Nevin Manimala

Ind Health. 2025 Mar 17. doi: 10.2486/indhealth.2024-0158. Online ahead of print.

ABSTRACT

This study investigated the association between work stress and sleep disturbance among Korean workers, focusing on the mediating effects of somatic and cognitive pre-sleep arousal symptoms. Data were derived from the “Korean Work, Sleep, and Health Study (KWSHS),” involving 4,393 participants. Work stress was assessed using the Korean Occupational Stress Scale, and sleep disturbances were measured using the Insomnia Severity Index and Pittsburgh Sleep Quality Index. The Pre-Sleep Arousal Scale was utilized for assessing pre-sleep arousal status. For statistical analyses, the χ² test, logistic regression analysis, and mediation analysis were used. Mediation analysis revealed that somatic pre-sleep arousal predominantly mediated the relationship between hazardous physical environments and insomnia symptoms (52.5%), while cognitive pre-sleep arousal was the primary mediator for high job demands (48.0%), organizational injustice (48.6%), and job insecurity (46.6%). These findings suggest that somatic and cognitive pre-sleep arousal serve distinct mediating roles in the relationship between specific types of work stress and sleep disturbances.

PMID:40090712 | DOI:10.2486/indhealth.2024-0158

Int Heart J. 2025 Mar 15. doi: 10.1536/ihj.24-560. Online ahead of print.

ABSTRACT

The aim of this study was to explore the association between angiotensin-converting enzyme (ACE) gene insertion/deletion polymorphism in the 16th intron and the occurrence of left ventricular hypertrophy (LVH) in hypertensive individuals.This study included 269 patients with hypertension from Dushu Lake Hospital Affiliated to Soochow University who underwent echocardiographic examinations. Among them, 55 patients had hypertension combined with LVH, while 214 patients with hypertension did not have LVH, serving as the case and control groups, respectively. Polymerase chain reaction-restriction fragment length polymorphism was used to perform genetic testing for hypertension in all 269 patients. The Hardy-Weinberg equilibrium test was used to assess genetic equilibrium. The differences in genotype frequencies between the case and control groups were analyzed using the chi-square test. All statistical analyses were performed using SPSS software (version 27.0.1), with statistical significance set at P < 0.05.Genotype distribution in the case and control groups conformed to the Hardy-Weinberg equilibrium (P > 0.05). There was a significant difference in genotype distribution between the case and control groups.Conclusion: ACE gene polymorphism is associated with an increased risk of hypertension combined with LVH.

PMID:40090707 | DOI:10.1536/ihj.24-560

Psychogeriatrics. 2025 May;25(3):e70024. doi: 10.1111/psyg.70024.

ABSTRACT

OBJECTIVE: The objectives of this study were to examine the factors associated with suicidal ideation in a community-dwelling older adult population in Korea. Specifically, the study focuses on the role of emotional abuse and depression, and investigates the mediating effect of depression in the relationship between emotional abuse and suicidal ideation.

METHODS: This study utilised data from 10 097 individuals aged 65 and older, based on a 2020 survey conducted by the Korea Institute for Health and Social Affairs.

RESULTS: In our study, 1.9% of older adults reported suicidal ideation, 4.4% reported experiencing emotional abuse, and 12.8% reported having depression (defined as a score of ≥8 on the short version of the Geriatric Depression Scale). Our results revealed that younger-older adults, older adults living without a spouse, poor social support, subjective health status, emotional abuse (odds ratio (OR) = 2.929), and depression (OR = 5.152) were found to be significantly associated with suicidal ideation after controlling for all confounding factors. Furthermore, the mediation analysis revealed that the OR for emotional abuse decreased from 3.284 to 2.929 after accounting for depression, suggesting that depression partially mediates the relationship between emotional abuse and suicidal ideation.

CONCLUSION: Emotional abuse and depression were found to be associated with suicidal ideation in community-dwelling Korean older adults. Notably, depression was found to buffer the relationship between emotional abuse and suicidal ideation, indicating a mediating effect.

PMID:40090698 | DOI:10.1111/psyg.70024

BMJ Glob Health. 2025 Mar 15;10(3):e018333. doi: 10.1136/bmjgh-2024-018333.

ABSTRACT

OBJECTIVE: This study estimated the proportion of children aged 12-23 months who were fully vaccinated in sub-Saharan Africa (SSA), explored geographical disparities across subregions and countries, and identified country-level factors associated with full vaccination (FV).

DESIGN: Cross-sectional study.

SETTING: SSA.

PARTICIPANTS: Children aged 12-23 months.

PRIMARY OUTCOME: FV.

METHODS: Data for this study were extracted from the most recent Demographic and Health Survey (DHS) conducted in 34 SSA countries between 2012 and 2023. The study included a total weighted sample of 69 218 children. Univariate analyses were performed to describe the socio-demographic profile of the participants and estimate the proportion of FV and the proportion for each of the eight vaccines (BCG, DTP1, DTP2, DPT3, Polio1, Polio2, Polio3, Measles1) at regional level. Bivariate and spatial analyses were produced to examine existing disparities at regional, subregional and countries’ income levels. A multivariate logistic regression analysis was fitted for identifying country-level factors associated with FV.

RESULTS: 54.1% (95% CI 53.7% to 54.5%) children aged 12-23 months in SSA were fully vaccinated. In addition, substantial inequalities emerged in FV coverage across countries ranging from 23.9% in Guinea to a high of 95.5% in Rwanda. The same pattern was observed for the eight vaccines. Findings also showed that children of birth order 3 and above, who were delivered at home, had received less than four antenatal visits, from poor households and households with more than 5 members, whose mothers were under 25, had primary education level and below, and had no income-generating activities were less likely to be fully vaccinated.

CONCLUSION: To achieve WHO’s global vaccination coverage target of 90% by 2030 in SSA, vaccination programmes must take account of regional, subregional and national inequities. Our findings also underline the need for interventions tailored to each SSA country’s socio-cultural context.

ETHICAL CONSIDERATION: Ethical approval was not required as this is a secondary analysis of publicly available data.

PMID:40090697 | DOI:10.1136/bmjgh-2024-018333

BMJ Glob Health. 2025 Mar 15;10(3):e017206. doi: 10.1136/bmjgh-2024-017206.

ABSTRACT

PURPOSE: This study longitudinally assessed the quality of life (QoL) in patients who completed chemoradiation (CRT) for cervical cancer in Botswana and compared the QoL for those living with and without HIV infection.

METHODS: Patients with cervical cancer recommended for curative CRT were enrolled from August 2016 to February 2020. The European Organisation for Research and Treatment of Cancer Core Quality-of-Life (QLQ-C30) and cervical cancer-specific (QLQ-Cx24) questionnaires, translated into Setswana, were used to assess the QoL of patients prior to treatment (baseline), at the end of treatment (EOT) and in 3 month intervals post-treatment for 2 years, and statistical analyses were performed.

RESULTS: A total of 294 women (median age: 46 years) were enrolled and followed up for an average of 16.4 months. Of women with recorded staging, most had FIGO stage III/IV disease (64.4%). Women living with HIV (WLWH; 74.1%) presented at earlier ages than those without HIV (44.8 years vs 54.7 years, p<0.001). The QoL for all domains did not differ by HIV status at baseline, EOT or 24 month follow-up. Per QLQ-C30, the mean global health status score (72.21 vs 78.37; p<0.01) and the symptom (12.70 vs 7.63; p=0.04) and functional scales (88.34 vs 91.85; p<0.01) improved significantly from the EOT to the 24 month follow-up for all patients; however, using the QLQ-Cx24 survey, no significant differences in the symptom burden (12.53 vs 13.67; p=0.6) or functional status (91.23 vs 89.90; p=0.53) were found between these two time points.

CONCLUSION: The QoL increased significantly for all patients undergoing CRT, underscoring the value of pursuing curative CRT, regardless of the HIV status.

PMID:40090695 | DOI:10.1136/bmjgh-2024-017206

BMJ Open. 2025 Mar 15;15(3):e088507. doi: 10.1136/bmjopen-2024-088507.

ABSTRACT

OBJECTIVE: This study aimed to assess the prevalence of diabetic macular oedema and its associated factors among adult patients with diabetes attending comprehensive specialised hospitals in Northwest Ethiopia in 2023.

DESIGN: An institution-based, cross-sectional study.

SETTING: The study was conducted at the University of Gondar, Felege Hiwot and Debre Markos comprehensive specialised hospitals in Northwest Ethiopia from 8 May to 15 June 2023.

PARTICIPANTS: This study was conducted on 890 adult patients with diabetes selected using a systematic random sampling technique.

OUTCOME MEASURES: Participants with diabetic macular oedema were assessed using slit lamp biomicroscopy with a +90 dioptre Volk lens. Blood glucose levels were measured by fasting blood sugar tests. Data were collected through physical examination, review of medical records and face-to-face interview.

RESULTS: Among a total of 890 study participants, the prevalence of diabetic macular oedema was 25.8% (95% CI 23.1 to 28.8). Peripheral neuropathy (adjusted OR (AOR)=3.02, 95% CI 1.76 to 5.29), hypertension (AOR=1.98, 95% CI 1.24 to 3.17), poor blood glucose control (AOR=5.06, 95% CI 2.95 to 8.67), obesity (AOR=5.03, 95% CI 2.50 to 10.13), longer duration of diabetes mellitus (AOR=3.78, 95% CI 2.21 to 6.24) and poor adherence to diabetic medication (AOR=2.06, 95% CI 1.32 to 3.28) were significantly associated with diabetic macular oedema.

CONCLUSION: In Northwest Ethiopia, a quarter of patients with diabetes were found to have diabetic macular oedema. Factors such as peripheral neuropathy, hypertension, poor blood glucose levels, obesity, long duration of diabetes mellitus and poor adherence to diabetic medications were significantly associated with diabetic macular oedema. Improvement of glucose control and exercise for optimal body weight maintenance are recommended to prevent the development of diabetic macular oedema.

PMID:40090690 | DOI:10.1136/bmjopen-2024-088507

BMJ Open. 2025 Mar 15;15(3):e087808. doi: 10.1136/bmjopen-2024-087808.

ABSTRACT

INTRODUCTION: Type 2 Diabetes Mellitus (T2DM) and its complications significantly increase the risk of premature mortality and disability among patients, placing a considerable burden on socioeconomic development. Evidence has shows that effective transitional care can improve health outcomes for patients with T2DM. However, T2DM transitional care faces challenges including service discontinuity, communication breakdowns and a lack of personalised design, leading to potential issues of undertreatment and overtreatment, increasing the risk of improper blood sugar management. To address these challenges, our research team developed the Hospital-Community-Home Tiered Transitional Care (HCH-TTC) programme for patients with T2DM, aiming to evaluate its effectiveness and feasibility through a randomised controlled trial (RCT).

METHOD AND ANALYSIS: The multicentre, pragmatic, double-blind RCT will enrol 180 patients with T2DM from the Jinqiao Medical Union in Pudong New Area, Shanghai, China. Participants will be randomly assigned to either the experimental group or the control group. The experimental group will participate in a 6-month HCH-TTC programme, which provides personalised transitional care strategies tailored to patients’ evolving health conditions and nursing needs. This tiered management approach includes follow-up, health education, personalised guidance and health monitoring, with variations in intensity, frequency and type based on individual requirements. The control group will receive Hospital-Community-Home Routine Transitional Care programme, consisting of routine follow-up, health education and health monitoring during the same period. Data collection will be conducted at baseline, 1 month postintervention, 3 months and 6 months. The primary outcomes are glycated haemoglobin (HbA1c). Secondary outcomes include fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPPG), diabetes knowledge level, diabetes self-management ability, diabetes treatment adherence, nursing service satisfaction, diabetes complications rate and unplanned readmission rate. Statistical analysis will employ independent sample t-tests and repeated measures analysis of variance.

ETHICS AND DISSEMINATION: The Gongli Hospital Ethics Committee (GLYY1s2021-010) approved the study. Results will be disseminated through publication in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry ChiCTR2200063322.

PMID:40090689 | DOI:10.1136/bmjopen-2024-087808

Pak J Pharm Sci. 2025 Jan-Feb;38(1):37-44.

ABSTRACT

Upper limb spasticity is a common and serious sequelae in patients with hemiplegia after stroke. Radial extracorporeal shock wave therapy (rESWT) can improve upper limb dysfunction and relieve pain in patients, However, its efficacy as a single treatment is limited. In traditional Chinese medicine, Tetramethylpyrazine (TMP) is the main pharmacological component of Ligusticum chuanxiong. It exhibits significant effects on the prevention and treatment of ischemic cerebrovascular diseases, protecting against cascade reaction-induced damage. This study encompassed 120 stroke patients with upper limb spasticity and limited elbow mobility who were admitted to the Second Rehabilitation Hospital of Shanghai from March 2021 to March 2023. They were divided into 3 groups: A rESWT group received rESWT, a TMP group received TMP and a Coalition group received TMP combined with rESWT. Statistical analysis and evaluation were conducted using SPSS 29.0. The research findings revealed that compared with the rESWT group and TMP group, the Coalition group showed more significant improvements in FMA, MAS, VAS scores, spasticity of elbow flexors, NIHSS and BI scores after 4 weeks of treatment. The combination of rESWT and TMP can enhance spasticity in stroke patients with upper limb spasticity, alleviated pain, and improved motor function and neurological functions.

PMID:40089928

Med J Aust. 2025 Mar 17;222(5):240-248. doi: 10.5694/mja2.52613.

ABSTRACT

OBJECTIVE: To examine the accuracy of the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), the population-based clinical quality registry for people with kidney failure, in identifying Aboriginal and/or Torres Strait Islander people.

DESIGN: Population-based cohort study of reporting accuracy.

SETTING: New South Wales, 2006-2020.

PARTICIPANTS: Incident kidney failure patients.

MAIN OUTCOME MEASURES: Sensitivity and specificity of identification of Aboriginal and/or Torres Strait Islander people in ANZDATA compared with identification with Enhanced Reporting of Aboriginality (ERA) methods using linked health datasets.

RESULTS: Of 11 708 patients, 693 (5.9%) were identified as Aboriginal and/or Torres Strait Islander people using ERA methods, with 484 recognised in ANZDATA. Overall ANZDATA sensitivity was 67.0% (95% CI, 63.3-70.5%), with high specificity (99.8%; 95% CI, 99.7-99.9%). Sensitivity was lowest for males (63.8%; 95% CI, 58.7-68.6), people aged under 18 years (45.0%; 95% CI, 23.1-68.5%) or over 65 years (61.7%; 95% CI, 53.8-69.2%), and those with greater socio-economic advantage (56.6%; 95% CI, 46.6-66.2%), living in major cities (53.8%; 95% CI, 48.0-59.5%) and with no comorbidities (47.7%; 95% CI, 37.0-58.6%). Aboriginal and/or Torres Strait Islander people identified in ANZDATA had lower rates of waitlisting for kidney transplantation (17.8% v 25.3%; P = 0.016) and receiving a kidney transplant (12.2% v 23.1%; P < 0.001) and a higher rate of death (56.0% v 44.5%; P = 0.004) compared with those not recognised in ANZDATA.

CONCLUSION: Aboriginal and/or Torres Strait Islander people were under-reported in ANZDATA. There were multiple biases in characteristics and outcomes for people identified in ANZDATA compared with those identified by ERA using linked data. This highlights the importance of data integration as a quality improvement mechanism and identifying barriers to disclosure.

PMID:40089918 | DOI:10.5694/mja2.52613

Probl Endokrinol (Mosk). 2024 Nov 2;71(1):40-49. doi: 10.14341/probl13535.

ABSTRACT

BACKGROUND: Self-monitoring of blood glucose (SMBG) is the main tool to achieve carbohydrate metabolism targets in patients with type 1 diabetes mellitus (DM). Remote monitoring of SMBG in Russia appeared relatively recently and needs to be evaluated for effectiveness.

AIM: To evaluate the effect of remote monitoring of SMBG on carbohydrate metabolism and quality of life in patients with type 1 DM in order to form new therapeutic approaches.

MATERIALS AND METHODS: Patients with type 1 DM with glycated hemoglobin (HbA1c) from 8.0 to 12.0% were divided into the main (n=107) and control group (n=20). Patients from the main group performed SMBG using glucometers with the possibility of remote data transmission, patients from the control group continued the traditional SMBG. The dynamics of HbA1c, derived time spent in the target ranges, recognition of hypoglycemia (GOLD scale, Clarke questionnaire), quality of life according to the SF-36 questionnaire were evaluated. The statistical analysis was carried out in the SPSS Version 26.0 program (IBM, USA).

RESULTS: In the main group (n=88) the HbA1c was statistically significant decreased after 6 months from 9.0% [8.4; 9.9] to 8.1% [7.4; 9.2] (p&lt;0.001), with SMBG more than 4 times a day – up to 7.3% [7.0; 7.8] (p=0.001). In the control group (n=20), by the 6th month, HbA1c increased to 10.1% [8,9; 11,2] (p=0,010). Derived Time In Range in the main group increased to 69.9±13.0 (95% CI 65.73-74.03; p&lt;0.001); derived Time Above Range significantly decreased to 9.5% [6.4; 15.0] (p&lt;0.001), derived Time Below Range – to 6.7% [2.8; 12.2] (p=0.044); Coefficient of Variation reached 36.3±7.9 (95% CI 33.7-38.8; p&lt;0.001). According to the results of SF-36, the physical and psychological components of the quality of life in the main group significantly improved (p&lt;0.001). Recognition of hypoglycemia improved in the intervention group (-4.5% of patients (p=0.046) according to the Clarke questionnaire; -8% (p=0.008) on the GOLD scale).

CONCLUSION: Remote monitoring of SMBG is a prospective therapeutic approach due to its positive effect on carbohydrate metabolism and quality of life in patients with type 1 DM.

PMID:40089884 | DOI:10.14341/probl13535