Tag: pubmed

BMC Med Educ. 2025 Dec 11. doi: 10.1186/s12909-025-08443-6. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescence is a crucial stage for forming long-term health and nutritional habits. Many healthcare providers lack formal training in adolescent nutrition. This study assessed the effectiveness of a training course grounded in Merrill’s First Principles of Instruction in enhancing healthcare providers’ knowledge and satisfaction.

METHODS: This quasi-experimental study employed a pretest-posttest control group design with three measurement points and was; conducted in the Damghan Health Network (August 2024). A total of 100 health care providers were selected through convenience sampling and assigned to two groups: an intervention group (n = 40) and a control group (n = 50). The data collection tools included a 12-item nutrition knowledge test and 10-item satisfaction questionnaire. The training for the intervention group was designed usingaccording to Merrill’s five principles, whileereas the control group received standard training. Data were analyzed using ANCOVA.

RESULTS: The average knowledge score in the intervention group increased from 7.52 ± 1.92 to 10.71 ± 1.70 (42% increase), while the control group improved from 7.31 ± 1.47 to 9.17 ± 1.70 (25% increase). After adjusting for the pretest, the difference between groups was statistically significant (F = = 35.64, p < 0.001, η²= = 0.28, d = = 0.9). At the two-week follow-up, the intervention group maintained a higher mean score (8.27 ± 2.41) compared to baseline (p = 0.02). Participant satisfaction was also significantly higher in the intervention group (42.3 ± 4.1 vs. 36.8 ± 5.2; p < 0.001).

CONCLUSIONS: Training based on Merrill’s principles significantly improved providers’ knowledge and satisfaction regarding adolescent nutrition, supporting its use in health education programs.

PMID:41372975 | DOI:10.1186/s12909-025-08443-6

Res Involv Engagem. 2025 Dec 10. doi: 10.1186/s40900-025-00815-y. Online ahead of print.

ABSTRACT

BACKGROUND: The Family Engagement in Research (FER) Course launched in 2018 for researchers and family members to co-learn the principles and practice of engagement in neurodevelopmental disability and child health research. The first six cohorts of the FER Course (2018-2021) were part of a pre-post evaluation to assess learners’ perceptions and satisfaction of the FER Course, and the impact on their perceived knowledge, abilities, attitudes, and self-confidence in FER. This paper reports on the findings from this pre-post study.

METHODS: Sixty-nine self-selected researchers and family members enrolled in the course completed pre-and post-evaluations; satisfaction was evaluated after the course only (n = 96). Data collection involved surveys with 10-point Likert Scale questions about experiences of the course, perceived knowledge, abilities, attitudes towards, and self-confidence in family engagement in research, and overall satisfaction. We conducted Wilcoxon rank sum to compare differences between researchers and family members’ responses about self-confidence to engage, with the Wilcoxon signed rank tests used to evaluate change in outcomes from before to after the course. Open-ended survey responses were analyzed descriptively.

RESULTS: There were statistically significant increases in survey respondents’ perceived knowledge, abilities, and self-confidence to engage in research. Positive attitudes towards FER were rated highly at baseline and post-test, with no significant change. Respondents reported high levels of satisfaction with the FER Course.

CONCLUSIONS: The FER Course meets the need for training both family members and researchers, so that they are equipped with the perceived knowledge, abilities, and confidence to collaborate in neurodevelopmental disability and child health research.

PMID:41372969 | DOI:10.1186/s40900-025-00815-y

BMC Womens Health. 2025 Dec 10. doi: 10.1186/s12905-025-04171-7. Online ahead of print.

ABSTRACT

BACKGROUND: Cervical cancer (CC) causes significant morbidity and mortality in low-and middle-income settings, ranking second commonest female cancer in Ghana, affecting 26.4/100,000 with mortality rate 22.9/100,000 women. Previous studies focused on adults, females and involved smaller sample sizes. This study assessed CC knowledge among secondary school students in Ghana to generate evidence for implementing school-based educational interventions.

METHODS: It was a multi-site, cross-sectional study across 14 secondary schools in Greater Accra (GAR) and Central regions(C/R) of Ghana. Self-administered pre-tested questionnaires focused on students’ knowledge on causes, risk factors, symptoms, and prevention of CC. Four main domains were covered: general knowledge; cervical cancer features; risk factors; and screening and prevention. Domain scores were categorised into adequate knowledge (>50%) and inadequate knowledge (< 50%). Chi-square was used to test association between knowledge in various domains with participants’ gender, school type, and region. P-value below 0.05 was considered statistically significant.

RESULTS: A total of 9,767 students from 14 schools, 25.6% (n=2,280) males and 74.4% (n=6,630) females with mean age 16.9+1.2years participated. Overall, 58.4% of students had adequate general knowledge about CC; 61.1% demonstrated adequate knowledge of risk factors; 21.5% adequate knowledge of features, and 51.8% also had adequate knowledge of screening and prevention. Across all domains tested, 60.6%% of students had inadequate knowledge. More female students(60.9%) had adequate general knowledge than males(50.1%) (p< 0.001).

CONCLUSION: Significant knowledge gaps exist on risk factors, features, screening and prevention of cervical cancer among senior high school students in Ghana, necessitating targeted educational interventions based on identified gaps.

PMID:41372939 | DOI:10.1186/s12905-025-04171-7

BMC Nurs. 2025 Dec 10. doi: 10.1186/s12912-025-04189-0. Online ahead of print.

ABSTRACT

BACKGROUND: Venous ulcers negatively affect quality of life and generate high health care costs. Physical activity may improve their evolution; however, the evidence is limited and heterogeneous.

OBJECTIVE: To evaluate the effectiveness of a structured physical activity intervention as an adjunct treatment for the complete healing of venous ulcers in primary care at 3 and 6 months of follow-up.

DESIGN: This was a randomized, pragmatic clinical trial with 6 months of follow-up.

METHODS: Between February 2021 and June 2023, 44 people with a diagnosis of venous ulcers and an ankle-brachial index between 0.8 and 1.3 were recruited from 13 health centres in Madrid. Both groups received standard treatment. The intervention group also received a structured educational intervention of physical exercise and daily walking guidelines. The main outcomes were complete healing (RESVECH 2.0 scale) and time to healing (days). The secondary variables included degree of healing, ulcer area, pain, adherence, and variables related to healing and prognosis. Data were collected at the beginning and at 3 and 6 months of follow-up. Survival analysis (Kaplan‒Meier and Cox) was performed to measure the effectiveness of the treatments, as was intention-to-treat analysis.

RESULTS: At 3 months, 77.3% [95% CI 54-91] of the patients in the intervention group and 68.2% [95% CI 45-85] of those in the control group achieved complete healing, without statistically significant differences between groups. Overall adherence to the intervention was low; only 20% and 46% of the participants reached the level of compliance established in the first two visits, which progressively decreased.

CONCLUSIONS: The Active Legs programme showed a positive effect on the healing of venous ulcers in primary care.

TRIAL REGISTRATION: http://NCT04039789. [https://ClinicalTrials.gov]. 11/07/2019.

PMID:41372918 | DOI:10.1186/s12912-025-04189-0

Eur J Med Res. 2025 Dec 10. doi: 10.1186/s40001-025-03614-z. Online ahead of print.

ABSTRACT

OBJECTIVES: Several prior studies have shown that in metastasized colorectal cancer, the primary cancer’s location influences patients’ survival rates, with left-sided colorectal cancer being associated with longer survival than right-sided colorectal cancer. This study aimed to explore the influence of the primary location of colorectal cancer on survival following brain metastasis.

METHODS: To address this clinical question, we conducted a systematic review and meta-analysis. We included studies focused on patients diagnosed with brain metastasis from colorectal cancer. These studies reported survival outcomes based on different primary tumor sites (right versus left and colon versus rectum). The primary outcome was to aggregate the hazard ratio (HR) of left-sided colorectal cancer when metastasized to the brain compared with right-sided colorectal cancer. The secondary outcome was to aggregate the HR of rectal cancer when it metastasized to the brain compared with colon cancer.

RESULTS: Ten studies with a total of 1792 patients were included in the meta-analysis, and combined HR was calculated. Left-sided colon cancer showed higher overall survival compared with right-sided colon cancer when metastasized to the brain (HR: 0.71, 95% CI: 0.54-0.94, I² = 0%). Rectal cancer did not show a statistically significant difference in overall survival compared with colon cancer (HR: 0.75, 95% CI: 0.40-1.41, I² = 81%).

CONCLUSIONS: Concordant with lung and liver metastases, the primary location of colorectal cancer influenced overall survival when metastasized to the brain. Left-sided colon cancer demonstrated higher overall survival than right-sided colon cancer.

PMID:41372917 | DOI:10.1186/s40001-025-03614-z

BMC Complement Med Ther. 2025 Dec 10. doi: 10.1186/s12906-025-05213-1. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is a pressing public health issue worldwide. Accordingly, primary and secondary CVD prevention are essential. Many clinical trials have investigated the effects of sumac (Rhus Coriaria) supplementation on CVD risk factors (CVDRFs). However, these studies have yielded contradictory findings. This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to comprehensively assess the impact of sumac supplementation on CVDRFs in human subjects.

METHODS AND MATERIALS: We searched the MEDLINE/PubMed, EMBASE, CENTRAL, and Web of Science to identify the relevant studies in any language until March 2025. RCTs that investigated the impact of sumac supplementation compared no sumac consumption or placebo capsule interventions or consumed substitutions containing no sumac on CVD outcomes in adults at least 2 weeks were included for data synthesis. The primary outcomes were the mean difference in lipid profiles, blood pressure, glycemic control, and anthropometric indices. Secondary outcomes were the mean difference in inflammatory and oxidative stress markers. The quality of the included trials was assessed using the Cochrane Risk-of-Bias tool. Effect sizes were calculated using a random effect model and presented as weighted mean differences and 95% confidence intervals (CIs), while the I² index was utilized to assess between-study heterogeneity. To explore the potential sources of heterogeneity, subgroup and meta regression analyses were evaluated. Additionally, publication bias and sensitivity analyses were conducted. Finally, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to evaluate the quality of evidence.

RESULTS: A total of 17 trials (comprising 18 treatment arms) with 1170 participants were included in our analysis. The findings revealed statistically significant effects of sumac consumption on various CVDRFs, including low-density lipoprotein cholesterol (-9.62 mg/dL; 95% CI= -14.59 to -4.65), total cholesterol (-9.47 mg/dL; 95% CI= -15.92 to -3.02), triglycerides (-8.96 mg/dL; 95% CI= -16.19 to -1.73), high-density lipoprotein cholesterol (2.95 mg/dL; 95% CI = 0.66 to 5.25), diastolic blood pressure ( -2.87 mmHg; 95% CI= -4.23 to -1.51), insulin (-1.68 µU/mL; 95% CI: -3.26 to -0.09), homeostatic model assessment of insulin resistance ( -0.87; 95% CI: -1.61 to -0.14), body weight ( -1.03 kg; 95% CI= -1.89 to -0.17), body mass index (WMD = -0.31 kg/m; 95% CI= -0.55 to -0.07), waist circumference (-0.59 cm; 95% CI= -1.06 to -0.12), malondialdehyde (0.84 µmol/L; 95% CI = 0.38 to 1.30), and total antioxidant capacity ( -0.83 µU/L; 95% CI = -1.10 to -0.56). However, no significant effects were observed for other analyzed CVDRFs, such as systolic blood pressure, fasting blood glucose, quantitative insulin sensitivity check index, hip circumference, waist-to-hip ratio and hypersensitive C-reactive protein. These results were stable in sensitivity analysis, and no significant publication bias was detected. The GRADE profile for sumac supplementation evaluated the certainty of the outcomes and indicated that the quality of evidence was was rated as very low to high across all outcomes.

CONCLUSION: The findings of our present study suggest that sumac supplementation may have potential benefits in improving various CVDRFs, such as blood lipid levels, blood glucose control, weight management, and oxidative stress markers. Therefore, integrating sumac could be explored as a complementary dietary approach to improve the overall cardiometabolic health. However, these results warrant cautious interpretation, as the findings were derived predominantly from Iranian populations, and significant heterogeneity was observed across trials for different outcomes. Moreover, our pooled results were based on unadjusted estimates, the precise effect of sumac on CVDRFs could be impacted by various confounders. Further large-scale and high-quality RCTs with longer duration are required to confirm these results.

PMID:41372916 | DOI:10.1186/s12906-025-05213-1

BMC Health Serv Res. 2025 Dec 10;25(1):1591. doi: 10.1186/s12913-025-13649-x.

ABSTRACT

BACKGROUND: Patient satisfaction is a key indicator of healthcare system performance and legitimacy. Understanding its determinants provides valuable insights for policy design. To identify healthcare-related and socioeconomic determinants at both the individual and contextual levels (including regional indicators such as healthcare expenditure, physician density, life expectancy, and poverty rate) associated with satisfaction with the Spanish public healthcare system, and to assess changes in satisfaction levels before and after the COVID-19 pandemic.

METHODS: We conducted a cross-sectional analysis using nationally representative data from the Spanish Healthcare Barometer for the years 2018, 2019, 2022, and 2023. Individual-level data were linked with regional-level indicators, aggregated at the level of Spain’s autonomous communities, including public healthcare expenditure, physician density, life expectancy, and poverty rate. Descriptive statistics were used to examine temporal trends. For descriptive purposes, overall satisfaction was analyzed using the original 1-10 scale. For multivariate analysis, satisfaction was operationalized as a three-category ordinal outcome (low, moderate, and high satisfaction). Additional models included interaction terms with the pandemic period, defined as surveys conducted from March 2020 onwards, to assess changes in determinants over time.

RESULTS: The final sample included 29,146 adult respondents. Based on the original 1-10 scale, overall satisfaction declined significantly following the pandemic (from 6.66 to 6.26; p < 0.001), indicating a negative shift in public perception after COVID-19. Higher satisfaction was associated with better self-rated health, lower frequency of healthcare visits, and recent utilization of public healthcare services, including hospital, specialist, and emergency care. Sociodemographic factors such as being female, younger, and born outside of Spain were also positively associated with satisfaction. Lower satisfaction was observed among individuals with chronic conditions, lower socioeconomic status, or limited educational attainment. Contextual variables showed weaker associations, with only life expectancy exhibiting a significant positive relationship.

CONCLUSIONS: Satisfaction with the Spanish healthcare system is primarily shaped by individual characteristics and experiences, with only limited evidence of associations with broader contextual indicators. The post-pandemic decline in satisfaction highlights the need for targeted policies that improve responsiveness, equity, and user confidence in public healthcare services.

PMID:41372909 | DOI:10.1186/s12913-025-13649-x

Reprod Health. 2025 Dec 10. doi: 10.1186/s12978-025-02236-2. Online ahead of print.

ABSTRACT

BACKGROUND: Antenatal care (ANC) is essential for improving maternal and child health outcomes, as it helps prevent pregnancy complications and reduces maternal and child mortality. Ensuring that all pregnant women receive comprehensive, high-quality ANC is critical for a positive pregnancy experience. This study aimed to identify the determinants of quality ANC visits among pregnant adolescent girls and women in Sierra Leone.

METHODS: We analyzed data from the 2019 Sierra Leone Demographic and Health Survey, including 7,276 adolescent girls and women who had a live birth or stillbirth in the two years preceding the survey. Quality antenatal care was defined as receipt of all essential ANC components: at least four ANC visits, receipt of tetanus toxoid injection, blood pressure measurement, urine and blood sample collection, and counseling on pregnancy complications. Binary logistic regression was used to identify factors associated with quality ANC, adjusting for demographic and socioeconomic variables. Survey weights were applied to account for the sampling design.

RESULTS: Overall, 79.7% of adolescent girls and women received quality antenatal care services. In the fully adjusted mixed effects model, attending four or more ANC visits (aOR: 1.92; 95% CI: 1.42-2.59) and receiving care from a skilled provider (aOR: 1.80; 95% CI: 1.40-2.31) were both strongly associated with increased odds of receiving quality ANC. Conversely, initiating ANC in the second trimester was linked to lower odds of receiving quality care (aOR: 0.61; 95% CI: 0.51-0.74) compared to those who began care in the first trimester. Socioeconomic factors also played an important role: adolescent girls and women in the richest wealth quintile (aOR: 1.89; 95% CI: 1.12-3.19) and those residing in the Western region (aOR: 3.78; 95% CI: 2.26-6.31) were significantly more likely to receive quality ANC visits. Furthermore, urban residence was associated with lower odds of receiving quality ANC visits (aOR: 0.68; 95% CI: 0.47-0.97) compared to rural areas. While higher education level, being married, and having media access were positively associated with quality ANC visits, these relationships did not reach statistical significance.

CONCLUSION: While most adolescent girls and women in Sierra Leone received quality antenatal care, significant disparities persist based on demographic, socioeconomic, and healthcare-related factors. These findings underscore the urgent need for targeted interventions by the national directorate of reproductive and child health, reproductive health and family planning, and school and adolescent health programmes. Strategies should prioritize improving early ANC initiation, expanding access to skilled providers, and addressing barriers faced by the poorest and urban populations. Tailored community outreach, education campaigns are essential to reduce inequities and ensure that all pregnant adolescent girls and women receive comprehensive, high-quality ANC services.

PMID:41372898 | DOI:10.1186/s12978-025-02236-2

BMC Oral Health. 2025 Dec 10;25(1):1893. doi: 10.1186/s12903-025-06951-x.

ABSTRACT

BACKGROUND: This study aimed to investigate the relationship between posterior mandibular ridge morphology, cortical bone characteristics, and the Mandibular Cortical Index (MCI), and to assess their potential impact on the complexity of dental implant placement. Understanding these parameters is essential to optimize implant planning, minimize surgical complications, and improve clinical outcomes, particularly in regions where anatomical variations pose increased risks.

METHODS: In this retrospective observational study, 100 cone-beam computed tomography (CBCT) scans of edentulous mandibles were analyzed in Turkish population. Each mandible was evaluated through 10 sagittal cross-Sect. (5 from each side), resulting in 1000 sections. The sample consisted of equal numbers of male and female patients aged between 32 and 79 years. Morphological parameters, including lingual concavity and convexity, bucco-lingual width, cortical bone thickness (buccal and lingual), alveolar crest height, and ridge morphology types, were evaluated in sagittal sections. Ridge shapes were categorized as saddle, kidney, pen shape, toucan beak, straight, hourglass, or basal. The MCI was classified as C1 (normal cortex), C2 (moderate erosion), or C3 (severe erosion) based on cortical integrity. Statistical analyses were conducted to determine the relationships between MCI, ridge morphology, and bone parameters.

RESULTS: A statistically significant relationship was observed between MCI groups and ridge morphology types (p < 0.001). The C3 group exhibited significantly thinner lingual cortical bone (0.81 ± 0.22 mm), lower alveolar crest heights, and increased bucco-lingual width compared to the C1 group (1.29 ± 0.26 mm, p < 0.001), along with lower alveolar crest heights and increased bucco-lingual width (p < 0.05). Basal-shaped ridges showed the widest bucco-lingual dimensions but the lowest alveolar crest heights, suggesting advanced vertical bone loss. Conversely, straight and pen-shaped ridges demonstrated greater lingual cortical thickness. Lingual concavity was more pronounced in cases with lower MCI.

CONCLUSION: CBCT-based evaluation of mandibular ridge morphology and cortical bone integrity, supported by appropriate statistical analyses (ANOVA, Chi-square, Kruskal-Wallis), offers clinically valuable insights for implant planning. Incorporating these assessments helps identify patients at greater risk for complications, guides the need for augmentation procedures, and supports safer and more predictable implant placement. These findings underscore the clinical relevance of ridge morphology and MCI in preoperative risk assessment, helping clinicians tailor implant planning strategies to anatomical variations and minimize complications.

PMID:41372870 | DOI:10.1186/s12903-025-06951-x

BMC Pediatr. 2025 Dec 10. doi: 10.1186/s12887-025-06391-0. Online ahead of print.

ABSTRACT

BACKGROUND: Late preterm infants (33-36 weeks gestation) are at increased risk for neurodevelopmental delays, but early signs often go unrecognized due to subtle presentations and inconsistent follow-up. While screening tools are available, few studies have examined how well parents identify developmental concerns compared to trained professionals.

AIM: To evaluate neurodevelopmental outcomes in late preterm infants at 3 and 6 months of corrected age by comparing parental and therapist-reported developmental scores, and to identify predictors influencing developmental scores.

METHODS: Sixty late preterm infants were screened using the Trivandrum Developmental Screening Tool (TDST) at discharge and followed up at 3 and 6 months of corrected age. Both therapists and parents completed the TDST independently during follow-up. Developmental scores were compared using Wilcoxon signed-rank tests. Regression analyses were conducted to identify predictors that influence parent and therapist scoring. A p-value of < 0.05 was considered statistically significant.

RESULTS: At 3 months there is no significant difference between the parent and therapist TDST overall scores, while at 6 months, therapist and parent TDST overall scores showed significant difference (p < 0.001). Regression analysis identified rolling and object transfer as strong predictors of overall scores for both parent and therapist scores at 6 months.

CONCLUSIONS: Despite similar overall scores at 3 months, significant discrepancies between parent and therapist scoring emerged by 6 months. These findings emphasise the importance of caregiver education in early neurodevelopmental surveillance.

PMID:41372868 | DOI:10.1186/s12887-025-06391-0