Tag: pubmed

BMC Public Health. 2025 Nov 13;25(1):3935. doi: 10.1186/s12889-025-25103-y.

ABSTRACT

BACKGROUND: Opioid-related harms and deaths remain a persistent public health crisis across Ontario, Canada, with non-urban regions facing a disproportionate burden. However, discussions of opioid-related harms across Ontario’s geographic regions have provided an oversimplified assessment, contrasting rural and urban regions which mask the unique challenges and true disparities faced by sparsely populated communities, which are commonly located in the Northern regions. Our study aims to provide a more in depth understanding of the opioid crisis in Ontario across different geographic classifications in accordance to population size, such as rural, urban, and sparsely populated regions, presenting data in both absolute numbers and crude rates with contextual grounding of regional characteristics. A number of different opioid-related indicators such as hospitalizations, overdose rates, opioid service provision and harm reduction supply distribution were analyzed across all 34 of Ontario’s public health units (PHUs) to understand the differences in these indicators based on region across the province. The findings can inform the development of targeted interventions and improve service accessibility for those most affected by the overdose crisis in Ontario.

METHODS: Publicly-available secondary data for each PHU was collected from several provincial and national data sources and analyzed between November 2024 and January 2025. Annual data from 2022 to 2023 on opioid-related harms, opioid agonist treatment (OAT) prescribers and engagement, and the distribution of harm reduction supplies, as well as annual data from 2024 on opioid-inclusive service provision, were collected. Using Statistics Canada’s 2023 Health Region Peer Group Classification, the PHUS were grouped into four geographic classifications: sparsely populated, rural, urban/rural mix, and urban. Crude average rates were calculated for all indicators. Statistical analysis was performed to assess significance of indicators between regions.

RESULTS: Sparsely populated PHUs were primarily located in Northern Ontario, while rural, urban/rural mix, and urban PHUs were mainly concentrated in Southern Ontario. Urban PHUs have the highest number and lowest rate of opioid-related harms (e.g. 947 opioid-related deaths, representing a rate of 12.5 per 100,000 population), while sparsely populated PHUs reflect the opposite trend (e.g. 158 opioid-related deaths, representing a rate of 44.2 per 100,000 population). A similar pattern emerges for harm reduction services and naloxone distribution. The number of treatment services is highest in rural PHUs (n = 237) and lowest in sparsely populated PHUs (n = 83), despite having the highest rate. OAT prescribers, OAT engagement, and needle distribution follow a similar trend. Statistical significance was found between geographic regions for most indicators, except opioid-inclusive support services, harm reduction services, and naloxone distribution.

CONCLUSION: Sparsely populated and rural PHUs experience the highest burden of opioid-related harms, coupled with limitations in service accessibility, demonstrating a clear need for additional harm reduction services. Decision-makers may be misled into underestimating the crisis in non-urban areas as a result of oversimplified reporting, resulting in inadequate support for these regions. Addressing these disparities is key to reducing opioid-related mortality and ensuring equitable access to life-saving services across Ontario.

PMID:41233802 | DOI:10.1186/s12889-025-25103-y

BMC Nurs. 2025 Nov 13;24(1):1397. doi: 10.1186/s12912-025-03979-w.

ABSTRACT

BACKGROUND: Near-miss incidents represent critical learning opportunities in healthcare, yet they are frequently underreported due to fear of blame and lack of organizational support. A Just Culture framework promotes fairness, trust, and learning from errors, which may encourage voluntary reporting, especially among nurse interns in high-stakes clinical environments.

AIM: To assess the perception of Just Culture among nurse interns and examine its influence on their willingness to report near-miss events in governmental university hospitals in Egypt.

METHODS: A cross-sectional analytical study was conducted among 163 nurse interns (sampling frame N = 264) using systematic random sampling across five university hospitals in Cairo, Egypt. Data were collected between March and April 2025 using a self-administered questionnaire comprising the Just Culture Assessment Tool (JCAT) and a researcher-developed Willingness to Report Near-Miss Scale. Data analysis included descriptive statistics, correlation analysis, and multiple linear regression.

RESULTS: The mean Just Culture score was 3.6 (SD = 0.5), while the mean willingness to report near-miss events was 3.6 (SD = 0.5). Significant positive correlations were observed between Just Culture dimensions (trust, feedback, openness, balance, and continuous improvement) and willingness subdomains (awareness, skills, attitude, behavior) (p < 0.001). Regression analysis indicated that Just Culture score (B = 0.70, β = 0.67, p < 0.001) was the strongest predictor of willingness to report, explaining 55% of the variance.

CONCLUSION: A supportive Just Culture significantly enhances nurse interns’ willingness to report near-miss events. Strengthening institutional safety culture through leadership, training, and non-punitive policies is essential to fostering early-career nurses’ engagement in safety reporting.

PMID:41233794 | DOI:10.1186/s12912-025-03979-w

BMC Ophthalmol. 2025 Nov 13;25(1):643. doi: 10.1186/s12886-025-04496-9.

ABSTRACT

PURPOSE: To evaluate the long-term benefit of early targeted panretinal photocoagulation (PRP) combined with anti-VEGF therapy (IVL group) versus anti-VEGF monotherapy (IV group) in treatment-naïve eyes with macular edema (ME) secondary to ischemic RVO.

METHODS: A retrospective analysis of 143 patients (85 IVL, 58 IV) with ischemic RVO. Baseline ischemic index (IsI), central retinal thickness (CRT), best-corrected visual acuity (BCVA), and age were adjusted.

RESULTS: Over 48 months, the IVL group showed a reduction in mean CRT from 475.6 ± 117.3 μm to 282.0 ± 69.5 μm and improved BCVA from 0.61 ± 0.34 LogMAR to 0.44 ± 0.34 LogMAR. The IV group demonstrated CRT reduction from 479.4 ± 135.5 μm to 340.9 ± 127.3 μm and BCVA improvement from 0.58 ± 0.32 LogMAR to 0.50 ± 0.43 LogMAR. The IVL group received 26.0 ± 8.6 intravitreal anti-VEGF treatments (IVT), compared to 25.5 ± 6.2 IVT in the IV group.

CONCLUSIONS: The IVL group exhibited a trend toward better treatment response, particularly in patients with severe retinal ischemia, though findings were not statistically significant. Baseline IsI quantification is recommended for optimal RVO management.

PMID:41233793 | DOI:10.1186/s12886-025-04496-9

Int J Equity Health. 2025 Nov 13;24(1):311. doi: 10.1186/s12939-025-02696-9.

ABSTRACT

BACKGROUND: The imbalance between supply and demand in China’s healthcare sector has become increasingly pronounced. This study aims to quantitatively assess the coupling and coordination status of health resource supply and demand in China, reveal its determinants, with the goal of narrowing regional disparities and improving the overall coordination level. By analyzing the spatiotemporal evolution of health resource allocation from 2002 to 2021, we seek to provide evidence-based policy recommendations for addressing the imbalance in China’s healthcare sector.

METHODS: Using provincial panel data from 2002 to 2021, we constructed a comprehensive evaluation index system for the health resource supply-demand system. The entropy weight method and the Technique for Order Preference by Similarity to Ideal Solution were employed to quantify the comprehensive levels of supply and demand. The coupling coordination degree (CCD) and its types were assessed using a coupling coordination model. Finally, the geographically and temporally weighted regression (GTWR) model and Geodetector model was used to analyze the spatiotemporal evolution and determinants of CCD in 31 provinces of China from 2002 to 2021.

RESULTS: From 2002 to 2021, the CCD of health resource supply-demand in China improved significantly, increasing from 0.400 to 0.804, reaching a good coupling coordination level. Although the regional coefficient of variation (CV) of CCD decreased from 0.225 to 0.206, regional heterogeneity persisted, with the eastern region exhibiting the highest coordination, followed by the central, western, and northeastern regions. Analysis using Geodetector and GTWR models identified key spatiotemporal determinants. Notably, education level emerged as the core factor explaining the spatial heterogeneity (q = 0.608), and its interaction with urbanization (q = 0.885) significantly amplified these spatial differences. Population density, government support, and transportation accessibility were also identified as important influencing factors.

CONCLUSIONS: The current healthcare supply-demand conflict in China is characterized by insufficient supply, low quality, and an irrational structure and layout. Although coupling coordination has improved under recent reforms and policies, challenges such as poor coordination degrees and significant regional disparities persist. The Chinese government should strengthen supply-side healthcare reforms to address regional disparities and enhance the coupling coordination of health resource supply and demand.

PMID:41233779 | DOI:10.1186/s12939-025-02696-9

J Headache Pain. 2025 Nov 13;26(1):259. doi: 10.1186/s10194-025-02190-1.

ABSTRACT

BACKGROUND: Migraine is prevalent among women of childbearing age and is associated with increased long-term cardiovascular and cerebrovascular risk. Pregnancy, a hypercoagulable state, may potentiate these risks. This study aimed to quantify the association between migraine or pregnancy-related headaches and cerebrovascular and cardiovascular events during pregnancy and the postpartum period.

METHODS: We conducted a PRISMA-compliant systematic review and meta-analysis of observational studies comparing pregnant women with and without migraine or pregnancy-related headaches. PubMed, Scopus, and Web of Science were searched through May 8, 2025. Adjusted odds ratios (ORs) were pooled using random-effects models.

RESULTS: Twelve studies encompassing 94,195,776 pregnancies met the inclusion criteria. Migraine was associated with markedly increased odds of all strokes and transient ischemic attacks (OR 10.45; 95% CI 4.27-25.57) and ischemic stroke (OR 7.14; 95% CI 2.51-20.31). Hemorrhagic stroke risk was elevated but not statistically significant overall (OR 2.25; 95% CI 0.99-5.18), while subarachnoid hemorrhage showed a 69% increased odds. Regarding cardiovascular events: myocardial infarction risk increased by 96%, peripartum cardiomyopathy odds were 2.68-fold (95% CI 1.73-4.14), and spontaneous coronary artery dissection odds were 9.21-fold higher (95% CI 3.72-22.82). All included studies were rated as “good” quality by the Newcastle-Ottawa Scale.

CONCLUSIONS: Migraine and pregnancy-related headaches are independent risk factors for a broad spectrum of cerebrovascular and cardiovascular events during pregnancy and the puerperium. These findings highlight the need for heightened clinical surveillance, targeted cardiovascular risk counselling, and multidisciplinary management strategies for this population.

PMID:41233752 | DOI:10.1186/s10194-025-02190-1

BMC Public Health. 2025 Nov 13;25(1):3932. doi: 10.1186/s12889-025-24820-8.

ABSTRACT

BACKGROUND: Depression and physical activity (PA) are interrelated elements crucial to human health. However, the evidence regarding the relationship between depression, PA, and mortality remains limited.

OBJECTIVE: To estimate the single and joint associations PA and depression on mortality risk, and further examine whether PA moderates the association between depression and mortality.

METHODS: Data were from the National Health and Nutrition and Examination Survey (NHANES) conducted between 2007 and 2018 and linked to the National Death Index death certificate records. Depression status was determined by the 9-item Patient Health Questionnaire (PHQ-9) and PA levels were measured by self-reporting activity (type, metabolic equivalent (MET) and time per week). Kaplan-Meier method and Cox proportional hazards models were applied to explore the single and joint associations between depression and PA with all-cause mortality.

RESULTS: A total of 26,150 participants were enrolled, of whom 9.2% (n = 2412) died during follow-up (median 81 months), 29.9% (n = 7810) met the PA recommendation and 9.2% (n = 2416) suffered from depression (scored ≥ 10 on the PHQ-9). For the single association, depression (HR 1.40, 95% CI 1.16-1.69, serious depression vs. no) was positively associated with mortality, but the association of PA (HR 0.66, 95% CI 0.58-0.76, regular PA vs. physically inactive) was inverse. Joint association analyses showed that the association between depression and mortality was influenced by PA, whereas more frequent PA was associated with lower mortality risk irrespective of the level of depression symptoms: compared to participants who were depressed and did not participate in PA, those who did participate in PA, whether depressed or not, had a lower risk of death. Especially, for participants who were moderately depressed and did not PA, both insufficient PA (HR, 0.43; 95% CI, 031-0.61) and regular PA (HR, 0.37; 95% CI, 0.24-0.58) significantly reduced the risk of all-cause mortality.

CONCLUSIONS: Our study found that depression was positively associated with increased mortality risk, while PA was negatively associated with it; moreover, the mortality risk associated with depression worsened with low levels of physical activity. These findings underscore the critical importance of promoting physical activity, especially among individuals with depression, as a potential strategy to mitigate mortality risk. This highlights the need for integrated public health interventions that address both mental health and physical activity to improve overall population health outcomes.

PMID:41233750 | DOI:10.1186/s12889-025-24820-8

BMC Public Health. 2025 Nov 13;25(1):3929. doi: 10.1186/s12889-025-25046-4.

ABSTRACT

BACKGROUND: Early childhood is a crucial developmental period whereby children acquire nutrition knowledge and skills, presenting a significant potential for lifestyle interventions. This study aimed to assess the effects of a nutrition intervention on knowledge and food choice behavior among preschool students.

METHODS: A semi-experimental, pre-post design study was conducted with 45 children (20 girls and 25 boys) aged 60-72 months, preschool students. Students participated in a 4-week nutrition education. The researchers carried out a pre- and post-intervention evaluation of a nutrition education intervention, employing age-appropriate visual food cards, a plate icon, and a traffic light icon. A questionnaire was used to collect data, and anthropometric measurements of children were recorded. Data were analyzed using IBM SPSS Statistics 26.0. Paired t-tests were applied for quantitative variables and the McNemar test for categorical variables. Statistical significance was set at p < 0.05.

RESULTS: The mean age of preschool children was 61.8 ± 4.40 months. Based on BMI for age z-score classification in children, more than half of the children are of normal weight (51.1%), while 22.2% are underweight and 26.7% are overweight or obese. The total mean NutriSTEP^® score for preschool children before intervention was 22.9 ± 5.82. After nutrition education, preschool students significantly improved MyPlate knowledge and healthy and unhealthy food choice behaviors (p < 0.001).

CONCLUSIONS: Nutrition education intervention has been shown to be effective in identifying food types and differentiating between healthy and unhealthy food among preschool children. The use of food cards and visual materials can be a valid strategy for determining the effectiveness of nutrition education. Developing financially accessible, plausible, and culturally pertinent methods to enhance student health through nutrition education may augment preschool students’ knowledge and healthy choice of foods.

PMID:41233742 | DOI:10.1186/s12889-025-25046-4

BMC Med Res Methodol. 2025 Nov 13;25(1):255. doi: 10.1186/s12874-025-02712-0.

ABSTRACT

BACKGROUND: Continuous biomedical data is often dichotomized into two or more groups for analysis, despite long-standing warnings from statisticians that this constitutes bad practice. This dichotomisation is typically discouraged because it reduces statistical power and may obscure important trends. This paper considers another reason to discourage this practice: that dichotomisation is a powerful tool to manipulate data, as dichotomising at an arbitrary yet flexible threshold (which we term ‘promiscuous dichotomisation’) represents a powerful researcher degree of freedom.

METHODS: The motivating question is how probable is it that given a set of uniformly distributed data a threshold can be engineered to produce the illusion of a true effect when none exists? To estimate this, we employed both analytical approaches and Monte-Carlo simulation approaches to quantify the expected number of spurious findings that could arise from manipulating a dichotomous threshold for an arbitrary data set. We also illustrate an example of this with NHANES data, showing how a spurious relationship between blood glucose and herpes status could be engineered.

RESULTS: For even a relatively small sample of [Formula: see text], a false positive rate of [Formula: see text] can be observed, rising to over [Formula: see text] if low counts scenarios are not excluded. With larger samples even with low-count exclusion, false positive rates in excess of [Formula: see text] for [Formula: see text] and [Formula: see text] for [Formula: see text] are possible, climbing to in excess of [Formula: see text] and [Formula: see text] respectively if low-count scenarios were not excluded. For most configurations, manipulation of thresholds was a highly viable methods of crafting a false positive result.

CONCLUSIONS: It is likely that manipulating cut-off points in measured variables represents a significant source of data manipulation in published science, and the ease of access of larger health databases means this is an issue that is likely to grow in severity. We discuss implications of this, and means of identifying potential promiscuous dichotomisation.

PMID:41233729 | DOI:10.1186/s12874-025-02712-0

BMC Plant Biol. 2025 Nov 13;25(1):1560. doi: 10.1186/s12870-025-07545-z.

ABSTRACT

BACKGROUND: Macrotyloma geocarpum is a socio-economically important and nutrient-rich opportunity legume crop in which a broader genetic basis is required for an accelerated higher-yielding cultivar development.

MATERIALS AND METHODS: Here, we reported for the first time the performance of a set of 300 mutants developed along with five local checks for their agronomic features spanning vegetative, physiological, developmental, seed and yield traits in an augmented design scheme. Descriptive statistics, correlation and multivariate analyses were combined to analyze the data.

RESULTS: Broader genotypic variability was observed in grain yield. Mutants were top outperformers for all traits. For instance, we observed a four-fold variation for grain yield between the best check (Check 3: 643.7 kg.ha^-1) and the most productive mutant (ML645: 2,942.42 kg.ha^-1) genotypes. Higher positive correlation (r = 0.98, p < 0.001) was recorded between the time to 50% flowering and time to maturity while higher negative one (r = -0.92, p < 0.001) was recorded between plant height and time to maturity. Heritability estimates ranged from 1.85 to 96.4% and two traits including seed length and grain yield exhibited high heritability estimates. The 305 genotypes were categorized in three clusters, with Cluster 3 encompassing individuals with the best characteristics.

CONCLUSION: Genotypes of this Cluster 3 including for instance mutants ML645, ML619, ML10126 and ML1000 offer a good opportunity for market development and can be leveraged to advance elite individuals’ selection for M. geocarpum improvement.

PMID:41233726 | DOI:10.1186/s12870-025-07545-z

BMC Geriatr. 2025 Nov 13;25(1):897. doi: 10.1186/s12877-025-06472-w.

NO ABSTRACT

PMID:41233725 | DOI:10.1186/s12877-025-06472-w