Nevin Manimala

Nurs Open. 2026 Apr;13(4):e70523. doi: 10.1002/nop2.70523.

ABSTRACT

AIM: This study was conducted to examine the effect of nursing practice environment individual and occupational characteristics on nurses’ attitudes towards medical error.

DESIGN: Cross-sectional study.

METHODS: The questionnaire was used for data collection in a tertiary university hospital from 4 March to 30 April 2022. The questionnaire included the “Information Form”, the “Practice Environment Scale-Nursing Work Index (PES-NWI)” and the “Medical Error Attitude Scale”. The population of this study included 1329 nurses. A total of 355 nurses who voluntarily completed the questionnaires constituted the study sample. Convenience sampling was used to select participants. Since the study was conducted at a single hospital, the survey was emailed to all nurses at the institution to ensure broad accessibility. Pearson correlation analysis was used to assess the relationships between continuous variables. Multiple linear regression analysis was employed to examine factors influencing the scores on the Medical Error Attitude Scale. Ethical approval was obtained from the institutional ethics committee, and informed consent was obtained from all participants. The findings were reported following the STROBE guidelines.

RESULTS: The mean score of the PES-NWI was 2.60 ± 0.45 and the mean score of the Medical Error Attitude Scale was (3.50 ± 0.39). Regression analysis was performed to identify factors influencing nurses’ attitudes towards medical errors. According to the results of the multiple regression analysis, age (p < 0.001), duration of experience in the institution (p < 0.001), educational status (p < 0.001), general satisfaction with patient safety in the unit (p < 0.05) and two subdimensions of the PES-NWI-“Nurse manager ability, leadership and support of nurses” (p < 0.05) and “Staffing and resource adequacy” (p < 0.05)-were significant predictors. These six variables collectively explained 12.8% of the total variance in the Medical Error Attitude Scale score (R² = 12.8%, F = 7.454, p < 0.001).

CONCLUSIONS: The study concluded that both the nursing practice environment and certain individual and occupational characteristics of nurses impact their attitudes towards medical errors. In line with this study’s results, we recommend that institutional managers and nurse managers make necessary arrangements to improve nurses’ attitudes towards medical errors, as well as to develop institutional strategies designed to prevent medical errors in their units/institutions, thereby improving patient safety and quality of care.

NO PATIENT OR PUBLIC CONTRIBUTION: The participants of this study were nurses and this contribution has been explained in the data collection section. There was no patient contribution in this study.

PMID:41936116 | DOI:10.1002/nop2.70523

Pharm Nanotechnol. 2026 Mar 25. doi: 10.2174/0122117385394646251111112131. Online ahead of print.

ABSTRACT

Wounds associated with diabetes mellitus are among the most serious complications, with the potential to progress to cell necrosis and, in severe cases, necessitate amputation. Current statistics indicate that diabetic wounds affect approximately 15% of patients with diabetes, and 20% of these cases lead to limb amputation. Conventional therapies often prove ineffective due to molecular and structural alterations in the injured tissue, highlighting the need for innovative delivery methods to enhance treatment efficacy. Recent research has focused on developing advanced materials for wound management, particularly through phyto-nanotechnology. Topical applications of nanoscaffolds and nanofibers have shown promising outcomes in promoting wound healing. Nano-sized particles facilitate smooth progression through the healing phases by enhancing cellular and molecular interactions. Among these, silver nanoparticles (AgNPs) have attracted attention for diabetic wound treatment due to their potent antibacterial and anti-inflammatory properties. AgNPs also stimulate cellular mechanisms that support the repair of chronic wounds; however, potential toxicities remain a concern. This review examines the role and mechanisms of biogenic AgNPs in diabetic wound management, with a focus on their efficacy in wound dressings. Additionally, it examines marketed AgNP formulations for wound care, highlights reported toxicity issues, and discusses clinical trials and future prospects for their application in wound healing.

PMID:41936080 | DOI:10.2174/0122117385394646251111112131

Alcohol Alcohol. 2026 Mar 17;61(3):agag020. doi: 10.1093/alcalc/agag020.

ABSTRACT

BACKGROUND AND AIMS: The present study aimed to: (i) compare a patient group with solely alcohol use disorder (AUD) to a group with poly-substance use disorder (poly-SUD) regarding sociodemographic background, morbidity, mortality, and the prevalence of the A1 allele of the Taq1A polymorphism. (ii) Investigate whether gender, age, poly-SUD, and the prevalence of the A1 allele or interactions among these factors, are associated with mortality risk over an 18-year follow-up period.

METHODS: This study comprised 360 individuals treated for severe alcohol withdrawal symptoms in 1997 at a treatment unit in Sweden. Genotyping was performed during their hospital stay, and participants were followed annually for up to 18 years using data from Swedish registers.

RESULTS: Fifty-three percent of the participants had died over the 18 year period. Poly-SUD patients exhibited higher rates of psychiatric disorders, gastrointestinal diseases, and intoxication as the primary diagnosis. Patients with AUD exhibited a higher prevalence of cardiac diseases. Traumatic causes of death were more prevalent in the poly-SUD group, whereas somatic diseases were more common among individuals with AUD. Male sex and age were the strongest predictors of premature death among individuals with AUD. The A1 allele of the Taq1A polymorphism showed a borderline association with an increased hazard of death.

CONCLUSIONS: Male sex and age are the strongest predictors of premature death. Patients with poly-SUD may represent a distinct subgroup with different comorbidities and causes of death. To determine whether there is a genetic vulnerability as indicated by the findings, research using larger samples with sufficient statistical power is needed.

PMID:41936048 | DOI:10.1093/alcalc/agag020

Aging Ment Health. 2026 Apr 5:1-12. doi: 10.1080/13607863.2026.2643895. Online ahead of print.

ABSTRACT

OBJECTIVES: Subjective wellbeing is a self-defined appraisal of happiness that includes judgments of life satisfaction and overall affect. Health-related quality of life is an appraisal of wellbeing focused on one’s health status. Factors influencing these different aspects of wellbeing in old age remain unclear, with particular uncertainty around cognition. This study examined these relationships through assessments over 12 years.

METHOD: One-thousand-and-thirty-seven people without dementia were recruited as part of a population-based cohort study. Participants completed a neuropsychological battery, medical history, and measures of life satisfaction, positive affect, health-related quality of life, depression, and anxiety biennially over 12 years. Participants also completed personality measures and informants completed measures of function. Linear mixed models were used to examine whether cognition and other variables were associated with wellbeing measures.

RESULTS: Life satisfaction, positive affect, and health-related quality of life were moderately correlated at baseline. Cognition had a small, but statistically significant longitudinal association with each of these outcomes after adjusting for potential confounders. Physical health, function, personality, and anxiety also predicted wellbeing measures.

CONCLUSION: Cognition is associated with subjective wellbeing and health-related quality of life in older people. Physical health, function, personality, and anxiety are also important predictors of wellbeing in old age.

PMID:41936036 | DOI:10.1080/13607863.2026.2643895

Orv Hetil. 2026 Apr 5;167(14):547-555. doi: 10.1556/650.2026.33516. Print 2026 Apr 5.

ABSTRACT

INTRODUCTION: Greater emphasis must be placed on monitoring mental health in the healthcare sector in order to ensure the standard and quality of patient care, taking into account psychosocial and socioeconomic factors. The mental state of healthcare professionals plays a major role in patient safety.

OBJECTIVE: To assess and compare the general well-being, depression, and burnout levels of healthcare professionals in a sample from Békés county (Hungary) and Hargita county (Romania).

METHOD: We conducted our cross-sectional questionnaire survey among nurses in Békés and Hargita counties using the WHO Well-Being Questionnaire, the Beck Depression Questionnaire, and the Maslach Burnout Inventory. We analyzed our responses using chi-square and t-tests, nonparametric measurement tools, and Spearman’s correlation analysis (p<0.05) with the help of SPSS 30.0 software. The study included 117 Hungarian and 109 Romanian professionals (n = 226).

RESULTS: Based on the results, we found that there was no significant correlation between general well-being (p = 0.772), depressive symptoms (p = 0.338), and burnout in the dimensions of depersonalization (p = 0.090) and personal efficacy (p = 0.586) in the two groups studied. Among Hungarian professionals, emotional exhaustion is significantly higher (p<0.05) and their subjective assessment of their general and mental health is worse than that of their Romanian colleagues (p<0.05).

DISCUSSION: We detected a risk of depression and burnout in both target groups. The study highlights the need for intervention in the mental health of Hungarian healthcare professionals and the justification for further research into the causal factors.

CONCLUSION: The workload of healthcare professionals remains high in the post-pandemic period, and the domestic situation is further complicated by the fact that chronic diseases are more prevalent among Hungarian nurses, which has a significant impact on our mental health indicators. Improving mental health would require reforming the sector, increasing the frequency of continuing education, and integrating practical mental hygiene methods. Orv Hetil. 2026; 167(14): 547-555.

PMID:41936032 | DOI:10.1556/650.2026.33516

Clin Nurs Res. 2026 Apr 5:10547738261429348. doi: 10.1177/10547738261429348. Online ahead of print.

ABSTRACT

Critically ill patients frequently require intrahospital transport (IHT) to diagnostic exams or procedures and must remain connected to life-sustaining medical lines. During IHT, the risk of tangled medical lines is unavoidable. The idea for a novel medical line securement device was inspired by a patient transport nurse due to frustrations and workflow inefficiencies managing tangled medical lines. The study aim was to explore the correlation between the utilization of a single-use securement device to manual or accidental disconnections of medical lines during IHT, and nurses’ perception of efficiency, compared to the current practice of no utilization of a securement device. In 2019, a randomized, descriptive, correlational study was conducted on 142 progressive and intensive care hospitalized patients. Study coordinators measured the number of times either IV lines or monitor cords were accidentally or manually disconnected to detangle during or after transportation and the perception of transport efficiency. Results revealed fewer manual disconnections among intervention group compared to the control. Nurses’ perception regarding the efficiency between the intervention and control group was statistically significant when the device was utilized to secure the lines and cords during transport. Nurses reported much higher satisfaction rates of transport efficiency when the device was used. This finding showed the device’s utility for improving nurse satisfaction during IHT of critically ill patients. Utilization of the medical line securement device may be generalizable across other healthcare settings and disciplines where the complexity of medical lines may exist.

PMID:41936022 | DOI:10.1177/10547738261429348

Arch Gynecol Obstet. 2026 Apr 5;313(1):153. doi: 10.1007/s00404-026-08386-3.

ABSTRACT

BACKGROUND: This study analyzed medical records of patients with climacteric syndrome at a Korean medicine hospital and investigated the interrelationships among their symptoms using network analysis.

METHODS: A retrospective chart review was conducted on 81 women (aged 45-60 years) who visited a women’s health clinic between 1 January 2020 and 31 December 2021. Network analysis was performed on unstructured text from first-visit medical records to identify symptom patterns and compute centrality indices.

RESULTS: The most common symptoms were ‘pain’, ‘hot flush’, ‘facial blushing’, ‘fatigue’, and ‘sleep disorder’. Among them, pain and hot flush showed high node strength, betweenness centrality, and closeness centrality, which indicated their central role in symptom co-occurrence. Although there were no statistically significant differences in the frequency of symptoms between the premenopausal and postmenopausal groups, variations in symptom centrality and modular analysis results before and after menopause were noted, emphasizing the importance of detailed symptom analysis in clinical settings.

CONCLUSIONS: By analyzing medical records of patients with climacteric syndrome, this study clarified symptom patterns in menopausal women, providing data for targeted and stage-specific treatments.

PMID:41935990 | DOI:10.1007/s00404-026-08386-3

J Cardiovasc Electrophysiol. 2026 Apr 5. doi: 10.1111/jce.70332. Online ahead of print.

ABSTRACT

BACKGROUND: Pulmonary vein isolation (PVI) remains the primary ablation strategy for atrial fibrillation (AF). However, additional interventions are often required in patients with persistent AF. Ethanol infusion into the vein of Marshall (EIVOM) offers access to epicardial arrhythmic circuits, which has demonstrated incremental benefit in patients with persistent AF.

AIM: This study aimed to evaluate whether adding VOM ethanol infusion and mitral isthmus ablation to PVI with posterior wall debulking improves long-term arrhythmia outcomes in patients with persistent AF.

METHODS: A total of 123 patients with persistent AF undergoing catheter ablation between June 2021 and December 2023 were retrospectively analyzed. Patients were assigned to PVI + posterior wall debulking (PWD) (n = 85) or PVI + PWD + VOM ethanol infusion + mitral isthmus ablation (n = 38). Demographic, clinical, echocardiographic, and laboratory data were compared. Recurrence of atrial tachyarrhythmia was assessed using Kaplan-Meier survival analysis, and predictors of recurrence were evaluated with Cox proportional hazards models.

RESULTS: During a median follow-up of 12-15 months, long-term arrhythmia recurrence occurred in 12.9% of patients treated with PVI + PWD and 7.9% of those receiving the additional VOM and mitral isthmus ablation extended approach (p = 0.546). The unadjusted model showed a nonsignificant trend toward reduced recurrence with VOM ethanol infusion (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.45-1.22), which remained similar after multivariate adjustment (HR 0.80, 95% CI 0.52-1.18).

CONCLUSIONS: Although adjunctive VOM ethanol infusion and mitral isthmus ablation resulted in a lower observed recurrence rate, no statistically significant improvement in long-term rhythm outcomes was observed.

PMID:41935977 | DOI:10.1111/jce.70332

Pediatr Neonatol. 2026 Mar 21:S1875-9572(26)00029-X. doi: 10.1016/j.pedneo.2025.04.010. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric drug poisoning poses significant risks, with some cases resulting in life-threatening outcomes. This study analyzes drug poisoning of children under 18 years of age in Taiwan, utilizing a comprehensive 30-year database to identify factors associated with severe to fatal outcomes.

METHODS: We conducted a retrospective analysis of cases from the Taiwan Poison Control Center (PCC-Taiwan) database (1991-2020), focusing on various drugs, including pharmaceuticals, pesticides, environmental agents, and herbal medicines. Demographic data, poisoning characteristics, involved substances, and clinical outcomes were extracted. Cases were classified by severity: asymptomatic to moderate versus severe to fatal (life-threatening). Statistical analyses were performed to compare demographic data and identify factors associated with severe to fatal outcomes.

RESULTS: Of 17,274 cases, 99.0% were asymptomatic to moderate, while 1.0% (175 cases) were severe to fatal, resulting in an overall mortality rate of 0.26% (n = 45). Significant differences in demographics and specific management were observed between severity groups (p < 0.001). Among severe to fatal cases, peak incidence occurred in early childhood (0-5 years: 49.7%) and late adolescence (12-17 years: 42.3%).The most common toxic substances identified were organophosphates, anticonvulsants, and amphetamines. Intentional exposures accounted for 38.9% of severe to fatal cases, of which 55.9% were suicide attempts and 25.0% involved drug abuse. Significant factors associated with severe to fatal outcomes included prolonged exposure, intentionality, injection route, pesticide/herbal medicine use, and the requirement for specific management (p < 0.001). Pesticide use and requirement for specific management are risk factors for death in life-threatening cases (p < 0.01).

CONCLUSION: Between 1991 and 2020, life-threatening outcomes occurred in 1.0% of pediatric drug poisoning cases, primarily affecting young children and adolescents. Intentional exposures, especially suicide attempts and drug abuse, were significant contributors to these cases, while pesticides use was associated with higher mortality rates. Further studies on targeted prevention strategies and effective interventions are essential to improving outcomes for this vulnerable population.

PMID:41935946 | DOI:10.1016/j.pedneo.2025.04.010

Chin J Traumatol. 2026 Mar 31:S1008-1275(26)00067-2. doi: 10.1016/j.cjtee.2026.03.001. Online ahead of print.

ABSTRACT

PURPOSE: Anterior-column acetabular fractures extending posteriorly toward the sacroiliac (SI) region without SI joint disruption represent a rare and under-recognized fracture pattern. It remains unclear whether these fractures behave as atypical anterior-column fractures or as combined pelvic-acetabular injuries that necessitate sacroiliac fixation. This study addresses the lack of systematic data on this morphology and provides a biomechanical insight that the continuity of the SI ligamentous complex preserves pelvic stability despite posterior extension. This study aims to evaluate clinical, radiological, and functional outcomes of this fracture type and to clarify whether posterior fixation is necessary.

METHODS: A retrospective case series was conducted, including 19 adult patients with anterior-column acetabular fractures that extended posteriorly toward the SI region, while the posterior ligamentous complex remained intact between January 2015 and January 2022. Inclusion criteria were: (1) adults aged ≥ 18 years, (2) patients diagnosed with acute anterior column acetabular fractures confirmed on CT, (3) fractures demonstrating posterior extension toward the SI region without evidence of diastasis or ligamentous injury. Fractures associated with SI dissociation or pelvic-ring instability, both-column fractures with complete posterior involvement, pathological fractures secondary to tumor or infection, prior ipsilateral hip or pelvic surgery, and inadequate imaging or follow-up shorter than 24 months were all excluded. Preoperative evaluation included thin-slice CT with 3-dimensional reconstruction to confirm SI integrity. All patients underwent anterior fixation via either the ilioinguinal (n = 11) or modified Stoppa approach (n = 8). Reduction quality, fracture union, SI stability, and functional outcomes (Harris hip score, modified Merle d’Aubigné-Postel, and Western Ontario and McMaster Universities Osteoarthritis Index scores) were assessed over a mean follow-up of (39.8 ± 13.5) months. Statistical analyses were performed with SPSS (version 27). Mean ± standard deviation was used to describe continuous variables, while categorical variables were presented as frequency and percentage. Comparisons between subgroups were carried out using Student’s t-test or Mann-Whitney U test for continuous variables, and Chi-square or Fisher’s exact test for categorical variables. A p < 0.05 was considered statistically significant.

RESULTS: The mean age of the included patients was (45.7 ± 11.8) years. The mean union time of all fractures was (4.8 ± 0.7) months. Anatomical reduction was achieved in 16 patients (84.2%) and imperfect reduction in 3 (15.8%). No patient required SI fixation, and SI joint congruity was maintained in all cases. Functional outcomes were favorable. The mean Harris hip score at final follow-up was 88.9 ± 6.8. According to the Western Ontario and McMaster Universities Osteoarthritis Index score, 14 patients (73.7%) had excellent outcomes, 4 patients (21.1%) had good outcomes, 1 patient (5.3%) had a fair outcome, and no poor outcomes were recorded. All patients were evaluated using the modified Merle d’Aubigné-Postel score: 15 (78.9%) achieved an excellent rating, 3 (15.8%) a good rating, 1 (5.3%) a fair rating, and none were rated as poor. Complications were minimal, including 1 superficial wound infection and 1 transient lateral femoral cutaneous nerve neuropraxia.

CONCLUSION: Posterior extension of anterior-column fractures without SI ligamentous disruption behaves biomechanically as an isolated acetabular injury, obviating the need for posterior fixation. Accurate preoperative CT assessment and intraoperative verification enable safe anterior fixation, ensuring union, stable SI articulation, and excellent function. These findings highlight a distinct morphologic variant overlooked by current classification systems, warranting refinement to integrate functional stability criteria.

PMID:41935945 | DOI:10.1016/j.cjtee.2026.03.001