Tag: nevin manimala

Eur J Public Health. 2025 Jul 21:ckaf123. doi: 10.1093/eurpub/ckaf123. Online ahead of print.

ABSTRACT

Lithuania has one of the highest adult mortality rates in Europe. A study analysing three large groups of healthcare employees, physicians, nurses, and assistant nurses, found no significant differences in all-cause mortality compared to other sectors. However, after controlling for education, physicians became the highest-risk group. Nurses and assistant nurses had the lowest risk, but no significant differences were found. Excess all-cause mortality of physicians after controlling for education is striking and needs to be investigated further. Given the low number of deaths by suicide among healthcare workers, more research is required to obtain more statistically robust inferences.

PMID:40690760 | DOI:10.1093/eurpub/ckaf123

JMIR Res Protoc. 2025 Jul 21;14:e69610. doi: 10.2196/69610.

ABSTRACT

BACKGROUND: University students and staff members, especially those who frequently eat out and spend considerable time on campus, form a crucial demographic facing challenges related to high salt and sugar intake in out-of-home food. Recognizing the high prevalence of eating out among these populations, it is imperative to understand the salt and sugar consumption levels of campus communities.

OBJECTIVE: This protocol describes the rationale and design of a 3-part cross-sectional and longitudinal interventional study to reduce salt and sugar contents in canteen foods and intakes among students and staff at Sunway University and Sunway College in Malaysia.

METHODS: First, the knowledge, attitudes, and practices (KAPs) and perception, barriers, and enablers (PBEs) of salt and sugar intake and reduction were assessed among students and staff (part 1 of the study). Second, the KAPs and PBEs of salt, oil, and sugar reduction were assessed among canteen staff (part 2 of the study). Third, a longitudinal interventional study was conducted by implementing a campus-wide executive order to reduce salt and sugar in all foods sold on campus (part 3 of the study). The salt and sugar contents of selected foods were measured at baseline and at 3 months and 6 months postreduction. Participants who eat frequently on campus were selected as the intervention group, while those who do not comprised the control group. All participants had their urine electrolytes and body compositions measured and recorded 24-hour dietary intakes for 2 weekdays and 1 weekend at baseline, 3 months, and 6 months after salt and sugar reduction.

RESULTS: The study protocols were approved by the institutional review board of Sunway University (SUREC 2024/029 and SUREC 2024/040). Recruitment for the cross-sectional studies began in May 2024, while that for the longitudinal intervention study began in June 2024. The 6-month intervention began in September 2024 immediately after the official launch of the campus-wide executive order to reduce salt and sugar. We targeted recruitment of 1000, 50, and 300 participants for parts 1, 2, and 3, respectively. We anticipate reduced dietary salt and sugar intakes by 30% and 50%, respectively (World Health Organization targets), and beneficial health effects on the participants.

CONCLUSIONS: The insights gained from this study will help to create a healthier food environment, benefitting individuals who regularly eat out, especially at the workplace.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06473038; https://clinicaltrials.gov/study/NCT06473038.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69610.

PMID:40690753 | DOI:10.2196/69610

JMIR Res Protoc. 2025 Jul 21;14:e63716. doi: 10.2196/63716.

ABSTRACT

BACKGROUND: Falls are a critical source of injury and hospitalization and leave many older adults unable to return home, especially in rural communities with limited access to health care and support services. Studying falls prevention among rural older adults is essential because they may face an increased risk of falls due to unique environmental factors, geography, and outdoor activities. Moreover, rural older adults may have limited awareness regarding fall-related risks and preventive activities.

OBJECTIVE: The objective of this scoping review is to explore the literature about falls prevention from the perspectives of older adults living within a rural context. This review protocol aims to identify the search parameters and methodology that will be used in the scoping review.

METHODS: This scoping review will be guided by Arksey and O’Malley’s 5-step methodological framework. We will search for relevant peer-reviewed English language literature from 5 databases: CINAHL, PubMed, Academic Search Complete, PsycINFO, and Scopus. The reference lists of relevant studies will be hand-searched to identify papers. Inclusion criteria (English language, peer-reviewed journal papers, original research, focusing on rural perspectives to support falls prevention, and published from January 2013 to December 31, 2023) will be used to determine the eligibility of the journal papers. The data from the included papers will be extracted using a standardized table and analyzed using thematic analysis.

RESULTS: This protocol was registered with the Open Science Framework on June 26, 2024. The scoping review’s data collection and analysis were conducted from September to December 2024. Results from the review will be distributed through publication in a peer-reviewed journal paper, conference presentation, webinar, and a rural community workshop.

CONCLUSIONS: Understanding rural older adults’ perspectives of falls prevention is critical to supporting independence and healthy aging in rural communities. This review’s findings about falls prevention may have important implications for rural community leaders, policy makers, and health practitioners working to support falls prevention in rural communities.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/63716.

PMID:40690750 | DOI:10.2196/63716

Perspect Psychol Sci. 2025 Jul 21:17456916251347926. doi: 10.1177/17456916251347926. Online ahead of print.

ABSTRACT

Cognitive dysfunction is essential to conceptualizing, defining, and assessing much of psychopathology. Despite this prominence, cognitive abilities are not included in the prevailing empirically based classification system: the Hierarchical Taxonomy of Psychopathology (HiTOP). This gap exists because the factor-analytic literature the HiTOP is based on has solely used reporter measures rather than neuropsychological tests needed to measure cognitive ability. Given HiTOP’s influence on research and clinical practice, the omission of cognitive functions from the model is consequential. This study aimed to determine how cognitive abilities fit into the empirical structure of psychopathology with a meta-analytic joint factor analysis. We pooled data from three published meta-analyses into a single correlation matrix of eight disorders from the Diagnostic and Statistical Manual of Mental Disorders and seven cognitive functions. We then fit a series of models to the meta-analytic correlation matrix using exploratory factor analysis and correlated factors across levels to estimate the hierarchical structure. The highest level of the model included a general factor with strong loadings of all disorders and cognitive functions (median λ = |.51|, range = |.30| to |.64|). At the lowest level were three superspectra: psychosis and cognitive dysfunction, externalizing, and emotional dysfunction. Our results show cognitive abilities can be integrated into the HiTOP model and point to actionable next steps in research to accomplish this goal.

PMID:40690691 | DOI:10.1177/17456916251347926

AIDS Care. 2025 Jul 21:1-11. doi: 10.1080/09540121.2025.2534540. Online ahead of print.

ABSTRACT

This ecological study analyzed spatial patterns of non-adherence to antiretroviral therapy (ART) among pregnant women initiating treatment in Brazil from 2014 to 2019. Data were obtained from national systems: SICLOM, SISCEL, and IBGE. Among 23,757 pregnant women aged 15-49, most were aged 20-29 (54%), identified as brown (37.7%), had 8-11 years of education (7.9%), and lacked a partner (36.7%). The non-adherence rate was 20% (n = 4,742). Higher non-adherence was associated with being aged 20-24 (29%, p < 0.005), brown skin color (39.8%, p < 0.005), low education (0-7 years, 27.2%, p < 0.005), no partner (38%, p < 0.005), and changes in ART regimens (19.9%, p < 0.005). Spatial analysis showed higher non-adherence rates in the North and Northeast and lower rates in the South and Central-West. These findings reveal that social vulnerabilities, particularly in less developed regions, hinder ART adherence. Strengthening social policies and improving health service distribution are crucial to ensuring equitable access and supporting pregnant women living with HIV, especially in rural and remote areas.

PMID:40690690 | DOI:10.1080/09540121.2025.2534540

Proc Natl Acad Sci U S A. 2025 Jul 29;122(30):e2509354122. doi: 10.1073/pnas.2509354122. Epub 2025 Jul 21.

ABSTRACT

Understanding the drivers of spatial patterns in fossil communities is fundamental to paleoecology, yet direct evidence for biological mechanisms regulating interindividual spacing remains elusive. Brachiopod setae, hypothesized to function in feeding or defense, are exceedingly rare in the fossil record, especially among post-Cambrian taxa. Here, we present the report of exquisitely preserved setae from an exceptional in situ fossil assemblage of the early Silurian rhynchonelliform brachiopod Nucleospira calypta. Multiproxy analyses (scanning electron microscopy, X-ray fluorescence, and microcomputed tomography) revealed intricate ultrastructural details and diverse taphonomic pathways, leading to a reinterpretation of apparent calcitic preservation as primarily iron oxides with subsequent coating. Critically, the undisturbed nature of this aggregation allowed rigorous spatial point pattern analysis (Nearest-Neighbor Analysis, Thiessen polygons). This revealed a statistically significant, nonrandom, checkerboard-like distribution among individuals within the studied fossil deposit, indicative of active spacing regulation. Strikingly, the measured average interindividual spacing quantitatively relates to the length of the preserved setae. This provides the direct paleontological evidence demonstrating that these subtle morphological structures could have actively mediated spatial organization within a dense benthic community. Our findings illustrate a biological mechanism capable of shaping community structure, operating beyond passive environmental constraints or initial larval settlement preferences, and highlight the potential for subtle anatomical features to exert significant ecological influence in deep time.

PMID:40690671 | DOI:10.1073/pnas.2509354122

Proc Natl Acad Sci U S A. 2025 Jul 29;122(30):e2505418122. doi: 10.1073/pnas.2505418122. Epub 2025 Jul 21.

ABSTRACT

Global forests provide key ecosystem services, from climate regulation to biodiversity habitat, but are under increasing pressure from the combined impacts of climate and land use change. Here, we show that forest disturbance due to fire is growing globally, with the most dramatic increases in intact forest landscapes, highlighting an existential threat to remaining high biomass, high biodiversity forests. The global annual area of forest disturbance due to fire for 2023 and 2024 was highest since the beginning of monitoring in 2001. Compared to 2002-2022 average annual forest disturbance due to fire, the 2023-2024 average was 2.2 times higher globally and 3 times higher in the Tropics. More than ¼ of all 2024 forest disturbance from fire occurred in tropical forests. We found a statistically significant increasing trend of forest disturbance due to fire from 2002 to 2024 in all climate domains except Subtropical. High forest, low deforestation tropical countries were not exempt, with Guyana and the Republic of the Congo experiencing record forest disturbance due to fire. Our results agree with recently estimated increases in global forest fire emissions and active fire detections. The unprecedented scale of fires in the world’s most remote forests is a potential harbinger of ecosystem tipping points. Protecting these remaining unfragmented high conservation value forests from this threat poses a daunting and as yet undeveloped policy and capacity challenge.

PMID:40690667 | DOI:10.1073/pnas.2505418122

JMIR Mhealth Uhealth. 2025 Jul 21;13:e64889. doi: 10.2196/64889.

ABSTRACT

BACKGROUND: Mobile health (mHealth) technologies, such as smartphones and wearables, enable continuous assessments of individual health information. In chronic musculoskeletal conditions, pain flares, defined as periods of increased pain severity, often coincide with worsening disease activity and cause significant impacts on physical and emotional well-being. Using mHealth technologies can provide insights into individual pain patterns and associated factors.

OBJECTIVE: This study aims to characterize pain flares and identify associated factors in rheumatoid arthritis (RA) by (1) describing the frequency and duration of pain flares using progressively stringent definitions based on pain severity, and (2) exploring associations between pain flares and temporal changes in symptoms across emotional, cognitive, and behavioral domains.

METHODS: Our 30-day mHealth study collected daily pain severity and related symptoms (scores 1-5, higher are worse) via a smartphone app and passively recorded sleep and physical activity via a wrist-worn accelerometer. Pain flares were defined using a 5-point scale: (1) above average (AA): pain severity > personal median, (2) above threshold (AT): pain severity > 3, and (3) move above threshold (MAT): pain severity moves from 1, 2, 3 to 4 or 5. A case-crossover analysis compared within-person variations of daily symptoms across hazard (3 days before a pain flare) and control (3 days not preceding a pain flare) periods using mean and intraindividual standard deviation. Conditional logistic regression estimated the odds ratio (OR) for pain flare occurrence.

RESULTS: A total of 195 participants (160/195, 82.1% females; mean age 57.2 years; average years with RA: 11.3) contributed 5290 days of data. Of these, 88.7% (173/195) experienced at least 1 AA flare (median monthly rate 4, IQR 2.1-5). Nearly half experienced at least 1 AT or MAT flare (median monthly rate 2, IQR 1-4). These pain flares lasted 2 days (IQR 2-3) on average across definitions, with some extending up to 12 days. Worsening mood over 3 days was associated with a 2-fold increase in the likelihood of AT flares the following day (OR 2.04, IQR 1.06-3.94; P<.05). Greater variability in anxiety over 3 days increased the likelihood of both AT (OR 1.67, IQR 1.01-2.78; P<.05) and MAT flares (OR 1.82, IQR 1.08-3.07; P<.05). Similarly, greater variability in sleepiness (OR 1.89, IQR 1.03-3.47; P<.05) also increased the likelihood of AT flares. Sedentary time (%) consistently showed almost no influence across all definitions. Similarly, the simplest definition of AA demonstrated no significant associations across all symptoms.

CONCLUSIONS: Pain flares were commonly observed in RA. Changes in sleep patterns and emotional distress were associated with pain flare occurrences. This analysis demonstrates the potential of daily mHealth data to identify pain flares, opening opportunities for timely monitoring and personalized management.

PMID:40690663 | DOI:10.2196/64889

Med Educ Online. 2025 Dec;30(1):2535411. doi: 10.1080/10872981.2025.2535411. Epub 2025 Jul 21.

ABSTRACT

Sexual and gender minority (SGM) individuals in Japan experience significant health disparities. While Western curricula devote multiple hours to structured SGM health modules, Japanese medical schools offer only about 1 h, leaving future providers underprepared. This study aims to 1) develop a health equity education program on SGM for medical undergraduates in Japan, 2) assess the program’s effects while considering empathy levels and SGM identities, and 3) evaluate participant satisfaction with the program. A 3-h educational program was integrated into a psychology course for undergraduate freshmen within the faculty of medicine. Utilizing a pretest-posttest single-group design, the study evaluated outcomes through validated self-report measures and a satisfaction survey. ANOVA models examined the program effects on the awareness of inequities faced by SGM groups and attitudes towards them, while considering the moderating roles of empathy and SGM identities. Descriptive statistics examined program satisfaction. Among 112 participants (mean age 18.5 years, SD = 0.6), 2.7% identified as SGM, with 15.2% unsure. Awareness of SGM health disparities significantly increased from pre to postintervention (p < .001). Interaction analyses showed that this gain did not vary with empathy level (p = .286) or with SGM identity status (p = .445). Attitudes toward SGM individuals likewise improved (p < .001). Interaction analyses showed that this gain did not vary with empathy level (p = .699) or by identity (p = .414). Overall, 99.1% of participants reported satisfaction with the program, and all recognized its utility. The program appeared beneficial even for students who had not yet developed high levels of empathy or those with diverse identities. Our findings call for a sustained effort to embed such education within medical training programs, ensuring that future healthcare professionals are well-equipped to provide inclusive care to SGM individuals.

PMID:40690662 | DOI:10.1080/10872981.2025.2535411

WMJ. 2025;124(2):192-195.

NO ABSTRACT

PMID:40690646