Nevin Manimala

Am J Epidemiol. 2025 Jun 6:kwaf119. doi: 10.1093/aje/kwaf119. Online ahead of print.

ABSTRACT

Estimating the temporal trends in infectious disease activity is crucial for monitoring disease spread and the impact of interventions. Surveillance indicators routinely collected to monitor these trends are often a composite of multiple pathogens. For example, ‘influenza-like illness’-routinely monitored as a proxy for influenza infections-is a symptom definition that could be caused by a wide range of pathogens, including multiple subtypes of influenza, SARS-CoV-2, and RSV. Inferred trends from such composite time series may not reflect the trends of any one of the component pathogens, each of which can exhibit distinct dynamics. Although many surveillance systems routinely test a subset of individuals contributing to a surveillance indicator-providing information on the relative contribution of the component pathogens-trends may be obscured by time-varying testing rates or substantial noise in the observation process. Here we develop a general statistical framework for inferring temporal trends of multiple pathogens from routinely collected surveillance data. We demonstrate its application to three different surveillance systems covering multiple pathogens (influenza, SARS-CoV-2, dengue), locations (Australia, Singapore, USA, Taiwan, UK), scenarios (seasonal epidemics, non-seasonal epidemics, pandemic emergence), and temporal reporting resolutions (weekly, daily). This methodology is applicable to a wide range of pathogens and surveillance systems.

PMID:40481640 | DOI:10.1093/aje/kwaf119

Psychol Rep. 2025 Jun 6:332941251347255. doi: 10.1177/00332941251347255. Online ahead of print.

ABSTRACT

Anomalous experiences are often viewed as red flags for psychosis-yet many individuals who report them show no signs of clinical disorder. This study reveals a paradox: traits associated with the Highly Sensitive Person (HSP) do not increase Anomalous Perceived Phenomena (APP). Instead, when considered within the Psychosis Continuum Model (PCM), sensitivity appears to act as a suppressor. Drawing on data from 1215 adults, we tested the Integrated Temperamental-Sensitivity Theory of Anomalous Experience (ITSTAE), a multifactorial model integrating temperament, HSP traits, and PCM dynamics. As expected, psychotic traits predicted higher APP scores. However, HSP traits only became predictive when moderated by PCM-and notably, the effect was negative. The more sensitive the individual, the fewer anomalous perceptions they reported under psychotic pressure. Structural Equation Modeling (SEM) confirmed the model’s fit, with explained variance in APP rising from 47.1% to 61.4% when PCM mediation was included. Multitrait-Multimethod (MTMM) analyses further validated the conceptual independence of HSP and PCM. These findings challenge psychiatric reductionism and suggest a more nuanced, non-pathologizing lens on altered perception. Far from signaling fragility, heightened sensitivity may serve as a buffer-a cognitive shield-against psychosis-linked anomalous experiences. This model reframes sensitivity not as vulnerability, but as a form of psychological complexity.

PMID:40481636 | DOI:10.1177/00332941251347255

Am J Hum Biol. 2025 Jun;37(6):e70082. doi: 10.1002/ajhb.70082.

ABSTRACT

PURPOSE: To investigate the interrelationships between 24-h movement behaviors, health-related physical fitness, and inhibitory control performance in adolescents.

METHODS: This cross-sectional study included 216 Brazilian adolescents (aged 16.7 ± 1.2 years) from a federal public school. Movement behaviors-moderate-to-vigorous physical activity (MVPA), smartphone screen time, sleep duration, and excessive daytime sleepiness-were assessed using the Global School-based Student Health Survey, digital well-being tools, and the Pediatric Daytime Sleepiness Scale. Aerobic capacity was measured using the PACER test, muscular strength by the FitnessGram push-up test, and body composition through body mass index. Inhibitory control was assessed using the Flanker task (E-Prime v3.0). Separate network analyses were performed for congruent and incongruent reaction times (RT).

RESULTS: Physically active adolescents had faster RTs than their insufficiently active peers, with physical activity negatively associated with RT in both the congruent (-0.116) and incongruent (-0.125) networks. Aerobic capacity (e.g., expected influence: 0.879-0.902) and muscular strength (expected influence: 1.360-1.384) appeared as central components in both network structures. However, no associations were found between sleep duration, screen time, or excessive daytime sleepiness and inhibitory control.

CONCLUSIONS: Adherence to MVPA guidelines was directly associated with improved inhibitory control performance among adolescents. Health-related physical fitness, particularly aerobic capacity and muscular strength, was indirectly associated with inhibitory control. Other movement behaviors were not associated with cognitive performance in this sample.

PMID:40481614 | DOI:10.1002/ajhb.70082

BMC Psychol. 2025 Jun 6;13(1):623. doi: 10.1186/s40359-025-02945-0.

ABSTRACT

BACKGROUND: This study examines the mechanisms linking parental psychological control and depressive symptomatology among Chinese junior middle school students, focusing on the mediating role of psychological resilience and the moderating role of school climate.

METHOD: A questionnaire survey was conducted among 1991 middle school students using a depressive symptomatology scale, the psychological control sub-questionnaire, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived School Climate Scale. Data analysis included descriptive statistics, correlation analysis, and tests of the moderated mediation model.

RESULTS: (1) parental psychological control positively predicts depressive symptomatology (β = 0.34, p < 0.001), with psychological resilience mediating this relationship (β = 0.02, 95% Bootstrap CI= [0.01, 0.04]); (2) in the mediation model, school climate moderates the first and second half pathways (β_{parental psychological control× school climate} = -0.03, 95% Bootstrap CI= [-0.07, -0.00]; β_{psychological resilience × school climate} = -0.08, 95% Bootstrap CI= [-0.11, -0.05]) and the mediating effect. Specifically, under a high-level school climate, the effect of parental psychological control on psychological resilience, and the effect of psychological resilience on depressive symptomatology were significantly stronger than those in a low-level school climate. The indirect effect of psychological resilience was also stronger in a high-level than a low-level school climate (Contrast _{high minus low level} = 0.03, 95% CI [0.01, 0.05]. Psychological resilience could not moderate the psychological control-depressive symptomatology relationship.

CONCLUSION: Parental psychological control indirectly affects depressive symptomatology through psychological resilience, with school climate moderating the mediating effect. The findings show how family and school environments, along with individual traits, collectively influence adolescents’ depressive symptomatology. The study has the following application implications. Interventions such as the resilience-building program and the mindfulness program could improve parents’ educational styles and students’ psychological resilience respectively. Educators can strengthen school climate through learning guidance and game activities and so on. Courses such as teacher training should incorporate methods of family-school collaboration. Further longitudinal studies could explore the development of the relationships between the main variables. Objective measurements could also be incorporated for more accurate measurement.

PMID:40481606 | DOI:10.1186/s40359-025-02945-0

J Occup Med Toxicol. 2025 Jun 6;20(1):19. doi: 10.1186/s12995-025-00467-4.

ABSTRACT

BACKGROUND: Occupational factors and the type of instrument played may influence physical and psychological health, affecting oral health-related quality of life (OHRQoL). This study assessed the prevalence of orofacial pain, sleep bruxism, stress, and OHRQoL among woodwind musicians (oboe, flute, clarinet, bassoon) in German professional orchestras, compared to cellists.

METHODS: A standard online questionnaire was sent to all 129 German professional orchestras. Orofacial pain, stress, and sleep-related issues in the past 30 days were evaluated. The German version of the Oral Health Impact Profile-14 (OHIP-14) assessed OHRQoL. Logistic and linear regression analyses were performed (statistical significance p < 0.05).

RESULTS: A total of 243 musicians were included. Orofacial pain was reported by 35.8%, sleep bruxism by 63.0%, and stress by 88.9% of the participant. Orofacial pain was significantly associated with female gender (p = 0.027; odds ratio [OR] = 2.09, 95% confidence interval [CI]: 1.09-4.02), frequent sleep bruxism (p = 0.013; OR = 2.65, 95%-CI: 1.23-5.69), frequent stress (p = 0.002; OR = 3.19, 95%-CI: 1.53-6.63), and difficulties initiating sleep after evening shifts (p = 0.003; OR = 2.90, 95%-CI: 1.45-5.80), but not with the instrument played. OHIP-14 scores did not differ significantly between instrument groups (p = 0.629), but correlated with orofacial pain (p < 0.001), sleep bruxism (p < 0.001), stress (p = 0.002), and sleep difficulties (p = 0.040).

CONCLUSIONS: Orofacial pain and sleep bruxism are common among professional musicians, with stress-related factors playing a more significant role than the instrument played.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT06618898, 27.09.2024.

PMID:40481603 | DOI:10.1186/s12995-025-00467-4

Eur J Med Res. 2025 Jun 7;30(1):464. doi: 10.1186/s40001-025-02724-y.

ABSTRACT

BACKGROUND: A single-center retrospective study was conducted to investigate whether the prophylactic application of a single-use negative pressure wound therapy (sNPWT) dressing on closed surgical incisions following incisional hernia (IH) repair of the abdominal wall with meshes reduces the risk of surgical site occurrence (SSO) and the necessity for surgical reoperation.

METHODS: A retrospective study was conducted on 55 patients with incisional hernias classified as W2 (> 4-10 cm) or W3 (> 10 cm) according to the European Hernia Society classification, treated between 2013 and 2023. All patients underwent open surgical repair with mesh and were assigned to either a conventional flat dressing group (n = 34) or an sNPWT group using PICO 7 (n = 21). Weekly follow-ups were performed, and outcomes were statistically analyzed to compare the incidence of SSOs and reoperations between the two groups.

RESULTS: At 30 days postoperatively, the control group showed a higher incidence of SSOs (32.35%, 11 cases) compared to the PICO 7 group (19.05%, 4 cases, P = 0.28). The need for surgical reintervention was also higher in the control group (17.65%, 6 cases) versus the PICO 7 group (10.53%, 2 cases, P = 0.41). Regardless of dressing type, elevated BMI (P = 0.02), advanced age, and diabetes were identified as key risk factors for SSOs.

CONCLUSIONS: sNPWT with PICO 7 may reduce SSOs and reoperations in open incisional hernia repair, particularly in high-risk patients with elevated BMI. Although statistical significance was not achieved, sNPWT appears to be a valuable adjunct in postoperative management. Further research is necessary to confirm its efficacy and determine the ideal patient population.

PMID:40481597 | DOI:10.1186/s40001-025-02724-y

J Health Popul Nutr. 2025 Jun 6;44(1):191. doi: 10.1186/s41043-025-00937-9.

ABSTRACT

BACKGROUND: Childhood obesity is not only a concern for the immediate health of children but also imposes varied health implications throughout the life course and a significant burden on the healthcare system. Parental feeding attitudes and lifestyles, especially mothers’, significantly influence the development of children’s eating behaviours and nutritional outcomes. This study examines the relationship between ‘maternal junk food consumption’ and ‘childhood obesity’ in India.

METHODS: Using the 2021 round of the National Family Health Survey, we analysed data from 191,126 children aged 0-5 years across 36 states and Union Territories of India. The study measured childhood overweight/obesity through weight-for-height Z-scores (WHZ). Further, the study constructed a junk food consumption intensity score by creating a composite measure based on the intake frequency of aerated drinks and fried foods. We employed multiple binary logistic regression models and robustness checks to examine the association between ‘maternal junk food consumption’ and ‘children with overweight/obesity’ net of parental, household, and geographical characteristics.

RESULTS: Children of mothers with high junk food consumption exhibited a higher prevalence (4.01%) compared to those with moderate (3.29%) and no/low consumption (3.27%). The differences further increased when we adjusted the results for other covariates. Adjusted odds ratio shows that children of mothers with “high” and “moderate” junk food consumption have 1.390 (p < 0.01) times and 1.204 times (p < 0.05), respectively, higher odds of having children with overweight or obesity compared to those with “no/low” consumption. Further, the results are confirmed through multiple robustness checks.

CONCLUSIONS: Interpreting these results in the context of existing evidence and policy suggests that tackling childhood obesity necessitates comprehensive, multi-level interventions – spanning individual, family, community and facility levels. These interventions should aim to enhance food and nutrition literacy, foster healthy dietary practices, and promote positive behaviours that minimise risks associated with all obesogenic factors among children and their families.

PMID:40481596 | DOI:10.1186/s41043-025-00937-9

Addict Sci Clin Pract. 2025 Jun 6;20(1):47. doi: 10.1186/s13722-025-00574-x.

ABSTRACT

BACKGROUND: High-risk opioid prescribing (e.g., high daily dose opioids, concurrent opioid-sedatives) is prevalent in hospitals and linked to adverse outcomes. Opioid stewardship programs (OSP) have the potential to reduce high-risk opioid prescribing through audit-and-feedback recommendations.

METHODS: We evaluated an audit-and-feedback based OSP implemented in January 2020 at a Vancouver, Canada tertiary care hospital using interrupted time series analysis. An electronic health record (EHR) system with computerized provider order entry (CPOE) was simultaneously operationalized. The main outcome was: any high-risk opioid prescribing (based on 10 evidence-based indicators), including high daily dose of morphine milligram equivalent (MME) prescribing (> 90MME), long opioid prescription duration (> 5 days post-admission), and concurrent opioid-sedative prescribing.

RESULTS: Between January 2018 and March 2022, 5,477 active opioid patient encounters were included. While no significant change occurred in overall high-risk opioid prescribing post-OSP (p > 0.05), a significant reduction was seen in the level of high daily dose of MME prescriptions (estimate: -0.044; 95% confidence interval [CI]: -0.082, -0.006). Conversely, the trend in long opioid duration increased (estimate: 0.006; 95%CI: 0.000, 0.011), likely due to the removal of automatic stop dates with the implementation of the EHR with CPOE. Post-OSP intervention, we initially saw an acute increase in concurrent opioid-sedative prescriptions (estimate: 0.013; 95%CI: 0.005, 0.020). A benzodiazepine ordering intervention implemented in May 2021 reversed this trend, reducing both the level (estimate: 0.874; 95%CI: 0.374, 1.375) and slope (estimate: -0.022, 95%CI: -0.034, -0.011) of concurrent prescriptions.

CONCLUSION: The implementation of a new EHR concordant with that of the OSP may have impacted our study’s results. While our research suggests the OSP reduced high-dose opioid prescribing, other indicators impacted by the EHR system did not benefit as highly from the OSP. Nevertheless, the OSP proved able to rapidly respond to unintended consequences by introducing interventions to reduce concurrent opioid and sedative prescribing.

PMID:40481582 | DOI:10.1186/s13722-025-00574-x

Popul Health Metr. 2025 Jun 6;23(1):22. doi: 10.1186/s12963-025-00386-w.

ABSTRACT

BACKGROUND: In this scoping review, we aimed to examine evidence on methods used to construct disability indicators in linked administrative datasets and describe the approaches used to assess the validity of the indicators.

METHODS: Medline (Ovid) and Embase (Ovid) were searched for studies published between January 2010 and June 2023. Original, peer-reviewed studies that aimed to construct a disability indicator using linked administrative data sources were included. Studies identifying any types of disability were included, but not those which defined the target population in terms of specific health conditions. We produced a narrative synthesis of findings related to disability indicator construction methods and validation approaches.

RESULTS: Thirty-six relevant studies were included, with 30 of those identifying a cohort of people with intellectual and/or developmental disability. Health data sources were most commonly used for indicator construction, with 33 of the studies using at least one health data source. Disability and education sector data sources were also commonly used. Diagnostic codes were used for disability identification in 34 of the 36 studies; 16 used diagnostic codes alone and 18 used diagnostic codes along with other information. A subgroup of 19 studies had a primary aim to create a disability cohort or estimate disability prevalence. Thirteen of these 19 studies compared their estimated prevalence rates with previously published estimates. Only five studies conducted testing to investigate the extent to which their derived disability indicator captured the intended target population.

DISCUSSION: We found a paucity of evidence on methods for identifying a target population of people with diverse disabilities. In the existing literature, diagnostic information is relied upon heavily for disability identification, likely due to a lack of other types of disability-relevant information in administrative data sources. Use of derived disability indicators within linked data holds potential to advance research regarding people with disability. It is crucial, however, to conduct and report validation testing to understand the strengths and limitations of the indicators and inform their use for specific purposes.

PMID:40481580 | DOI:10.1186/s12963-025-00386-w

BMC Nurs. 2025 Jun 6;24(1):650. doi: 10.1186/s12912-025-03311-6.

ABSTRACT

BACKGROUND & AIM: Migration is a phenomenon that both developed and developing countries are struggling with. Given that the decision to migrate is formed during the student period, the present study aimed to compare the degree of intention to migrate and related factors in undergraduate nursing students at universities of medical sciences in Kerman, Iran and Erbil, Iraq in 2023.

METHODS: This cross-sectional descriptive study focused on a sample of nursing students from Kerman University of Medical Sciences, Polytechnic, and Hawler University of Iraq. To ensure a representative sample, a simple random sampling method was utilized. The sample size conducted on 487 nursing students. 272 students selected from Kerman University of Medical Sciences and 215 students from Erbil University in Iraq. Data collection was performed using a structured questionnaire, which included items related to the intention to migrate, factors influencing this intention, and demographic information. The collected data were analyzed using both descriptive and correletional statistical methods, And SPSS-22 software was used.

FINDINGS: The data revealed that 69.5% of Iranian nursing students and 58.1% of Iraqi nursing students intended to emigrate. The most important reasons for the intention to migrate among Iranian students were better quality of life (4.39), the balance between income and living expenses (4.35), and economic and social stability (4.34). In addition, Iraqi students reported better quality of life (3.89), professors’ behavior with students (3.70), and professors’ teaching methods (3.56) as the reasons behind their intention to migrate.

CONCLUSION: Iranian and Iraqi nursing students had a significant intention to migrate. Thus, effective policies should be adopted to reduce the intention to migrate among nursing students. Moreover, interventional studies need to explore the factors that can motivate this group of students to stay in the country.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40481576 | DOI:10.1186/s12912-025-03311-6