Tag: nevin manimala

J Nurs Manag. 2026;2026(1):e3078316. doi: 10.1155/jonm/3078316.

ABSTRACT

AIM: To describe the prevalence of Missed Nursing Care and its predictors in Greek public hospitals.

BACKGROUND: Missed Nursing Care is defined as any aspect of required patient care that is omitted or delayed. Despite the available studies, little is still known in countries with significant nursing shortages, such as Greece, where 2.23 registered and assistant nurses per 1000 population have been reported, significantly below the EU-27 average.

METHODS: A national cross-sectional study was conducted in 28 of 124 public hospitals in Greece. Nurses and nursing assistants working in medical or surgical units, providing direct care to adult patients, and with at least 3 months of experience were eligible. The MISSCARE Survey Part A (5-point Likert scale; 1 = never, 5 = always missed), Part B (reasons, four-point Likert scale; 1 = not significant, 4 = significant reason) and the Practice Environment Scale of the Nurse Work Index (4-point Likert scale; 1 = totally agree, 4 = totally disagree) were used. Descriptive and inferential statistics were applied.

RESULTS: A total of 676 nurses participated. The Missed Nursing Care Part A total score was 2.06 (±0.65), with patients’ daily activities (mean = 2.32 ± 0.73) receiving higher scores than activities related to health status and treatments (mean = 1.80 ± 0.63). The overall score on the Practice Environment Scale of the Nurse Work Index was 2.53 (±0.49). Multiple linear regression analysis showed that issues in nursing care standards for quality of care, staffing adequacy and communication within the team were the most significant predictors of Missed Nursing Care.

CONCLUSION: Missed Nursing Care is a major problem in Greek hospitals. Inadequate staffing is a key factor in missed care according to nurses’ perceptions. Increasing nursing staff, along with implementing standards for nursing care and improving communication among team members, will enhance the quality of health services in Greece.

IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening staffing levels and reinforcing nursing standards are essential strategies for reducing Missed Care in Greek public hospitals.

PMID:42059103 | DOI:10.1155/jonm/3078316

J Nurs Manag. 2026;2026(1):e8888440. doi: 10.1155/jonm/8888440.

ABSTRACT

BACKGROUND: Mushroom management, a leadership style characterized by withholding information, excluding employees from strategic processes, and maintaining top-down control, has been linked to adverse organizational outcomes. However, its impact on nurses and the psychological mechanisms through which this influence operates remain underexamined.

PURPOSE: This study examines the direct and indirect effects of mushroom management on nurses’ job satisfaction, with organizational identification (OI) as the mediating variable, guided by affective events theory and social identity theory.

METHODS: A cross-sectional survey was conducted with 317 nurses employed in private hospitals in Diyarbakır, Türkiye. Data were collected using validated Turkish versions of the Mushroom Management Scale (Birincioğlu and Tekin, 2018), Job Satisfaction Scale (Judge et al., 2008; Keser and Bilir, 2019), and Organizational Identification Scale (Mael, 1988; Tüzün and Özdoğan, 2006). All scales use a five-point Likert format (1 = strongly disagree to 5 = strongly agree). Confirmatory factor analysis confirmed good model fit (χ²/df = 2.21, CFI = 0.95, RMSEA = 0.062). Mediation was tested using Hayes’ PROCESS macro (Model 4) in SPSS 23.0 with 5000 bootstrap samples.

RESULTS: Mushroom management had significant negative effects on OI (standardized β = -0.46, p < 0.001) and job satisfaction (standardized β = -0.21, p = 0.001). OI positively predicted job satisfaction (standardized β = 0.48, p < 0.001). Mediation analysis confirmed a significant indirect effect (standardized β = -0.22, 95% CI [-0.31, -0.14]), with OI accounting for 51% of the total effect indicating partial mediation.

CONCLUSIONS: Mushroom management is associated with lower OI and job satisfaction among nurses, with OI serving as a key identity-based psychological mechanism. Healthcare leaders should prioritize transparent communication, participatory decision-making, and identity-affirming leadership practices to enhance nurse well-being and retention.

IMPLICATIONS FOR NURSING MANAGEMENT: Findings highlight the need for structured information-sharing protocols, mushroom-management-specific leadership training, and shared governance structures in private hospital settings. Periodic organizational climate monitoring using validated instruments is recommended.

PMID:42059094 | DOI:10.1155/jonm/8888440

Australas Psychiatry. 2026 Apr 30:10398562261444981. doi: 10.1177/10398562261444981. Online ahead of print.

ABSTRACT

ObjectivesThis survey evaluated psychiatry trainees’ attitudes toward conceptual and philosophical issues in psychiatry practice, research and training.MethodsA 20-item Likert questionnaire was administered to 156 psychiatry trainees (53 UK, 103 US) via Webropol (UK) and REDCap (US). The survey assessed demographics, familiarity with conceptual and philosophical issues, attitudes toward its importance, confidence in three domains of conceptual competence, and views on specific philosophical issues. Descriptive statistics and Mann-Whitney U tests were used to analyze UK and US responses. Free-text responses provided qualitative data.ResultsMost trainees (82% research, 92% practice) recognized the importance of conceptual and philosophical issues in psychiatry, with 96% supporting their inclusion in training, but only 28% felt their current training had adequately prepared them. Trainees were ‘somewhat confident’ in recognizing conceptual assumptions implicit in psychiatric work but felt less confident that they possessed the requisite philosophical vocabulary and ability to critically evaluate philosophical issues. Regarding specific philosophical positions, responses revealed a strong endorsement of explanatory pluralism and a rejection of naturalist definitions of mental disorder.ConclusionTrainees viewed conceptual skills as important but felt unprepared by current training programs. This article advocates for the integration of ‘conceptual competence’ in psychiatric education.

PMID:42059093 | DOI:10.1177/10398562261444981

Otolaryngol Head Neck Surg. 2026 Apr 30. doi: 10.1002/ohn.70258. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate longitudinal trends in female authorship in high-impact otolaryngology journals and assess changes in representation across first and last author positions over a 20-year period.

STUDY DESIGN: Cross-sectional bibliometric analysis.

SETTING: Three high-impact otolaryngology journals: JAMA Otolaryngology-Head & Neck Surgery, The Laryngoscope, and Otolaryngology-Head and Neck Surgery.

METHODS: Research articles published in 2004 and 2024 were identified. First and last author genders were determined using publicly available sources. Descriptive statistics and proportional comparisons were performed to compare gender distribution across authorship positions and time points.

RESULTS: A total of 3733 authors across 1948 original articles were analyzed. Overall female authorship increased from 15.5% in 2004 to 33.5% in 2024 (P < .001). Female first authorship more than doubled from 15.9% to 39.9% (P < .001), while female last authorship rose more modestly from 15.6% to 26.4% (P < .001).

CONCLUSION: Female authorship in otolaryngology has grown substantially over the past 2 decades, reflecting progress in early-career scholarly participation. However, persistent underrepresentation in senior authorship positions highlights enduring barriers to academic advancement. Continued efforts to improve mentorship, sponsorship, and equitable promotion practices are essential to achieving gender equity in otolaryngology scholarship.

PMID:42059091 | DOI:10.1002/ohn.70258

Circ Popul Health Outcomes. 2026 Apr 30:e012967. doi: 10.1161/CIRCOUTCOMES.125.012967. Online ahead of print.

ABSTRACT

BACKGROUND: Sudden cardiac death (SCD) can be caused by heritable cardiac conditions, as such, up to 50% of family members may be at risk. Coroners are responsible for communicating this risk, in addition to investigating the cause of death. The purpose of this study was to explore how family members of SCD victims experience the type, timing, and suitability of communication with coroners about the cause of death and their own risk for SCD.

METHODS: We conducted an explanatory sequential mixed methods study. Eligible family members of SCD victims aged 2 to 70 years, who died in 2021 from a potentially heritable cardiac condition and were investigated by the Office of the Chief Coroner of Ontario (Canada), were invited to complete a web survey or telephone interview. We used descriptive statistics to analyze the survey data and thematic analysis to analyze the interview data. Quantitative and qualitative data integration occurred at multiple levels.

RESULTS: We sent survey invitations to 126 family members of 115 SCD victims; 50 completed the web-based survey between September 2022 and February 2024. We interviewed a subset of 17 participants. Most received initial communication by phone (n=30, 60%) or in-person (n=13, 26%). Although many (n=39; 78%) received a timeline for death investigation results, 16 (32%) did not receive results within the expected timeframe. In interviews, family members described effective communication as clear, with the coroners’ demeanor being important, in particular, perceived as kind, accessible, and approachable. When communication needs went unmet, families relied on external support networks (outside of the coroner system) to fill information gaps. Suggestions for improved communication included repeating information and using multiple communication modes to enhance understanding.

CONCLUSIONS: Findings emphasize the need for coroners to use empathetic approaches and provide timely, clear information. Addressing communication gaps may better meet the needs of grieving SCD families.

PMID:42059081 | DOI:10.1161/CIRCOUTCOMES.125.012967

Hypertension. 2026 Apr 30. doi: 10.1161/HYPERTENSIONAHA.125.26364. Online ahead of print.

ABSTRACT

BACKGROUND: Blood pressure (BP) is a dynamic trait associated with cardiovascular disease. We aimed to estimate age-specific BP levels and rates of change from childhood to mid-adulthood and to examine their associations with subsequent subclinical target organ damage.

METHODS: We included 2508 participants from the Hanzhong Adolescent Hypertension Study with BP measured ≥4× from 1987 to 2023. Surrogate markers of target organ damage were assessed, including arterial stiffness, left ventricular hypertrophy, and albuminuria. Growth models were used to construct BP trajectories and estimate age-specific BP levels and rates of change (slopes).

RESULTS: Rates of change in BP at each age point from childhood to mid-adulthood were positively associated with arterial stiffness and albuminuria in mid-adulthood, independent of corresponding BP levels. The magnitude of the associations rose from childhood, peaked in adolescence, and declined thereafter. For example, odds ratios (95% CIs) per 1 SD increase in systolic BP change rates for arterial stiffness increased from 1.94 (1.69-2.24) at age 6 to 2.11 (1.82-2.44) at age 13, then declined to 1.13 (1.01-1.28) by age 52. Faster BP increases were more strongly associated with arterial stiffness and albuminuria than concurrent BP levels during childhood and adolescence, whereas the opposite trend was observed in young and mid-adulthood. Similar age-dependent trends were identified for left ventricular hypertrophy, with minor variations in the ages at which associations reached statistical significance.

CONCLUSIONS: Accelerated BP increases during childhood and adolescence show a stronger association with mid-adult subclinical target organ damage than increases occurring in adulthood.

PMID:42059070 | DOI:10.1161/HYPERTENSIONAHA.125.26364

Orbit. 2026 Apr 30:1-9. doi: 10.1080/01676830.2026.2649276. Online ahead of print.

ABSTRACT

PURPOSE: The study aimed to evaluate international practice patterns among oculofacial plastic surgeons regarding postoperative patching, given evolving evidence and uncertainties surrounding benefits and risks.

METHODS: A web-based survey was distributed to members of nine oculoplastic societies worldwide. The survey included thirty-eight questions about postoperative patching practices for oculofacial procedures. Descriptive statistics, chi-squared tests and logistic regression analyses were performed to assess practice patterns and identify demographic factors associated with patching decisions.

RESULTS: A total of 519 surgeons completed the survey. Patching practices varied substantially by procedure: 29.1% routinely patched after eyelid surgery, 51.1% after orbital surgery, 23.9% after lacrimal surgery, and 80.3% after skin graft surgery. Logistic regression showed that surgeons practicing outside the United States were more likely to patch for eyelid (Odds Ratio (OR) = 5.00, p < 0.001), orbital (OR = 2.94, p < 0.001), and lacrimal (OR = 1.96, p = 0.02) surgeries. Surgeons aged ≥ 40 years were less likely to patch in eyelid (OR = 0.64, p = 0.04) and lacrimal (OR = 0.51, p = 0.002) surgeries.

CONCLUSIONS: Postoperative patching practices among oculofacial plastic surgeons show significant variation, influenced by geographic location, surgeon age, and procedure focus. These findings highlight the need for further research to evaluate the impact of these practices on surgical outcomes and to develop consensus guidelines that optimize patient care.

PMID:42059067 | DOI:10.1080/01676830.2026.2649276

Stroke. 2026 Apr 30. doi: 10.1161/STROKEAHA.125.054194. Online ahead of print.

ABSTRACT

BACKGROUND: As life expectancy rises, identifying causes and risk factors for incident acute ischemic stroke (AIS) among the oldest-old (≥80 years) is increasingly important. We examined whether the effect of age at stroke on AIS subtype is mediated by embolic risk factors and whether these factors improve AIS prediction.

METHODS: Stroke-free participants from the ARIC study (Atherosclerosis Risk in Communities) who developed AIS between visit 5 (2011-2013) and visit 10 (2023) were included for causal analysis; Stroke-free participants at visit 5 were included for prediction analysis. In logistics regression models, the association between age at stroke-onset (≥80 versus <80 years) and adjudicated AIS subtype (embolic ischemic stroke versus thrombotic ischemic stroke) was determined. Bootstrapped mediation analyses (1000-iterations) tested whether atrial fibrillation, myocardial infarction, coronary heart disease, heart failure, and electro/echocardiogram measures mediated the age-AIS subtype relationship. C statistics were calculated for AIS prediction (Predicting Risk of Cardiovascular Disease Events, CHA₂DS₂-VASc) and compared preinclusion and postinclusion of embolic risk factors.

RESULTS: Of 6213 stroke-free participants at visit 5, 277 (4.4%) developed AIS during a median (Q1-Q3) of 5.1 (2.6-7.1) years (median [Q1-Q3] age: 76 [72-80] years; median [Q1-Q3] age at AIS: 81 [77-86] years; 62% female; 99 embolic ischemic stroke and 178 thrombotic ischemic stroke). Individuals with AIS ≥80 years had higher odds of embolic ischemic stroke (versus thrombotic ischemic stroke) compared with those aged <80 years (odds ratio, 1.90 [95% CI, 1.09-3.31]). The effect of age at stroke-onset on embolic ischemic stroke was mediated by atrial fibrillation (44%; P=0.03), an abnormal left atrium volume index (45%; P=0.048), or an abnormal P-wave axis (43%; P=0.04). The predictive performance for AIS ≥80 years using the Predicting Risk of Cardiovascular Disease Events equation (N=5702, C statistic, 0.49 [95% CI, 0.45-0.53]), or CHA₂DS₂-VASc score (N=5739, C statistic, 0.57 [95% CI, 0.55-0.59]) was poor, but inclusion of embolic risk factors improved the performance (Predicting Risk of Cardiovascular Disease Events: C statistics, 0.77 [95% CI, 0.74-0.80]; CHA₂DS₂-VASc: C statistics, 0.63 [95% CI, 0.59-0.67]).

CONCLUSIONS: These findings suggest that identification and control of embolic risk factors are critical to reduce stroke risk as people age, and better stroke-specific prediction tools are needed.

PMID:42059062 | DOI:10.1161/STROKEAHA.125.054194

Int J Geriatr Psychiatry. 2026 May;41(5):e70217. doi: 10.1002/gps.70217.

ABSTRACT

BACKGROUND: Bipolar disorder (BD) in older adults is linked to significant medical comorbidities and hospitalization burden, yet nationwide data remain scarce. This study aims to compare younger versus older BD hospitalization trends, patient characteristics, and the impact of comorbidities on hospitalization outcomes in Portugal (2008-2015).

METHODS: A retrospective observational study was conducted using a Portuguese administrative database, selecting hospitalization episodes of patients aged ≥ 60 years with a primary BD diagnosis. Variables analyzed included demographics, psychiatric comorbidities, Charlson Comorbidity Index (CCI), length of stay (LoS), in-hospital mortality, hospital charges, and readmissions.

RESULTS: From a total of 21,793 BD hospitalizations, there were 4801 (22.0%) BD-related hospitalizations in the older age group, and the annual hospitalization rate was 23.4 per 100,000 inhabitants. The median admission age was 66.0 years, and 67.7% were female. BD type I with a manic episode (32.9%) was the most frequent subtype, and 85.5% of admissions were emergent. The median LoS was 18.0 days, significantly longer than in younger adults (p < 0.001). Readmission occurred in 52.4% of cases, with in-hospital mortality at 0.7%. Comorbidities were present in 23.0% of hospitalizations, with diabetes (13.1%) and dementia (3.2%) being most prevalent.

LIMITATIONS: The study relies on secondary administrative data, subject to coding inaccuracies, and its retrospective design limits causal inferences.

CONCLUSIONS: BD hospitalizations in older adults carry a high medical burden, with comorbidities impacting outcomes. Early screening, multidisciplinary care, and targeted interventions are crucial to improving management and reducing hospitalizations. Further research is needed to explore long-term outcomes and outpatient care strategies.

PMID:42059056 | DOI:10.1002/gps.70217

J Glob Health. 2026 Apr 30;16:04098. doi: 10.7189/jogh.16.04098.

ABSTRACT

BACKGROUND: Lower limb conditions (LLCs) are a major cause of pain, disability, and loss of livelihood globally, yet their prevalence and functional impacts in low- and middle-income countries, including Nepal, remain poorly described.

METHODS: We conducted a cross-sectional, community-based survey in three Nepali districts representing plains, hills, and mountains. Of 2525 screened households, the first 500 adults with self-selected LLCs were interviewed using structured questionnaires adapted from validated tools (Global Alliance for Musculoskeletal Health, COPCORD, Washington Group, WHODAS 2.0). Descriptive statistics summarised condition type, pain location, activity limitations, employment impact, and comorbidities. χ² tests assessed regional differences in condition types.

RESULTS: Of 2525 households, 671 (26.6%, 95% CI = 24.9-28.3) reported a member with an LLC; 11.2% (95% CI = 10.5-12.0) of adults were affected. Among 500 participants surveyed (mean age 57 years; 65% female), pain/discomfort was most common (97%), mainly in the knee (74%) and foot/ankle (48%). Across participants, 628 LLCs were reported; conditions included injury/trauma (19%), deformity (7%), wounds (1%), and amputation (<1%). Prevalence varied by district. Functional limitations were substantial: 82% with pain and all with amputation reported severe activity restriction. Ten percent were unemployed, mostly due to health, and >70% of those doing household work had left other jobs because of their LLC.

CONCLUSIONS: This study offers preliminary, population-based estimates of person-reported LLCs across three ecological zones in Nepal. Musculoskeletal pain was most common, often multi-site and substantially limiting daily activities and employment. While findings highlight the impact of LLCs on well-being and livelihoods, they remain exploratory due to limited geographic scope and self-reporting. Larger, nationally representative studies are needed to confirm these results, differentiate chronic from transient pain, and guide rehabilitation and prevention strategies.

PMID:42059016 | DOI:10.7189/jogh.16.04098