Nevin Manimala

BMC Nurs. 2025 Mar 4;24(1):245. doi: 10.1186/s12912-025-02899-z.

ABSTRACT

BACKGROUND: Clinical teaching and learning empower students to translate classroom learning into patient care, facilitating their evolution into competent nurses and midwives. Developing competent nurses is crucial for enhancing the quality of the healthcare system, necessitating quality nursing education to equip them with the required knowledge and skills. The quality of clinical placements significantly influences how students acquire skills, knowledge, and clinical reasoning, as well as how they develop as professional nurses and midwives. However, significant research gaps exist in assessing the quality of clinical placements among student nurses and midwives in Northern Ghana.

AIM: The current study aimed to evaluate the perceptions and satisfaction levels of student nurses and midwives regarding the quality of clinical training placements in Northern Ghana.

METHODS: The study adopted a multi-center, descriptive cross-sectional design. A structured questionnaire was used to collect data from the respondents. Proportionate sampling was used to determine the number of respondents per institution. Respondents were selected to participate in the study using a simple random sampling technique. Data were analysed using SPSS Statistics Version 27. Descriptive statistics were used to summarize the results in frequencies, percentages, means, and standard deviations. Hypothetical relationships between students’ perceptions of clinical training quality, satisfaction, and demographics were tested using One-way ANOVA, t-tests, and Pearson correlation. Tukey LSD post hoc analysis assessed pairwise differences, and statistical significance was pegged at P < 0.05.

RESULTS: Overall, students had a good perception (M = 4.01, SD = 0.87) and satisfaction (M = 6.93, SD = 1.94) with their clinical training placement quality. The majority of respondents (92.2%) strongly agreed or agreed with the statement “This placement was a good learning environment”, whereas 72.0% strongly agreed or agreed with the statement “I received regular and constructive feedback”. Both One-way ANOVA and the independent sample t-test indicated that diploma level (p = 0.008) and the educational institution attended (p < 0.001) had a significant impact on how students perceived the quality of their clinical training placement. Also, there was a significant positive correlation between perceptions of the quality of clinical training placement and satisfaction with clinical training placement among the students (r = 0.65, p < 0.001).

CONCLUSION: Students generally had good perceptions of their clinical placements and were moderately satisfied with their clinical training placements. However, there are also clear differences in the quality of clinical placements amongst the educational institutions in Northern Ghana. Clinical placement settings and academic institutions should collaborate to examine and develop specific teaching methods, supervision approaches, and learning frameworks that can improve clinical learning and teaching among students.

TRIAL REGISTRATION: This is not applicable.

NO PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were involved in setting the research objectives, designing the study, analyzing or interpreting the data, or preparing the manuscript. Nursing and midwifery students from five colleges in Ghana’s Northern, Savannah, and Northeast regions answered the research questionnaire.

PMID:40038700 | DOI:10.1186/s12912-025-02899-z

BMC Oral Health. 2025 Mar 4;25(1):336. doi: 10.1186/s12903-025-05705-z.

ABSTRACT

BACKGROUND: Traditional treatments often involve chemotherapeutic agents; however, immune modulation agents, such as probiotics, propolis, Vitamin E, and vegetable oils, may offer alternative approaches to reduce inflammation and bone damage. In this study, we aimed to investigate the effect of various host modulation agents (probiotics, propolis, Vitamin E, and vegetable oils) on inflammation and bone loss in a rat model of experimental apical periodontitis (AP).

METHODS: Eight-week-old Sprague-Dawley rats (n = 79) were used. AP was induced by exposing the coronal pulp of the mandibular right first molar. Rats were divided into seven groups: Control, AP, AP + Vegetable Oil, AP + Probiotic, AP + Propolis, AP + Vitamin E, and AP + Physiological Serum. The host modulation agents were administered daily for 30 days. Serum calcium, phosphorus, and alkaline phosphatase levels were measured, along with histopathological and immunohistochemical evaluations. Statistical analyses were conducted using one-way ANOVA and Tukey’s test (p < 0.05).

RESULTS: Vitamin E and vegetable oil significantly reduced inflammation by 33% and 28%, respectively, compared with the AP group (p < 0.0001 for both). Probiotics reduced fibrosis by 36% (p = 0.0002), and all agents except propolis showed lower serum calcium levels (p = 0.0017) than the AP group. Osteoblastic activity was higher in the AP and Vitamin E groups (p = 0.0366), whereas both propolis and vitamin E treatments resulted in a 20% reduction in osteoclastic activity (p = 0.0389). No significant effect on abscess formation was observed (p = 0.2610). Compared to the AP group, RANKL levels were significantly lower in the supplemented groups by 28-50% (p = 0.0036).

CONCLUSIONS: Specific nutritional supplements with host modulation effectively reduced inflammation and bone loss in experimental AP. These findings suggest the potential of these agents in improving endodontic treatment outcomes. Further studies are required to explore their clinical application.

PMID:40038698 | DOI:10.1186/s12903-025-05705-z

BMC Med. 2025 Mar 5;23(1):138. doi: 10.1186/s12916-025-03968-5.

ABSTRACT

BACKGROUND: The primary challenges in CD19-specific chimeric antigen receptor T-cell (CD19 CAR T) therapy for patients with refractory/relapsed B-cell acute lymphoblastic leukemia (r/r B-ALL) are non-response and relapse; it is urgent to reveal these mechanisms. Neutrophils play a critical role in the immunosuppressive tumor microenvironment (TME), which can hinder CAR T efficacy. Our previous research identified a subset of immunosuppressive neutrophils with a special phenotype (CD14^–CD10^–CD45^–HLA-DR^–SSC⁺⁺, termed CD10^– neuts), which suppress T cell function. Therefore, we speculate that CD10^– neuts may also influence CAR T efficacy, and this study aims to clinically validate this hypothesis.

METHODS: We enrolled 44 patients with r/r B-ALL undergoing CD19 CAR T therapy and 47 healthy controls (HCs). Peripheral blood samples were obtained prior to CAR T infusion to detect CD10^– neuts levels by flow cytometry. Key parameters included the percentage of CD10^– neuts in neutrophils (CD10^– neuts/neutrophils), in all nucleated cells (CD10^– neuts/nucleated cells), and the absolute count of CD10^– neuts. We analyzed the correlations between these indicators and therapeutic response, relapse-free survival (RFS), overall survival (OS), and CAR T cell persistence time.

RESULTS: CD10^– neuts levels were significantly elevated in patients with r/r B-ALL compared to HCs. Additionally, non-responding patients exhibited higher CD10^– neuts levels than those in remission. Specifically, CD10^– neuts/neutrophils, CD10^– neuts/nucleated cells, and absolute CD10^– neuts count were 64.44% vs. 25.43% (p = 0.004), 28.61% vs. 9.81% (p = 0.018), and 766.1/μL vs. 152.9/μL (p = 0.04), respectively. Among these indices, only CD10^– neuts/neutrophils emerged as an independent risk factor for CAR T response (OR = 19.8, p = 0.013), relapse (HR = 4.704, p = 0.004), and survival (HR = 6.417, p = 0.001). Patients with CD10^– neuts/neutrophils ≥ 21.57% demonstrated significantly shorter RFS and OS compared to those with lower levels (p = 0.001; p = 0.0002). Furthermore, CD10^– neuts/neutrophils were negatively correlated with the persistence time of CAR T cells.

CONCLUSIONS: As one of the key factors in the TME, abnormally elevated CD10^– neuts correlate with CAR T therapy resistance. Targeting these neutrophils could enhance the effectiveness of CAR T treatment.

PMID:40038688 | DOI:10.1186/s12916-025-03968-5

BMC Med Educ. 2025 Mar 4;25(1):335. doi: 10.1186/s12909-025-06884-7.

ABSTRACT

BACKGROUND: Compassion is an important competence for nursing students, and it is essential to identify factors that affect it, such as emotional intelligence and fear of compassion. The purpose of this study was to examine the levels of emotional intelligence, fear of compassion, and compassion competence and their association among nursing students.

METHODS: A cross-sectional correlational study was carried out in the faculty of nursing and midwifery, Hamadan University of Medical Sciences in Iran. Data were collected via census sampling. A sample of 213 nursing students participated, completing general information questionnaire, Wong and Law Emotional Intelligence Scale, the fear of compassion scale, and the compassion competence scale. Statistical analysis was performed using the SPSS-24 software at a significance level of less than 0.05.

RESULTS: The total mean scores for emotional intelligence, fear of compassion, and compassion competence were found to be 80.37 (15.36), 63.15 (22.09), and 61.68 (7.47), respectively. Results of multiple regression analyses indicate that the total score of emotional intelligence (β = 0.191; p < 0.01) had a positive significant influence on the nursing students’ compassion competence, whereas the total score of fear of compassion (β = -0.213; p < 0.01) negatively influenced the nursing students’ compassion competence. By controlling demographic characteristics, emotional intelligence and fear of compassion predict 12.4% of the variance of the nursing students’ compassion competence. The total score of emotional intelligence was negatively correlated with fear of receiving compassion from others (r = -0.218, p = 0.001), fear of self-compassion (r = -0.276, p < 0.001), and the total score of fear of compassion (r = -0.252, p < 0.001).

CONCLUSIONS: Effective emotional intelligence training programs are suggested to reduce nursing students’ fear of compassion and improve their competence in compassion. Interventions that will reduce nurses’ fear of compassion may be one way to improve compassion competence.

PMID:40038685 | DOI:10.1186/s12909-025-06884-7

BMC Pediatr. 2025 Mar 4;25(1):166. doi: 10.1186/s12887-025-05487-x.

ABSTRACT

OBJECTIVE: The study investigates the impact of age at initial diagnosis on the prognosis of pediatric hepatoblastoma (HB) patients, aiming to provide a basis for optimizing risk stratification.

METHODS: Data from 403 patients with HB diagnosed at the First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023 were collected. Kaplan‒Meier survival analysis, Cox regression analysis, and binary logistic regression were employed for statistical analysis.

RESULTS: The hazard ratios (HRs) for event-free survival (EFS) reduction in HB patients were 1, 0.862, 1.393, 2.008, 1.325, 1.859, 3.667 (P = 0.001), and 2.502 (P = 0.023) for first-diagnosis ages of 0-1, 1-2, 2-3, 3-4, 4-5, 5-6, 6-8, and ≥ 8 years, respectively. After adjusting for newly diagnosed alpha-fetoprotein (AFP), pretreatment extent of tumor (PRETEXT) stage, and PRETEXT stage annotation factors, the prognosis of HB for patients diagnosed at ≥ 6 years old and < 6 years old remained significantly different. Children diagnosed at age ≥ 6 years who received the full-course high-risk group chemotherapy regimen had a higher EFS compared to those who did not receive the full-course high-risk group chemotherapy regimen (P = 0.033).

CONCLUSION: Age ≥ 6 years is an independent risk factor for poor prognosis in HB patients. The inclusion of patients aged ≥ 6 years at first diagnosis in the high-risk group for risk stratification was deemed appropriate. This age factor can guide adjustments in chemotherapy intensity.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40038677 | DOI:10.1186/s12887-025-05487-x

BMC Pediatr. 2025 Mar 5;25(1):167. doi: 10.1186/s12887-024-05181-4.

ABSTRACT

INTRODUCTION: Meconium aspiration syndrome is a life-threatening respiratory disease due to the aspiration of meconium-stained amniotic fluid into the lungs, resulting in neonatal morbidity and mortality. Impacts of meconium aspiration syndrome include respiratory failure, intellectual disability, persistent pulmonary hypertension, and air leaks. But there is a paucity of literature in Ethiopia, especially in the study area regarding the study topic. The aim of this study is to assess the proportion of meconium aspiration syndrome and associated factors among neonates admitted at the neonatal intensive care unit in North West Comprehensive Specialized Hospital, Northwest Ethiopia, 2023.

METHODS: -An institutional-based cross-sectional study was conducted among 414mothers-neonate pairs from April 15-May 15/2023. Systematic random sampling was used to obtain study participants. Maternal interviews and a review of neonatal charts were used to gather data from 414 respondents. Then the collected data was entered and coded into EPi-Data version 4.6.0.2 and exported to STATA version 14 for analysis. Both the bi-variable and multi-variable logistic regression models were used for analysis. AOR and 95% CI were used to measure association and strength, with statistical significance assessed at a p-value < 0.05.

RESULTS: – A total of 414 neonate-mother pairs were involved with a 98% response rate. The overall prevalence of meconium aspiration syndrome was 23.43% with a 95% CI (19.6-27.8). Gestational age ≥ 41 wks (AOR = 4.8, CI = 2.02-11.22), labor duration ≥ 12 h (AOR = 2, 95%CI = 1.10-3.84), Premature Rupture of Membrane (AOR = 4.6, 95%CI = 1.12-10.12), oligohydramnios (AOR = 4.2, 95%CI, 2.17-8.14) and breech presentation (AOR = 6.9, 95%CI = 2.169-8.13) were significantly associated with meconium aspiration syndrome.

CONCLUSION AND RECOMMENDATION: The prevalence of meconium aspiration syndrome was relatively high. And Postterm gestation, oligohydramnios, duration of labor, Premature Rupture of Membrane, and breech presentation increased the prevalence of meconium aspiration syndrome. Therefore, to reduce the risk of meconium aspiration syndrome, Health professionals should assess laboring women for the presence of these factors and should stay alert to detect MSAF early for better fetal and maternal health outcomes.

PMID:40038672 | DOI:10.1186/s12887-024-05181-4

BMC Med Educ. 2025 Mar 4;25(1):331. doi: 10.1186/s12909-025-06918-0.

ABSTRACT

BACKGROUND: Sepsis is one of the most challenging and complex clinical states, with persistently high mortality rates. Guidelines recommend the early identification of sepsis patients and immediate initiation of the Hour-1 Bundle treatment to reduce mortality from sepsis. Emergency nurses play a vital role in the early screening of sepsis. Studies indicate that mind mapping and In-Situ Simulation (ISS) training not only aid healthcare professionals in reinforcing theoretical knowledge retention but also enhance skills in coordination, task management, and communication during simulation exercises. This, in turn, promotes the effective implementation of various treatments during resuscitation. The combination of theoretical and practical training methods is more effective than a single training approach. In June 2023, our hospital’s emergency department conducted training for emergency nurses on sepsis mind mapping combined with ISS.

OBJECTIVE: To explore the effect of mind mapping combined with ISS training in promoting the emergency nurses’ implementation of the Hour-1 Bundle in sepsis patients.

METHODS: Using mind mapping and ISS training methods, 24 emergency nurses were divided into 6 groups for a 12-week training period. The study compared their pre- and post-training knowledge of sepsis, identification and diagnostic time, Hour-1 Bundle treatment completion rate, and non-technical skill scores. Post-training, the emergency nurses evaluated the effectiveness of the training.

RESULTS: The scores for sepsis knowledge among emergency nurses before and after training were 44.17 ± 9.21 and 60.42 ± 5.29, respectively. The identification and diagnostic times (hours) were 0.63 ± 0.18 and 0.49 ± 0.13, respectively. The Hour-1 Bundle treatment completion rates were 58.33% and 85.7%, respectively. There was a significant increase in all non-technical skill scores, with statistical significance (P < 0.05, P < 0.001). After two ISS trainings, the SET-M scores progressively increased, indicating a high satisfaction rate among nurses with the mind mapping and ISS training.

CONCLUSION: The combination of mind mapping and ISS training enables emergency nurses to identify sepsis earlier and promotes the effective implementation of the Hour-1 Bundle treatment in sepsis patients, while also enhancing their cognitive understanding of sepsis and non-technical skills.

PMID:40038666 | DOI:10.1186/s12909-025-06918-0

BMC Public Health. 2025 Mar 4;25(1):856. doi: 10.1186/s12889-025-22067-x.

ABSTRACT

BACKGROUND: Treatment adherence is one of the major challenges in methadone maintenance treatment (MMT). This study aimed to investigate the effect of educational intervention using a transtheoretical model (TTM) on adherence to MMT.

METHODS: This quasi-experimental educational intervention study was conducted in Shiraz, Fars Province, Iran (2019), with 114 men aged 20 to 50 years. Participants were recruited using a two-stage cluster random sampling method. The mean age of the participants in the intervention group (n = 58) was 36.98 ± 7.76 years, while the control group (n = 56) had a mean age of 39.44 ± 6.54 years. The intervention group attended five educational sessions based on the Trans theoretical Model (TTM). Data analysis was conducted using SPSS with a significance level set at < 0.05. Statistical methods included Chi-square, paired t-test, independent t-test, and non-parametric tests when the data were not normally distributed.

RESULTS: The results indicated no significant difference between the two groups in terms of self-liberation, counter-conditioning, helping relationships, stimulus control, reinforcement management, temptation, confidence, and adherence to MMT before the intervention (p > 0.05). However, two months after the intervention, the intervention group showed a significant increase in each of the mentioned constructs (p < 0.05) except counterconditioning and MMT adherence.

CONCLUSION: The study’s findings indicate that the educational program successfully improved participants’ knowledge and skills regarding the processes of change, as well as their self-efficacy, which was assessed through two key constructs: temptation and confidence. However, the program did not succeed in enhancing participants’ adherence to treatment. Policymakers should consider integrating structured educational programs based on the Theory of Planned Behavior (TPB) into existing Medication Management Therapy (MMT) services. This approach aims to enhance patients’ understanding of their treatment processes and promote adherence. Furthermore, since the intervention positively impacted self-confidence and self-efficacy, it is advisable to develop policies that focus on educating patients to bolster their self-efficacy in resisting drug-related temptations. Future studies should also aim to include diverse populations, such as women and individuals from various age groups, to assess the generalizability of the findings beyond the male participants from specific regions.

PMID:40038646 | DOI:10.1186/s12889-025-22067-x

BMC Med Educ. 2025 Mar 4;25(1):334. doi: 10.1186/s12909-024-06623-4.

ABSTRACT

BACKGROUND: In dental radiography education, students typically observe instructor demonstrations and practice on mannequins or peers. However, owing to the large student-to-instructor ratio, providing individualized feedback is challenging. Repeated practice is also hindered by radiation exposure from dental radiography machines. Implementing three-dimensional (3D) object-based virtual reality (VR) simulations can address these concerns. We developed a 3D object-based VR-simulation tool for dental radiography learning (namely, 3DOVR-DR) and evaluated user experiences.

METHODS: For the development of 3DOVR-DR, a virtual dental radiography room was constructed using 3D objects. The intraoral radiography process was divided into 12 steps, and the Unity 3D engine was used to create an interactive VR environment for step-by-step learning. This study was a randomized controlled trial. To evaluate user experience, 79 participants were randomly assigned to a control group (n = 39), which used Google Cardboard for VR, or an experimental group (n = 40), which used 3DOVR-DR, to evaluate the user experience. A survey questionnaire of 22 items was administered to all participants. Statistical analyses included descriptive statistics and Mann-Whitney U test.

RESULTS: The 3DOVR-DR tool provided an immersive experience for simulating and learning the dental radiography process within a VR setting. Users performed step-by-step tasks related to dental radiography in the virtual space, adjusting and repeating the entire process or specific steps as needed for their learning. Users received guidance and practiced dental radiography using 3DOVR-DR. User-experience ratings were significantly higher in the experimental group (4.35±0.47) compared to the control group (3.63±0.66; P < 0.001).

CONCLUSIONS: The 3DOVR-DR tool shows potential as a learning medium for intraoral radiography education. Further analysis is needed to examine the impact and mediating effects of the 3D object-based VR experience on dental radiographic practice. Future research should include pedagogical analysis to evaluate the educational effectiveness of this learning tool.

PMID:40038644 | DOI:10.1186/s12909-024-06623-4

BMC Cancer. 2025 Mar 4;25(1):395. doi: 10.1186/s12885-025-13770-4.

ABSTRACT

BACKGROUND: The association between the oral pathogen Porphyromonas gingivalis (PG) and the gut microbiota in colorectal cancer (CRC) patients has been explored with inconsistent results. This study aims to systematically assess this potential association.

MATERIALS AND METHODS: A systematic review was conducted across three databases (Pubmed, Embase and Web of Science) from inception up to January 2023 and updated until November 2024. Inclusion criteria were observational studies examining PG in the microbiota of adults with CRC compared to healthy controls. Exclusion criteria were studies without control group of healthy individuals, other designs or without full-text access. Two reviewers independently selected and extracted data following a pre-registered protocol. Disagreements were resolved by consensus or with a third reviewer. Risk of bias (RoB) was assessed using the Newcastle-Ottawa Scale (NOS). Results were summarized with a flow diagram, tables, and narrative descriptions. Meta-analysis was not feasible, so Fisher’s method for combining p-values and the sign test were used as alternative integration methods.

RESULTS: Finally, 18 studies, with 23 analysis units were included, providing a total sample of 4,373 participants (48.0% cases and 52.0%controls), 38.2% men and 61.8% women, with a similar distribution among cases and controls. The mean (SD) age of cases was 63.3 (4.382) years old and 57.0 (7.753) years for controls. Most of the studies analyzed the presence of PG in feces (70.0%) collected before colonoscopy (55.0%) and were classified with good quality (70.0%) in the RoB assessment. Results suggested an effect (Fisher’s test, p = .000006) with some evidence towards a positive association of PG in CRC patients compared to healthy controls (Sign test, p = .039).

CONCLUSIONS: Results of the systematic review suggest that PG is associated with the microbiota of CRC patients. Lack of information to calculate the effect size prevented the performance of a meta-analysis. Future research should aim for standardized protocols and statistical approaches.

FUNDING: No funding was received for this work.

SYSTEMATIC REVIEW REGISTRATION: The research protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 2023 (registration number: CRD42023399382).

PMID:40038641 | DOI:10.1186/s12885-025-13770-4