Tag: pubmed

Anesthesiology. 2026 Feb 23. doi: 10.1097/ALN.0000000000006005. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative gastric ultrasonography serves as an objective tool for evaluating the risk of pulmonary aspiration. However, measurements obtained from gastric ultrasonography at the abdominal aorta (AA) plane and the inferior vena cava (IVC) plane may vary substantially. This study aims to identify the measurement plane that most closely reflects the actual gastric volume (GV), thereby informing clinical practice.

METHODS: All participants initially underwent gastric ultrasonography at both the AA and IVC planes following a fasting period, representing the low GV state. Subsequently, they consumed apple juice at a volume of 2.3 ml/kg, after which gastric ultrasonography was repeated to represent the high GV state. The predicted ingested volume (PIV) was calculated as the predicted GV after ingestion minus the baseline predicted GV. Comparisons were made between AA plane and IVC plane measurements in both low GV and high GV. The agreement between the PIV and the actual ingested volume (AIV) was assessed for the AA plane, IVC plane, higher-measured gastric volume plane, and lower-measured gastric volume plane, along with their detection rates for high aspiration risk.

RESULTS: Ultimately, 196 volunteers were included in the final statistical analysis. The results showed that, in both low and high GV state, gastric ultrasonography measurements at the AA plane and the IVC plane differed significantly (P< 0.001). Among all measurement planes, only the higher-measured gastric volume plane showed no statistically significant difference between the predicted and actual GV, with the smallest bias (bias = -4.27 ml, P= 0.076).

CONCLUSIONS: Notable differences exist between gastric ultrasonography measurement planes. When applying existing predictive models, measurements obtained from the higher-measured gastric volume plane provide greater accuracy. Differentiating between measurement planes during model development may enhance the predictive accuracy of such models.

PMID:41730171 | DOI:10.1097/ALN.0000000000006005

JMIR Hum Factors. 2026 Feb 23;13:e75496. doi: 10.2196/75496.

ABSTRACT

BACKGROUND: Digital health tools are increasingly prevalent in postoperative care management, yet limited research exists on digital health literacy and tool adoption among safety-net hospital populations. Understanding these factors is crucial for developing effective digital health solutions for historically underserved communities.

OBJECTIVE: This study aimed to evaluate digital health literacy, assess technology adoption readiness, and examine the relationship between patient-reported capabilities and demographic factors in a postoperative care context at a safety-net hospital.

METHODS: We conducted a mixed methods study with 71 postoperative patients and 29 health care providers at a safety-net hospital. Participants completed a modified eHealth Literacy Scale (eHEALS) assessment and a demographic questionnaire, followed by usability testing of PocketDoc, a digital health prototype. The modified 7-item eHEALS demonstrated adequate internal consistency (Cronbach α=0.77). Qualitative data from think-aloud protocols during usability testing were collected for future analysis. This study focused on quantitative assessments of digital health literacy (using the modified eHEALS on a 5-point Likert scale) and technology adoption readiness (via usability metrics on a 10-point Likert scale) analyzed using nonparametric statistical tests. Correlations between demographic factors and digital health literacy were examined using Spearman rank-order correlation.

RESULTS: Despite common assumptions about technology barriers in safety-net populations, 69% (49/71) of patients reported high confidence (score of ≥3 on a 5-point scale) in finding health resources online, and 61% (43/71) expressed confidence in using the internet for health-related questions. However, only 49% (35/71) felt confident in using digital resources for health decision-making. Digital health literacy scores did not correlate with age or educational level, although 79% (56/71) of patients reported ≥10 years of digital device experience. Both patients and health care providers rated PocketDoc highly for ease of use (median 10, IQR 8-10) and task intuitiveness (median 10, IQR 8-10). Patients’ confidence in finding and using health resources online positively correlated with interface satisfaction (ρ=0.262-0.304 and ρ=0.010-0.027, respectively).

CONCLUSIONS: Our exploratory findings from 100 participants suggest that digital health tools may be more feasible in safety-net settings than previously considered, although the sample size and single-site design limit generalizability. However, the gap between patients’ ability to find health resources (49/71, 69% confident) and their confidence in using these resources for health decision-making (35/71, 49% confident) highlights the need for targeted support in translating digital capabilities to health management skills.

PMID:41730170 | DOI:10.2196/75496

JMIR Mhealth Uhealth. 2026 Feb 23;14:e68930. doi: 10.2196/68930.

ABSTRACT

BACKGROUND: The growth of mobile health has underscored the critical importance of equitable internet access in promoting healthy aging. Among older adults, particularly those in digitally underserved populations, access to mobile data is often limited due to affordability and technological barriers, leading to a phenomenon known as “data deprivation.” This form of digital inequality limits the older adults’ ability to participate in social, recreational, and community-based activities, which are protective against isolation and decline in later life. In South Korea, where unlimited smartphone data plans have become increasingly accessible, a unique opportunity exists to examine the real-world association of improved data accessibility on older adults’ social lives and digital engagement.

OBJECTIVE: This study aimed to examine whether switching to unlimited smartphone data plans enhances social participation among older adults in South Korea. It also explored whether this relationship differs by demographic and socioeconomic characteristics, such as age, gender, region, household composition, and income level. The study focused on offline domains of social participation, including hobby gatherings, religious services, volunteering, and routine activities such as shopping.

METHODS: Data were drawn from the Korea Media Panel Survey (2016-2022), a nationally representative longitudinal dataset. The final sample included 5021 individuals. Social participation was measured using a self-reported 8-item scale (8-64 points) covering outdoor activities, volunteering, and more. A difference-in-differences approach was used to assess the association of switching from limited to unlimited smartphone data plans on social activity scores. Subgroup analyses examined heterogeneity by gender, household composition, income, and region.

RESULTS: Overall, among individuals aged 60 years and older, switching to an unlimited data plan was not associated with a statistically significant change in social activity scores. However, within this group, those aged 70 years and older showed a more notable-though not statistically significant-improvement (differential of 1.54, 95% CI -0.41 to 3.50). In contrast, older men living alone experienced a significant differential improvement of 6.44 (95% CI 3.39 to 9.50) points, compared with those who remained on limited plans.

CONCLUSIONS: Although the overall association of unlimited data plans was limited, certain vulnerable subgroups-particularly older men living alone-experienced meaningful gains. These findings suggest that improving mobile data accessibility may enhance social engagement among digitally underserved older adults. Compared with more complex or resource-intensive interventions, expanding access to unlimited smartphone data plans may offer a relatively simple and scalable strategy to support healthy aging and reduce social isolation.

PMID:41730168 | DOI:10.2196/68930

JMIR Form Res. 2026 Feb 23;10:e77010. doi: 10.2196/77010.

ABSTRACT

BACKGROUND: The sociopolitical crisis in Haiti affects health care center attendance, creating significant challenges in ensuring patient compliance with medical appointments.

OBJECTIVE: This study aimed to assess the effectiveness of text message reminders on patient attendance in the context of the sociopolitical crisis of Haiti, examining the influence of patient perceptions, behaviors, and socioeconomic factors.

METHODS: We conducted a cross-sectional study using a telephone survey of 386 randomly selected patients who had an appointment during the third quarter of 2024 at 2 health care centers in the Port-au-Prince metropolitan area. We collected appointment and socioeconomic data, as well as perceptions and behaviors toward text message reminders. We described patients’ perceptions and behaviors toward text message reminders, as well as appointment attendance and patient characteristics. We performed bivariate and multivariate logistic regression models to assess whether receiving text message reminders and socioeconomic factors influenced overall appointment attendance.

RESULTS: Among 386 patients, 259 attended their appointments on either the appointment day or at a later date for an overall attendance rate of 67.1 % ( 95% CI 62.4%-71.8%). Attendance rates were higher among the 147 patients who confirmed receiving a reminder (77.6%) compared to the 239 who did not (60.7%). SMS text messaging reading behavior varied among patients. Overall, 219/386 (56.7%) patients always, 66/386 (17%) often, 75/386 (19%) sometimes, 21/386 (5%) rarely, and 5/386 (1%) never read their SMS text messaging. All patients liked the initiative of sending reminders and found them helpful. In the multivariate analysis, patients who confirmed receiving a reminder were more likely to attend their appointment compared to those who did not (adjusted odds ratio [AOR] 2.0, 95% CI 1.18-3.39). A patient satisfaction rate of 8 or higher with their physicians was significantly associated with higher attendance rates, compared to 6 or lower, with AORs increasing with satisfaction. Travel time less than 30 minutes (AOR 2.31, 95% CI 1.03-5.19) and 30-60 minutes (AOR 2.78, 95% CI 1.24-6.21), and being with a chronic disease (AOR 0.42, 95% CI 0.23-0.79) were also associated with appointment attendance.

CONCLUSIONS: Our study highlights the potential of text message reminders to improve appointment attendance in Haiti, despite the sociopolitical crisis. The overall acceptability and positive perceptions of SMS text messaging reminders suggest that they can be a valuable tool in health care settings, especially when adapted to the local context. We recommend that health care centers in Haiti consider integrating SMS text messaging reminder systems into routine patient management to enhance adherence and optimize care delivery.

PMID:41730165 | DOI:10.2196/77010

Commun Dis Intell (2018). 2026 Feb 24;50. doi: 10.33321/cdi.2026.50.001.

ABSTRACT

OVERVIEW: We analysed Australian Immunisation Register (AIR) data, predominantly for National Immunisation Program (NIP) funded vaccines, as at 4 February 2024 for children, adolescents and adults, focusing on the calendar year 2023 and trends from previous years. This report aims to provide comprehensive analysis and interpretation of vaccination coverage data to inform immunisation policy and programs.

CHILDREN: Fully vaccinated coverage in Australian children in 2023 was lower than in 2022 at the 12-month (92.8%, down from 93.3%), 24-month (90.8%, down from 91.0%) and 60-month (93.3%, down from 93.4%) age assessment milestones. This follows the 1.1-1.5 percentage point decrease at these three milestones between the 2020 and 2022 reports, which came after eight years of generally increasing coverage. Fully vaccinated coverage in Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) children was also slightly lower in 2023 than in 2022 at the 12-month (89.7%, down from 90.0%), 24-month (87.8%, down from 87.9%) and 60-month (95.0%, down from 95.1%) milestones, following a 1.9-3.3 percentage point decrease between the 2020 and 2022 reports. Due to the lag time involved in assessment, fully vaccinated coverage figures for 2023 predominantly reflect vaccinations due in 2022, when COVID-19 pandemic-related restrictions had largely been removed. Factors contributing to this ongoing decline in coverage in children include a combination of acceptance and access issues.

ADOLESCENTS: Among adolescents turning 15 years in 2023, 84.2% of girls and 81.8% of boys (80.9% and 75.0% of Indigenous girls and boys) had received at least one dose of human papillomavirus (HPV) vaccine by their fifteenth birthday, 1.1 and 1.3 percentage points lower than in 2022, respectively (2.1-3.1 percentage points lower for Indigenous adolescents). Coverage of an adolescent dose of meningococcal ACWY vaccine in adolescents turning 17 years in 2023 was 72.8% overall and 62.3% in Indigenous adolescents, 3.1 and 3.3 percentage points lower than in 2022, respectively. These decreases reflect impacts of the pandemic on school-based programs in 2020-2021. To provide an early insight into any immediate impacts on coverage of moving to the NIP single-dose HPV vaccine schedule in 2023 (offered in Year 7 in all jurisdictions), we calculated coverage of at least one dose of HPV vaccine by 31 December in adolescents turning 13 years, with South Australia excluded due to change of delivery from Year 8 in 2022, and found it to be around 3 percentage points lower in 2023 than 2022, and 6 percentage points lower in Indigenous girls, with patterns of diphtheria-tetanus-pertussis vaccination (also single-dose at this age) and HPV vaccination coverage broadly similar. This decrease in vaccinations due in school programs after pandemic restrictions had been removed could be due to impacts of the single-dose HPV transition (i.e. if fewer opportunities for vaccination are provided due to fewer school visits) or may be due to other factors that have changed or disrupted previous school immunisation program operations or reduced parental confidence in vaccination. It is important to promote catch-up vaccination and to monitor renewed efforts to ensure equitable coverage is achieved, particularly given HPV vaccine coverage by 15 years of age in 2023 was 4-8 percentage points lower in adolescents residing in socio-economically disadvantaged and remote areas.

ADULTS: Zoster vaccination coverage in adults turning 71 years was 41.0% overall in 2023, down from 41.3% in 2022, and 36.1% in Indigenous adults, down from 36.5%. However, the availability of the new (non-live) protein-based herpes zoster vaccine (Shingrix) from 1 November 2023 has resulted in increased uptake for the larger eligible cohort. Coverage of 13-valent pneumococcal conjugate vaccine (13vPCV) in adults turning 71 years was 37.6% in 2023, up from 33.8% in 2022, and 43.0% in Indigenous adults, up from 37.7%. Coverage of 13vPCV was lower among Indigenous adults turning 50-59 years (17.5%) and 60-69 years (23.4%) in 2023, despite this vaccine being funded under the NIP. Influenza vaccination coverage decreased across all adult age groups in 2023, both overall and in Indigenous adults, with decreases ranging from 5-11 percentage points.

CONCLUSIONS: There have continued to be modest but concerning declines in vaccination coverage in children and adolescents relative to pre-pandemic peaks, with decreases greater in Indigenous children and adolescents. Evidence suggests that the factors contributing to these ongoing declines are complex and variable but include both vaccine acceptance and access issues. The picture for adult coverage is more mixed, with coverage increasing for 13vPCV, stable for zoster and decreasing for influenza vaccination, though consistently suboptimal across all vaccines. Ongoing monitoring of vaccination coverage, and further exploration of the reasons underpinning these decreases and suboptimal coverage, are needed to inform approaches to address barriers effectively and to increase vaccine uptake and equity of coverage.

PMID:41730159 | DOI:10.33321/cdi.2026.50.001

Commun Dis Intell (2018). 2026 Feb 24;50. doi: 10.33321/cdi.2026.50.011.

ABSTRACT

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae poses a pressing public health threat. Current surveillance programs via antimicrobial susceptibility testing (AST) depend on successfully cultivating the organism via bacterial culture. However, AST is more challenging in extragenital sites and in remote clinical settings where there is a delay between sample collection and testing. This study evaluated whether an enhanced specimen transport system involving direct plating of samples onto selective agar with carbon dioxide enrichment (Bio-BagTM Type C, Becton Dickinson) improved N. gonorrhoeae recoverability compared to the standard method of rayon swabs in Amies gel (TransystemTM, Copan Diagnostics). Men with urethral or rectal gonorrhoea confirmed by nucleic acid amplification testing were consecutively recruited from an urban Sydney clinic. Among 33 rectal samples, enhanced transport yielded a slightly higher culture positivity rate (72.7%) than the standard method (69.7%), though this difference was not statistically significant (p = 0.790). Notably, rectal specimens arriving at the laboratory within five hours had significantly higher culture yields (100%) than those with longer transport times (61.5%; p = 0.049). Future studies of the impact of enhanced transport in rural and remote settings are critical to enhance AMR surveillance.

PMID:41730157 | DOI:10.33321/cdi.2026.50.011

Commun Dis Intell (2018). 2026 Feb 24;50. doi: 10.33321/cdi.2026.50.012.

ABSTRACT

BACKGROUND: Adverse event following immunisation (AEFI) surveillance in Victoria is conducted through Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC), an enhanced surveillance system integrated with clinical services for vaccinees experiencing an AEFI. This report summarises SAEFVIC’s surveillance and vaccine pharmacovigilance activities in 2019 and 2020.

METHODS: A retrospective cohort study approach was used to analyse AEFI reports submitted in 2019 and 2020, compared to those since 2015. Data were categorised by vaccinee demographics (age; sex; pregnancy; and Indigenous status), vaccines administered and reported AEFI. Age cohorts were defined as best fit to the National Immunisation Program age groups. Proportional reporting ratio was determined for perceived signals being investigated. Clinical services and educational activities were described.

RESULTS: There were 3,828 AEFI reports received in 2019 and 2020 (28.8 per 100,000 population), with 7.6% defined as serious; 52% of all reports were female vaccinees; 56 of 464 reports among adult females (12.1%) were pregnant vaccinees; and 29 reports (0.9%) were Indigenous Australians. Reporting trends by age group were similar across all cohorts. No vaccine safety signals were confirmed. Telehealth consultations at Specialist Immunisation Clinics increased in 2020 in-line with Medicare eligibility criteria changes. Educational resources on various vaccine safety topics were published, particularly the anticipated coronavirus disease 2019 (COVID-19) vaccination program.

CONCLUSION: AEFI surveillance in Victoria continues to be robust through the SAEFVIC model and provides confidence in informing the safety profile of vaccines administered in Australia. These data provide a baseline for AEFI surveillance for comparison to the COVID-19 vaccination program commenced in 2021.

PMID:41730156 | DOI:10.33321/cdi.2026.50.012

J Speech Lang Hear Res. 2026 Feb 23:1-17. doi: 10.1044/2025_JSLHR-25-00700. Online ahead of print.

ABSTRACT

PURPOSE: This study examined the effects of visual biofeedback approaches and nonbiofeedback motor-based treatment on generalization outcomes following speech therapy for children with residual speech sound disorders (RSSDs).

METHOD: A total of 108 children aged 9-15 years with RSSD affecting American English /ɹ/ were randomly assigned to receive 19 motor-based speech treatment sessions, with or without visual biofeedback (divided into ultrasound or visual-acoustic biofeedback). The treatment included practice designed to implement several motor learning principles, with task difficulty systematically adjusted based on the child’s performance. Children’s /ɹ/ accuracy on untreated words before and after treatment was rated as correct or incorrect by lay listeners who were blinded to participant characteristics, treatment conditions, and time points.

RESULTS: The mixed-effects regression model revealed a statistically significant interaction between treatment type and time point. Specifically, both the biofeedback and nonbiofeedback motor-based treatment groups made progress over time, but the amount of generalization to untreated words was significantly greater in the biofeedback condition than in the motor-based treatment. In a subanalysis comparing biofeedback types, greater generalization was observed following ultrasound biofeedback than visual-acoustic biofeedback, although this effect was strongest at one treatment site.

DISCUSSION: This randomized controlled trial found that adding biofeedback to motor-based treatment can increase the rate of accurate production of the American English /ɹ/ in untreated words.

PMID:41730150 | DOI:10.1044/2025_JSLHR-25-00700

J Speech Lang Hear Res. 2026 Feb 23:1-14. doi: 10.1044/2025_JSLHR-25-00427. Online ahead of print.

ABSTRACT

PURPOSE: The human voice is a complex acoustic signal shaped by multiple anatomical and environmental factors. It serves as a primary medium for communication, allowing individuals to express emotions, intentions, and identity. These features can change due to aging, lifestyle habits, health conditions, and several sociocultural factors. Given the impact of voice disorders on daily life and psychological well-being, accurate assessment tools are essential for early detection and intervention. Given the natural variability of the human voice and the need for appropriate assessment tools, normative studies centered on young populations are necessary, as most existing studies focus on older populations more prone to vocal health problems. The aim of this study was to establish normative acoustic data for 23 acoustic parameters including the Acoustic Voice Quality Index (AVQI) and the Acoustic Breathiness Index (ABI) in young adult, native Spanish speakers, analyzed separately by gender.

METHOD: A total of 194 participants (82 men, 112 women) aged 18 to 25 years were recruited, who reported no prior history of voice disorders. Recordings of sustained vowels and connected speech were analyzed using Voxplot, a clinical tool based on Praat. Descriptive statistics were calculated, and gender differences were explored through t tests.

RESULTS: Normative values were obtained for 23 acoustic parameters in young Spanish-speaking adults. Several measures showed significant gender differences, particularly those related to fundamental frequency and spectral characteristics. Additionally, preliminary threshold values for mild dysphonia were calculated.

CONCLUSIONS: This study provides normative acoustic data for young adult speakers and exploratory threshold values for parameters that may be obtained through Voxplot. The preliminary thresholds values may serve as reference points for early detection of vocal alterations. However, future studies should include groups with vocal pathologies in order to establish cutoff points.

PMID:41730148 | DOI:10.1044/2025_JSLHR-25-00427

Rev Esc Enferm USP. 2026 Feb 23;60:e20250323. doi: 10.1590/1980-220X-REEUSP-2025-0323en. eCollection 2026.

ABSTRACT

OBJECTIVE: To analyze the scientific literature on the effectiveness of educational interventions aimed at acquiring cultural competencies in nurses and nursing students.

METHOD: Searches were conducted in the following databases PubMed, Lilacs, Esmerald, Scopus, and Scielo, focusing on the study of educational interventions related to cultural competencies. The PRISMA methodology was used, critical reading was performed with the CASPe tool, and random-effects meta-analyses were conducted with RevMan.

RESULTS: Thirteen studies were included, 11 of which were educational interventions. These significantly improved cultural competencies, especially in knowledge, communication skills, and self-awareness. Qualitatively, a positive impact was evidenced, and quantitatively, the effect on knowledge was statistically significant (P < 0.00001).

CONCLUSION: The meta-analysis reveals a significantly positive effect, in a generalized way, of educational interventions on cultural competence in nurses and students. Continuous learning and innovative educational practices are necessary to maintain and reinforce knowledge. Further studies using both qualitative and quantitative methods are needed to improve both educational initiatives and cultural competence training.

PMID:41730134 | DOI:10.1590/1980-220X-REEUSP-2025-0323en