Nevin Manimala

Curr Med Res Opin. 2025 Jan 15:1-17. doi: 10.1080/03007995.2024.2442515. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the demographic/clinical characteristics, treatment patterns, and mortality among patients hospitalized with COVID-19 during Omicron predominance by immunocompromised and high-risk status.

METHODS: Retrospective observational study of patients hospitalized with COVID-19 between January 1, 2022 and November 30, 2022, using data from the Optum de-identified Clinformatics® Data Mart Database. Patient demographic/clinical characteristics, treatments, mortality and costs, were assessed, during the emergence of BA.1 BA.4, BA.5, BA.2.12.1, BA.2.75, BQ.1, XBB Omicron viral subvariants.

RESULTS: Overall, 43,123 patients were included, with a mean (standard deviation [SD]) age of 75.5 (12.4) years, 51.8% were female. Immunocompromised patients accounted for 36% of hospitalized patients while only 5.8% received any outpatient COVID-19 treatment within 30 days of hospital admission. The mean (SD) hospital length of stay was 7.9 (7.5) days with 15.5% mortality within 30 days of admission. Mean (SD) hospital costs were $33,975 ($26,392), and 30-day all-cause readmission was 15.1%. Patients with immunocompromised status and those with a higher number of high-risk conditions proceeded to have an elevated proportion of hospital readmissions and mortality within 30 days. Moreover, a higher proportion of mortality was observed during the BA.1 period (20.1%) relative to other variant periods (11.0%).

CONCLUSION: COVID-19 imposed a large healthcare burden, particularly among immunocompromised patients and those with underlying high-risk conditions during Omicron period. Low utilization of outpatient COVID-19 treatments was observed in these high-risk populations eligible for treatment. Continued surveillance and research regarding COVID-19 variants and the impact of outpatient treatment options on high-risk patients is crucial to inform and guide public health action.

PMID:39811881 | DOI:10.1080/03007995.2024.2442515

Integr Cancer Ther. 2025 Jan-Dec;24:15347354241313048. doi: 10.1177/15347354241313048.

ABSTRACT

INTRODUCTION: Balance problems arising from cancer and its treatments can significantly impact daily functionality and quality of life. Improving balance as part of a cancer treatment plan could result in better patient outcomes. Thus, the aim of this study was to determine whether an integrative therapeutic yoga intervention can improve balance in a heterogenous population of cancer survivors (CS).

METHODS: This is a secondary analysis of data from a 16-week feasibility study where therapeutic yoga was supplemented with psychosocial support to maximize health-related quality of life in adult CS of any stage and site. In this study, we investigated balance, as it has been shown to be an important outcome in CS due to its role in physical function and quality of life. The intervention included therapeutic yoga three times per week for 16 weeks and daily psychosocial support provided via text message. Participants’ balance was assessed while standing on a pressure mat with feet together, eyes opened and closed, for 30 seconds in each condition. Data on the “sway path distance” (displacement of the center of gravity) in the two conditions were obtained. Changes in balance after the intervention (from baseline to follow-up) were analyzed using paired-sample t-tests. Changes in balance were also assessed using responder analysis. We described the proportion of participants that improved their balance or not based on 10% difference from baseline scores.

RESULTS: Of the 29 participants included, 22 (76%) completed post-assessments. Changes in both balance assessment conditions were not statistically significant (eyes opened: 80.06 ± 374.99, p = .702; eyes closed: -1.82 ± 24.01, p = .068). Responder analysis showed that 8 participants improved their balance with eyes opened, while 8 worsened, and 6 did not change. Analysis of balance with eyes closed showed that 5 improved, 8 worsened, and 9 did not change.

CONCLUSION: This secondary analysis of data from a heterogenous cohort of adult CS did not support our hypothesis at the group level. However, at the individual level, responder analysis indicated improved balance in some survivors. Future research is needed to determine factors related to the cancer experience which might mediate balance outcomes to inform better integrative interventions.

PMID:39811878 | DOI:10.1177/15347354241313048

J Educ Health Promot. 2024 Nov 29;13:447. doi: 10.4103/jehp.jehp_1067_23. eCollection 2024.

ABSTRACT

BACKGROUND: Burnout is a mental condition caused by chronic emotional or psychological stress. Organizational commitment is always an important issue in the field of organizational development of clinical nurses. The study aimed to assess the association between organizational commitment, work environment, and burnout in clinical nurses.

MATERIALS AND METHODS: This is a correlational descriptive study that was conducted from November 2021 to January 2021 on 456 clinical nurses at the Hazrat Rasul Akram University Hospital in Iran. The convenience sampling method was used. Data were collected using socio-demographic and work-related data collection sheet, the Working Environment Scale (WES-10), the Organizational Commitment Questionnaire (OCQ), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Data were analyzed by the Statistical Package for the Social Sciences (SPSS) version 23.

RESULTS: The overall results showed that the mean score of organizational commitment was 29.87 ± 8.19, the mean score of burnout was 91.98 ± 17.40, and the mean score of work environment satisfaction was 24.62 ± 7.53. There were negative and significant relationships between organizational commitment with burnout (r = -0.324, P < 0.001) and work environment satisfaction (r = -0.440, P < 0.001). Also, there was a positive and significant relationship between work environment satisfaction with burnout (r = 0.386, P < 0.001).

CONCLUSION: The nursing profession is widely recognized as one of the most stressful professions, often characterized by high rates of staff turnover, absenteeism, and burnout. The result of this study highlights the importance of positive work conditions for ensuring the commitment and well-being of clinical nurses.

PMID:39811874 | PMC:PMC11731336 | DOI:10.4103/jehp.jehp_1067_23

J Educ Health Promot. 2024 Nov 29;13:442. doi: 10.4103/jehp.jehp_1301_23. eCollection 2024.

ABSTRACT

BACKGROUND: Learning and studying approaches are among the topics of great importance in medical sciences universities. Different approaches to learning can explain why some students learn better than others. This study aims to assess the relationship between learning or thinking styles and academic performance among nursing and medical students.

MATERIALS AND METHODS: This is a quantitative and cross-sectional study that was conducted on 364 nursing and medical students of Kermanshah University of Medical Sciences in 2022-2023. The tools used in the present study are as follows: the short version of the Approaches and Study Skills Inventory for Students, the Sternberg-Wagner Thinking Styles Inventory, the Academic Performance Index including the semester grade point average and the overall grade point average. Descriptive statistics, including mean and standard deviation were employed for data analysis. Moreover, inferential statistics such as normality or correlation coefficient, independent sample t-test, and regression analysis were used to determine the predictor coefficients.

RESULTS: A positive and significant correlation was found between nursing and medical students’ thinking or learning styles and their academic performance (P < 0.001). In addition, the two groups showed a statistically significant difference between learning styles with respect to gender (P < 0.001) and thinking styles (P < 0.001).

CONCLUSION: Since the strategic approach is a predictor of academic performance, identifying and determining the types of approaches adopted by students using diagnostic evaluation is a method of evaluating students’ learning styles at the beginning of the educational process so that teachers can tailor the most effective approach and instructional strategies that suit the needs of students and improve academic performance.

PMID:39811873 | PMC:PMC11731330 | DOI:10.4103/jehp.jehp_1301_23

J Educ Health Promot. 2024 Nov 29;13:420. doi: 10.4103/jehp.jehp_1370_23. eCollection 2024.

ABSTRACT

BACKGROUND: Pre-hospital emergency medical services (PHEMS) training system is an integral part of the health system of any country. Therefore, knowing the status of graduates of this field can provide a new analysis for the policymakers of the National Health System. The purpose of this study was to analyze the status of PHEMS graduates in Iran.

MATERIALS AND METHODS: The present survey research was conducted with the participation of 437 pre-hospital emergency medicine graduates of Iranian medical science universities in spring and summer of 2022. Sampling in this study was convenience. The documents of the National Organization of Educational Testing were used as well. The data collection tool was a researcher-made questionnaire. Statistical analyses were performed by SPSS25 software using descriptive statistics and analytical statistics.

RESULTS: Among the graduates, the largest number (41.5%) was reported to be in the associate degree. According to the emergency system structure in Iran, graduates were employed in operational, communication, and headquarters areas, respectively, of which 76.8% were working in government centers. Most of the graduates were from the medical sciences universities of Zone 2 (35.6%) in the eastern area of Iran, while most of the workers were related to the medical sciences universities of Zone 1 (27.9%) in the capital region.

CONCLUSION: Our findings revealed that the distribution of EMS graduates was not proportional to the distribution of the population and geographical area. Therefore, it is suggested that the policymakers of the country’s health system should make changes in the recruitment of students in each medical zone.

PMID:39811868 | PMC:PMC11731247 | DOI:10.4103/jehp.jehp_1370_23

Glob Health Res Policy. 2025 Jan 14;10(1):2. doi: 10.1186/s41256-024-00393-8.

ABSTRACT

BACKGROUND: As population aging intensifies, it becomes increasingly important to elucidate the casual relationship between aging and changes in population health. Therefore, our study proposed to develop a systematic attribution framework to comprehensively evaluate the health impacts of population aging.

METHODS: We used health-adjusted life expectancy (HALE) to measure quality of life and disability-adjusted life years (DALY) to quantify the burden of disease for the population of Guangzhou. The HALE and DALY projections were generated using both the Bayesian age-period-cohort models and the population prediction models. Changes in HALE and DALY between 2010-2020 and 2020-2030 were decomposed to isolate the effects of population aging. Three scenarios were analyzed to examine the relative relationship between disease burden and population aging. In Scenarios 1 and 2, the disease burden rates in 2030 were assumed to either remain at 2020 levels or follow historical trends. In Scenario 3, it was assumed that the absolute numbers of years of life lost (YLL) and years lived with disability (YLD) in 2030 would remain unchanged from the 2020 levels.

RESULTS: Between 2010 and 2020, 56.24% [69.73%] of the increase in male [female, values in brackets] HALE was attributable to the mortality effects in the population aged 60 and over, while – 3.74% [- 9.29%] was attributable to the disability effects. The increase in DALY caused by changes in age structure accounted for 72.01% [46.68%] of the total increase in DALY. From 2020 to 2030, 61.43% [69.05%] of the increase in HALE is projected to result from the mortality effects in the population aged 60 and over, while – 3.88% [4.73%] will be attributable to the disability effects. The increase in DALY due to changes in age structure is expected to account for 102.93% [100.99%] of the total increase in DALY. In Scenario 1, YLL are projected to increase by 45.0% [54.7%], and YLD by 31.8% [33.8%], compared to 2020. In Scenario 2, YLL in 2030 is expected to decrease by – 2.9% [- 1.3%], while YLD will increase by 12.7% [14.7%] compared to 2020. In Scenario 3, the expected YLL rates and YLD rates in 2030 would need to be reduced by 15.3% [15.4%] and 15.4% [15.6%], respectively, compared to 2020.

CONCLUSIONS: The disability effects among the elderly population hinder improvements in quality of life, while changes in age structure are the primary driver of disease burden accumulation. To mitigate the excess disease burden caused by population aging, it is essential to achieve a reduction of more than 15% in the disease burden by 2030 compared to 2020. Our proposed attribution framework evaluates the health impacts of population aging across two dimensions: quality of life and disease burden. This framework enables comparisons of these effects over time and across different regions.

PMID:39810282 | DOI:10.1186/s41256-024-00393-8

J Orthop Surg Res. 2025 Jan 15;20(1):46. doi: 10.1186/s13018-024-05419-y.

ABSTRACT

BACKGROUND: Wound repair methods are commonly used in clinical practice, such as skin graft and flap repair, which can cause secondary injuries, and high costs. Many methods for skin stretching and repair have been reported domestically and internationally. However, their clinical use is limited owing to lack of equipment, complexity, and high costs. Therefore, we introduce a novel technique to repair wound.

METHODS: We collected 125 patients with skin defects of lower limb from January 2019 to June 2024. Among them, 77 cases were repaired using our novel technique (suture-stretching technique, we designed a simple and feasible skin traction device that used 2-0 (polydioxanone sutures) PDS sutures, 2.0 mm Kirschner wires, and nylon binding tapes to repair skin defects and accommodate irregular wounds according to Ilizarov’s “tension-stress” law, SS group); skin grafting (SG group) was used for repairing 48 cases of wounds. We collected the data of the two groups, including wound size, number of debridements, operation time, wound healing time, hospital stays, and surgury cost, and the data were analyzed statistically.

RESULTS: There was no statistically significant difference between the two groups in terms of age, gender, wound size and wound healing time (p > 0.05).However, the number of debridements (p < 0.0001), operation time (p < 0.0001), hospital stays (p < 0.0001) and surgery time (p < 0.0001) in the suture group were better than those in the skin grafting group with statistically significant difference.

CONCLUSION: The application of suture-stretching technique to repair skin defect wounds of lower limb have good clinical efficacy, which can reduce the number of operations, shorten the operation time, and avoid secondary injuries caused by skin graft or skin flaps. Meanwhile, it also has obvious advantages regarding hospital stays and surgery costs.

PMID:39810267 | DOI:10.1186/s13018-024-05419-y

Arch Public Health. 2025 Jan 14;83(1):13. doi: 10.1186/s13690-024-01497-w.

ABSTRACT

BACKGROUND: A preterm neonate is defined by the World Health Organization as a child delivered before 37 weeks of gestation. In low- and middle-income countries, including Ethiopia, preterm-related complications are serious health problems due to increases in the mortality and morbidity of newborns and children under 5 years of age. The aim of this study was to assess the time to neonatal mortality and its predictors among preterm neonates admitted to the neonatal intensive care unit in northern Ethiopia, 2023/2024.

METHODS: An institution-based retrospective cohort study was conducted among 495 randomly selected preterm neonates in six out of the fourteen general hospitals of Tigray, Ethiopia from October 2023 to June 2024. Epi Data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Descriptive statistics were carried out to determine the distribution. Kaplan-Meier analysis, life table, and log rank were computed. Cox proportional hazards models were fitted to identify independent predictors of preterm mortality.

RESULTS: The proportion of preterm neonatal mortality was 109 (22.7%). The overall median survival time was 21 (95% CI: 20, 28) days. Initiation of breast milk (AHR = 0.38 (95% CI: 0.24, 0.61)), respiratory distress syndrome (AHR = 1.9 (95% CI: 1.07,3.63)), perinatal asphyxia (AHR = 2.05 (95% CI: 1.05, 4.00)), receiving kangaroo mother care practice (AHR = 0.5 (95% CI: 0.34, 0.83)), and gestational age (AHR = 1.6 (95% CI 1.07, 2.59) were the predictors of time to death.

CONCLUSION: Respiratory distress syndrome, gestational age less than 32 weeks, and perinatal asphyxia at admission were found to be independent risk factors for preterm neonatal mortality. Breastfeeding and receiving kangaroo-mother care were independent preventive predictors of preterm neonatal mortality. It is better to give full emphasis and close follow-up to preterm neonates, especially during the early neonatal period.

PMID:39810265 | DOI:10.1186/s13690-024-01497-w

Malar J. 2025 Jan 14;24(1):15. doi: 10.1186/s12936-025-05246-4.

ABSTRACT

BACKGROUND: The increased occurrence of malaria among Africa’s displaced communities poses a new humanitarian problem. Understanding malaria epidemiology among the displaced population in African refugee camps is a vital step for implementing effective malaria control and elimination measures. As a result, this study aimed to generate comprehensive and conclusive data from diverse investigations undertaken in Africa.

METHODS: This review adhered to PRISMA standards, involving searches across electronic data bases such as Google Scholar, PubMed, Web of Science, Scopus, and Science Direct. In addition, grey literature was retrieved from several professional associations. The quality of selected studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Data extraction was executed using Microsoft Excel, and the meta-analysis was performed with STATA 14 software. A random-effects model was used to estimate the pooled prevalence and associated factors of malaria. Meta-regression and subgroup analysis were used to identify heterogeneity, while funnel plots and Egger’s statistical tests assessed the publication bias. Furthermore, a sensitivity analysis was performed.

RESULTS: The overall random-effects pooled prevalence of malaria infection (comprising symptomatic and asymptomatic cases) across all included studies was 35.93% (95% CI 24.71-47.15). This study showed a high level of heterogeneity between studies (I2 = 97.1; P < 0.001). Of the identified Plasmodium species, Plasmodium falciparum constituted 99.3%. The frost plot indicated that the overall prevalence of P. falciparum was 34.94% (95% CI 24.34-45.53). Subgroup analysis revealed significant variation (P < 0.001) in malaria prevalence between asymptomatic and symptomatic cases, with a prevalence of 4.39% (95% CI 2.57-6.21) and 45.10% (95% CI 27.28-62.92), respectively. Lack of insecticide-treated mosquito net utilization (AOR 2.43; 95% CI 1.01-5.88) and living near mosquito breeding sites (AOR 2.76, 95% CI 1.56-4.87) were risk factors of malaria.

CONCLUSION: This study determined that the pooled prevalence of malaria among displaced individuals in refugee camps was high and exhibited variations across different population groups. This signifying there is still a need to improve and recheck existing malaria prevention and control strategies to establish an effective malaria control and elimination programme in Africa.

PMID:39810255 | DOI:10.1186/s12936-025-05246-4

BMC Psychol. 2025 Jan 14;13(1):37. doi: 10.1186/s40359-025-02347-2.

ABSTRACT

INTRODUCTION: Mental health is crucial for overcoming obstacles, completing tasks, and contributing to society. Mental, social, and cognitive healths are included. In demanding fields like medicine, academic pressure can cause exhaustion, poor performance, and behavioral changes. Mental health must be addressed to improve student success and well-being. Medical students’ coping strategies, anxiety, depression, and behavioral changes in uncontrollable situations will be studied.

METHODOLOGY: A cross-sectional study involved 393 medical students from various universities in Khartoum. Data was collected using an online questionnaire to assess mental health responses during both controllable and uncontrollable situations across all academic years.

RESULTS: Data analysis using SPSS 27 indicated minimal missing data (0.25%) among the 393 participants. PHQ-4 scores assessed psychological distress, anxiety, and depression. The study found that 74.2% of participants experienced behavioral, cognitive, and emotional changes. Significant associations were observed between PHQ-4 scores and these changes (p < .05) using Chi-Square testing. Most participants were females aged 20 to 22, primarily from the Medicine and Pharmacy departments. The study revealed that most individuals utilized pharmacological coping strategies following significant life changes due to uncontrollable situations.

CONCLUSION: The study highlights that women experienced stress, dissatisfaction, concern, and anger more frequently than men during ongoing war and the post-COVID-19 lockdown. Medical students faced substantial challenges in behavior, emotions, and cognition during societal unrest, including fatigue, feelings of failure, and sleep disturbances. Over 74% reported multiple changes in their emotions and behaviors. Coping strategies included nicotine, sleeping aids, socializing, exercise, venting, meditation, and journaling.

PMID:39810254 | DOI:10.1186/s40359-025-02347-2