Tag: nevin manimala

BMC Nurs. 2025 Jun 2;24(1):627. doi: 10.1186/s12912-025-03252-0.

ABSTRACT

BACKGROUND: Self-management and empowerment are critical components in the treatment of diabetes, a chronic condition that has become an increasingly significant global health issue. While standard diabetes education is essential for effective disease management, personalized interventions aligned with the patient’s preferences are also necessary. One promising solution is the integration of coaching approaches into chronic disease management.

METHODS: This study was designed as a randomized controlled trial with a pretest-posttest design and three parallel arms: a Holistic Nurse Coaching group (n = 34), a Diabetes Education (n = 34) group, and a control group (n = 34). Data were collected through a Sociodemographic Data Collection Form, a Diabetes Data Collection Form, the Type 2 Diabetes Mellitus Self-Management Scale and the Diabetes Empowerment scale. The aim was to evaluate the effect of Holistic Nurse Coaching on glycemic control, diabetes self-management, and empowerment in individuals with type 2 diabetes. The Holistic Nurse Coaching group received nine individualized holistic nurse coaching sessions over a three-month period. The Diabetes Education group participated in nine group-based diabetes education sessions over the same period. The control group received no intervention. Mean comparison tests, correlation tests and multiple regression analysis techniques were employed in the statistical analysis. A 5% margin of error (p < 0.05) was adopted to determine statistical significance.

RESULTS: Following the holistic nurse coaching intervention, statistically significant improvements were observed in participants’ diabetes self-management, empowerment, and HbA1c levels (d = 3.752, d = 3.104, and d = 1.147, respectively; p < 0.001). A strong, positive, and statistically significant correlation was identified between posttest diabetes self-management and empowerment scores. Furthermore, the diabetes empowerment scores accounted for approximately 68.5% of the variance in diabetes self-management scores (p < 0.05).

CONCLUSIONS: Holistic nurse coaching was found to significantly enhance diabetes self-management and empowerment. These findings suggest that holistic nurse coaching may serve as an effective, person-centered intervention to support individuals with type 2 diabetes in managing their condition.

TRIAL REGISTRATION: The study was registered in ClinicalTrials NCT05545722. Retrospectively registered. 16/09/2022.

PMID:40457333 | DOI:10.1186/s12912-025-03252-0

BMC Cancer. 2025 Jun 2;25(1):984. doi: 10.1186/s12885-025-14389-1.

ABSTRACT

BACKGROUND: Numerous studies have explored the histological overlap between endometrial carcinoma and adenomyosis, yet the clinical implications of their co-occurrence remain ambiguous. This study aims to evaluate the impact of adenomyosis on the staging, progression, and prognosis of endometrial cancer.

METHOD: This retrospective cohort study analyzed 388 endometrial cancer (EC) patients undergone hysterectomy with lymphadenectomy between January 2019 to Decmber 2024 after ethical approval (No.: 2024-KY-0671-001). The diagnostic criterion for adenomyosis was the identification of endometrial glands and stroma infiltrating the myometrium at a depth of ≥ 2.5 mm from the endometrial-myometrial junction. Variables included demographics, surgery type, histopathology, stage, molecular markers, treatment, and survival. Kaplan-Meier and log-rank tests assessed survival. Statistical analysis used Mann-Whitney U and Chi-square tests (P < 0.05). Multivariate Cox regression was unfeasible due to limited recurrence events and disease-free survival outcomes are provided as supplementary material.

RESULTS: Among 388 EC patients, 73 (18.8%) had adenomyosis and 315 (81.2%) did not. The adenomyosis group was younger (median age 52 vs. 55 years, P = 0.011) and had a lower menopause rate (63% vs. 75.2%, P = 0.049). Adjuvant therapy was less frequent in the adenomyosis group (21.9% vs. 37.8%, P = 0.015), while concurrent endometrial hyperplasia was more common (64.4% vs. 32.4%, P < 0.001). No significant differences were observed in tumor characteristics, complications, TCGA subtypes, or survival outcomes. Median follow-up was 56 months for the adenomyosis group and 61 months for the non-adenomyosis group.

CONCLUSION: This study shows that adenomyosis does not affect tumor progression or survival outcomes, indicating a neutral role in endometrial cancer prognosis. However, the interpretation of survival statistics is limited by the low recurrence rate. Patients with adenomyosis are younger, have a lower menopause rate, and require less adjuvant therapy. The higher prevalence of endometrial hyperplasia suggests a potential link to tumor pathogenesis. Overall, adenomyosis appears to be an incidental co-occurrence rather than a biological contributor to endometrial cancer.

PMID:40457332 | DOI:10.1186/s12885-025-14389-1

Matern Health Neonatol Perinatol. 2025 Jun 3;11(1):14. doi: 10.1186/s40748-025-00210-1.

ABSTRACT

BACKGROUND: The enduring conflict in Somalia has precipitated significant humanitarian crises, including severely weakened health systems and poor health indicators. The situation has led to almost two million Somalis living abroad, often as refugees or asylum seekers in more high-resource settings in the Global North. To understand outcomes of care of pregnant women and their babies in host countries, this systematic review and meta-analysis aims to synthesise existing evidence on adverse maternal and perinatal outcomes among Somali migrant women compared to host populations.

METHODS: We conducted a comprehensive search across multiple electronic databases, including PubMed, Scopus, CINAHL Plus, and the Directory of Open Access Journals, using tailored keyword combinations. No language or date restrictions were applied, and the search concluded on June 30, 2024. Following data extraction and quality assurance using the STROBE Checklist, we conducted a meta-analysis for outcomes with sufficient data, using a random-effects model to account for heterogeneity across populations. Subgroup analyses were conducted by host country, with heterogeneity assessed using I² and τ² statistics. Potential publication bias was evaluated through Egger’s test and funnel plots. The results provide pooled estimates of maternal and perinatal outcomes.

RESULTS: Across all databases, 116 articles were retrieved, with 17 meeting the eligibility criteria. From these articles, pregnancy-related data from 1978 to 2018 on 55,119 Somali migrant women and 5,190,459 women from the host population was extracted. Somali migrant women, compared to host populations, had significantly increased odds of emergency caesarean section (CS) (pooled OR 2.54, 95%CI: 2.22-2.86), non-progressing/induced labour (pooled OR 1.25, 95%CI: 1.19-1.31). Their babies had higher odds of small for gestational age (SGA) (pooled OR 2.03, 95%CI: 1.89-2.17), neonatal morbidity (pooled OR 1.51, 95%CI: 1.40-1.61), and neonatal mortality (pooled OR 1.39, 95%CI: 1.25-1.54). Conversely, Somali migrant women had lower odds of assisted instrumental delivery (OR 0.72, 95%CI: 0.66-0.78), post-partum depression (OR 0.27, 95% CI: 0.12-0.63), preterm birth (OR 0.92, 95%CI: 0.88-0.96), and low birth weight (OR 0.87, 95% CI: 0.80-0.94) compared to host populations.

CONCLUSION: Significant disparities in maternal and perinatal outcomes between Somali migrant women and host populations exist. Though more research is needed, available evidence points to the need for more culturally aware obstetric services that address the specific needs of Somali migrant women.

PMID:40457329 | DOI:10.1186/s40748-025-00210-1

Am J Hosp Palliat Care. 2025 Jun 2:10499091251345723. doi: 10.1177/10499091251345723. Online ahead of print.

ABSTRACT

BackgroundImplicit bias pervades health care, decreases quality of care, and disproportionately affects health outcomes for persons of color. Little is known about the use of biased language in the care of seriously ill children as documented in the electronic health record (EHR).ObjectiveTo describe the use of biased language in the EHR of critically ill pediatric patients and to assess if there is a difference based on patient demographics and clinical characteristics.Setting/ParticipantsA retrospective review of EHRs was conducted on patients admitted to a Pediatric Intensive Care Unit (PICU) with a palliative care consult at a large, urban academic center in the United States in 2019.MeasurementsDemographics and clinical characteristics were compared between patients with and without biased language in their EHR in univariate and multivariate analyses. Frequencies of descriptor usage and health care team members using the descriptor were recorded. Exemplar quotes using biased language were recorded.ResultsIn 63 patients, no differences were found in demographic or clinical characteristics between patients with and without positively and negatively biased language. In adjusted analysis, there was no effect of demographics or clinical characteristics on the odds of having at least 1 instance of negatively biased language. Physicians and social workers used more biased language than other health care team members.ConclusionDespite no statistically significant difference noted in this pilot study, linguistic biases exist in the EHR of seriously ill children, which may lead to testimonial injustice. Efforts to combat bias and racism in pediatric health care documentation may focus on revising note templates and educating across disciplines.

PMID:40456187 | DOI:10.1177/10499091251345723

Medwave. 2025 Jun 2;25(5):e3022. doi: 10.5867/medwave.2025.05.3022.

ABSTRACT

INTRODUCTION: The impact of confinement on eating habits has been associated with mental health, gender, and socioeconomic status. This study examined the consumption of sugar-sweetened beverages and fast food during the COVID-19 confinement period in Chile, a country with a history of high consumption of processed foods.

METHODS: A cross-sectional design was done from responses obtained through an online survey between May and August 2020. Data were collected and managed using the SurveyMonkey® electronic tool (hosted at the Institut d’Investigació en Atenció Primària (IDIAP) Jordi Gol i Gurina, Barcelona, Spain). We recruited through online platforms and social networks using convenience and snowball sampling. People aged 18 years and older were included. The consumption of sugar-sweetened beverages and fast food was analyzed in relation to socioeconomic and sociodemographic variables. Logistic and log-binomial regression models were evaluated using Stata v18. P<0.05 was considered statistically significant.

RESULTS: 6971 (93%) people completed the questionnaire. The participants were predominantly born in Chile (94.6%), with a majority being women (63.5%) and under 50 years old (74%). The prevalence of consumption of sugary drinks and fast food was 15.4% (men, 14.6%; women, 15.9%) and 19.6% (men, 17.2%; women, 21%), respectively. Age 40 years and older was a protective factor for both women and men. Factors associated with the consumption of sugar-sweetened beverages included a change in employment status (prevalence ratio 1.26; 95% confidence interval 1.02 to 1.45) and, for fast food consumption, being female (1.18; 1.06 to 1.32).

CONCLUSIONS: Sex, age, and change in income were associated with increased consumption of sugar-sweetened beverages and fast food during the COVID-19 pandemic. These results reaffirm the importance of implementing social and communicational strategies that promote healthy eating, especially during health emergency scenarios.

PMID:40456140 | DOI:10.5867/medwave.2025.05.3022

JMIR Res Protoc. 2025 Jun 2;14:e72672. doi: 10.2196/72672.

ABSTRACT

BACKGROUND: A substantial proportion of patients require acute hospital care after hospital discharge post surgery, and many regions and countries have surgical backlogs.

OBJECTIVE: The Post Discharge After Surgery Virtual Care with Remote Automated Monitoring Technology-3 (PCV-RAM-3) trial tests the hypothesis that informing surgeons and patients of virtual care with remote automated monitoring (VC-RAM) assignment will promote earlier discharge, thereby reducing the index length of hospital stay, and that postdischarge VC-RAM will reduce acute hospital care.

METHODS: The PVC-RAM-3 trial is a randomized controlled trial that compares VC-RAM to standard postdischarge care among 2500 adults undergoing elective noncardiac surgery in 3 Canadian hospitals. Following the randomization of patients prior to surgery, surgeons and patients are immediately notified whether the patient has been allocated to the VC-RAM or control group. Outcome adjudicators remain blinded to each participant’s group assignment. Patients in the intervention arm learn to use a Health Canada-approved cellular modem-enabled tablet computer and Bluetooth-enabled remote automated monitoring technology from Cloud DX to take daily wound photos for 7 days and measure daily vital signs (ie, blood pressure, heart rate, oxygen saturation, temperature, and weight) three times daily on days 1-7 and twice daily on days 8-14 post discharge, along with completing a brief recovery survey. Nurses review these data and conduct scheduled virtual visits (days 1, 3, 7, and 14). Nurses will escalate care to a preassigned and available perioperative care physician if predetermined vital sign thresholds are exceeded, concerning symptoms arise, or a medication error is detected. These physicians manage the issues and add or modify treatments as needed. The standard care group will receive postdischarge care as per the standard of care at the hospital where they undergo surgery. The coprimary outcomes are acute hospital care and the index hospital length of stay within the first 30 days after randomization.

RESULTS: Study recruitment and follow-up are completed, and analysis of the study results is underway.

CONCLUSIONS: This trial will offer insights into the role of VC-RAM in reducing acute hospital care and index length of hospital stay among adults undergoing elective surgery.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05171569; https://clinicaltrials.gov/ct2/show/NCT05171569.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/72672.

PMID:40456137 | DOI:10.2196/72672

Retina. 2025 Jun 2. doi: 10.1097/IAE.0000000000004542. Online ahead of print.

ABSTRACT

PURPOSE: to evaluate the effectiveness and safety of the fluocinolone acetonide implant (0.2 µg/day FAc, ILUVIEN®) in macular edema due to retinal amyloid angiopathy (RAA) in patients with hereditary transthyretin amyloidosis associated with the V30M mutation (ATTRV30M).

METHODS: retrospective observational case series of ATTRV30M patients’ eyes treated with the implant for macular edema, from January 2010 to December 2019. Best corrected visual acuity (BCVA), central foveal thickness (CFT) and intraocular pressure (IOP) were measured at baseline, at 1 week, and at months 1, 3, 6, and 12.

RESULTS: fifteen eyes of 15 ATTRV30M patients with FAc implants were included. All patients had already received a liver transplant. All had already been submitted to cataract surgery, 87% had an Ahmed valve implant and 80% were vitrectomized due to vitreous amyloidosis. A statistically significant improvement in BCVA and in CFT at all time points was found compared to baseline. There was no statistically significant difference in IOP during the follow-up.

CONCLUSIONS: patients with macular edema due to RAA treated with the FAc implant showed sustained increased functional results and anatomical improvement compared to baseline.

PMID:40456135 | DOI:10.1097/IAE.0000000000004542

Adv Neonatal Care. 2025 Jun 2. doi: 10.1097/ANC.0000000000001269. Online ahead of print.

ABSTRACT

BACKGROUND: In many cultures, placing a newborn infant on a lap or in a rocking bed is often used to calm the infant. In addition, rocking beds are used to calm crying infants and ease their transition to sleep in some neonatal intensive care units.

PURPOSE: The study was performed to determine the effect that a rocking bed has on comfort, physiological parameters, and cerebral oxygenation level in preterm infants.

METHODS: Data were collected from 36 preterm infants with a postnatal age of 32-36+6 weeks between March 2021 and September 2022. For each infant, successive rocking bed treatment and control treatment (open bed) were performed in a crossover design.

RESULTS: No differences were detected in the physiological parameters and cerebral oxygenation levels of the infants in the measurements made during the rocking bed treatment (P > .05). There was no difference between the treatments in COMFORTneo scores before the start of rocking and at 15 minutes of the intervention (P > .05). However, 15 minutes and 30 minutes after the intervention, the preterm infants in the rocking bed treatment group had significantly lower COMFORTneo scores compared with the control treatment group (F = 9.701, P = .004; F = 7.680, P = .009).

IMPLICATION FOR PRACTICE AND RESEARCH: The rocking bed seems to be a safe practice for preterm infants as there were no statistically significant differences in the physiological parameters and cerebral oxygenation of the infants between the rocking bed and open bed treatments.

PMID:40456125 | DOI:10.1097/ANC.0000000000001269

JMIR Infodemiology. 2025 Jun 2;5:e64639. doi: 10.2196/64639.

ABSTRACT

BACKGROUND: Global medical tourism for aesthetic surgery has become a popular phenomenon through ease of access in the digital era, though such services are not without potential risks. The application of infodemiology for global health surveillance may provide unique insights into unknown patient travel patterns and surgeon workforce dynamics abroad.

OBJECTIVE: This study aimed to evaluate American cosmetic tourism trends in oculofacial plastic surgery, including demand profile and qualifications of the most sought-after international eyelid surgeons on social media.

METHODS: This cross-sectional infodemiology study queried Google Trends to assess US interests in aesthetic eyelid surgery abroad in 25 destination countries from 2013 to 2023. The highest-rated content posted by 55 eyelid surgeons (US: n=11; international: n=44) on a social media platform (Instagram; Meta Platforms) was evaluated. The main outcomes included Google search volumes for aesthetic eyelid surgery for each destination country, as well as specialty training and professional medical society affiliations of popular eyelid surgeons on social media in each of these countries.

RESULTS: The top 5 destinations Americans sought for aesthetic eyelid surgery abroad were South Korea, Mexico, Canada, Turkey, and China. Interest in eyelid surgery abroad remained stable over the last decade despite 118% growth in blepharoplasty searches. Social media indicated eyelid surgeons abroad were more often general plastic surgeons than in the United States (30/44, 68% vs 2/11, 18%; P=.003). US surgeons more frequently completed oculofacial plastics, facial plastics, or aesthetic plastics fellowships compared with international surgeons (9/11, 82% vs 10/44, 23%; P<.001) and had membership in professional medical societies (11/11, 100% vs 22/44, 50%; P=.002).

CONCLUSIONS: American demand for international eyelid surgery remained stable over the past decade despite a 2-fold increase in the US interest for blepharoplasty. Digital epidemiology data reveal a shortage of international surgeons with specialized aesthetic eyelid fellowship training or professional society affiliations on social media among the preferred destinations for Americans seeking aesthetic eyelid surgery. These findings may provide beneficial insights for patients interested in traveling abroad for eyelid surgery, as well as for surgeons or academic societies seeking to increase social media presence or patient-directed educational content via social media engagement.

PMID:40456124 | DOI:10.2196/64639

JMIR Form Res. 2025 Jun 2;9:e72775. doi: 10.2196/72775.

ABSTRACT

BACKGROUND: Dementia-related stigma is a significant global health concern. However, public awareness and education about dementia-related stigma remain limited, especially on social media. Examining dementia-related stigma on social media is critical because it impacts how the public perceives people living with dementia. By understanding dementia-related stigma on social media, we can develop educational strategies to target false stereotypes, beliefs, and misinformation to improve the quality of life of people living with dementia.

OBJECTIVE: This study examines dementia-related stigma on the X platform (formerly Twitter) during World Alzheimer’s Month to identify opportunities for intervention to address dementia-related stigma.

METHODS: A total of 266,211 posts were scraped from X during the World Alzheimer’s Awareness Month from September 1-30, 2022, a global advocacy campaign organized by Alzheimer’s Disease International. We used filters to exclude non-English content, duplicate posts, and reply posts with missing content. To ensure rigor and trustworthiness in the research, several measures were employed, ranging from peer debriefing sessions to documenting the research process.

RESULTS: After filtering the data, 1981 posts were examined using thematic analysis. A total of four main themes were identified including: (i) dementia stereotypes: “a burden to society”; (ii) discrimination and denied dignity: “discrimination exists in public spaces”; (iii) devaluing the lives of people with dementia: “society should legalize euthanasia”; and (iv) countering dementia-related stigma: “break down the stigma.” Although the World Alzheimer’s Awareness Month is helpful for raising awareness, more research is needed to address dementia-related stigma, stereotypes, and discrimination on social media.

CONCLUSIONS: By analyzing how stigma manifests on social media, our study sheds light on the dementia education and information needed to address false beliefs, misinformation, and dementia-related stigma. The findings from our study have important implications for policymakers, health professionals, and community advocates working to design awareness campaigns to reduce dementia-related stigma on social media.

PMID:40456118 | DOI:10.2196/72775