in Oman. The case group involved failed Vaginal Birth After Cesarean requiring repeat cesarean, while the control group comprised successful Vaginal Birth After Cesarean. Descriptive and inferential statistics were used. Additionally, logistic regression analysis was conducted to identify significant predictors of failed vaginal birth after cesarean.

RESULTS: Data of 364 participants were analyzed. The predictors of Vaginal Birth After Cesarean failure were high body mass index (32.66 ± 7.53; p < .001), low parity (median = 1; p < .001), low cervical dilation (2 cm vs. 4 cm; p < .001), obstetric complications (42.6% vs. 29.2%; p = .010), and meconium-stained amniotic fluid (16.3% vs. 6.9%; p = .006). Postpartum hemorrhage (21.6% vs. 4.6%; p < .001), scar tenderness (11.5% vs. 0.5%; p < .001), and low APGAR scores (p < .001) were more common in the case group.

CONCLUSIONS: The study findings advance the regional literature with critical information supporting the development of standardized Middle Eastern specific Vaginal Birth After Cesarean guidelines. Higher body mass index, lower parity, lower cervical dilation at admission, meconium-stained amniotic fluid, and obstetric complications are significant predictors of Vaginal Birth After Cesarean failure. A failed Vaginal Birth After Cesarean attempt may increase the risks of post-partum hemorrhage, scar tenderness, and lower APGAR scores. Future research may prioritize prospective multicenter studies across diverse regions of the Middle East to validate the Vaginal Birth After Cesarean predictive variables.

PMID:41526856 | DOI:10.1186/s12884-025-08594-w

BMC Geriatr. 2026 Jan 12. doi: 10.1186/s12877-025-06911-8. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to determine the amount of fluid consumed, factors influencing fluid intake, and the symptoms of thirst in elderly individuals living in the community, and to examine the relationship between thirst discomfort, hydration status, and ocular surface health.

METHODS: The study employed a quantitative, cross-sectional, descriptive design and was conducted between July 2023 and December 2024, in the Aydıntepe district of Bayburt Province. The study included 110 individuals aged 65 and older who were able to communicate and agreed to participate. Data were collected through face-to-face interviews. Participants’ demographic information was recorded using the Introductory Information Form. The level of thirst discomfort was assessed with the Thirst Discomfort Scale (TDS); ocular symptoms were measured with the Ocular Surface Disease Index (OSDI). Information about urine colour and daily fluid consumption was obtained from the participants. The results were analysed using SPSS version 26.0. Descriptive statistics, t-test for independent groups, ANOVA, and Pearson correlation analysis were used to analyse the data.

RESULTS: The study found that the mean total TDS score was 20.61 ± 6.43, indicating moderate levels of thirst discomfort among elderly individuals. According to the OSDI results, individuals with severe ocular symptoms exhibited significantly higher discomfort related to thirst (F = 3.936, p = 0.010). A trend toward significance was observed between hydrated, moderately dehydrated, and dehydrated individuals regarding thirst discomfort levels; dehydrated individuals tended to have higher scores (F = 3.019, p = 0.053).

CONCLUSIONS: In elderly individuals, thirst discomfort was moderate, and ocular symptoms influenced the perception of thirst. The findings emphasise the importance of individualised approaches to thirst management and regular monitoring of hydration status in older adults.

CLINICAL RELEVANCE: Dehydration is a significant issue that can impact the quality of life for elderly individuals. Health professionals should regularly assess individuals’ hydration status and develop individualised strategies to improve fluid intake. Given the relationship between ocular surface disease symptoms and fluid intake, interventions should be planned using a multidisciplinary approach.

TRIAL REGISTRATION: Not applicable.

PMID:41526836 | DOI:10.1186/s12877-025-06911-8

J Headache Pain. 2026 Jan 13. doi: 10.1186/s10194-026-02271-9. Online ahead of print.

ABSTRACT

BACKGROUND: Trigeminal neuralgia, classified as a painful disorder of the trigeminal nerve (PDTN), is characterized by brief, electric shock-like or stabbing pain localized mainly to the maxillary and mandibular regions. The severity of these paroxysmal attacks severely impairs quality of life and, in extreme cases, may lead to suicidal ideation. We hypothesized that PDTN shares a common neuroanatomical signature with other chronic pain disorders, while also exhibiting disorder-specific alterations.

METHODS: High-resolution T1-weighted structural MRI scans from 85 individuals diagnosed with painful disorders of the trigeminal nerve (PDTN) and 49,280 control participants from the UK Biobank were analyzed. A non-parametric permutation test (10,000 iterations) randomly reassigned group labels between 85 PDTN cases and 85 individuals reporting no chronic pain or pain-related conditions to generate a null distribution for statistical inference. A second analysis compared the same PDTN group with 85 matched participants reporting chronic pain (excluding orofacial pain), using five covariates and nearest-neighbor matching (1:1 ratio).

RESULTS: Compared to individuals reporting no chronic pain, PDTN patients exhibited significant volumetric reductions in eight amygdala and nineteen thalamic nuclei, as well as eighteen hippocampal subfields. When compared to the chronic pain group, significant differences were restricted to six thalamic nuclei and seven hippocampal subfields.

CONCLUSIONS: These findings underscore that PDTN is associated with a distinct neuroanatomical signature, particularly involving subcortical structures such as the thalamus and hippocampus.

PMID:41526814 | DOI:10.1186/s10194-026-02271-9