Tag: pubmed

BMC Nurs. 2026 Feb 6. doi: 10.1186/s12912-026-04387-4. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical training exposes nursing internship students to intense ethical challenges that may threaten their sense of meaning and contribute to psychological emptiness. Protective psychological and moral resources, such as purposefulness and moral resilience, may play a crucial role in mitigating this existential vulnerability.

OBJECTIVE: This study aimed to test a structural model examining the direct and indirect associations between purposefulness and psychological emptiness, with moral resilience as a mediating variable, among nursing internship students.

METHODS: A cross-sectional study was conducted among 215 nursing internship students in Tabriz, Urmia, and Ardabil, Iran. Data were collected using the Sense of Purpose Scale-Revised Persian Version (SOPS-2-PERS), the Rashed Moral Resilience Scale (RMRS), and the Psychological Emptiness Scale (PES). Descriptive and inferential analyses were performed using SPSS v14. Structural equation modeling (SEM) with bias-corrected bootstrap procedures (5000 resamples) was conducted in AMOS 24.0 to examine the hypothesized relationships.

RESULTS: The proposed structural model demonstrated a good fit to the data. Purposefulness was positively associated with moral resilience, and moral resilience was negatively related to psychological emptiness. Although the direct association between purposefulness and psychological emptiness was negative, it did not reach statistical significance. Bootstrap analysis confirmed a significant indirect effect of purposefulness on psychological emptiness through moral resilience, indicating that the association was transmitted mainly via moral resilience.

CONCLUSION: The findings suggest that moral resilience plays a key mediating role in the relationship between purposefulness and psychological emptiness. Enhancing students’ sense of purpose may reduce psychological emptiness, primarily by strengthening moral resilience during clinical training.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41652387 | DOI:10.1186/s12912-026-04387-4

BMC Public Health. 2026 Feb 6. doi: 10.1186/s12889-026-26516-z. Online ahead of print.

ABSTRACT

BACKGROUND: Sleep represents a key modifiable risk factor for cardiovascular diseases (CVDs). Although previous studies have examined separate associations of nighttime sleep duration and napping duration with CVDs, few have investigated their combined effects or elucidated how this association differs across age or gender. This study aimed to assess how different sleep combinations influence the CVD risk.

METHODS: This study used longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2020. Baseline information on sleep and other relevant variables was obtained through self-reported questionnaires, and incident CVDs were identified during follow-up. Cox proportional hazards regression models were applied to evaluate independent and combined effects of nighttime sleep duration and napping duration on CVD incidence. Stratified analyses by age and gender explored potential heterogeneity, and sensitivity analyses were conducted to test result robustness.

RESULTS: A total of 7,975 participants were included, of which 2,117 participants (26.55%) developed CVDs after follow up. After adjusting for confounders, insufficient nighttime sleep (< 6 h) was independently associated with a higher risk of CVDs (hazard ratio [HR]: 1.189, 95% confidence interval [CI]: 1.071-1.319). Compared with participants having moderate nighttime sleep without napping, those with < 6 h/night without napping (HR: 1.177, 95% CI: 1.021-1.357), < 6 h/night with napping duration ≤ 0.5 h (HR: 1.558, 95% CI: 1.236-1.962), and < 6 h/night with napping duration > 1 h (HR: 1.300, 95% CI: 1.020-1.655) had significantly higher CVD risk. Among these, the combination of < 6 h/night with napping duration ≤ 0.5 h was associated with the highest observed CVD incidence. Stratified analysis revealed significant heterogeneity by gender, with less pronounced associations between sleep combinations and CVD risk in men compared with those in women. Sensitivity analyses supported the robustness of findings.

CONCLUSIONS: Adequate nighttime sleep is associated with lower CVD risk. Most combinations of insufficient nighttime sleep and daytime nap increased CVD risk among middle-aged and older adults. However, the combination of insufficient nighttime sleep with moderate napping was not associated with increased CVD risk in this population. These results provide a scientific foundation for targeted sleep interventions and clinical guidance.

PMID:41652381 | DOI:10.1186/s12889-026-26516-z

BMC Pregnancy Childbirth. 2026 Feb 7. doi: 10.1186/s12884-026-08721-1. Online ahead of print.

ABSTRACT

BACKGROUND: Early pregnancy loss (EPL) is a global public health concern with significant physical and psychological effects on individuals and society. The specific etiology of many EPL cases is not well understood, and first trimester maternal diet may play a role in EPL occurrence. This study aimed to examine the differences in first trimester maternal nutrient intake, nutritional habits and nutritional knowledge levels between healthy pregnant women and women who experienced EPL.

METHODS: A single center retrospective case-control study was conducted at a public hospital in Istanbul, Turkey between May-October 2024. The case group comprised 65 women who experienced first-time pregnancy loss. The control group included 65 healthy pregnant women in the first trimester without a previous PL history, with both groups matched for age, body mass index (BMI) and parity. Data were collected from the participants regarding their general information, dietary habits, the Quantitative Food Frequency Questionnaire (QFFQ), and the Nutrition Knowledge Level Scale for Adults (NKLSA). Dietary nutrient intakes were evaluated on the basis of the Dietary Reference Intakes (DRI) values and compared between the two groups. To further investigate the link between specific dietary nutrient intakes and EPL risk, adjusted binary logistic regression models were employed.

RESULTS: The mean age of the participants was 28.5 years, and their mean BMI was 24.20 kg/m². The dietary intake of carbohydrates, dietary fiber, monounsaturated fatty acids, omega-3 fatty acids, folate, vitamin C, potassium, iodine and total minerals were statistically higher in the control group (p < 0.05). Dietary vitamin D and cholesterol intake and the omega-6/omega-3 ratio were greater in the case group without statistical significance (p > 0.05). The control group presented significantly higher proportions of dietary supplement use, regular consumption between meals, and higher daily meal number (p < 0.05). Adjusted binary logistic regression analysis revealed negative correlations between total dietary fiber intake (continuous and Q3/Q4) and EPL risk in all models, even after adjusting for all potential confounders (p < 0.05). There was no statistically difference regarding nutrition knowledge level between two groups (p > 0.05).

CONCLUSIONS: This study contributes to the literature by showing the protective role of maternal nutritional status in the first trimester against EPL risk.

PMID:41652374 | DOI:10.1186/s12884-026-08721-1

BMC Public Health. 2026 Feb 6. doi: 10.1186/s12889-026-26444-y. Online ahead of print.

ABSTRACT

BACKGROUND: In public health, simulation models are important tools for policy evaluations, and the nature of the problems these models address is complex. System dynamics (SD) modelling is acknowledged as a methodology for complex systems, but there is limited insight in the development and application of SD models for noncommunicable diseases (NCDs) and lifestyle-related risk factors. Therefore, this review investigates how these SD models are developed and utilised to project health outcomes and evaluate policy interventions.

METHODS: Relevant studies were identified through a systematic search strategy. Studies were selected based on eligibility criteria, and data were extracted in two phases: (1) extraction of study characteristics, and (2) detailed examination of applied methods for a subset of included studies focussing on mental health and substance use disorders. For the second phase, data extraction was stratified according to steps of the modelling cycle, and the reporting quality of each study was assessed.

RESULTS: In phase 1, 63 studies were included, mainly on mental health and substance use disorders (27%), obesity (17%), and diabetes (13%), with the number of studies increasing over time. In phase 2, 17 studies on mental health and substance use disorders were included. These studies commonly used dedicated software for SD modelling for the mathematical formulation and computerisation of their models. However, in 76% of these studies, the underlying mathematical equations were not shared, and in 82%, the models were not openly accessible. A (slight) majority of studies validated model outcomes against empirical data (65%), and performed sensitivity analysis (53%). Few studies reported model verification (18%) and face validation of model outcomes (18%).

CONCLUSIONS: SD models are increasingly developed for NCDs and lifestyle-related risk factors, and particularly applied to mental health and substance use disorders. This review offers insights into applied techniques for developing SD models for mental health and substance use disorders, and shows that steps of the modelling cycle are reported on with considerable variation. Although studies frequently report on certain aspects of testing and validation, many report incompletely on other activities of the modelling cycle, and the models sometimes lack transparency. Improving this would enhance the credibility of SD modelling in public health.

PMID:41652355 | DOI:10.1186/s12889-026-26444-y

BMC Infect Dis. 2026 Feb 6. doi: 10.1186/s12879-026-12783-z. Online ahead of print.

NO ABSTRACT

PMID:41652354 | DOI:10.1186/s12879-026-12783-z

BMC Geriatr. 2026 Feb 12. doi: 10.1186/s12877-026-07059-9. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Alzheimer’s disease and related dementias (ADRDs) are prevalent conditions that are stressful and elevate emotional distress in couples after diagnosis. Without treatment, emotional distress may become chronic and negatively affect couples’ quality of life. We report results from an NIH Stage 1A open pilot of Resilient Together for Dementia (RT-ADRD), a novel, dyadic, skills-based intervention aimed at preventing chronic emotional distress in couples early after diagnosis. We describe results from our mixed-methods single arm feasibility study, including preliminary feasibility and acceptability of the intervention, and qualitative feedback from exit interviews. We also present exploratory analyses for change in outcomes and mechanisms of action.

METHODS: Six couples (N = 12 individuals) were recruited within six months of ADRD diagnosis by their diagnosing providers. Participants completed baseline assessments, participated in weekly RT-ADRD sessions together, then completed post-intervention assessments and one 60-min exit interview together.

RESULTS: RT-ADRD exceeded all a-priori feasibility and acceptability benchmarks (> 70%). Feedback from exit interviews suggested that participants had favorable impressions of the program and found the skills useful and relevant. Participants also offered perspectives on barriers and facilitators of engagement and program enhancement. In exploratory analyses, persons living with dementia exhibited significant reductions in perceived stress at post-intervention (p < .05; Cohens d > 0.8). Both persons living with dementia and their care partners exhibited statistically significant improvements in positive dyadic interactions measured by the Dyadic Relationship Scale (ps < .05); Cohens ds > 0.8).

CONCLUSIONS: RT-ADRD shows promise as a feasible and acceptable dyadic intervention delivered early after diagnosis. Results support a future NIH Stage 1B trial of RT-ADRD to establish definitive feasibility markers of both intervention and control before formal efficacy testing.

TRIAL REGISTRATION: This open pilot was registered on ClinicalTrials.gov (NCT06421545) on 05/20/2024.

PMID:41652334 | DOI:10.1186/s12877-026-07059-9

BMC Microbiol. 2026 Feb 6. doi: 10.1186/s12866-026-04789-z. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm birth is the leading cause of death in children under five years of age worldwide. The association between preterm birth and long-term outcomes is vaguely known. In very preterm infants, the gut microbiome is highly variable and impacted by the neonatal intensive care unit environment. Our objective was to better understand the crosstalk between the gut microbiome and the host at one month of age in very preterm infants and its impact on neurological outcomes at two years of age. We performed a multi-omics analysis of fecal samples collected in 2011 from 73 very preterm French infants at one month of age, grouped according to their neurodevelopment assessed at two years of age using the Ages & Stages questionnaire. Multi-omics profiling and integrative analyses were performed between 2022 and 2023, including fecal microbiome, metabolome, and host transcriptome characterization using 16 S rRNA gene sequencing, LC-MS, and mRNA sequencing, respectively.

RESULTS: The gut microbiome of very preterm infants at one month is mostly driven by either Escherichia or Staphylococcus, which are differentially associated with host immune markers (CAMP), metabolomic pathways, notably the energy pathway due to the presence of various nicotinamide adenine dinucleotides (NAD+) and two-year neurodevelopmental outcomes.

CONCLUSION: The gut microbiome at one month of age could be a noninvasive biomarker of gut immaturity and metabolic defects. Escherichia and Staphylococcus proportions were found to be the best indicators of physiological maturity and immaturity, respectively. Escherichia may help the process of intestinal maturation in preterm infants through specific metabolites production and is associated with a better neurodevelopment.

PMID:41652328 | DOI:10.1186/s12866-026-04789-z

Thyroid. 2026 Feb 6:10507256261423184. doi: 10.1177/10507256261423184. Online ahead of print.

ABSTRACT

BACKGROUND: Iodine deficiency disorders (IDDs) remain a public health concern, especially in pregnancy, despite universal salt iodization (USI) programs. Iran has sustained iodine sufficiency since the 1990s through national USI, but recent evidence suggests recurrent iodine insufficiency among pregnant women. This study reports findings from the sixth National Monitoring Survey (2022-2023) to reassess iodine status in schoolchildren and pregnant women in Iran.

METHODS: This cross-sectional survey included 11,221 schoolchildren aged 8-10 years and 2929 pregnant women from all 31 provinces. Multistage cluster sampling ensured national representativeness for children. At the same time, pregnant women were recruited from health centers by equal provincial quotas (60 per province, not population-weighted), and their individual intake of iodide along with folic acid supplements was documented. Urinary iodine concentration (UIC) was measured using the Sandell-Kolthoff method, and salt iodine content was assessed by iodometric titration at production and household levels. Data were analyzed with descriptive and nonparametric statistical methods.

RESULTS: The median UIC in schoolchildren was 133 µg/L (interquartile range [IQR]: 88-183), within the World Health Organization (WHO)-recommended range, with 67.7% having UIC ≥100 µg/L. However, 22.8% had a UIC of 50-100 µg/L and 9.5% <50 µg/L. In pregnant women, the median UIC was 128 µg/L (IQR: 84-187), below the WHO threshold of 150 µg/L, with 61.2% having UIC <150 µg/L and 34.4% <100 µg/L. 73.7% of pregnant women used iodide + folic acid supplement, with wide provincial variation of 38-84%. Household salt median iodine content was 32 ppm, but 30.6% of samples were <20 ppm, and only 54% were stored properly. Production-level salt had a median iodine content of 33.8 ppm.

CONCLUSIONS: Although Iran has maintained iodine sufficiency in the general population during the last three decades, mild iodine deficiency has reappeared among pregnant women due to incomplete usage of iodide folic acid supplementation. Strengthened monitoring, stricter quality assurance in salt production, improved adherence to iodine supplementation in pregnant women, and targeted provincial interventions are needed to sustain IDD elimination.

PMID:41652324 | DOI:10.1177/10507256261423184

Scand J Caring Sci. 2026 Mar;40(1):e70195. doi: 10.1111/scs.70195.

ABSTRACT

BACKGROUND: Unfinished nursing care refers to situations in which necessary nursing care is insufficient, incomplete, or not provided at all. Nursing students’ evaluations of unfinished nursing care based on their clinical observations are important indicators of their professional awareness and ethical development.

PURPOSE: This study aimed to examine the relationship between nursing students’ ethical values and their perceptions of unfinished nursing care.

METHODS: This descriptive and cross-sectional study was reported in accordance with the STROBE guidelines. The research was conducted between March 3 and May 30, 2025, with 615 students enrolled in the nursing department of a university located in western Türkiye. Data were collected using the ‘Descriptive Information Form’, the Unfinished Nursing Care Survey for Students, and the Ethical Values Scale for Students Studying in Health Sciences. Descriptive statistics and multiple linear regression analyses were performed to analyse the data.

RESULTS: The mean total score for interventions related to unfinished nursing care was 73.83 ± 12.08, and the mean score for reasons underlying unfinished care was 76.22 ± 13.35. The mean score for ethical values was 117.70 ± 15.08. According to the multiple regression analysis, significant predictors of unfinished nursing care included academic year level (β = 0.094, p = 0.031) and ethical values (β = 0.217, p < 0.001) (R² = 0.065, F = 7.998, p < 0.001). Among these predictors, ethical values were identified as the strongest predictor of unfinished nursing care levels.

CONCLUSION: Higher levels of ethical values among nursing students were associated with lower levels of unfinished nursing care. These findings suggest that nursing education programs should incorporate content aimed at strengthening students’ ethical values. These findings highlight the importance of integrating ethics education and reflective clinical supervision into nursing curricula to enhance students’ ethical competence and professional development.

PMID:41652306 | DOI:10.1111/scs.70195

Epileptic Disord. 2026 Feb 6. doi: 10.1002/epd2.70198. Online ahead of print.

ABSTRACT

OBJECTIVE: To quantitatively evaluate regional brain volume differences between pediatric patients with epilepsy and healthy controls using a fully automated volumetric magnetic resonance imaging (MRI) analysis performed with the Vol2Brain platform.

METHODS: This retrospective study included 150 children (75 with epilepsy and 75 healthy controls) who underwent 1.5 T cranial MRI examinations. High-resolution three-dimensional T1-weighted images were processed using Vol2Brain, a fully automated segmentation tool based on SPM12 and CAT12 frameworks. Absolute and relative volumes of 135 cortical and subcortical structures were computed. Statistical comparisons between groups were performed using the Shapiro-Wilk and Mann-Whitney U tests (p < .05).

RESULTS: Patients with epilepsy demonstrated significantly lower volumes in the hippocampus, frontal and temporal gray matter, thalamus, cerebellum, and total brain compared with controls, accompanied by a compensatory increase in cerebrospinal fluid volume. No significant volumetric differences were found in the remaining 128 brain structures, indicating a diffuse morphometric reorganization pattern extending beyond the epileptogenic focus.

SIGNIFICANCE: Fully automated volumetric MRI analysis using vol2Brain can reliably detect widespread structural brain alterations in pediatric epilepsy. These findings support the concept of epilepsy as a diffuse network disorder extending beyond focal lesions. Quantitative morphometry provides an objective approach to characterize subtle structural reorganization and may serve as a basis for future studies investigating clinical and neurocognitive correlations in pediatric epileptology.

PMID:41652297 | DOI:10.1002/epd2.70198