Tag: nevin manimala

J Particip Med. 2026 Feb 13;18:e83149. doi: 10.2196/83149.

ABSTRACT

BACKGROUND: The Veterans Health Administration is promoting patient-reported outcome measure (PROM) collection for measurement-based mental health care. Understanding veteran preferences about how and when to complete PROMs is critical to support their implementation.

OBJECTIVE: We examined veteran preferences for timing and use of different technology platforms to complete mental health-related PROMs.

METHODS: We invited a national sample of 1373 veterans to complete a survey; 858 (62.5%) responded. Surveys asked about veteran preferences for how and when to complete mental health-related PROMs. We characterized responses using descriptive statistics and estimated multiple logistic regression models to examine associations between veteran demographic and health characteristics and preferences for completing PROMs.

RESULTS: Most veterans preferred completing PROMs between appointments (607/801, 75.8%) using features of a patient portal (410/801, 51.2%), during appointments (589/801, 73.5%) verbally (413/801, 51.6%), and while at the medical center (480/801, 59.9%) on paper (189/801, 23.6%) or a tablet computer (180/801, 22.5%). Hispanic (vs non-Hispanic) veterans had 3.32 (95% CI 1.04-10.58) times higher odds of preferring to complete PROMs at the medical center, and veterans with lower (vs higher) socioeconomic status had lower odds (odds ratio 0.61, 95% CI 0.40-0.93) of preferring to complete PROMs in between appointments but 1.97 (95% CI 1.23-3.16) times higher odds of preferring to complete PROMs during appointments.

CONCLUSIONS: As the Veterans Health Administration and other health care systems seek to expand the integration of PROM data into health care services, adaptive and flexible approaches to PROM administration that align with patient preferences, including those that leverage technology platforms in the remote collection of these data, may bolster implementation. Our results indicate that such implementation efforts should consider patient ethnicity and socioeconomic status. Our findings further suggest that these efforts could benefit from incorporating PROM administration into online patient portals, developing mobile health apps that support PROM completion through patients’ personal devices in between clinical encounters, and engaging care team members in PROM administration during appointments.

PMID:41687098 | DOI:10.2196/83149

JMIR Public Health Surveill. 2026 Feb 13;12:e82496. doi: 10.2196/82496.

ABSTRACT

BACKGROUND: In France, reluctance toward hepatitis B vaccination remains high, despite the availability of a safe and effective vaccine to prevent this infection. To boost vaccination coverage, it is therefore essential to identify the factors that are likely to encourage a more favorable opinion of this vaccine. Health literacy (HL) is one such factor. It refers to the individual ability to access, understand, critically appraise, and apply health information to make informed decisions about health issues for oneself and for others.

OBJECTIVE: This study explored the mechanisms through which HL might affect opinions about hepatitis B vaccination, both directly and indirectly, by relevant factors, including opinions about vaccination in general, trust in government health agencies, and trust in medical doctors.

METHODS: The analysis used data from the SLAVACO-Wave 3 (Suivi Longitudinal des Attitudes à l’Égard d’un Vaccin Contre la COVID-19) survey, conducted in December 2021 among a representative sample of French adults (N=1932). Favorable and unfavorable opinions of hepatitis B vaccination were measured using a 5-point Likert scale, while HL was assessed using the HLS₁₉-Q12 questionnaire (12-item general health literacy questionnaire used in Health Literacy Survey 2019-2021). A structural equation model examined the relationship between HL and hepatitis B vaccination opinions, taking into account the potential mediating role of trust in the health care system (ie, government health agencies and medical doctors).

RESULTS: Findings showed that individuals with a favorable opinion of hepatitis B vaccination (1437/1932, 74.4%) had a higher HL level than those with a negative or neutral opinion (62.6 vs 57.0, P<.001). The association between HL and hepatitis B vaccination opinions was fully mediated by trust in the health care system. The indirect effect of HL was estimated at 0.068 (95% CI 0.042-0.093), accounting for 52.4% (0.068/0.1297) of the total effect. This effect was particularly pronounced in people over 50 years (0.084, 95% CI 0.042-0.126, accounting for 0.084/0.1306, 64.3% of the total effect). Goodness-of-fit indicators were satisfactory.

CONCLUSIONS: Enhancing HL might positively influence hepatitis B vaccination opinions and uptake through greater trust in the health care system. From a public health perspective, strategies should go beyond providing clear information and access to vaccines and actively work to strengthen trust in health care institutions and professionals. National campaigns correcting misconceptions about hepatitis B vaccination could be complemented by targeted interventions for groups most likely to hold negative opinions. Repeating this survey in the post-COVID-19 context could also reveal different trends, given evolving public perceptions of vaccines and health authorities.

PMID:41687090 | DOI:10.2196/82496

J Neurosurg Pediatr. 2026 Feb 13:1-12. doi: 10.3171/2025.9.PEDS25180. Online ahead of print.

ABSTRACT

OBJECTIVE: Neural tube defects (NTDs) represent a significant global concern, impacting an estimated 300,000 individuals each year. Sub-Saharan Africa (SSA) is considerably affected due to various biopsychosocial factors, dietary issues such as folic acid deficiency, and fumonisin-contaminated maize consumption, and sex-based disparities. This study sought to understand epidemiology and trends in NTD in SSA from 1990 to 2021.

METHODS: The Global Burden of Disease database was utilized to obtain epidemiological data on the variables of interest, which included disability-adjusted life years (DALYs), incidence, prevalence, and mortality of patients with NTD in SSA. The countries in SSA were divided into 4 separate regions-Central, Eastern, Western, and Southern-based on the designations by the African Union. Variations in measurements of NTDs between regions in SSA were assessed using R Studio, and statistical significance was determined with a threshold p value of < 0.05.

RESULTS: The global burden of NTDs was significantly lower than the burden of NTDs in Central, Eastern, and Western SSA (p < 0.0001). Among the regions, Southern SSA experienced better outcomes in terms of DALYs, mortality, incidence, and prevalence, compared to the other regions of SSA (p < 0.001). When a sex-specific burden analysis was performed, female sex was associated with higher DALYs and mortality of NTDs within SSA, especially in Western SSA (p < 0.0001). Other regions of the world, including North America, Latin America and Caribbean, Europe and Central Asia, and Middle East and Northern Africa, also showed associations between female sex and higher DALYs and mortality of NTDs (p < 0.05). When the incidence and prevalence of NTDs was analyzed, there were mixed results, as female sex was associated with higher and lower rates in different regions of the world.

CONCLUSIONS: Understanding the epidemiology of NTDs in SSA underscores the need for quality interventions that not only increase disease awareness and healthcare access but strive for prevention. With identification of the multifaceted factors contributing to NTDs and promotion of proactive health practices, significant strides could be made toward reducing the incidence of NTDs. Partnerships between governments and international agencies are vital to mobilize resources and reduce the burden and related health disparities.

PMID:41687089 | DOI:10.3171/2025.9.PEDS25180

Prim Care Companion CNS Disord. 2026 Feb 12;28(1):25m04071. doi: 10.4088/PCC.25m04071.

ABSTRACT

Objective: To examine the prevalence and clinical correlates of suicidal mental imagery among individuals who have attempted suicide in India.

Methods: This cross-sectional study included 63 participants who recently attempted suicide. Assessments included the Mini-International Neuropsychiatric Interview, Version 6, suicidality subscale; Patient Health Questionnaire-9; Beck Suicide Intent Scale; Scale for Assessment of Lethality of Suicide Attempt; and a sociodemographic data questionnaire. Data were collected from June 2023 to April 2024.

Results: The majority of participants were unemployed, educated, unmarried, and from nuclear families and rural backgrounds. Common attempt methods were drug overdose and poisoning. Of the participants, 79.4% reported past mental illness. Suicidal mental imagery was present in 38.1% of participants. Associations were found with female sex, unemployment, past mental illness, and higher depression/suicidality scores.

Conclusions: The relationship between depression, suicidality, and mental imagery suggests that addressing imagery could be important for treatment and prevention.

Prim Care Companion CNS Disord 2026;28(1):25m04071.

Author affiliations are listed at the end of this article.

PMID:41687087 | DOI:10.4088/PCC.25m04071

Acta Med Port. 2026 Feb 13. doi: 10.20344/amp.23078. Online ahead of print.

ABSTRACT

Survival analysis is a fundamental tool in clinical research for evaluating time-to-event outcomes. While the Kaplan-Meier method remains a widely used univariable approach for estimating survival probabilities and comparing groups, it does not account for multiple risk factors simultaneously. To address this limitation, multivariable regression models are employed, with the Cox proportional hazards model (Cox regression) being the most commonly used. This paper provides a practical guide to Cox regression for clinicians, emphasizing its application in survival analysis rather than focusing on mathematical derivations. We discuss key concepts, including hazard ratios, model assumptions, variable selection, and interpretation of results. Additionally, we explore essential methodological considerations, such as assessing proportional hazards assumptions, handling missing data, and avoiding overfitting. By offering a step-by-step approach to implementing Cox regression in clinical research, this article aims to enhance understanding and improve the quality of survival analysis in medical studies. Practical examples illustrate how to interpret Cox regression results and their relevance in clinical decision-making.

PMID:41687085 | DOI:10.20344/amp.23078

Can J Physiol Pharmacol. 2026 Feb 13. doi: 10.1139/cjpp-2025-0274. Online ahead of print.

ABSTRACT

This study evaluated the presence of bacterial species in the placenta of women with pre-eclampsia and compared with that of normotensive women. One hundred and twenty participants, comprising 60 pre-eclamptic (30 early- and late-onset, respectively) and 60 age-matched normotensive women (30 early and late-gestation normotensive, respectively) were recruited. After informed consent was obtained, the placenta were obtained through caesarean section with sterile and standardized clinical procedures. DNA was extracted from each tissue, and the samples were pooled into six libraries and sequenced on Illumina NextSeq500 using a shotgun metagenomic approach. Bioinformatics was used to analyse the reads with the implementation of Kraken2/MetaPhlAn classification methods and complemented by multi-layered contamination assessment strategy that included frequency-based decontam filtering. Most reads were classified as belonging to the phyla Cutibacterium acnes, Staphylococcus epidermidis, and various Bradyrhizobium species. PE samples showed notable Corynebacterium tuberculostearicum and Pseudomonas species, while Bradyrhizobium and Cutibacterium acnes dominated normotensive samples. Further analysis showed no significant difference between bacterial species of pre-eclamptic and normotensive placental samples. The results show very low levels of bacteria in the placental samples. In addition, a little difference was observed between the bacterial compositions of pre-eclamptic and age-matched normotensive placental tissues, but not statistically significant.

PMID:41687083 | DOI:10.1139/cjpp-2025-0274

Ophthalmic Plast Reconstr Surg. 2026 Feb 13. doi: 10.1097/IOP.0000000000003188. Online ahead of print.

ABSTRACT

PURPOSE: To determine current dacryocystorhinostomy (DCR) practice patterns of American Society of Ophthalmic Plastic and Reconstructive Surgery members and identify surgeon and case-related factors impacting preference for endoscopic versus external DCR and the use of preoperative imaging.

METHODS: A cross-sectional web-based anonymous 16-question survey was distributed to 277 American Society of Ophthalmic Plastic and Reconstructive Surgery members enrolled in survey-based research. The survey assessed surgeons’ demographics, practice settings, surgical preferences, and imaging practices. Responses were summarized and compared using statistical tests for frequency distribution.

RESULTS: A total of 111 surgeons (40.0%) responded to the survey. Utilization of endoscopic DCR (endoDCR) was highly variable, with 57% of junior surgeons (<5 years in practice) using it for >66% of their cases, compared with only 18.3% of surgeons with >15 years postfellowship experience. High utilization of endoDCR (>66% of cases) was more common in academic surgeons compared with private practice (48.4% vs. 19.6%, p < 0.01). The most cited reasons for endoDCR were scar avoidance and revision surgery. For external DCR, anatomical barriers and concern for mass/need for biopsy were common indications. Most surgeons only order imaging for certain indications, such as prior sinonasal surgery, facial trauma, suspected tumor, or atypical presentation.

CONCLUSION: Utilization of endoDCR was correlated with years in practice, with younger surgeons preferring the endoscopic technique. A large majority felt that the relevance of imaging is low in most patients. Future research is needed to standardize case-based indications for endoscopic versus external approaches and preoperative imaging.

PMID:41687079 | DOI:10.1097/IOP.0000000000003188

MSMR. 2026 Feb 4;32(12):36-43.

ABSTRACT

Although mental health conditions are the leading underlying cause of maternal mortality, there is limited research on the prevalence of perinatal mental health conditions among active duty service women (ADSW). In this study of live-born deliveries among U.S. ADSW (n=62,729) with pregnancy start and end dates (i.e., dates of last menstrual period and infant delivery, respectively) from October 1, 2016 through December 31, 2021, International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes were used to identify mental health conditions: trauma and stressor-related disorders, anxiety and panic disorders, depressive disorders, suicidal ideation or attempt, and eating disorders. Data were collected through 1 year postpartum, until December 31, 2022. The prevalence of diagnosed mental health conditions from 1 year prior to pregnancy through 1 year postpartum was 33.8%. Trauma and stressor-related disorders were most prevalent (23.1%), followed by anxiety and panic disorders (16.9%), depressive disorders (14.6%), suicidal ideation or attempt (1.6%), and eating disorders (0.4%). The prevalence of mental health conditions was higher in the postpartum period (22.0%) compared to pregnancy (18.4%) and prior to pregnancy (15.0%). Overall, higher prevalence of these conditions was found among non-Hispanic Black ADSW (37.4%), and those who were unmarried (38.4%), never deployed (34.9%), or in the Army (37.4%) and Navy (36.4%). One in 3 active duty service women were diagnosed with a mental health condition in the year preceding pregnancy through 1 year postpartum. Overall, non-Hispanic Black and junior enlisted active duty service women demonstrated higher prevalences of mental health conditions compared to all other racial and ethnic groups and military ranks.

PMID:41687061

MSMR. 2026 Feb 4;32(12):25-35.

ABSTRACT

Mental health disorders have long been recognized as a problem in a wide range of domains, including the military, resulting in significant impacts on general morbidity, health care provision, disability, and military discharges. From 2020 through 2024, a total of 560,035 U.S. active component service members were diagnosed with at least 1 mental health disorder. Annual incidence rates of mental health disorder increased steadily from 2020 until 2022, but adjustment disorder decreased since then, anxiety gradually increased, and the remaining conditions remained relatively unchanged. Most mental health disorder diagnoses were attributable to adjustment disorders, anxiety disorders, depressive disorders, post-traumatic stress disorder, alcohol-related disorder, and other mental health disorders. Historically, mental health disorders have often been misunderstood and stigmatized, leading to under-reporting, delayed treatment, and poor prognoses. Reflecting the unique stressors and cultural stigmas of military life, ongoing efforts to raise awareness, encourage help-seeking, and improve treatment options are essential to supporting the mental and emotional well-being of service members. While the incidence of U.S. service members who were diagnosed with at least 1 mental health disorder remained stable from 2023 to 2024, the annual incidence rate of anxiety disorders demonstrated a continual increase from 2020 to 2024.

PMID:41687060

JMIR Mhealth Uhealth. 2026 Feb 13;14:e71412. doi: 10.2196/71412.

ABSTRACT

BACKGROUND: eHealth is an increasingly used method of health care in the field of psycho-oncology. While many reports highlight the positive impact of psychological eHealth tools, some patients refuse to use them.

OBJECTIVE: This study aimed to expand knowledge of the motivation and psychoemotional functioning of patients who consciously refuse to use eHealth technology in the form of a mobile psycho-oncology app offered as part of a clinical trial. To our knowledge, this is the first study to address this topic.

METHODS: A retrospective cross-sectional study was conducted between December 2022 and February 2023 to investigate the reasons why 56 patients with breast cancer refused to use the psycho-oncology mobile app offered as part of a clinical trial by the Breast Cancer Unit. The primary aim of the study was to analyze patients’ self-reported reasons for not engaging with the app, while also exploring their psychoemotional functioning, including stress levels (measured using the distress thermometer), personality traits (measured using the Ten-Item Personality Inventory), coping strategies (measured using the Coping Orientation to Problems Experienced Questionnaire), and Self-efficacy (measured using the General Self-Efficacy Scale). Participants in this study declined the app intervention but agreed to participate in this separate observational study, indicating that their refusal was related to the app itself rather than to participation in clinical research in general.

RESULTS: The patients experienced a clinically meaningful elevation in stress levels (mean 5, SD 2.1 points) and Self-efficacy (mean 32.1, SD 5.1 points). Among 5 dimensions of personality traits, patients scored highest in Agreeableness (mean 6.5, SD 0.8 stens) and Conscientiousness (mean 6.4, SD 0.9) and lowest in Neuroticism (mean 3.4, SD 1.8) (other dimensions: Extraversion [mean 5.8, SD 1.6 stens] and Openness to Experiences [mean 4.4, SD 1.5 stens]). In terms of coping with stress, patients most frequently used the strategies of Active Coping (mean 2.6, SD 0.5 points), Acceptance (mean 2.6, SD 0.6 points), and Seeking Emotional Support (mean 2.6, SD 0.6 points), and least frequently used the strategies of Psychoactive Substance Use (mean 0.2, SD 0.6 points) and Restraint (mean 0.5, SD 0.7 points). Patient responses regarding refusal to participate in app testing were divided into four categories: (1) Focus on Life Outside the Disease, (2) Focus on Disease and Treatment, (3) Denial Mechanism, and (4) Technical Issues. Statistically significant differences were found between the groups. The Focus on Life Outside the Disease group of patients had higher levels of Self-efficacy, lower Neuroticism, and more frequent use of the Positive reevaluation strategy compared to the other groups.

CONCLUSIONS: Our patients’ decision not to use the eHealth psycho-oncology app was mainly influenced by characteristics suggesting better emotional coping with the disease and treatment. These factors were significantly more influential than other factors studied, particularly those related to technology. Assessing reasons for opting out of eHealth and associated psychomotional functioning may be important for improving patients’ adoption of eHealth solutions.

PMID:41687056 | DOI:10.2196/71412