Category: Statistics

BMC Psychol. 2025 Jul 15;13(1):793. doi: 10.1186/s40359-025-03136-7.

ABSTRACT

PURPOSE: Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder during adolescence. Self-care behaviors are the cornerstone of diabetes management. Effective self-care behaviors require individuals to perform a range of complex daily tasks, including monitoring blood glucose, adhering to dietary recommendations, administering insulin, and recognizing symptoms of hypo- or hyperglycemia. Two critical psychosocial and cognitive factors that influence the success of self-management are self-efficacy and health literacy. There are limited studies on the factors related to self-efficacy and health literacy associated with self-care behaviors among adolescents with T1DM in the Arab World, including Palestine. Therefore, this study investigated the associations between self-efficacy, health literacy, select demographic variables, and self-care behaviors among adolescents with T1DM in Palestine.

METHODS: A cross-sectional correlational design was used, and 156 adolescents aged 14-18 years were selected by a convenience sampling method from primary healthcare settings in Palestine between February and June 2024. A self-reported questionnaire was used to collect data, which included demographic variables, the Diabetic Health Literacy Scale, the Self-Efficacy for Diabetes Scale, and the Self-Care Inventory. Descriptive statistics, Pearson’s and point biserial correlation tests, and multiple linear regression were used to examine the relationships between the study variables.

RESULTS: Participants reported high levels of self-efficacy (M = 108.80, SD = 14.92), low levels of health literacy (M = 2.12, SD = 0.78), and low engagement in self-care behaviors (M = 33.82, SD = 7.79). A positive correlation was found between self-efficacy and self-care behaviors (r = 0.396, p < 0.01). In contrast, age was negatively associated with self-care behaviors (r = -0.249, p < 0.01). Furthermore, self-efficacy and age were significant predictors of self-care behaviors (β = 0.196, p < 0.001; β = -1.256, p < 0.01, respectively).

CONCLUSIONS: This study helps policymakers, healthcare providers, and parents develop strategies to enhance self-care behaviors through targeted interventions and educational programs. The findings may guide any future educational program or training sessions to improve self-care behaviors among adolescents with T1DM.

PMID:40665435 | DOI:10.1186/s40359-025-03136-7

J Eat Disord. 2025 Jul 15;13(1):138. doi: 10.1186/s40337-025-01264-4.

ABSTRACT

BACKGROUND: Early detection and treatment of eating behavioral problems among pregnant women are essential due to the associated adverse impact on pregnancy and the health of the offspring. Prenatal Eating Behaviors Screening (PEBS) tool, a 12-item self-administered questionnaire, can be used to screen for eating disorders (ED) during pregnancy. This study performed an Arabic translation of PEBS and a psychometric analysis to determine its validity and reliability.

METHODS: The standard forward-backward translation method was used to generate PEBS-Arabic. The 12-item Likert scale questionnaire was completed by 116 antenatal women in the tertiary maternity care hospital in Qatar. Content validity was determined by the content validity index (CVI) using input from five experts. Reliability was assessed using Cronbach’s alpha, and confirmatory and exploratory factor analysis (CFA & EFA) to test construct validity. The correlations between PEBS-Arabic scores and maternal characteristics were explored.

RESULTS: The mean total PEBS score in the cohort was 16.3 (± 5.2), with nulliparity and higher educational level resulting in statistically significantly higher mean scores. The PEBS-Arabic had a very good item-CVI and scale-CVI of 1.00. The overall Cronbach’s alpha was 0.77, which demonstrated good and acceptable reliability. The CFA using a single-factor solution showed an acceptable correlation for most items. In the EFA, a two-factor solution resulted in most items loading accurately into the pre-determined factors (bulimia and anorexia) with acceptable correlations.

CONCLUSION: The PEBS-Arabic is the first translated version of this pregnancy-specific screening tool for ED. This tool demonstrates good reliability, content and construct validity. This study is a valuable step towards understanding and detecting the prevalence and determinants of ED in pregnancy, with the aim of improving maternal, fetal and child health.

PMID:40665434 | DOI:10.1186/s40337-025-01264-4

Isr J Health Policy Res. 2025 Jul 16;14(1):44. doi: 10.1186/s13584-025-00708-1.

ABSTRACT

BACKGROUND: Nurses play a vital role in disaster response during emergencies. Nevertheless, limited attention has been paid to factors that influence nurses’ responses and challenges in prehospital settings. These issues became evident during the October 7, 2023, terror attack on Israel, when nurses heroically provided medical treatment, but there was no organized nurse-led initiative to provide emergency care in a prehospital setting.

AIMS: (1) To examine the factors associated with nurses’ intentions to provide prehospital emergency reponse during disasters; and (2) To understand multilevel determinantsof nurses’ prehospital emergency response to inform health policy recommendations.

METHODS: This study employed an explanatory sequential mixed-methods design. Between February and December 2024, a self-reporting questionnaire was distributed to Israeli nurses (n = 315), followed by a qualitative phase involving an open-ended questionnaire completed by 20 healthcare professionals involved in medical care during the attack or in senior emergency preparedness roles. Descriptive and inferential statistics and qualitative content analysis were employed. We applied the socioecological framework to organize the results from both phases.

RESULTS: High personal resilience, readiness and self-efficacy, along with positive attitudes, low hesitancy, and residence in a rural-type settlement significantly predicted nurses’ intention to provide prehospital emergency care. Qualitative analysis revealed four key themes related to nurses’ prehospital roles: (1) individual barriers and facilitators, (2) interprofessional relationships and teamwork, (3) nurses’ roles within the community, and (4) organizational and policy challenges. Findings from both phases were synthesized using the socioecological framework for analysing prehospital nursing care during emergencies.

CONCLUSION: Nurses’ prehospital emergency response intentions are shaped by personal, professional, and policy-level factors. Beyond education, targeted health policies must clearly define nurses’ roles, strengthen interprofessional collaboration, and integrate nursing into disaster preparedness frameworks to improve system resilience and patient outcomes, particularly in the face of escalating environmental crises globally.

PMID:40665433 | DOI:10.1186/s13584-025-00708-1

Acta Epileptol. 2025 Jul 15;7(1):39. doi: 10.1186/s42494-025-00230-6.

ABSTRACT

Deep brain stimulation (DBS) has emerged as an important therapeutic intervention, effectively addressing a spectrum of drug-resistant neurological and psychiatric disorders. Although its efficacy has been validated in adult populations, the current literature reveals a significant gap concerning its application in pediatric patients. Specifically, pediatric populations afflicted with severe conditions such as dystonia, drug-resistant epilepsy, Tourette syndrome, and some other neuropsychiatric conditions demonstrate an urgent need for alternative therapeutic options. This review systematically examined the existing literature on the application of DBS in pediatric neurological disorders, focusing on the aforementioned conditions. Preliminary findings indicate that while DBS shows potential for a specific subset of pediatric patients, the current data is limited and lacks statistical power. Reported cases exhibit varying degrees of therapeutic success. Although adverse effects associated with DBS in pediatric populations are rare, further investigation is essential to define safety profiles accurately. Future research should focus on conducting large-scale, randomized controlled trials to validate outcomes and determine optimal patient selection criteria, thereby broadening its clinical application within the pediatric population.

PMID:40665432 | DOI:10.1186/s42494-025-00230-6

Eur J Med Res. 2025 Jul 16;30(1):632. doi: 10.1186/s40001-025-02893-w.

ABSTRACT

OBJECTIVE: Plenty of evidence proves the prospective diagnostic and prognostic utility of inflammatory markers in osteoporosis (OP). However, the relations of immune-inflammatory indices to OP remain elusive, with scarce conclusive evidence-based findings. Our systematic review and meta-analysis endeavored to unveil the links between immune-inflammatory indices and OP.

METHODS: PubMed, Web of Science, Embase, as well as Cochrane Library, were thoroughly retrieved for research investigating the links of immune-inflammatory indices to OP, from database inception to February 20, 2025. Data were analyzed using odds ratio (OR), standardized mean difference (SMD), as well as corresponding 95% confidence interval (CI). Sensitivity and subgroup analyses were carried out for result robustness evaluation and heterogeneity source identification. Review Manager 5.4 and STATA 18.0 were utilized in every statistical analysis.

RESULTS: A total of 24 studies were included in this analysis. Eight cohort studies and 16 case-control studies based on 397,525 subjects and 11,904 cases were eventually screened and retained. The findings indicated significant positive relations of immune-inflammatory indices to OP risk. For categorical variables, elevated neutrophil-to-lymphocyte ratio (NLR) (OR = 2.34, 95% CI 1.77-3.11; P < 0.00001), platelet-to-lymphocyte ratio (PLR) (OR = 1.05, 95% CI 1.01-1.08; P = 0.01), as well as systemic immune-inflammation index (SII) (OR = 1.16, 95% CI 1.04-1.30; P = 0.01) notably correlated with a increased OP risk. For continuous variables, individuals with OP exhibited significantly higher levels of NLR (SMD = 0.71, 95% CI 0.35-1.07; P = 0.0001), PLR (SMD = 0.43, 95% CI 0.17-0.68; P = 0.001), monocyte-to-lymphocyte ratio (MLR) (SMD = 0.54, 95% CI 0.16-0.91; P = 0.005), and SII (SMD = 0.25, 95% CI 0.03-0.47; P = 0.03) compared to non-OP populations. Subgroup analyses revealed that geographic region and age were major contributing factors influencing the association between immune-inflammatory indices and OP.

CONCLUSION: Immune-inflammatory indices such as NLR, PLR, MLR, and SII are significantly linked to increased risk of OP. These indices may facilitate the early identification of individuals at high risk for OP and support timely preventive strategies. Given the inherent limitations of the current study, further prospective, multicenter clinical investigations are warranted to validate the relations of immune-inflammatory indices to OP. Trial registration Systematic review registration: PROSPERO, identifier: CRD420250656296.

PMID:40665418 | DOI:10.1186/s40001-025-02893-w

Eur J Med Res. 2025 Jul 16;30(1):633. doi: 10.1186/s40001-025-02900-0.

ABSTRACT

BACKGROUND: Inflammation is a crucial factor in the development of both osteoporosis and sleep disturbances; however, the mechanisms that connect these two conditions are not yet fully understood. This study aims to investigate the relationship among inflammation, osteoporosis, and sleep disturbances, and to assess whether osteoporosis acts as a mediating factor between inflammation and sleep disturbances.

METHODS: This study conducted a cross-sectional analysis utilizing data from participants aged 50 and older, sourced from the NHANES database for the years 2005-2010 and 2017-2018. The primary objective was to investigate the associations among inflammatory markers, the Dietary Inflammatory Index (DII), osteoporosis, and sleep disturbances. All participants underwent measurement of inflammatory markers, including C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Additionally, DII scores were computed to assess dietary inflammation. To account for potential confounding variables, such as age, sex, and body mass index (BMI), we conducted multivariable regression analyses.

RESULTS: The results demonstrated that the ‘osteoporosis with sleep disturbances’ group exhibited significantly higher CRP levels and DII scores but lower NLR levels compared to the ‘without osteoporosis and sleep disturbances’ group. Among the four groups, two groups without sleep disturbances showed notably lower CRP levels. After controlling for potential confounding variables, we found a positive correlation among inflammatory markers, osteoporosis, and sleep disturbances. Notably, sex (with males as the reference group) moderated the relationship between inflammatory markers and sleep disturbances, demonstrating an adjusted effect size of – 0.430 for NLR (interaction p value = 0.008) and – 0.163 for CRP (interaction p value = 0.012). Additionally, a non-linear relationship was observed between NLR and sleep disturbances, as well as between NLR, DII, and osteoporosis. Mediation analysis indicated that osteoporosis partially mediates the effect of DII on sleep disturbances, accounting for 5.4574% of the total effect (p = 0.002).

CONCLUSIONS: Men may exhibit a reduced resistance to inflammation-induced sleep disturbances in comparison to women. An increase in the DII may serve as a risk factor for both osteoporosis and sleep disturbances. Furthermore, osteoporosis partially mediates the relationship between the DII and sleep disturbances.

PMID:40665412 | DOI:10.1186/s40001-025-02900-0

BMC Sports Sci Med Rehabil. 2025 Jul 15;17(1):202. doi: 10.1186/s13102-025-01225-z.

ABSTRACT

PURPOSE: We conducted a systematic review and meta-analysis to identify factors influencing physical activity (PA) in children and adolescents aged 5-18 years through a social-ecological model (SEM) perspective. Additionally, we examined the combined effects of factors across SEM levels on PA behaviors.

METHODS: Following a comprehensive search of Chinese and English databases, two researchers independently screened studies, assessed quality, and selected 15 articles meeting inclusion criteria. A dual analytic approach was employed: semi-quantitative evaluation Method (systematic scoring of study findings to synthesize directional associations) and meta-analysis using R4.4.2 to pool effect sizes (Cohen’s d) with random-effects models. Subgroup analyses addressed heterogeneity sources.

RESULTS: Semi-quantitative synthesis revealed consistent positive associations for interpersonal-level factors, including parental co-participation in PA (83.3%), parental rules (66.7%), peer support (66.7%), and team sports participation (100%). At the individual level, self-efficacy (84.6%) and enjoyment (62.5%) showed the strongest effects. Meta-analysis confirmed multilevel SEM influences (SMD = 0.443,95%CI [0.784,0.885]), Due to variations in statistical methods (I² = 45.9-99.8%), survey setting scope (I² = 0-99.6%), geography (I² = 0.86-99.7%), and Research design (I² = 67.5-99.8%), there was a considerable degree of heterogeneity among the included studies.

CONCLUSIONS: Key findings indicated that at the individual level, PA engagement was significantly associated with perceived barriers, self-efficacy, motivation, and enjoyment. At the interpersonal level, parental co-participation, rule-setting, peer support, and team sports emerged as critical facilitators. However, meso-level factors (e.g., school physical education curricula, accessibility of community sports facilities, extracurricular programming) and macro-level structural determinants (e.g., national physical education policy alignment, urban built environment planning, sociocultural sports values) remain underexplored, with current research disproportionately focused on micro-level individual traits (e.g., motivation) and interpersonal dynamics (e.g., family support). The study recommends: (1) individual-level interventions prioritizing self-efficacy and intrinsic motivation enhancement; (2) interpersonal strategies fostering family-peer collaborative networks; (3) meso-level improvements to school PA curricula and equitable community infrastructure; and (4) macro-level research on policy coherence and sociocultural value systems. Future investigations should integrate longitudinal designs within social-ecological frameworks to elucidate dynamic interactions across multilevel factors, thereby advancing theoretical and policy frameworks for youth PA promotion. These insights provide empirical foundations for optimizing school-based PA initiatives, urban planning for active spaces, and culturally responsive community interventions.

TRIAL REGISTRATION: PROSPERO CRD420250651231.

PMID:40665401 | DOI:10.1186/s13102-025-01225-z

Parasit Vectors. 2025 Jul 15;18(1):284. doi: 10.1186/s13071-025-06917-6.

ABSTRACT

BACKGROUND: Chagas disease, caused by the protozoan Trypanosoma cruzi, remains a significant public health issue in South America, with increasing concern over its potential transmission in the USA. Triatoma sanguisuga, a triatomine vector, is found in Southern states of the USA, including Texas, raising questions about the local transmission dynamics of T. cruzi. This study aims to characterize Trypanosoma cruzi infection in Triatoma sanguisuga collected from dog kennels in Bulverde and Spring Branch, Texas, with a focus on parasite prevalence and load, genotypic diversity, and blood-feeding sources.

METHODS: A total of 48 T. sanguisuga insects were collected from kennels in Bulverde (N = 37) and Spring Branch (N = 11). DNA extraction was followed by quantitative polymerase chain reaction (qPCR) to detect and quantify T. cruzi, genotyping via Oxford Nanopore Sequencing of the Miniexon gene, and blood-feeding source identification using the 12S rRNA gene was also conducted. Statistical analysis was performed to assess differences in parasitic load among the locations.

RESULTS: Of the 48 insects, 81.1% from Bulverde and 100% from Spring Branch tested positive for T. cruzi. The median parasitic load was log₁₀ 8.09 equivalent parasites/mL, with significant differences in parasitic load between locations. Genotyping revealed that all samples were infected with TcI, with some co-infection of TcI and TcIV. Blood meal analysis identified multiple feeding sources, including dogs (Canis lupus), humans (Homo sapiens), and wildlife species.

CONCLUSIONS: This study provides insights into T. cruzi transmission dynamics in southern Texas, demonstrating the active role of domestic dogs and wildlife in the local cycle of infection suggesting endemism of T. cruzi in this region. These findings emphasize the need for continued surveillance and vector control measures to mitigate the risk of Chagas disease transmission in the USA.

PMID:40665373 | DOI:10.1186/s13071-025-06917-6

Child Adolesc Psychiatry Ment Health. 2025 Jul 15;19(1):77. doi: 10.1186/s13034-025-00942-0.

ABSTRACT

BACKGROUND: Burnout symptoms and secondary traumatic stress are especially high among Child Welfare Workers (CWWs) and psychotherapists and might have increased since the recent increase in refugee numbers. Little is known about the wellbeing of CWW and psychotherapists working with unaccompanied young refugees (UYR), especially in German child and youth welfare facilities where they work closely together. This study aims to assess levels of compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in German CWWs and psychotherapists, examining connections to demographic variables and group differences.

METHODS: N = 198 CWW and N = 97 psychotherapists were assessed via the Professional Quality of Life Scale (ProQOL). Descriptive statistics, t-test for independent samples, correlations between the ProQOL scales and hierarchical regression analyses with demographic variables as predictors were computed.

RESULTS: Both samples showed average to high levels of CS, and low to average levels of BO and STS. CWWs scored significantly higher than psychotherapists on BO and STS. In CWW, demographic variables were not associated with CS, BO or STS. Among psychotherapists, previous experiences in working with UYR (β = 0.38; p <.001) were positively associated with CS. Factors such as weekly therapy sessions (β = – 0.35, p =.001) and the psychotherapist’s migration background (β = – 0.20, p =.048) were negatively associated with STS. The number of PTSD cases treated (β = 0.27, p =.018) and additional training (β = 0.31, p =.006) were positively associated with STS.

CONCLUSION: Among psychotherapists, prior experience in working with UYRs may contribute to elevated levels of CS, whereas a higher number of previously treated PTSD cases appears to be associated with increased STS. Further research on the influence of sociodemographic variables is needed for CWWs to identify protective and risk factors. Supporting and training CWWs and psychotherapists is crucial for quality treatment of traumatized UYRs.

PMID:40665365 | DOI:10.1186/s13034-025-00942-0

Cardiovasc Diabetol. 2025 Jul 15;24(1):289. doi: 10.1186/s12933-025-02824-3.

ABSTRACT

BACKGROUND: We investigated the risk of type 2 diabetes (T2DM) and related comorbidities including cardiovascular disease (CVD), and mortality, based on changes in metabolic dysfunction associated steatotic liver disease (MASLD).

METHODS: We analyzed data from the Korean National Health Insurance Service for individuals aged ≥ 20 years. MASLD was defined as a fatty liver index (FLI), a prediction formula based on metabolic parameters, with a cutoff of ≥ 60. FLI measurements were compared within each individual over a 2 years period. Based on changes in FLI between two health checkups, individuals were classified into four categories; never MASLD (FLI consistently < 60), incident MASLD (FLI < 60 to ≥ 60), regressed MASLD (≥ 60 to < 60), and persistent MASLD (FLI consistently ≥ 60). The primary outcome was T2DM occurrence in the general population and myocardial infarction (MI), ischemic stroke, heart failure (HF) and mortality events in individuals with preexisting T2DM with adjustment for age, sex, smoking, alcohol drinking, and regular exercise.

RESULTS: In 4,397,808 individuals without T2DM, 229,475 (5.2%) developed T2DM during a median follow-up period of 7.3 years. The risk of incident T2DM was the highest in individuals with persistent MASLD compared to those who never had MASLD (HR = 5.28, 95% CI = 5.22-5.34). Individuals with incident or regressed MASLD also had increased risk of developing T2DM (HR = 3.30, 95% CI = 3.25-3.35 for incident MASLD, HR = 2.87, 95% CI = 2.82-2.92 for regressed MASLD). In a cohort of 636,520 individuals with preexisting T2DM followed for a median of 6.2 years, those with persistent MASLD had a higher risk of HF (HR = 1.28, 95% CI = 1.25 to 1.32), MI (HR = 1.15, 95% CI = 1.10 to 1.20), stroke (HR = 1.14, 95% CI = 1.09 to 1.19) and all-cause mortality (HR = 1.11, 95% CI = 1.09-1.14) compared to individuals who never had MASLD. Similarly, both incident and regressed MASLD were associated with an increased risk for HF, MI, stroke and all-cause mortality.

CONCLUSIONS: Persistent MASLD is associated with an increased risk of incident T2DM, and further elevates the risk of CVD, and mortality among individuals with T2DM. Even individuals with incident or regressed MASLD exhibit an increased risk of these adverse outcomes compared to those who never had MASLD.

TRIAL REGISTRATION: N/A.

PMID:40665356 | DOI:10.1186/s12933-025-02824-3