Tag: pubmed

BMC Nurs. 2025 Apr 1;24(1):355. doi: 10.1186/s12912-025-03009-9.

ABSTRACT

BACKGROUND: Patient safety is a global concern, with high rates of medical errors reported annually. Understanding the relationship between nurses’ job stress and patient safety culture (PSC) is crucial. Despite their pivotal role in healthcare, nurses face stress due to demanding job roles and the challenging healthcare system in Palestine. This study aims to explore the relationship between nurses’ job stress and PSC in Palestinian hospitals, identifying predictors that impact PSC to enhance healthcare outcomes and support healthcare professionals.

METHODS: This study employed a quantitative cross-sectional approach. Data collection took place from June to September 2023. The study utilized self-report surveys, including the Hospital Survey of Patient Safety Culture (HSOPSC) and the Nursing Stress Scale (NSS), administered to 355 nurses working in 16 North West Bank hospitals in Palestine. The data collected were analyzed via descriptive and inferential analysis.

RESULTS: Overall, 47% of the nurses reported having positive PSC. The areas with the most positive perception were “teamwork” and “organizational learning-continuous improvement”, with mean percentages of positive responses of 63.1% and 55.8%, respectively. Conversely, the composites with the lowest positive response scores included “Response to Error” and “Staffing and Work Pace”, with mean percentages of positive responses of 30.9% and 34.8%, respectively. Furthermore, the most common sources of job stress perceived by nurses were “workload” and “death and dying”, with mean scores of 1.42 and 1.20, respectively. However, the lowest-scoring sources of stress were in the subscales “Uncertainty concerning treatment” and “Inadequate preparation”, with mean scores of 1.02 and 1.06, respectively. Statistical tests revealed that six factors were significantly associated with the perception of PSC. Among these factors, income, hospital type, activities to improve PSC, patient safety ratings of work areas, and weekly night shifts emerged as predictors of PSC. Additional tests revealed nine factors significantly associated with job stress. Among these factors, gender, educational level, engagement in stress relief activities, participation in PSC improvement activities, and patient safety ratings emerged as predictors of job stress. Moreover, the study revealed negative correlations between job stress and PSC.

CONCLUSION: This study identified the need for tailored policies and interventions that address nurses’ specific stressors to enhance PSC within hospital settings. Moreover, the study shed light on the unique challenges faced by nurses in Palestine, such as limited resources, unemployment concerns, staffing, and transportation issues, which further exacerbated job stress levels and potentially compromised patient safety. Understanding these contextual factors is crucial for developing targeted interventions and support systems that prioritize the holistic well-being of nurses and the quality of patient care delivery.

PMID:40170149 | DOI:10.1186/s12912-025-03009-9

BMC Pregnancy Childbirth. 2025 Apr 1;25(1):379. doi: 10.1186/s12884-025-07534-y.

ABSTRACT

BACKGROUND: Preeclampsia (PE) is a heterogeneous, multi-organ pregnancy disorder that poses a significant health burden globally, with its pathogenesis remaining unclear. This study aimed to identify novel susceptibility genes for PE through a cross-ancestry genome-wide association study (GWAS).

METHODS: We performed meta-analysis to summarize the PE GWAS data from the United Kingdom, Finland, and Japan. Subsequently, the multi-ancestry sum of the single-effects model was used to perform cross-ancestry fine-mapping. The functional mapping and annotation (FUMA)-expression quantitative trait loci (eQTL) mapping method, transcriptome-wide association study (TWAS)- functional summary-based imputation (FUSION) method, genome-wide complex trait analysis (GCTA)-multivariate set-based association test (mBAT)-combo method, and polygenic priority score (PoPS) method were employed to screen for candidate genes. We utilized biomarker expression level imputation using summary-level statistics (BLISS), based on summary-level protein quantitative trait loci (pQTL) data, to conduct a multi-ancestry proteome-wide association study (PWAS) analysis, followed by candidate drug prediction.

RESULTS: Six novel susceptibility genes associated with PE risk were identified: NPPA, SWAP70, NPR3, FGF5, REPIN1, and ACAA1. High expression of the NPPA and SWAP70 and low expression of the remaining genes were associated with a reduced risk of PE. Furthermore, we identified drugs that target NPPA, NPR3, and REPIN1.

CONCLUSIONS: Our study identified NPPA, SWAP70, NPR3, FGF5, REPIN1, and ACAA1 as novel genes whose predicted expression was linked to the risk of PE, offering new insights into the genetic framework of this condition.

PMID:40170147 | DOI:10.1186/s12884-025-07534-y

BMC Surg. 2025 Apr 2;25(1):127. doi: 10.1186/s12893-025-02846-4.

ABSTRACT

BACKGROUND/OBJECTIVE: Surgical site infection (SSI) is the third common complication in spinal surgery and often results in poor clinical outcomes, prolonged hospital stays, and additional costs. This study estimated the incidence of SSI and identified risk factors in spine surgeries done within 10 years.

METHODOLOGY: This was a retrospective cohort review of all patients who had spine surgery between January 2014 and December 2023. Patients’ hospital records were retrieved, and relevant biodata and clinical information were obtained and entered into the Statistical Product and Service Solutions version 25. The incidence of SSI was computed and presented as a percentage, and a multivariable analysis to assess risk factors for SSI was done using the chi-square test and Fisher’s exact test. The level of significance was set at a p-value < 0.05 and a 95% Confidence Interval.

RESULTS: The incidence of SSI was 11.7%; (24/206), predominantly caused by Staphylococcus Aureus (37.5%,P = 0.01) and largely (70%) occurred among patients admitted ≤ 48 h before surgery. The majority were superficial incisional SSIs (19/24,79.2%). They occurred commonly among patients operated for spondylotic disease (13/67,19.4%) and bacterial spondylitis (one out of the two patients) compared to the other spinal pathologies (p = 0.042). Similarly, infection rates were significantly higher in surgeries performed at the lumbar (14/63,22.2%) and thoracolumbar junction (4/31, 12.9%) compared to the cervical and thoracic spine (p = 0.009). This was found to increase the odds of developing SSI by 2.2 times (odds ratio: 2.20;CI:1.38-3.47, P = 0.001), The median duration of hospital stay was 36.5 days for patients with SSIs versus 23 days for patients without SSI (p = 0.008).

CONCLUSION: This study found a relatively high incidence of SSI, which was predominantly superficial incisional SSI, caused by Staphylococcus Aureus, particularly among patients admitted within 48 h before surgery. Significant risk factors for these infections are patients operated on for spondylotic disease and those who had lumbar or thoracolumbar spine surgeries.

PMID:40170142 | DOI:10.1186/s12893-025-02846-4

BMC Pediatr. 2025 Apr 2;25(1):265. doi: 10.1186/s12887-025-05601-z.

ABSTRACT

BACKGROUND: The Centers for Disease Control and Prevention (CDC) reports that water fluoridation is among the ten greatest public health achievements of the 20^th Century. Tooth decay (TD) prevention and neurodevelopmental disorder (ND) risk were assessed in relation to childhood water fluoridation exposure.

METHODS: This longitudinal cohort study examined the Independent Healthcare Research Database (IHRD) composed of prospectively collected healthcare data from the Florida Medicaid system for the period 1990-2012, using logistic and frequency statistical modeling (with adjustment for covariates). A cohort of 73,254 children continuously enrolled for their first 10 years of life was examined. The yearly percentage of persons in Florida receiving fluoridated water exposure from community water systems was examined by county. The number of children diagnosed with TD, autism spectrum disorder (ASD), attention deficit-hyperactivity disorder (ADHD), intellectual disability (ID), and specific delays in development (SDD) was evaluated.

RESULTS: Fluoride exposure in the year of birth, statistically significantly and dose-dependently, slightly reduced the risk of TD, and, separately, slightly increased the risk of ASD, ADHD, ID, and SDD. During the first 10 years of life, children who were fluoride-exposed as compared to unexposed were at significantly lower risk for TD, and, separately, at significantly greater risk for ASD, ID, and SDD.

CONCLUSIONS: Findings from the present study, coupled with previous studies, suggest new risk/benefit analyses of water fluoridation should be undertaken.

PMID:40170137 | DOI:10.1186/s12887-025-05601-z

BMC Cancer. 2025 Apr 1;25(1):595. doi: 10.1186/s12885-025-13975-7.

ABSTRACT

BACKGROUND: Healthcare-associated infections (HAI) lead to poor patient outcomes, including morbidity, mortality, length of hospital stay (LOS) and costs. However, limited data exists on the impact of HAI on LOS, cost at different quantiles and the survival of patients with cancer.

OBJECTIVE: To assess the impact of HAIs on LOS, costs, and survival of cancer patients.

METHODS: This retrospective cohort study used data from January 2017 to December 2018 from a tertiary cancer hospital in Henan. Patient demographic data were sourced from the hospital’s electronic medical records. Inclusion criteria were primary cancer diagnoses (ICD codes C00-C97). We balanced the distribution of baseline characteristics between patients with HAI and without using propensity score matching. Quantile regression can estimate how independent variables affect dependent variables at different quantiles. We conducted a quantile regression that assessing the impact of HAI on LOS and costs for patients with cancer and using Kaplan-Meier survival curves to compare the survival.

RESULTS: Our study included 291,535 patients with cancer, among of whom 4,784(1.6%) were diagnosed with HAI and 286,748 were not. Patients with HAI exhibited significantly longer hospital stays, with a mean duration of 26.1 days (range: 17.0 to 40.6 days), compared to their counterparts without HAIs, who had an average stay of 7.2 days (range: 4.0 to 14.0 days) (p < 0.01). Economically, the average hospitalization cost for patients without HAI was $1575.8 (range: 865.6 to 3106.3), substantially lower than the $8710.8 (range: $4073.8 to 13434.0) observed for patients with HAI (p < 0.01). After adjusting for confounders in quantile regression models, HAI was associated with a median increase in LOS of 11.4 (95% confidence interval (CI): 10.9-12.0) days and with excess costs of USD 3449.3 (95% CI: 3281.9-3616.7). The hazard ratio (HR) of death for patients with an HAI was significantly higher than for patients without an HAI (HR: 1.62, 95% CI: 1.50-1.74).

CONCLUSION: HAI prolongs the LOS, increases hospital costs, and worsens the survival of patients with cancer compared with other diseases. Our quantile regression results indicate that the impact of HAI on hospitalization costs and LOS is more pronounced among patients with higher baseline costs and longer LOS (e.g., at the 95th percentile). This suggests that patients with more severe conditions or advanced disease stages are more vulnerable to the adverse effects of HAI.

RELEVANCE TO CLINICAL PRACTICE: Targeted surveillance and preventive interventions, such as early infection screening and strict adherence to infection control protocols, should focus on high-risk patients with prolonged LOS and high costs. By preventing infections in these patients, we can more effectively reduce the additional burden of HAI on costs and LOS. This study informs clinical practice and decision-making for nurses and nursing educators who manage HAI.

PATIENT OR PUBLIC CONTRIBUTION: Patients and healthcare professionals helped in data collection at the Hospital.

PMID:40170132 | DOI:10.1186/s12885-025-13975-7

BMC Public Health. 2025 Apr 1;25(1):1231. doi: 10.1186/s12889-025-22434-8.

ABSTRACT

PURPOSE: This study aimed to systematically evaluate the dose-response relationships between physical activity (PA), sedentary behavior(SB) (including near work [NW] and screen time [ST]), sleep duration (SD), and myopia risk among children and adolescents.

DESIGN: Systematic review and dose-response meta-analysis.

METHODS: We systematically searched PubMed, EMBASE, Cochrane Library, and Web of Science up to November 19, 2024. Methodological quality was assessed using Joanna Briggs Institute (JBI) and ROBINS-I tools. Random-effects meta-analyses were used to estimate categorical and continuous dose-response relationships. Subgroup analyses and sensitivity analyses were performed to explore heterogeneity sources and test robustness.

RESULTS: A total of 45 observational studies (766,848 participants aged 5-19 years) were included. Categorical analyses showed that, compared with the lowest exposure categories, higher PA levels (highest: OR = 0.77, 95% CI: 0.63-0.96; intermediate: OR = 0.76, 95% CI: 0.63-0.93) and longer SD (highest: OR = 0.67, 95% CI: 0.48-0.92; intermediate: OR = 0.82, 95% CI: 0.73-0.92) significantly reduced myopia risk. Conversely, higher levels of NW (highest: OR = 1.71, 95% CI: 1.28-2.27; intermediate: OR = 1.34, 95% CI: 1.19-1.50) and ST (highest: OR = 1.59, 95% CI: 1.14-2.22; intermediate: OR = 1.29, 95% CI: 1.12-1.49) were associated with significantly increased risk. In the continuous dose-response meta-analysis, a linear association was observed between PA, ST, and myopia. Each additional hour of PA per day reduced the risk of myopia by 12%, while each additional hour of ST increased the risk by 31%. Nonlinear associations were found between NW, SD, and myopia. Among children and adolescents, 1.5 and 2.5 h/day of NW increased the risk of myopia by 25% and 29%, respectively. Although longer SD was associated with a reduced risk of myopia, this effect did not reach statistical significance at any exposure level.Subgroup analyses revealed that protective effects of PA were more evident in low- and middle-income countries, smaller sample sizes, and cross-sectional studies, while increased risks related to ST and NW were stronger in low-income settings. No subgroup significantly modified the association between SD and myopia risk.

CONCLUSION: Increasing PA, while limiting ST and NW, effectively reduces the risk of myopia among children and adolescents. The association between sleep duration and myopia remains inconclusive, warranting further investigation.

PMID:40170130 | DOI:10.1186/s12889-025-22434-8

One Health Outlook. 2025 Apr 2;7(1):14. doi: 10.1186/s42522-024-00130-8.

ABSTRACT

BACKGROUND: Tuberculosis (TB) in cattle negatively affects the cattle economy in Africa, with zoonotic TB posing drug-resistance issues in humans. The burden of TB in cattle and zoonotic TB in humans in sub-Saharan Africa (SSA) is not well understood. This study aimed to determine the prevalence of both TB in cattle and zoonotic TB in humans in SSA through meta-analysis.

METHODS: Research on TB prevalence was sourced from multiple databases. A random effects meta-analysis model estimated TB prevalence in SSA and its regions, while meta-regression identified risk factors. The analysis included 114 studies for cattle and 59 for humans.

RESULTS: The estimated TB prevalence in cattle was 5.06% (95% CI: 3.76-6.78), with a higher burden in West Africa. The prevalence was greater on farms than at abattoirs. Among humans, M. bovis prevalence was 0.73% (95% CI: 0.53-1.01), increasing to 1.56% (95% CI: 1.04-2.33) in TB incident cases, especially in the West and East Africa. Higher prevalence was noted among livestock workers, and in drug-resistant cases. Significant factors influencing TB prevalence varied for cattle and humans, including country, diagnostic methods, and study populations.

CONCLUSION: Focusing interventions on farms and livestock workers could help reduce the disease burden.

PMID:40170127 | DOI:10.1186/s42522-024-00130-8

Aust N Z J Obstet Gynaecol. 2025 Apr 1. doi: 10.1111/ajo.70026. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide, and women who experience complications during pregnancy, such as pregnancy loss (miscarriage and stillbirth), hypertensive disorders of pregnancy and gestational diabetes, have a significantly higher risk of future CVD. Increasing awareness of CVD risk among these women is crucial for effective engagement in risk reduction programs.

METHODS: A descriptive cross-sectional survey using a non-probability sampling method was adopted to explore the CVD knowledge and awareness of women with a history of complications of pregnancy. Distribution occurred from February to December 2021 via two tertiary hospitals in Australia and various groups in social media.

RESULTS: Of 364 survey responses received, a sample of 299 completed responses were considered for final analysis. The participants’ mean knowledge score regarding CVD risk factors was 14.5 (SD ± 4.6; range 0-25). Among them, 50.2% had poor knowledge, 25.1% had moderate knowledge, and only 24.7% had good knowledge of CVD and its risk factors in women. Statistically significant differences in knowledge scores were observed based on ethnicity (p = 0.009) and education level (p = 0.007).

CONCLUSION: This study revealed a significant gap in CVD knowledge among women with pregnancy complications, highlighting the need for targeted educational programs. Improving health literacy, particularly among high-risk and lower socioeconomic groups, is crucial for reducing CVD incidence.

PMID:40170108 | DOI:10.1111/ajo.70026

Global Health. 2025 Apr 1;21(1):15. doi: 10.1186/s12992-025-01108-5.

ABSTRACT

BACKGROUND: Although international mobility of medical personnel has gained scholarly attention, there has been limited empirical research on overseas-educated dietetic professionals. China has experienced a notable return of highly skilled professionals. This study aims to explore the experiences of Chinese overseas-educated dietetic returnees, focusing on their practice areas, job satisfaction, motivations for returning, post-return challenges, and career development strategies.

METHODS: A web-based survey, conducted from July to December 2022, targeted dietetic returnees with degree(s) from institutions outside mainland China. Participants were recruited from professional group chats on a social media platform. Job satisfaction was assessed using a 7-item scale, with responses ranging from 0 to 5 for each item. Its internal consistency was evaluated via Cronbach’s alpha. Responses were analyzed using descriptive statistics, t tests, and ANOVA. A multivariate regression helps further predict job satisfaction. Thematic analysis guides the analysis of an open-ended question.

RESULTS: Participants (N = 138) were mainly female (86.2%), had a master’s degree (79.0%), and had studied in the United States (37.7%). Clinical roles dominated post-return employment, but returnees also pursued biomedicine, biotechnology, and media. The mean job satisfaction score of 3.39 indicated moderate satisfaction. Job satisfaction varied across subgroups (e.g., older participants); however, in the multivariable regression model, only salary level remained a significant predictor. Key motivations for returning included familial ties, societal connections, and a desire to contribute to home country development. Returnees identified limited domestic networking connections as a top challenge. Meanwhile, they demonstrated agency in navigating post-return career development, such as by leveraging transnational social networks. Returnees also envisioned systematic workforce changes, such as improving licensure and regulation for foreign-trained professionals.

CONCLUSION: Returnees have diverse career pathways. Post-return job satisfaction, however, was significantly predicted only by salary level, emphasizing the critical role of compensation and economic viability in sustaining careers in the dietetic field. Our findings suggest that while returnees were primarily motivated by personal and cultural factors, they faced significant re-entry challenges that warrant attention from educators and policymakers. Future research should explore the global mobility of the dietetic profession and its potential to contribute to ‘brain gain’ in China’s healthcare sector.

PMID:40170102 | DOI:10.1186/s12992-025-01108-5

J Clin Periodontol. 2025 Apr 1. doi: 10.1111/jcpe.14155. Online ahead of print.

ABSTRACT

AIMS: To evaluate the impact of an anti-sensitivity toothpaste on the oral-health-related quality of life (OHrQoL) in a real-world (RW) setting.

MATERIALS AND METHODS: This was a decentralised, prospective, 24-week, open-label study in participants with self-reported dentine hypersensitivity (DH). A total of 655 enrolled participants used a 5% potassium nitrate toothpaste per label instructions and completed the Dentine Hypersensitivity Experience Questionnaire (DHEQ) and Numerical Pain Rating Scale (NPRS) monthly for 24 weeks and numerical scale for satisfaction of self-management of DH at 24 weeks. An ANOVA model was used to assess changes from baseline, overall and within subgroups (age ≤ 40, > 40 years, DH diagnosis confirmed or not by a dentist, use of sensitivity toothpaste [non-user, intermittent and current users] and DH frequency [frequent: several times a week; less frequent: less than once a week]).

RESULTS: The intent-to-treat population included 577 participants. At each timepoint, compared to baseline, improvements were statistically significant for all measures of OHrQoL (p < 0.0001, except Global Oral Health) and for NPRS (p < 0.0001) in the overall population and among subgroups (p < 0.05). All participants were highly satisfied with the product for self-management of DH.

CONCLUSIONS: This study showed the effectiveness of an anti-sensitivity toothpaste in improving OHrQoL and self-reported DH in an RW setting, as measured by a validated questionnaire.

PMID:40170098 | DOI:10.1111/jcpe.14155