Nevin Manimala

Can J Respir Ther. 2025 Nov 3;61:262-271. doi: 10.29390/001c.146372. eCollection 2025.

ABSTRACT

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterized by respiratory muscle weakness, hyperinflation, and systemic inflammation, leading to impaired pulmonary function and quality of life. Respiratory muscle training (RMT) may strengthen the inspiratory and expiratory muscles, improve pulmonary function, reduce dyspnea, and enhance functional outcomes. This study assessed the impact of concurrent RMT on respiratory muscle strength, spirometry, dyspnea, and quality of life in patients with COPD.

MATERIALS AND METHODS: This was a single-cohort pre/post-intervention study initially recruiting 43 patients with COPD to participate in an 8-week RMT program using a threshold pressure device. Both inspiratory and expiratory training were performed using a PowerLung device with adjustable resistance. Training consisted of three sets of ten breaths twice daily for each mode, and participants were instructed to increase resistance incrementally when the load became easy. Assessments included spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), COPD Assessment Test (CAT), Medical Research Council (MRC) Breathlessness Scale, and Airways Questionnaire 20 (AQ20). Data were collected at baseline and post-intervention and analyzed using paired t-tests and Wilcoxon signed-rank tests, stratified by GOLD category.

RESULTS: Twenty-seven participants completed the study. Statistically significant improvements were observed in MIP (mean increase 14.1 cm H₂O, p < .001), MEP (mean increase 20.1 cm H₂O, p < .001), CAT (mean decrease 2.92, p = .020), and AQ20 (mean decrease 1.67, p = .005). FEV₁ improved modestly but did not reach statistical significance (mean increase 0.0367 L, p = .064). The GOLD distribution included eight participants in GOLD 2, 12 in GOLD 3, and seven in GOLD 4. Improvements in MIP and MEP were statistically significant within all GOLD categories. A clinically meaningful increase in FEV₁ (≥ 60 mL) was observed in participants in GOLD 3 and 4 stages, though not statistically significant. Correlations between muscle strength improvements and symptom scores were moderate to strong.

DISCUSSION: Concurrent RMT improves respiratory muscle strength and quality of life in patients with COPD, with the greatest benefits observed in advanced disease stages. Enhanced respiratory muscle efficiency may reduce dyspnea and promote exercise tolerance.

CONCLUSION: RMT is a promising intervention for COPD management that offers improved respiratory muscle strength and quality of life. Future studies should explore the long-term effects and optimize protocols for broader implementation.

PMID:41200708 | PMC:PMC12588354 | DOI:10.29390/001c.146372

J Caring Sci. 2025 Aug 15;14(3):182-190. doi: 10.34172/jcs.025.33367. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Family caregivers play a key role in supporting homebound older adults. This study explored the community context, developed, and evaluated a training program for family caregivers of homebound older adults in Selaphum District, Roi Et province, Thailand.

METHODS: We used a mixed method approach with three phases. In phase I, we conducted semi-structured interviews with eight family caregivers. In phase II, we developed a training program based on the interview findings. In phase III, we implemented and evaluated the program using a pretest-posttest nonequivalent control group design with 57 participants in each group. We collected data through in-depth interviews, and questionnaires on knowledge, attitude, and practice. We analyzed quantitative data using descriptive and inferential statistics, and qualitative data using content analysis.

RESULTS: Two themes were explored in Phase I: Low quality of care, and Caregivers burden. A program involves six activities: 1) providing family caregivers’ knowledge, 2) demonstrating and practicing caregiving, 3) providing homebound older adults’ hygiene care 4) promoting leisure and recreation activities to homebound older adults 5) modifying the safe environment and 6) creating a sense of self-worth and self-efficacy among the family caregivers. The quantitative results showed that the experimental group had significantly higher mean score in knowledge, attitude, and practice compared to the control group.

CONCLUSION: This study enhanced knowledge, attitude, and practice among family caregivers for caring homebound older adults, resulting in better caregiving outcomes and improved quality of life for both caregivers and care recipients.

PMID:41200707 | PMC:PMC12586893 | DOI:10.34172/jcs.025.33367

J Caring Sci. 2025 Aug 5;14(3):198-204. doi: 10.34172/jcs.025.33766. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: All nursing care must be performed without harming the patient. Medication errors pose a significant threat to patient safety. This study aimed to determine the relationship between medication safety competence (MSC) and clinical nurses’ perceptions of medication administration errors (MAEs).

METHODS: This descriptive-correlational study was conducted among 300 clinical nurses. Participants were selected using stratified random sampling in 2024. Data were collected using a demographic characteristics form, the Medication Safety Competence Scale (MSCS), and the Medication Administration Error Reporting Survey. Data were analyzed using SPSS version 13, employing descriptive and inferential statistics.

RESULTS: The results indicated that the mean (SD) scores for MSC and MAEs were 294.22 (26.61) and 135.48 (15.14), respectively. Scores ranged from 36 to 185 for MSC and 65 to 425 for MAEs. Statistical analysis revealed significant correlations between MAEs and gender, marital status, Work experience, and participation in the MSC workshop. Simple linear regression analysis showed that the “Underreporting of MAEs” domain was the strongest predictor of MSC among the variables examined.

CONCLUSION: The nurses who participated in this study reported moderate levels of MSC and perceived a moderate frequency of MAEs. Healthcare policymakers and decision-makers should implement strategies such as conducting ideation sessions and practical workshops to reduce medication errors and enhance nurses’ MSC.

PMID:41200704 | PMC:PMC12586892 | DOI:10.34172/jcs.025.33766

J Caring Sci. 2025 Aug 3;14(3):205-213. doi: 10.34172/jcs.025.33656. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Family presence during resuscitation (FPDR) has become a globally debated practice, offering both potential benefits and challenges. In Iran, however, family members are generally excluded from the resuscitation area. This study aimed to explore the attitudes of Iranian emergency department (ED) staff toward FPDR.

METHODS: This cross-sectional study was conducted among 124 nurses and 24 physicians in the EDs of four hospitals in Northwest Iran. Participants were selected using a census sampling method. Data were collected through a 27-item questionnaire and analyzed using descriptive and inferential statistical methods.

RESULTS: Over half of the ED nurses and physicians (52.4% nurses and 54.2% physicians) supported FPDR when the patient was the ED nurse’s or physician’s immediate family member. However, this support significantly declined and shifted toward opposition when the patients were neither ED nurses or physicians themselves nor their immediate family members (78.2% of nurses and 91.7% of physicians). Similarly, opposition remained high when the ED nurses or physicians imagined themselves as the patient undergoing resuscitation (91.1% of nurses and 83.3% of physicians opposed FPDR).

CONCLUSION: The study findings suggest that attitudes toward FPDR among Iranian ED nurses and physicians are influenced by their connections with the patient. While the majority initially opposed FPDR when treating unrelated patients or considering themselves as patients undergoing resuscitation, their opposition decreased significantly, and their attitudes shifted towards support when considering themselves as immediate family members of patients undergoing resuscitation.

PMID:41200703 | PMC:PMC12586900 | DOI:10.34172/jcs.025.33656

J Caring Sci. 2025 Sep 8;14(3):173-181. doi: 10.34172/jcs.025.33640. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Colorectal cancer (CRC), as a leading cause of cancer-related morbidity and mortality worldwide, often requires surgical interventions such as colostomy, which can substantially affect patients’ health-related quality of life. The presence of a colostomy adversely affects deferent aspects of patient’s life. The aim of this study is to compare the health-related quality of life in patients with and without a colostomy.

METHODS: In this comparative cross-sectional study, 256 patients with CRC were included through convenience sampling, comprising 127 patients with a colostomy (49.6%) and 129 without a colostomy (50.4%). The data collection tools included the demographic information form and the shortened form of the health-related quality of life questionnaire (SF-36). Statistical analyses were performed using IBM SPSS Statistics version 13, including descriptive statistics, independent samples t-tests, general linear modeling, and multiple regression analyses. Results: In this study, the health-related quality of life score (range: 0-100) was 43.03±17.08 in patients with a colostomy and 51.38±15.57 in those without a colostomy. Also, there was a statistically significant difference in physical functioning, role limitation due to physical health, role limitation due to emotional problems and health-related quality of life in people with and without colostomies (P<0.05). Finally, in sex stratified exploratory analyses, differences were evident among women but not among men.

CONCLUSION: This study demonstrates that patients with CRC, particularly those with a colostomy, experience significantly lower health-related quality of life. The findings emphasize the importance of early and targeted interventions to improve physical and psychosocial well-being in this population. Greater attention should be given to the needs of patients with colostomy in both hospital and community care settings to enhance their overall quality of life.

PMID:41200699 | PMC:PMC12586898 | DOI:10.34172/jcs.025.33640

Health Serv Insights. 2025 Nov 4;18:11786329251388775. doi: 10.1177/11786329251388775. eCollection 2025.

ABSTRACT

INTRODUCTION: The need for tailored services for individuals with young-onset dementia (YOD) is well established. Specialised services exist but regional disparities may hinder timely and appropriate care and support. Yet, a comprehensive overview of such services is currently lacking.

OBJECTIVE: To examine regional disparities in the delivery, access and management of YOD-specialised services in the Netherlands, revealing service gaps and opportunities for future development.

DESIGN: An exploratory cross-sectional survey (YOD self-scan) was developed and distributed to 39 Dutch healthcare organisations affiliated with a national YOD knowledge infrastructure, ensuring broad geographical representation.

METHODS: Quantitative and qualitative data were collected through open- and closed-ended questions between July and August 2023. Descriptive statistics and manifest content analyses were used to assess the delivery and management of YOD-specialised services in terms of utilisation, capacity, accessibility, variety and organisational factors.

RESULTS: A total of 1707 individuals with YOD utilised outpatient services, and 801 received permanent residential care. Service delivery and management varied across regions. Rural organisations reported shorter waiting times, more employees who had received specific YOD training, and higher day care utilisation per organisation. Urban organisations offered a broader range of services and more involvement of local governments. Most organisations (72.4%) reported service gaps, including limited day care options, inflexible residential services, and insufficient support for carers, especially children of individuals with YOD. Also, the need for more innovative services and improved coordination was identified.

CONCLUSIONS: YOD-specialised services are underutilised, likely due to unequal accessibility and regional disparities in the delivery and management of services. Addressing service gaps, expanding capacity, and enhancing knowledge exchange are important for equitable, high-quality care. These findings may inform future research and international efforts to improve equitable access and management of specialised dementia services.

PMID:41200695 | PMC:PMC12586858 | DOI:10.1177/11786329251388775

Indian J Community Med. 2025 Oct;50(Suppl 2):S213-S218. doi: 10.4103/ijcm.ijcm_72_24. Epub 2025 Apr 17.

ABSTRACT

BACKGROUND: City bus drivers are more prone to work-related musculoskeletal disorders (WRMSDs) due to the nature of their work, yet city bus drivers are the least studied population. The present study aims to assess WRMSDs in city bus drivers and to determine some factors related to them.

METHODS AND MATERIALS: The present cross-sectional study was conducted among bus drivers belonging to three bus depots of the city bus service. A simple random sampling was done to select the estimated sample size of 383 bus drivers. Data were collected by interview method using a self-designed questionnaire. The musculoskeletal disorders were assessed using the Cornell Musculoskeletal Discomfort Questionnaire. Univariate and multivariate analyses were done using Stata 17.

RESULTS: More than half of the bus drivers (202 (52.74%)) had WRMSDs, with 157 (40.99%) bus drivers having lower back discomfort. On univariate analysis, it was found that duration of driving ≥20 years (P = 0.007); driving distance ≥ 150 km (P = 0.001); waist-hip ratio ≥ 0.9 (P = 0.004); and self-perceived workstation factors such as seat adjustability (P = 0.04), seat comfortableness (P = 0.01), and body contour of the seat (P = 0.02); and congestion on the bus route (P = 0.05) were significantly related to musculoskeletal disorders. However, on multivariate logistic regression, driving distance ≥150 km per day, seat uncomfortableness, and lack of body contour of the seat were found to be statistically significant independent factors related to WRMSDs.

CONCLUSION: As the daily driving distance, seat uncomfortableness, and lack of body contour of the seat were statistically significantly related to WRMSDs, it is recommended that all the buses be retrofitted with proper ergonomically designed driver’s seats, and the daily average driving distance should be reduced.

PMID:41200692 | PMC:PMC12588123 | DOI:10.4103/ijcm.ijcm_72_24

Indian J Community Med. 2025 Oct;50(Suppl 2):S173-S179. doi: 10.4103/ijcm.ijcm_753_23. Epub 2025 Feb 21.

ABSTRACT

BACKGROUND AND OBJECTIVES: Postnatal morbidities if present adversely affect the health of the mother and baby, these being more in women residing in urban slums. The utilization of antenatal and postnatal care may act as factors to help curb these morbidities. Hence, this study was planned to estimate the prevalence of self-reported postpartum morbidity and its determinants among women aged 18-49 years and find the association between utilization of antenatal care and postnatal care received and morbidities reported.

MATERIALS AND METHODS: This was a cross-sectional study in the urban slums of Bhubaneswar over two years including 210 consenting postnatal women in the age group of 18-49 years using a two-stage stratified cluster sampling technique. A semi-structured pretested questionnaire was used for data collection which was entered into a Microsoft Excel sheet and analyzed using SPSS software. Multinomial logistic regression was used to ascertain independent association and a P value of < 0.05 was considered to be statistically significant.

RESULTS: The prevalence of self-reported postnatal morbidities was found to be 57.62%. Occupation of the spouse, number of ANCs received, and laboratory investigations conducted during the antenatal period were found to be statistically significant. The illiteracy of the study participant and the occupation of the spouse were found as statistically significant in the multinomial logistic regression model.

CONCLUSION: The postnatal morbidities were found to be high which reemphasises the importance of antenatal and postnatal care. Some ANC variables were found to contribute to the postnatal morbidities which when addressed timely can help curb these morbidities.

PMID:41200686 | PMC:PMC12588127 | DOI:10.4103/ijcm.ijcm_753_23

Indian J Community Med. 2025 Oct;50(Suppl 2):S228-S234. doi: 10.4103/ijcm.ijcm_86_24. Epub 2025 Feb 27.

ABSTRACT

BACKGROUND: The mankind has been fighting the pandemic of COVID-19 for the last few years and vaccines came in as a real game changer by the end of 2020. World’s biggest COVID-19 vaccination drive was started in India on January 16, 2021. A year later, vaccines were introduced for the adolescent population. The concern over Adverse Events Following Immunization (AEFI) surfaced and dampened vaccine uptake with increasing fear and misinformation toward vaccination. AEFI is any untoward medical occurrence that follows immunization, and not necessarily have a causal relationship with the usage of the vaccine. Although technical and toll-free numbers are available for the reporting of the AEFI, there is a high chance of under-reporting of the same. There were only very limited number of studies assessing the AEFI after Covaxin vaccination in the adolescent age group and hence this study was performed to assess the adverse reaction following immunization and the factors associated with it among the adolescent age group. Further, this study assessed perception, and ideas regarding acceptance of COVID-19 vaccination services among adolescent beneficiaries.

METHODOLOGY: A mixed methods study was conducted at AIIMS Bhubaneswar for adolescent beneficiaries aged 15-18 years between January 3^rd and March 31^st, 2022. A prospective longitudinal study was conducted with a sample size of 250. Study participants were selected by simple random sampling from the beneficiary list in CoWin app. Ten beneficiaries per day were selected for the telephonic interview regarding AEFI, 7 to 10 days following immunization. Data were collected using the tool based on the document for toxicity grading in healthy volunteers in preventive vaccine trials given by the US FDA. In-depth interview was conducted among adolescent beneficiaries using predesigned interview schedule. Analysis was performed using SPSS version 25.0 and Anthropac software for quantitative and qualitative data, respectively.

RESULTS: AEFI was assessed after first dose among participants, among which 84 (36.52%) had some kind of AEFI. Pain at the injection site was the most common AEFI reported. One-third participants (32.1%) had developed only one AEFI. More than one AEFI was reported in 10 participants. Among the 50 participants followed up in their second dose, 10 (20.83%) developed any AEFI in our study. Five participants reported having AEFI in the first and second doses. There was no statistical difference in the number of AEFI reported after the first and second doses. Majority of the adolescents seemed self-motivated to avail COVID-19 vaccine. According to the beneficiaries, vaccination certificate was the felt need to enter schools and sit for exams.

CONCLUSION: Covaxin (BBV152) has good safety profile among adolescent age group. The AEFI reported are less in comparison with other mRNA vaccines as well. Although AEFI is common after BBV152 among adolescent, majority are mild in nature. Still, further studies with larger cohort are warranted to study the long-term effects of vaccination as well. It’s encouraging that the adolescents were optimistic about availing vaccine.

PMID:41200685 | PMC:PMC12588121 | DOI:10.4103/ijcm.ijcm_86_24

Clin Oral Implants Res. 2025 Nov 6. doi: 10.1111/clr.70071. Online ahead of print.

ABSTRACT

AIM: To compare the clinical performance of two sandblasted, large-grit, acid-etched implant surfaces regarding changes in radiographic marginal bone level (MBL) 12 months after loading.

MATERIALS AND METHODS: In this randomized, split-mouth, dual-center clinical trial, each patient received one test (modified hydrophilic surface) implant and one control (conventional surface) implant. The primary endpoint was the change in MBL measured 12 months after loading. Secondary outcomes included the assessment of soft tissue wound healing index (WHI), adverse events, implant stability quotient (ISQ), peri-implant soft tissue parameters (probing pocket depth, bleeding on probing, keratinized mucosa width), and oral health-related quality of life (OHRQoL) measured with the Oral Health Impact Profile-14 (OHIP-14). Generalized linear models, paired Student’s t-tests, and Wilcoxon tests were employed for data analysis.

RESULTS: The study included 68 subjects (136 implants). No statistically significant differences were found between groups for any of the clinical outcomes measured. The mean change in MBL from loading to 12 months was 0.04 mm (SD = 0.39) for the modified hydrophilic implants and 0.07 mm (SD = 0.22) for the conventional implants (p = 0.658), with no significant differences between the groups.

CONCLUSIONS: Over a 12-month period of functional loading, both implant surfaces demonstrated comparable performance regarding peri-implant bone stability, safety, and clinical outcomes. Although a small but statistically significant difference between groups was observed in MBL changes from baseline to 12 months (MD = 0.15 mm), no significant differences were found in MBL changes from loading to 12 months (primary outcome), ISQ, soft tissue healing, or peri-implant health.

PMID:41199413 | DOI:10.1111/clr.70071