Nevin Manimala

Med J Aust. 2026 Mar;224(3):e70172. doi: 10.5694/mja2.70172.

ABSTRACT

Elder abuse can lead to serious physical injuries and long-term psychological consequences, but its recognition and documentation in healthcare settings remain limited. This study used linked data from four Australian states to examine elder abuse coded during emergency department presentations and hospitalisations among 965,986 older people assessed for aged care services between 2010 and 2019. Only 580 people (0.06%) had elder abuse coded during an emergency department presentation or hospitalisation, highlighting substantial under-recognition and under-reporting in hospital settings.

PMID:41873537 | DOI:10.5694/mja2.70172

J Nurs Manag. 2026;2026(1):e3056495. doi: 10.1155/jonm/3056495.

ABSTRACT

AIM: To identify factors associated with usability and adoption of continuous monitoring with deterioration alerting systems (CM-DAS) in non-ICU wards from clinicians’ perspectives.

BACKGROUND: Patient deterioration is a safety concern on general wards; intermittent vital sign checks can miss early decline. CM-DAS can help, but impact depends on usability and clinician adoption, which remain variably achieved.

METHODS: Convergent mixed methods using the unified theory of acceptance and use of technology (UTAUT) model to guide data collection: An online UTAUT-based survey (n = 111 clinicians, 20 countries; April-August 2023) and semistructured interviews (n = 10) were conducted. Quantitative data were analysed with nonparametric tests and composite PLS-SEM (3000 bootstraps); qualitative data underwent thematic analysis; findings were integrated narratively.

RESULTS: Perceived usefulness and ease of use were positively associated with the intention to adopt CM-DAS. In the multivariable PLS-SEM, only intention to use the system (β ˜ 0.29, p ˜ 0.01) and prior CM-DAS experience (β ˜ 0.28, p ˜ 0.01) were associated with routine bedside use; other constructs did not retain independent associations, and variance explained was modest (R²_use≈0.15). Interviews corroborated benefits (patient safety and workflow) and highlighted barriers-false alarms, reliability/connectivity issues, technical language/user interface and gaps in support and training. Peer practices and patient/family responses shaped the climate for adoption.

CONCLUSIONS: This study suggests that ensuring reliable infrastructure (signal stability, hospital Wi-Fi and integration with EHR) is foundational for safe and sustained CM-DAS operation. Routine use was most closely associated with clinicians’ intention to use the system and accumulated experience. Factors such as how easy a system is to use and how individuals perceived its usefulness strengthened an individual’s intention to use the system.

IMPLICATIONS FOR NURSING MANAGEMENT: Management should prioritise reliable infrastructure, implement tiered alarm governance to reduce nonactionable alerts, designate ward super-users supported by vendor service-level agreements and deliver brief, recurring, practice-embedded training so that intention translates into sustained, safe bedside use.

PMID:41873534 | DOI:10.1155/jonm/3056495

J Magn Reson Imaging. 2026 Mar 24. doi: 10.1002/jmri.70302. Online ahead of print.

ABSTRACT

BACKGROUND: Venous pulsatile tinnitus (VPT) is associated with transverse-sigmoid sinus (TSS) anomalies, bone dehiscence (BD), and hemodynamic disturbances. 4D Flow MRI enables comprehensive TSS evaluation, but causal relationships among TSS morphology, hemodynamics, and BD in VPT onset and progression remain unquantified. Reliable imaging predictors for VPT progression and BD’s mediating role are unestablished.

PURPOSE: To construct a directed acyclic graph (DAG) testing whether stenosis-induced hemodynamic abnormalities and bone changes predict VPT occurrence and 6-month progression.

STUDY TYPE: Prospective longitudinal cohort study.

POPULATION: 126 unilateral VPT patients (36 [31-44] years; 73.0% female) and 83 matched non-VPT participants (35 [28-42] years; 71.1% female); all VPT patients completed 6-month symptom follow-up.

FIELD STRENGTH/SEQUENCE: 3 T multi-shot turbo field echo 4D Flow MRI and fast field echo phase-contrast MR venography (PC MRV).

ASSESSMENT: Three blinded neuroradiologists independently assessed TSS morphology, hemodynamic indices, and petrous BD using PC MRV, 4D Flow MRI, and high-resolution CT multiplanar reconstruction. Interobserver reliability was evaluated with discrepancies resolved by consensus.

STATISTICAL TESTS: Kolmogorov-Smirnov, Chi-Square, Mann-Whitney U test, FDR-corrected correlation analysis, linear/logistic regression, mediation analysis, and ROC curve analysis.

SIGNIFICANCE: p < 0.05.

RESULTS: 74.6% of VPT patients had 6-month progression (increased Tinnitus Handicap Inventory, THI score vs. baseline). Peak flow velocity (38.79 cm/s cut-off) independently predicted 6-month progression (area under the curve, AUC = 0.840; 95% confidence interval, CI: 0.755-0.925). TSS stenosis combined with hemodynamic parameters predicted VPT occurrence (AUC = 0.895, 95% CI: 0.855-0.936). Mediation analysis confirmed BD mediated the effect of wall shear stress on THI. Hierarchical causal pathways among TSS morphology, hemodynamics, BD, and VPT were identified to verify quantifiable DAG.

DATA CONCLUSION: TSS stenosis initiates hemodynamic disturbances and bone changes, which collectively drive VPT occurrence and 6-month progression. Integrating these morphological and hemodynamic parameters yields accurate predictive models.

EVIDENCE LEVEL: 4.

TECHNICAL EFFICACY: Stage 3.

PMID:41873517 | DOI:10.1002/jmri.70302

Res Synth Methods. 2026 Mar 24:1-19. doi: 10.1017/rsm.2026.10081. Online ahead of print.

ABSTRACT

Meta-analytic-predictive (MAP) priors have been proposed as a generic approach to deriving informative prior distributions, where external empirical data are processed to learn about certain parameter distributions. The use of MAP priors is also closely related to shrinkage estimation (also sometimes referred to as dynamic borrowing). A potentially odd situation arises when the external data consist only of a single study. Conceptually, this is not a problem, it only implies that certain prior assumptions gain in importance and need to be specified with particular care. We outline this important, not uncommon special case and demonstrate its implementation and interpretation based on the normal-normal hierarchical model. The approach is illustrated using example applications in clinical medicine.

PMID:41873516 | DOI:10.1017/rsm.2026.10081

Eur J Psychotraumatol. 2026 Dec;17(1):2635919. doi: 10.1080/20008066.2026.2635919. Epub 2026 Mar 24.

ABSTRACT

Background: Evidence on the long-term mental and physical health effects of disaster-related bereavement remains limited.Objective: To compare long-term healthcare utilisation and disease incidence among individuals bereaved in the Sewol ferry disaster with matched controls.Method: This retrospective cohort study used Korean National Health Insurance data to match 388 bereaved individuals with 1,552 controls. Healthcare utilisation and disease incidence were examined over three years pre-disaster and eight years post-disaster using difference-in-differences and Cox proportional hazards models.Results: Psychiatric outpatient utilisation among the bereaved increased from 10% pre-disaster to 38% in year 1, stabilised around 20%, and rose again to 38% in year 8, whereas controls showed a gradual increase to 22%. Difference-in-differences analyses demonstrated significantly higher psychiatric outpatient visits in the bereaved group, with excess visits of 2.87 (95% CI 1.52-4.22) in years 1-3, 1.86 (0.51-3.21) in years 4-6, and 1.56 (0.21-2.91) in years 7-8. Psychiatric admissions also increased significantly across post-disaster periods. Physical outpatient visits showed delayed excess increases in years 4-6 and 7-8. Cox models indicated elevated risks for infectious, benign neoplastic, endocrine, mental, neurological, digestive, dermatological, and musculoskeletal disorders, as well as abnormal findings and injury.Conclusions: Eight years after the disaster, bereaved individuals continued to exhibit persistent mental health problems and greater physical healthcare utilisation. These findings highlight the need for long-term, integrated support addressing both mental and physical health beyond the immediate aftermath of disasters.

PMID:41873512 | DOI:10.1080/20008066.2026.2635919

J Nurs Manag. 2026;2026(1):e3543130. doi: 10.1155/jonm/3543130.

ABSTRACT

BACKGROUND: Problematic mobile phone use is an emerging public health issue, the prevalence of which has increased among nurses.

AIM: To synthesize and describe knowledge on problematic mobile phone use by nurses, its consequences, and strategies for addressing this phenomenon.

DESIGN: A systematic review was conducted following the checklist Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. This systematic review has been registered in PROSPERO (CRD420251052591).

METHODS: Four electronic databases were systematically searched from their inception to September 2025. The article’s reference lists were also manually searched. The study selection was carried out in three stages, with two reviewers independently analyzing the data and resolving disagreements. The quality assessment utilized the Mixed Method Appraisal Tool, considering the criteria established for each study design.

RESULTS: Sixteen studies from four online databases were selected, the majority of which were cross-sectional and descriptive. The risk factors for problematic mobile phone use, the negative consequences for mental and physical health, and the clinical work of nurses were highlighted, such as a combination of strategies to prevent and mitigate problematic mobile phone use in the clinical setting.

CONCLUSION: The problematic mobile phone use of nurses negatively affects their mental and physical health, as well as their performance in the clinical setting.

IMPLICATION FOR NURSING MANAGEMENT: The findings of this study may inform the need for nursing managers to develop and implement strategies to prevent and mitigate the problematic use of these devices among nurses and ensure the appropriate use of mobile phones in the clinical setting.

PMID:41873504 | DOI:10.1155/jonm/3543130

Hum Vaccin Immunother. 2026 Dec;22(1):2633892. doi: 10.1080/21645515.2026.2633892. Epub 2026 Mar 24.

ABSTRACT

As life expectancy increases, age-related diseases become more frequent and severe, making vaccination a key strategy for disease prevention. To assess the knowledge and attitudes toward herpes zoster and to determine associations with acceptability of vaccination among patients and dermatologists, a descriptive and quantitative analytic cross-sectional survey-based study was conducted among patients aged ≥50 y in a tertiary hospital, and dermatologists in the Philippines. Majority of dermatologists had good knowledge (97.5%) and attitudes (99.7%) toward vaccination. Reported barriers were vaccine cost, procurement, and storage. Only 32.8% of patients were aware of herpes zoster, of which 61.7% had good knowledge and 99.2% had positive attitudes toward vaccination. Majority (87.0%) were willing to be vaccinated. Fear of side effects and unwillingness to pay limited acceptance. Knowledge did not impact vaccine acceptance, but favorable attitudes were associated with acceptance in both groups. Recall and social desirability bias cannot be ruled out, and sampling of patients was limited to a single outpatient clinic. Overall, Filipino dermatologists exhibit high levels of knowledge, positive attitudes, and vaccine acceptability. While patient awareness was limited, vaccine acceptability is high, particularly when recommended by a physician, highlighting their critical role in primary care.

PMID:41873494 | DOI:10.1080/21645515.2026.2633892

Future Microbiol. 2026 Mar 24:1-7. doi: 10.1080/17460913.2026.2645506. Online ahead of print.

ABSTRACT

Vaccination programs have averted millions of childhood deaths, yet vaccine-preventable diseases (VPDs) continue to resurge as coverage declines and pathogen evolution undermines previously successful vaccines. Anticipating resurgence is a public health priority. We review theoretical and empirical advances in the study of early warning signals (EWS) of epidemic transitions, with a focus on critical slowing down (CSD) – a phenomenon in which recovery from perturbations becomes slower near the epidemic threshold. We summarize the mechanisms that generate CSD, indicators that can be extracted from surveillance data, and the conditions under which signals may be detectable. We then examine case studies to illustrate the opportunities and challenges of applying EWS to VPD resurgence. Theory and computer simulations show that CSD can precede both elimination and resurgence, with increases in variance and autocorrelation calculated from disease surveillance reports emerging as consistent indicators. Empirical evidence supports this potential, though performance depends on noise structure, seasonality, spatial clustering, and outbreak responses. Case studies highlight both successful applications and contexts where signals were weak or absent. EWS offer a promising framework for anticipating VPD resurgence, but further research is required to refine methods, integrate mechanistic and social-behavioral drivers, and evaluate applicability across pathogens and settings.

PMID:41873479 | DOI:10.1080/17460913.2026.2645506

Cephalalgia. 2026 Mar;46(3):3331024261431339. doi: 10.1177/03331024261431339. Epub 2026 Mar 24.

ABSTRACT

AimHeadaches are a common complaint among children and adolescents, with prevalence rising over the past decades. This study aimed to retrospectively analyze all emergency consultations presenting with headache as the primary symptom at a Level 1 Pediatric Emergency Department (PED) over 7 years, encompassing the COVID-19 pandemic.MethodsAll electronic health records (EHR) of patients aged 2 to 18 years who presented to the PED with non-traumatic headache between January 2018 and December 2024 were retrospectively reviewed. In addition to primary headache diagnoses, conditions commonly associated with headaches were included to identify relevant emergency department cases. Statistical analyses included the chi-square test or Fishers exact test, calculation of Odds Ratios and ANOVA, significant at p < 0.05.ResultsA total of 1278 children and adolescents (564 males, 44.1%; 714 females, 55.9%) with acute headaches visited our PED 1447 times. Of those patients, 668 (46.2%) were diagnosed with primary headaches, 677 (46.8%) with secondary headaches, five (0.3%) with cranial neuropathies and facial pain, and 97 (6.7%) had headaches that could not be clearly classified. Acute headache cases accounted for 3.6% of all PED visits. The largest relative increase compared to the baseline year (2018) was observed in 2023 (+36.2%). Immediate neuroimaging was performed in 19.1% of cases. Red flag symptoms, including systemic symptoms with fever, neoplasm in history, progressive headache, headache associated with severe vomiting and papilledema, were significantly associated with abnormal brain MRI findings. Pharmacological analgesic therapy was administered in 31.9% of cases, and pain assessment was recorded in 46.1% of cases.ConclusionVisits to the PED for headaches are increasing, particularly following the COVID-19 pandemic. The high prevalence of primary headache diagnoses, combined with still insufficient pain management, highlights the need for enhanced education for both pediatricians and parents. For secondary headaches, a thorough headache history focusing on all red flag symptoms, along with a detailed neurological examination assessing clinical features, should form the basis for deciding whether immediate neuroimaging is necessary.Trial registrationThe study has also been officially registered on the public webpage of the German Clinical Trials Registry (GermanCTR) at https://drks.de/search/en/trial/DRKS00036917 (Clinical Trial Number/ DRKS-ID: DRKS00036917, Date of Registration: 2025-05-16, last update: 2025-07-28, registration type: retrospective, status: recruiting complete, study complete).

PMID:41873465 | DOI:10.1177/03331024261431339

Ann Med. 2026 Dec;58(1):2637271. doi: 10.1080/07853890.2026.2637271. Epub 2026 Mar 24.

ABSTRACT

BACKGROUND: To evaluate the association between albumin administration as volume replacement and mortality in adult ARDS patients, we performed this meta-analysis and trial sequential analysis (TSA).

METHODS: We searched databases including PubMed, Science Direct, Scopus, Web of Science databases and Cochrane Central Register of Controlled Trials up to 12 December 2024. We screened trials that included adult ARDS patients and compared albumin with crystalloid. The 28-day mortality served as the primary endpoint, while the oxygenation change, the length of ICU stay and the length of hospital stay were designated as secondary outcomes. To clarify the differing concentrations of albumin, we formed two distinct subgroups: the hyper-oncotic albumin subgroup (≥20%) and the iso-oncotic albumin subgroup (4%∼5%). Statistical synthesis was performed with Cochrane Review Manager 5.4.1, employing random-effects models. To mitigate random errors, TSA was implemented with α = 0.05 and β = 0.20 parameters.

RESULTS: The analysis incorporated 5 publications: 3 randomized controlled trials (RCTs) and 2 non-randomized studies (NRSs). Overall mortality was lower in the albumin group (33.2%, 97/292) than in the crystalloid group (44.9%, 133/296) (OR = 0.61, 95%CI 0.43-0.85, p = 0.004). RCTs (n = 204) showed no benefit (OR = 0.83, p = 0.54), but NRSs (n = 384) demonstrated reduced mortality (OR = 0.52, p = 0.002). Hyper-oncotic albumin was associated with lower mortality in NRSs (OR = 0.40, p = 0.02) but not in RCTs (OR = 0.74, p = 0.57). Iso-oncotic albumin showed no benefit (OR = 0.88, p = 0.72). Regarding the impact of albumin on oxygenation, significant improvements in oxygenation were observed only on the first (p = 0.05) and second days (p < 0.0001). The TSA indicated a continued need for high-quality RCTs.

CONCLUSIONS: Our analysis suggests that hyper-oncotic albumin may reduce mortality and improve early oxygenation in ARDS patients compared to crystalloids. Larger RCTs are urgently needed to validate these findings and define their potential role in clinical management.

PMID:41873460 | DOI:10.1080/07853890.2026.2637271