Tag: nevin manimala

Healthc Q. 2025 Jan;27(4):64-71. doi: 10.12927/hcq.2025.27579.

ABSTRACT

In the context of long organ wait lists and few registered organ donors, Transplant Québec aimed to understand public views on deceased organ donation, as a basis for public-facing communications. It formulated four personas representing subgroups with varying views and behaviours related to organ donation. They were iteratively built via triangulation of findings from literature reviews, populational data, public polls, an expert panel and focus groups. Personas offer a more human approach to characterizing groups than statistics, which is particularly helpful for sensitive issues such as organ donation. This work may assist other organizations in tailoring public health communications.

PMID:40406843 | DOI:10.12927/hcq.2025.27579

Healthc Q. 2025 Jan;27(4):11-13. doi: 10.12927/hcq.2025.27590.

ABSTRACT

In 2023, Canada’s federal, provincial and territorial governments agreed to work together to improve healthcare across four priority areas and to develop common indicators to measure progress and report back to Canadians. In October 2024, the Canadian Institute for Health Information released Taking the Pulse: Measuring Shared Priorities for Canadian Health Care, 2024, which provides baseline results for 12 of these indicators. Some of the key findings include the following: Eighty-three percent of Canadians report having access to a regular healthcare provider. Half of Canadians referred to publicly funded community mental health counselling waited 25 days or less for their first scheduled session. Only two in five Canadians have accessed their personal health information electronically.

PMID:40406832 | DOI:10.12927/hcq.2025.27590

Healthc Q. 2025 Jan;27(4):7-10. doi: 10.12927/hcq.2025.27591.

ABSTRACT

Across Canada, millions of people are struggling to find a family doctor, nurse practitioner or primary care clinic and millions more are attached to a clinician who is over the age of 65. Research led by INSPIRE-PHC and analyzed at ICES has demonstrated the growing number of unattached people and their higher likelihood of being of lower income, racialized and having newly arrived in Ontario. Recent stresses include population growth, declining volume of services per physician and decreased attractiveness of comprehensive primary care, while underlying system causes point to the need for organized accountable systems designed to look after the entire population.

PMID:40406831 | DOI:10.12927/hcq.2025.27591

Palliat Support Care. 2025 May 23;23:e107. doi: 10.1017/S1478951525000513.

ABSTRACT

OBJECTIVES: This study aimed to map the actual care pathways for pediatric and adult palliative care (PC) patients at a hospital in the Region of Murcia (Spain) utilizing Process Mining (PM) techniques. The goal was to identify inefficiencies and areas for improvement in providing comprehensive and coordinated care to enhance patient outcomes.

METHODS: A retrospective review of anonymized clinical records was conducted, covering data from 2002 to 2021 for adult patients and from 2001 to 2021 for pediatric patients. The final dataset for adults comprised records from 85 patients and 2,696 episodes, and, for pediatric patients, the dataset included 57 individuals with 1,912 episodes. PM techniques (concretely, PMApp) facilitated the visualization and evaluation of actual care pathways, compared to theoretical models, highlighting bottlenecks and variabilities.

RESULTS: The analysis revealed distinct care pathways for adult and pediatric patients. Pediatric pathways showed inconsistencies with theoretical models due to variability in diseases and care needs, while adult pathways aligned better with expectations. Key inefficiencies included delays in shifting to home care and multiple visits to the hospital Emergency Department before referral to specialized teams. Simplified process models provided clearer insights into frequent care pathways and highlighted critical transition points, supporting optimization strategies.

SIGNIFICANCE OF RESULTS: The findings underscore the utility of PM in enhancing care pathway transparency, identifying inefficiencies, and supporting data-driven process redesign. The study advocates for updating theoretical models and adopting structured data collection to reduce variability and improve PC delivery. These measures are critical for achieving consistent, patient-centered care across diverse healthcare settings.

PMID:40406803 | DOI:10.1017/S1478951525000513

J Scleroderma Relat Disord. 2025 May 20:23971983251342065. doi: 10.1177/23971983251342065. Online ahead of print.

ABSTRACT

BACKGROUND: The study was conducted to investigate the impact of systemic sclerosis (SSc) on hospitalized COVID-19 patients.

METHOD: This retrospective observational study analyzed data from the National Inpatient Survey (NIS) in 2021. Patients hospitalized with COVID-19 were categorized into SSc and non-SSc groups. Characteristics of patients and comorbidities were compared. The primary outcome was the mortality rate. Secondary outcomes included resource utilization and acute in-hospital complications of SSc. Multivariate logistic regression analyses were conducted, with p-values < 0.05 considered statistically significant.

RESULT: Of all, 1865 patients hospitalized with COVID-19 had SSc. Patients with SSc had a higher mortality risk (aOR = 1.37 [1.03-1.82]; p = 0.032). The average cost of hospitalization was significantly higher in the SSc group (p = 0.048), with no difference in LOS (9.4 ± 0.65 days vs 8.4 ± 0.03 days; p = 0.260). COVID-19 patients with SSc significantly had a higher risk for DIC (aOR 2.82 [1.06-7.53]; p = 0.038), left-sided HF (aOR 1.76 [1.16-2.67]; p = 0.008), ventricular arrhythmia (aOR 3.17 [1.01-9.89]; p = 0.047), oxygen dependence (aOR 2.41 [1.64-3.55]; p < 0.001), cardiac arrest (aOR 2.61 [1.63-4.18]; p < 0.001), and ileus (aOR 2.61 [1.45-4.69]; p = 0.001).

CONCLUSION: Hospitalized COVID-19 patients with SSc were more likely to develop in-hospital complications and had a higher mortality risk.

PMID:40406796 | PMC:PMC12092399 | DOI:10.1177/23971983251342065

Cureus. 2025 Apr 22;17(4):e82780. doi: 10.7759/cureus.82780. eCollection 2025 Apr.

ABSTRACT

Background In India, sanitary pads are the most used menstrual hygiene product despite potential health and environmental risks. Menstrual cups offer a safer, sustainable alternative, but lack widespread study. This study examines awareness, attitudes, and practices of menstrual cup use among medical students and factors influencing adoption. Methods This cross-sectional study was conducted at a private medical college in Chennai in India among 250 medical students. Participants were selected through simple random sampling. After obtaining informed consent, data collection was carried out using a pre-structured and pre-tested questionnaire. Data was entered into MS Excel (Microsoft® Corp., Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Descriptive statistics are presented in tables, analytical statistics include the calculation of unadjusted odds ratios, followed by logistic regression analysis to assess associations between relevant variables. Results Among the 250 study participants, more than two-thirds were aged between 18 and ≤ 21 years. Poor knowledge about menstrual cups (56.4%), unfavorable attitudes (57.6%), and menstrual cup usage of 46.4% were noted among the study participants. Key factors significantly associated with poor knowledge about menstrual cups included family members who did not use menstrual cups (adjusted odds ratio (AOR) 3.21), non-availability of menstrual cups (AOR 5.12), experiencing frequent menstrual problems (AOR 2.11), and receiving doctors’ advice regarding menstrual issues (AOR 2.91). Unfavorable attitudes were linked to concerns while purchasing sanitary napkins (AOR 3.60), non-usage by family members (AOR 2.16), non-availability (AOR 3.10), menstrual issues (menorrhagia, recurrent infections), disposal concerns (AOR 2.60), and perceived difficulty of use (AOR 4.17). Conclusion This study highlights the necessity for enhanced education on menstrual hygiene practices, even within the medical community, to address the knowledge gap. It is essential to educate young medical students on the benefits and drawbacks of menstrual cups, with a focus on why they are a safer and more eco-sustainable option. Future research should be conducted in community settings to allow for the generalization of the findings.

PMID:40406792 | PMC:PMC12096921 | DOI:10.7759/cureus.82780

Cureus. 2025 Apr 22;17(4):e82802. doi: 10.7759/cureus.82802. eCollection 2025 Apr.

ABSTRACT

OBJECTIVE: To assess the early clinical and radiological outcomes of the midline lumbar interbody fusion (MIDLIF) approach with the use of robotic assistance and expandable spacers.

METHODS: A retrospective case series was performed on patients who underwent MIDLIF procedures for the treatment of degenerative spinal diseases, with a minimum of three months postoperative follow-up. Demographic (age, gender, body mass index [BMI], comorbidities, and diagnoses), surgical data (operative time, blood loss, hospital stay, intraoperative complications), patient-reported outcomes (PROs) (visual analogue scale [VAS] back pain and disability (Oswestry disability index [ODI]), and radiographic data were collected.

RESULTS: In total, 42 patients were included, with an average age of 53.6 years and a BMI of 28 kg/m². Surgical data showed the mean total operative time was 98.8 minutes, and the mean blood loss was 17.1 mL with no intraoperative complications. At three-month follow-up, all mean PROs showed statistically significant improvement (p<0.05) when compared with baseline. VAS back pain improved from 7.5 (standard deviation (stdev) 7.5±0.7) preoperatively to 3.0 (stdev 1.0) at three months postoperative, while ODI improved from 58.7 (stdev 7.2) to 26.3 (stdev 10.3) at the same time points. Radiographic data showed that using robotic assistance for planning and placing cortical screws yielded high accuracy, as evidenced by a mean tip deviation of 1.2 mm (stdev 0.6 mm), mean tail deviation of 1.1 mm (stdev 0.4 mm) and a mean angular offset of 1.4 mm (stdev 0.7). Two (4.8%) patients had postoperative complications at three-month follow-up, including a wound infection and one report of wound dehiscence.

CONCLUSION: MIDLIF is an efficient, reproducible surgical procedure with a low complication rate that resulted in significant improvements in early PROs. Robotic assistance for planning and placing cortical screws in MIDLIF was highly accurate. These initial findings suggest that using robotic assistance adds value to MIDLIF procedures and is a viable alternative to traditional posterior fusion procedures.

PMID:40406778 | PMC:PMC12097802 | DOI:10.7759/cureus.82802

Cureus. 2025 Apr 22;17(4):e82765. doi: 10.7759/cureus.82765. eCollection 2025 Apr.

ABSTRACT

INTRODUCTION: Medical schools were not immune to the difficulties posed by the COVID pandemic. Educational institutions were shut down. By April 2020, 73.8% of registered students in 186 countries were adversely affected. The circumstances forced academic institutions to transition to emergency online teaching, despite the controversies of the effectiveness of this method. The absence of face-to-face teaching greatly impacted the clinical placements and affected the physical and practical skills training of many institutions.

OBJECTIVE: There is a dearth of data showing how medical students perceive blended learning. As far as the authors are aware, no study has ever addressed the experience of medical students regarding blended, online, and physical teaching in Mauritius. Therefore, the objective of the research is to address the challenges they faced and provide suggestions to tackle the drawbacks and help the betterment of the style of teaching with enhanced academic performance. A qualitative and quantitative assessment of the students’ experience of these three methods was conducted.

METHODS: A mixed methods study, incorporating both qualitative and quantitative data, was conducted at Sir Seewoosagur Ramgoolam Medical College, Mauritius, to understand medical students’ perceptions of online, hybrid, and physical teaching. Statistical Product and Service Solutions (SPSS, version 29; IBM SPSS Statistics for Windows, Armonk, NY) was used for quantitative data analysis, whereas NVivo 12 Plus software was used for qualitative data analysis.

RESULTS: Out of 700 participants, 568 medical students participated in the study for quantitative data synthesis, resulting in an overall response rate of 81.14% (568). A total of 224 (69.1%) female students preferred a mixture of online and in-person lectures, followed by didactic lectures (100, 30.9%) and online (0, 0%). Among all male students, 160 (65.6%) preferred a mixture of online and in-person lectures, didactic lectures (68, 27.5%), and online lectures (16, 6.6%) (p<0.05). Webex was the most popular online video conferencing application utilized for the lectures, which was preferred by 248 (76.5%) female students, followed by Zoom (52, 16%), Google Meet (20, 6.2%), and Microsoft Teams (4, 1.2%). Regarding male students, 200 (82%) students preferred Webex, Zoom (32, 13.1%), Microsoft Teams (8, 3.3%), and Google Meet (4, 1.6%), which was statistically significant (p<0.05). A total of 144 (77.8%) Mauritian students, 34 (73.9%) South Africans, and 206 (61.7%) Indian students preferred a mixture of online and in-person lectures (p<0.05). A descriptive phenomenological qualitative data analysis generated three themes from the codes were as follows: online learning system, physical learning system, and blended learning system. Each theme had three different categories – emotional, academic, and related variables. Under each category, related codes were organized.

CONCLUSION: The novelty of this study is evident, and its practical implications stretch far beyond the lockdown and COVID-19, but its findings, particularly surrounding the reduction in the loss of class times during tropical storms and hurricanes, are invaluable. The hybrid model of teaching caters to a wider audience of students and helps create a balanced mental and physical educational experience, resulting in the best outcome for students in their studies by capitalizing on the advantages of both didactic and online lectures.

PMID:40406771 | PMC:PMC12096337 | DOI:10.7759/cureus.82765

BMC Glob Public Health. 2025 May 23;3(1):43. doi: 10.1186/s44263-025-00164-8.

ABSTRACT

BACKGROUND: In 2017, the Nigerian Federal Ministry of Health adopted and implemented the 2016 World Health Organization (WHO) antenatal care (ANC) policy, including the eight-visit ANC (8vANC) recommendation, to improve ANC uptake and reduce perinatal deaths. This study aimed to examine the impact of the 2016 WHO ANC policy implementation on selected birth outcomes in Nigeria.

METHODS: This research applied an implementation research approach to assess cesarean births, low birth weight (LBW), and perinatal death outcomes associated with the 2016 WHO ANC policy implementation across states in Nigeria. We used multilevel mixed-effects logistic regression model to perform secondary analyses on a matched sample of mothers and children, n = 10,864. A main fixed effect variable was generated from maternal adherence as penetration-fidelity and categorized as ” < 8vANC and partial/non-concordant,” ” < 8vANC and concordant,” “8vANC and partial/non-concordant,” and “8vANC and concordant.” We measured “concordant” as maternal self-reported adherence to five selected ANC components (timing of first ANC visit, blood pressure measurement, tetanus vaccinations, urinalysis, and blood sample test), whereas partial/non-concordant was defined as the receipt of fewer components.

RESULTS: There was no significant association between penetration-fidelity and cesarean births. Compared with children born to mothers who were categorized as ” < 8vANC and partial/non-concordant,” the final adjusted models indicated that penetration-fidelity was significantly associated with reduced odds of LBW among children of mothers who were categorized as “8vANC and concordant” (OR: 0.38, 95% CI: 0.20-0.71, p = 0.003) but with increased odds of perinatal death among children birthed to mothers categorized as “8vANC and concordant” (OR: 1.85, 95% CI: 1.05-3.26, p = 0.032). There was no statistically significant between-state residual variation associated with birth outcomes. Overall, multiparity was associated with increased odds of LBW and perinatal death, whereas advanced maternal age was associated with reduced odds.

CONCLUSIONS: Our findings suggest the need for more nuanced ANC promotion campaigns that would target the varied maternal age and parous spectrum along the maternal and child health continuum. Further research is needed to evaluate the degree to which the state-level implementation of the policy may have also influenced adherence to the 2016 WHO ANC recommendations.

PMID:40405319 | DOI:10.1186/s44263-025-00164-8

Alzheimers Res Ther. 2025 May 22;17(1):112. doi: 10.1186/s13195-025-01754-2.

ABSTRACT

BACKGROUND: The use of polygenic risk scores (PRS) for predicting disease risk in Japanese populations, particularly for dementia and related phenotypes, remains markedly unexplored. The aim of this study was to bridge this gap by developing a novel PRS model designed to predict amyloid-β (Aβ) deposition utilizing positron emission tomography (PET) imaging data from a Japanese cohort.

METHODS: Using the polygenic risk score-continuous shrinkage (PRS-CS) algorithm, we calculated PRS based on significant single nucleotide polymorphisms (SNPs) associated with Alzheimer’s disease (AD) in this population. We applied a PRS calculation approach informed by Japanese genome-wide association studies (GWAS) summary statistics into a Japanese dementia cohort from Keio University.

RESULTS: Our findings revealed that a p-value threshold of pT < 0.1 optimally enhanced the predictive capability of the Japanese Aβ PET positivity risk model. Moreover, we demonstrated that distinguishing between the counts of APOE2 and APOE4 alleles in our calculations significantly elevated model performance, achieving an area under the curve (AUC) of 0.759. Remarkably, this predictive accuracy remained robust even when the pT was adjusted to be < 1.0 × 10^{– 5}, maintaining an AUC of 0.735. This study validated the efficacy of the model in identifying individuals with a increased risk of amyloid pathology.

CONCLUSIONS: These findings highlight the potential of PRS as a noninvasive tool for early detection and risk stratification of AD, which could lead to enhanced clinical applications and interventions.

PMID:40405310 | DOI:10.1186/s13195-025-01754-2