Nevin Manimala

BMC Med Educ. 2024 Dec 23;24(1):1521. doi: 10.1186/s12909-024-06548-y.

ABSTRACT

BACKGROUND: Medical research is an essential aspect of the training of resident doctors and is required by postgraduate medical colleges in Nigeria as part of the fulfilment of fellowship awards. However, research participation among resident doctors in Nigeria is low, despite seemingly high interest in research among resident doctors. The objective of our study is to examine the knowledge, attitudes, practices, and barriers related to medical research among resident doctors in a public and private tertiary care in Nigeria.

METHODOLOGY: The study is a descriptive cross-sectional study carried out between November 2023 and December 2023 in a public tertiary hospital and a private tertiary hospital in Nigeria. A total of 352 participants were recruited for the study-303 from the public tertiary hospital and 49 from the private tertiary hospital. The obtained data were analysed using SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.). The significance level was set at P < 0.005.

RESULTS: The majority (63.92%) of the participants had spent between 2 and 5 years in residency training. A total of 57.67% had participated in research other than dissertations, while 35.23% had participated in research publications. The majority (48.58%) of participants assessed their research knowledge to be fair, whereas 2.56% assessed their knowledge to be excellent. Multivariate analysis revealed a significant positive correlation between self-reported knowledge of research and the number of research publications (adjusted ρ = 0.332; P < 0.001). The leading (60.8%) barrier to research participation among resident doctors in Nigeria was lack of time due to stress/pressure of the residency program. An overwhelming majority (95.17%) of resident doctors have shown interest in research participation, and up to 75.87% even want it to be mandatory for all resident doctors in Nigeria.

CONCLUSION: This study showed that despite limited participation, resident doctors have a positive attitude towards research. However, there is a struggle to translate this enthusiasm into practical application; hence, there is a need to address the barriers to effective participation of resident doctors in medical research.

PMID:39716182 | DOI:10.1186/s12909-024-06548-y

BMC Nurs. 2024 Dec 23;23(1):945. doi: 10.1186/s12912-024-02640-2.

ABSTRACT

INTRODUCTION: Simulation is defined as “the processes by which we are trying to achieve results approximating clinical practice as closely as possible.” It is a technique for replacing or completing real-life experiences with guided experiences.

OBJECTIVE: To assess and explore clinical simulation practice and associated factors among nurse and midwife educators working at teaching institutions in Bahir Dar, Ethiopia.

METHOD: An institutional mixed-method study was conducted from May 9 to June 7, 2022, at six teaching institutions in Bahir Dar City. A sample size of 220 was taken into account for the quantitative study, and a self-administered questionnaire was used to gather data. In-depth interviews were used to acquire data for the qualitative study, which involved eight participants. The data was entered into EpiData and exported to SPSS version 26 for additional analysis after being reviewed for consistency and completeness. To evaluate the relationship between the dependent and independent variables, binary logistic regression analysis with both (bi-variant) and (multivariable) inputs was carried out.

RESULT: Among respondents, 104 (49.1%) were government employees. Most of the respondents in this study were male (65.6%). Statistically significant associations simulation practice experience (AOR = 0.21; 95% CI: 0.07-64), training (AOR = 0.52; 95% CI: 0.27-0.98), educational qualification (AOR = 0.37; 95% CI: 0.15-0.93) and cost (AOR = 0.37; 95% CI: 0.18-0.74). The study showed that only 121 (57%) of the respondents’ practices were classified as “good practice,” while 91 (42.9%) were classified as “poor practice.” Qualitative findings revealed that a lack of classroom space, inadequate training in the institution, and a consistent checklist hampered the implementation of clinical simulation practice. CONCLUSION AND RECOMMENDATION: We determined that a shortage of classroom space, inadequate resources, high costs, and an absence of ongoing training were the key obstacles to the successful implementation of clinical simulation practice. Responsible governmental bodies should give attention for clinical simulation education.

PMID:39716181 | DOI:10.1186/s12912-024-02640-2

BMC Med Educ. 2024 Dec 23;24(1):1518. doi: 10.1186/s12909-024-06460-5.

ABSTRACT

BACKGROUND: Due to the complex and abstract anatomy of the nervous system, neurology has become a difficult subject for students of clinical disciplines. It is imperative to develop new teaching methods to improve students’ enthusiasm for learning this course. Small private online courses (SPOC) combined with problem based learning (PBL) blended teaching models based on massive open online course (MOOC) provides a new direction for future neurology teaching reform. This study aimed to investigate the effectiveness of applying SPOC combined with PBL in neurology teaching.

METHODS: This study was conducted during the 2020 intake of undergraduate students at the Second Hospital and Clinical Medical School, Lanzhou University. A total of 48 students were enrolled in the study and randomly assigned to either a Lecture-Based Learning (LBL) group or a SPOC + PBL group, with 24 participants in each group. After the classes, comparisons were made between the two groups in terms of teaching methods, increases in learning interest, level of participation in learning, satisfaction, and closed-book unit test scores.

RESULTS: The average unit test score of the SPOC + PBL group was 84.29 ± 1.65, the average score of LBL group was 77.0 ± 1.92. The difference in average scores between the two groups was statistically significant (P < 0.01). The proportion of students with 91-100 points in SPOC + PBL group was higher than that of LBL group, and the difference was statistically significant, P < 0.01. Student satisfaction survey in the SPOC + PBL group was significantly higher than that in the LBL group, P < 0.01.

CONCLUSIONS: The application of SPOC combined with PBL teaching based on MOOC in neurology teaching may be more effective than traditional LBL model. It is expected to help medical students overcome the “fear” of learning neurological diseases, improve the teaching effect of neurology courses, and meet the needs of modern medical education by employing a hybrid course structure and adopting a problem-oriented approach.

PMID:39716179 | DOI:10.1186/s12909-024-06460-5

BMC Public Health. 2024 Dec 23;24(1):3565. doi: 10.1186/s12889-024-21140-1.

ABSTRACT

BACKGROUND: The duration of sleep is linked to a range of disorders. Osteoarthritis (OA) stands as one of the most prevalent forms of arthritis and serves as a leading cause of disability. The correlation between the duration of sleep and OA remains ambiguous. Research indicates that waist circumference correlates with sleep duration and OA, respectively. This study aimed to investigate the association of sleep duration with OA and the mediated effect of waist circumference.

METHODS: The study sample comprised adults who were participants in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Insufficient sleep is characterized by a duration of less than seven hours, whereas 7-8 h is considered appropriate, and 9 h or more is categorized as a long sleep duration. Three models were employed in this study. Model 1 was not adjusted for any covariates, while Model 2 was adjusted for sex, age, and race. Model 3 has been adjusted to account for all covariates. Utilizing multivariable logistic regression, subgroup analysis, interaction tests and smoothing curve fitting, the correlation between sleep duration and OA was explored. The mediating effect of waist circumference on the association between sleep duration and OA was investigated through mediation analysis.

RESULTS: In this study, 9380 did not have OA, while 2424 were diagnosed with the ailment. After multivariable adjustment, the odds ratios (OR) for OA were 1.19 (95% CI 1.06, 1.34; P = 0.0026) for people with insufficient sleep duration and 1.18 (95% CI 1.03, 1.35 P = 0.0142) for participants with long sleep duration. Sleep duration and the incidence of OA were found to be related in a U-shaped manner. Additionally, 12.1% of the correlation between sleep duration and OA appeared to be mediated by waist circumference.

CONCLUSIONS: Increased OA was found to be correlated in a U-shaped manner with sleep duration in the middle-aged and elderly cohorts. Both insufficient and long sleep duration contribute to an elevated risk of developing OA. A potential mediating factor in the association between OA and sleep duration is waist circumference. Focus on sleep health and visceral obesity in middle-aged and older adults is necessary.

PMID:39716177 | DOI:10.1186/s12889-024-21140-1

BMC Musculoskelet Disord. 2024 Dec 23;25(1):1063. doi: 10.1186/s12891-024-08181-8.

ABSTRACT

BACKGROUND: The main key to the 4th industrial era is robots, and wearable robots are incorporated into human healthcare. Samsung Electronics’ Bot Fit is a hip joint-centered assistive robot that can induce walking posture and energetic walking exercises.

METHODS: This study is a cross-section study. Fifty-eight subjects consisting of older and younger adults participated. The straight walking test was conducted under the conditions of bare body, wearing the wearable robot Bot Fit assist mode, and applying voice coach. Spatio-temporal gait parameters were analyzed and the statistical significance level was set at 0.05.

RESULTS: When assist mode and voice coach were applied, pelvic movement in 3 axes, stride length, and walking speed compared to the bare body increased. In young adults, stride length difference decreased in assist mode 1 and voice coach 1 compared to the bare body.

CONCLUSION: Bot Fit’s assist mode and voice coach method positively influence walking efficiency, posture, stride length, and speed, though potential interaction effects between these interventions should be considered. Personalized, real-time adjustments show promise for optimizing walking exercises, warranting further investigation into their long-term and population-specific effects.

TRIAL REGISTRATION: Clinical Research Information Service, KCT0007974. Registered 12/07/2022.

PMID:39716173 | DOI:10.1186/s12891-024-08181-8

BMC Med Imaging. 2024 Dec 23;24(1):348. doi: 10.1186/s12880-024-01504-0.

ABSTRACT

OBJECTIVES: To investigate the diagnostic value of CT lymphangiography (CTL) and non-contrast MR lymphangiography (MRL) in lymphatic plastic bronchitis.

MATERIALS AND METHODS: The clinical and imaging data of 31 patients with lymphatic plastic bronchitis diagnosed by clinical, imaging and pathological results were retrospectively analyzed. All patients underwent CTL and MRL. The imaging findings of patients include: (i) abnormal lymphatic reflux of the bronchial mediastinal trunk, the subclavian trunk, the cervical trunk, the thoracic duct and the right lymphatic duct; Abnormal CTL reflux refers to abnormal iodide deposition outside the normal lymphatic reflux pathway; If the MRL can observe abnormal lymphatic dilatation, hyperplasia, or morphological abnormalities, it is assumed that abnormal lymphatic reflux may be present.; (ii) abnormal morphological changes of lymphatic vessels at the extremity of the thoracic duct, the extremity of the right lymphatic duct and the mediastinum, such as spot-like or tubular, cystic changes; (iii) abnormal CTL and MRL signs in the lungs. The Mcnemar test was used to compare the parameters between CTL and MRL. P< 0.05 was statistically significant. The Kappa test was used to evaluate the consistency of CTL and MRL in evaluating lymphatic plastic bronchitis.

RESULTS: MRL was superior to CTL in detecting abnormal lymphatic reflux in the right lymphatic vessel, thoracic duct, cervical trunk and subclavian trunk (P< 0.05).and the diagnostic consistency was general (Kappa < 0.40). There was no significant difference between MRL and CTL in the detection of abnormal lymphatic reflux in the bronchial mediastinal trunk (P> 0.05), and the diagnostic consistency was good (Kappa > 0.60). MRL was superior to CTL in detecting lymphatic abnormalities such as cystic changes at the extremity of the thoracic duct, spot-like or tubular changes at the extremity of the right lymphatic duct, cystic changes at the extremity of the right lymphatic duct, and cystic changes in the mediastinum (P< 0.05), and the diagnostic consistency was poor, fair, fair, and moderate (Kappa < 0.60), respectively. MRL and CTL showed abnormal signs in the lung: CTL was superior to MRL in showing the thickening of interlobular septum, lung nodules and airway stenosis (P< 0.05), and the diagnostic consistency was moderate, moderate and poor (Kappa < 0.60). There was no significant difference between CTL and MRL in atelectasis, consolidation in lobar and segmental distribution, consolidation in non-lobar and segmental distribution, and the thickening of the bronchovascular bundle (P> 0.05), and the diagnostic consistency was very good, very good, good, good (Kappa > 0.60). There was no significant difference between CTL and MRL in ground glass opacity, airway wall thickening and intralobular interstitial thickening (P> 0.05), and the diagnostic consistency was average, fair and poor (Kappa < 0.40).

CONCLUSION: The MRL is superior to CTL in showing the abnormalities of the thoracic duct, the right lymphatic duct and other abnormal lymphatic vessels. CTL is superior to MRL in the detection of pulmonary abnormalities. The combination of CTL and MRL can provide more comprehensive imaging information for diagnosing and treating lymphatic plastic bronchitis.

PMID:39716172 | DOI:10.1186/s12880-024-01504-0

BMC Pregnancy Childbirth. 2024 Dec 23;24(1):852. doi: 10.1186/s12884-024-07081-y.

ABSTRACT

BACKGROUND: Preeclampsia is a severe pregnancy complication affecting 2-8% of pregnancies globally, contributing to substantial maternal and fetal morbidity and mortality. Vitamin D deficiency has been associated with an increased risk of preeclampsia, yet the efficacy of its supplementation during pregnancy in reducing preeclampsia incidence remains uncertain.

OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the impact of vitamin D supplementation on the incidence of preeclampsia and related maternal and neonatal outcomes.

METHOD: We systematically searched PubMed, Scopus, Cochrane Library, and Web of Science until August 2024 for randomized controlled trials (RCTs) examining the effects of vitamin D supplementation on preeclampsia. Eligible studies included pregnant women with varying doses of vitamin D supplementation compared to placebo or standard care. Primary outcomes were the incidence of pre-eclampsia and preterm labor; secondary outcomes included serum 25-hydroxyvitamin D levels, low birth weight, and APGAR scores. Data were synthesized using R statistical software, with effect measures reported as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI).

RESULTS: A total of 33 RCTs involving 10,613 participants were included. Vitamin D supplementation significantly reduced the risk of preeclampsia by 44.8% (RR = 0.55, 95% CI [0.43, 0.71], P < 0.0001) and preterm labor by 30% (RR = 0.70, 95% CI [0.51, 0.96], P = 0.0286). Subgroup analyses indicated that the benefits were more pronounced when the control group received a placebo rather than low-dose vitamin D. Serum 25-hydroxyvitamin D levels significantly increased in the supplementation group (MD = 32.42 nmol/L, 95% CI [20.33, 44.50], P < 0.0001). However, no significant differences were observed in the incidence of low birth weight (RR = 0.65, 95% CI [0.42, 1.02], P = 0.057) or Apgar scores at 5 min (MD = 0.20, 95% CI [-0.01, 0.40], P = 0.057).

CONCLUSION: Vitamin D supplementation during pregnancy significantly reduces the risk of preeclampsia and preterm labor, though its impact on neonatal outcomes remains unclear. These findings underscore the potential value of vitamin D supplementation in prenatal care for improving maternal outcomes. Further research is needed to clarify its effects on neonatal health.

PMID:39716171 | DOI:10.1186/s12884-024-07081-y

J Neuroeng Rehabil. 2024 Dec 23;21(1):227. doi: 10.1186/s12984-024-01507-6.

ABSTRACT

OBJECTIVE: Cognitive-motor dual-tasking training (CMDT) might improve limb function and motor performance in stroke patients. However, is there enough evidence to prove that it is more effective compared with conventional physical single-task training? This meta-analysis and Trial Sequential Analysis of randomized clinical trials (RCTs) aimed to evaluate the effectiveness of CMDT on balance and gait for treating hemiplegic stroke patients.

METHODS: The databases were searched in PubMed, Web of Science, Ovid Database and The Cochrane Library, SinoMed database, Chinese National Knowledge Infrastructure (CNKI), Wan Fang database, and VIP database up to December 8, 2023. The Cochrane-recommended risk of bias (RoB) 2.0 tool was employed to assess risk of bias in trials. The statistical analysis was employed using R version 4.3.2. In addition, subgroup analyses and meta-regression were performed to explore the possible sources of heterogeneity. The evidence for each outcome was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. The Copenhagen Trial Unit’s Trial Sequential Analysis (version 0.9.5.10 Beta) was used for sequential analysis.

RESULTS: Seventeen randomized clinical trials (RCTs) (n = 751 patients) were included. The results demonstrated that cognitive-motor dual-task training (CMDT) might be beneficial on stroke patients on Berg Balance Scale (BBS) (MD = 4.26, 95% CI 1.82, 6.69, p < 0.0001) (low-quality evidence). However, CMDT might not affect Time Up and Go test (TUG) (MD = -1.28, 95% CI -3.63, 1.06, p = 0.284); and single-task walking speed (MD = 1.35, 95% CI -1.56, 4.27, p = 0.413) in stroke patients (low-quality evidence). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) results indicated that all findings were very low to low certainty. Trial Sequential Analyses demonstrated larger sample sizes are required for confirming our findings.

CONCLUSION: Cognitive-motor dual-task training (CMDT) compared with conventional physical single-task training might be an effective intervention for improving static balance function in stroke patients (low-quality evidence), which should be interpreted cautiously due to heterogeneity and potential biases. Nevertheless, further research is required to support the abovementioned findings. Trial Registration This protocol was registered in PROSPERO (CRD42023490530).

PMID:39716165 | DOI:10.1186/s12984-024-01507-6

BMC Psychiatry. 2024 Dec 23;24(1):940. doi: 10.1186/s12888-024-06412-9.

ABSTRACT

BACKGROUND: New mothers frequently encounter postpartum depression, anxiety, and stress symptoms, which pose challenges in diagnosis and treatment owing to their intricate interplay. This study employs network analysis to explore the interconnections between these symptoms and identify potential intervention points.

METHODS: The study was carried out from December 2023 to June 2024 at the postpartum clinics of three representative tertiary hospitals in Nantong City. The participants were mothers undergoing their 42-day postpartum check-up. Participants completed the Edinburgh Postnatal Depression Scale (EPDS), the Depression, Anxiety, and Stress Scales (DASS-21), and the Maternal postpartum stress scale (MPSS). The R language was used to construct the network. Network analysis was also carried out to explore the network structure, centrality indices (strength, closeness, betweenness, and expected influence), and the stability of the network.

RESULTS: A total of 625 women were included. The resulting network indicates a close interconnection between communities associated with depression, anxiety, and stress. As assessed on the centrality index, “I have felt sad or miserable” (EPDS-8), “Baby’s irregular patterns of daily sleep” (MPSS-9), “lack of time for myself” (MPSS-19), “I have been so unhappy that I have been crying” (EPDS-4), and “Physical appearance after childbirth” (MPSS-20) are the five most important nodes of these three network structures. High network stability (> 0.7).

CONCLUSION: Postpartum-specific stress symptoms play a significant role in the network of postpartum depression, anxiety, and stress, and identifying the central symptoms of depression, anxiety, and stress can provide a scientific basis for the development of precise interventions.

CLINICAL TRIAL NUMBER: Not Applicable.

PMID:39716162 | DOI:10.1186/s12888-024-06412-9

BMC Med Inform Decis Mak. 2024 Dec 23;24(1):400. doi: 10.1186/s12911-024-02826-3.

ABSTRACT

BACKGROUND: Hypoglycaemia is one of the most common complications during the neonatal period. Recurrent hypoglycaemia episodes can result in neurodevelopmental deficits and even sudden death. Available evidence indicates that healthcare professionals ought to promptly assess the risk of hypoglycaemia in newborns immediately following birth and formulate the most suitable preventive strategies. Consequently, this study was designed to develop a clinical nursing decision support system for neonatal hypoglycaemia prevention based on the prediction model for neonatal hypoglycaemia risk that was developed in a previous study, and to evaluate its efficacy.

METHODS: Nursing process as the theoretical framework, based on evidence-based nursing, standardized nursing language, and clinical decision support technology, the neonatal hypoglycaemia prevention nursing decision support system was developed.This system was implemented in the neonatology department of a tertiary grade A general hospital from September 1st to 30th, 2023.The application efficacy of the system was assessed and compared through the examination of the incidence of neonatal hypoglycemia, adverse outcomes associated with neonatal hypoglycemia, and the experiences of nurses following the implementation of the system.

RESULTS: The incidence of neonatal hypoglycaemia decreased after the system was implemented, and the difference was statistically significant (X² = 4.522, P = 0.033). None of the neonates experienced adverse outcomes during hospitalization. The rate of hypoglycaemia risk assessment in neonates after system implementation was 92.16%. The total Clinical Nursing Information System Effectiveness Evaluation Scale score was 104.36 ± 1.96.

CONCLUSION: The neonatal hypoglycaemia prevention nursing decision support system realizes neonatal hypoglycaemia risk assessment, intelligent decision-making, and effect evaluation, effectively diminishes the incidence of neonatal hypoglycaemia, and enhances the standardization of neonatal hypoglycaemia management.

PMID:39716159 | DOI:10.1186/s12911-024-02826-3