Tag: pubmed

JMIR Hum Factors. 2025 Jul 11;12:e68813. doi: 10.2196/68813.

ABSTRACT

BACKGROUND: Strengthening shared decision-making in mental health care may improve the quality of services and treatment outcomes, but its implementation in services for severe mental disorders is currently lacking.

OBJECTIVE: This study aims to explore the feasibility and acceptability of iTandem (University of Oslo), a mobile app designed to promote shared decision-making in the treatment of psychotic disorders. In addition, the study aims to investigate mechanisms that potentially contribute to the intended effect of the app. iTandem is a therapy supplement that facilitates patient involvement in decisions regarding treatment goals and focus areas. It is designed for personalized use and contains 8 optional modules: sleep, medication, recovery, mood, psychosis, activity, substance use, and feedback concerning therapy.

METHODS: Patients undergoing assessment or treatment for psychotic disorders and their clinicians were recruited for the study. Patients and clinicians jointly used iTandem as part of standard treatment in a 6-week trial. We used a mixed-methods study design with a clear emphasis on qualitative methods. Feasibility and acceptability were assessed through descriptive statistics based on preintervention and postintervention questionnaires and app usage data, in addition to text responses to open-ended items. We conducted a reflexive thematic analysis of postintervention interviews to elaborate these measures and to explore mechanisms potentially contributing to achieving shared decision-making when using iTandem.

RESULTS: A total of 9 patients and 8 clinicians completed the trial. The participants evaluated iTandem as a user-friendly and acceptable tool, but there were considerable variations in how the app was integrated into treatment and in perceptions of its clinical value. The thematic analysis suggests that iTandem has the potential to facilitate shared decision-making through supporting cognition and shifting the patient’s role. We also identified scaffolding structures, an analogy of personalized support, as a precondition for these mechanisms and for the overall feasibility and acceptability of iTandem.

CONCLUSIONS: iTandem was generally perceived as a feasible and acceptable tool in the treatment of patients with psychotic disorders. Our findings suggest that nonclinical aspects, such as support structures, are important to the feasibility and acceptability of such digital interventions and patients’ aptness for digitalized treatment in general. Future research should explore related nonclinical aspects further instead of defining potential target groups based on diagnoses and symptom severity alone.

PMID:40644621 | DOI:10.2196/68813

Rheumatology (Oxford). 2025 Jul 11:keaf382. doi: 10.1093/rheumatology/keaf382. Online ahead of print.

ABSTRACT

OBJECTIVES: The ASAS consensus defines “early axial spondyloarthritis (axSpA)” as symptom duration ≤2 years, a definition derived from expert opinion due to limited evidence. We performed a meta-analysis of randomized placebo-controlled trials (RCTs) of biologic and targeted synthetic DMARDs (bDMARDs/tsDMARDs) in axSpA to assess the impact of symptom duration on treatment response.

METHODS: RCTs in adult axSpA patients comparing b/tsDMARDs to placebo were identified through systematic literature reviews supporting the ASAS-EULAR management recommendations. Primary outcome was ASAS40 response, with secondary outcomes including disease activity, function and quality of life at each trial’s primary endpoint. Relative risks (RR) comparing two groups (shorter vs longer symptom duration) were calculated for efficacy outcomes for each arm and for several thresholds of symptom duration (1-5 years). RR ratios (RRR) were calculated as the ratio of RR of the b/tsDMARD and placebo arms. Pooled effects were obtained with random-effects meta-analysis.

RESULTS: Eleven bDMARD RCTs, comprising 3,272 axSpA patients, were included. No studies involving tsDMARDs met the eligibility criteria. At the 2-year threshold, pooled RR for ASAS40 response was 2.04 (95% CI, 1.48-2.84) in early axSpA and 2.28 (95% CI, 1.65-3.15) in established disease, yielding an RRR of 0.89 (95% CI, 0.63-1.26), with no statistical significance. There were no significant differences between efficacy in shorter and longer symptom duration for other outcomes or across other symptom duration thresholds (3-5 years).

CONCLUSIONS: Based on a meta-analysis of 11 trials, no significant differences were found in the efficacy of bDMARDs compared to placebo in patients with axSpA with shorter vs longer symptom duration, across thresholds from 2 to 5 years.

PMID:40644616 | DOI:10.1093/rheumatology/keaf382

Int J Periodontics Restorative Dent. 2025 Jul 11;0(0):1-22. doi: 10.11607/prd.7687. Online ahead of print.

ABSTRACT

Multiple adjacent gingival recessions are a challenge to the practitioner. Although the gold standard is still the bilaminar technique, where a coronally advanced flap (CAF) is associated with autogenous connective tissue graft (CTG), the morbidity of the procedure may lead clinicians to look for CTG substitutes. In this study, a prospective case series, 16 patients presenting multiple adjacent gingival recession were treated using CAF plus a volume stable collagen matrix (VXCM) soaked with a gel made of polynucleotides and hyaluronic acid (PNHA). Clinical measurements (probing depth, recession, attachment level, keratinised mucosa) were performed at baseline (T0), six months (T1) and twelve months (T2) post-operatively. Change in gingival thickness (dGT) was also measured using intraolar scans at T0 and T2, together with secondary variables, such as wound healing indices, patient-reported outcomes (pain, esthetics), and adverse events. Statistical analysis has been performed, setting significance with p<0.05. At one year evaluation, mean recession depth decreased of 2.42 ± 0.45, the percentage of root coverage was 96.02 + 0.09% (80.59% complete root coverage) , while gingival thickness dGT increased by 1.14 ± 0.34 mm, indicating that VXCM and PN-HA plus CAF are a suitable option for the treatment of multiple adjacent gingival recessions.

PMID:40644573 | DOI:10.11607/prd.7687

PLoS Negl Trop Dis. 2025 Jul 11;19(7):e0013319. doi: 10.1371/journal.pntd.0013319. Online ahead of print.

ABSTRACT

BACKGROUND: Worldwide, traditional medicine (TM) is an important and often underestimated part of health services. TM, of proven quality, safety, and efficacy, contributes to the goal of universal health coverage. However, no TM is approved worldwide for rabies treatment. Rabies is almost 100% fatal once symptomatic, leading to acute encephalitis. The challenges of rabies prevention and control in Ethiopia are multifaceted. Successful prevention and control of rabies requires the collaboration of important stakeholders with the One Health approach. But in Ethiopia, the one health model has missed a very important player in rabies control intervention, the traditional healers. This review aims to assess the proportion of individuals visiting traditional healers to provide evidence-based recommendation.

METHOD: We prepared a review protocol per Joanna Briggs Institute (JBI) manual for evidence synthesis and conducted a comprehensive search of PubMed, Cochrane, Google Scholar and African Index Medicus databases and grey literature from 17 December 2023-30 January 2024. The pooled proportion of traditional medicine use among rabies-exposed individuals was computed using R v 4.3.1 software. Subgroup analysis was done on sample size, geographical location and year of publication. Publication bias was assessed using a funnel plot.

RESULT: The pooled proportion of traditional medicine use following rabies exposure was 0.57 at 95% CI (0.45-0.69) for the random effects model with I2 = 98% and p < 0.01. To investigate the source of heterogeneity, sub-group analysis has been done on sample size, study area, and year of publication. All the above-listed variables were significant sources of statistical heterogeneity. Of which year of publication from 2019-2023 (I2 = 99%, p < 0.01), Studies from Oromia regional state (I2 = 99%, p < 0.01) and study sample size >500 (I2 = 99%, p < 0.01) were the highest source of heterogeneity.

CONCLUSION: More than half of rabies-exposed individuals visit traditional healers. This implies that significant healthcare demand related to rabies is addressed by traditional healers, even though the quality is not yet audited. The EMOH in collaboration with partners should work on the integration of traditional healers for rabies prevention and control interventions as One Health stakeholder.

PMID:40644528 | DOI:10.1371/journal.pntd.0013319

PLoS One. 2025 Jul 11;20(7):e0327395. doi: 10.1371/journal.pone.0327395. eCollection 2025.

ABSTRACT

The effectiveness of the q-rung ortho-pair fuzzy multi-attribute decision-making method is primarily influenced by the q-rung ortho-pair fuzzy number ranking method. This paper conducts an in-depth analysis of the shortcomings of eight existing q-rung ortho-pair fuzzy number ranking methods. A refined approach to ranking q-rung ortho-pair fuzzy numbers is proposed, wherein the method synthesizes the effects of the q-power transformation applied to both membership and non-membership degrees, alongside an exponential adjustment component. This formulation ensures greater discrimination power and robustness in uncertain environments. This method addresses the issues of poor robustness and the inability to achieve a complete ranking in existing approaches. Finally, the proposed ranking approach is incorporated into a q-rung orthopair fuzzy multi-attribute decision-making framework and is subsequently employed to address a practical case involving the selection of an optimal warehouse location for an e-commerce enterprise.

PMID:40644524 | DOI:10.1371/journal.pone.0327395

Rev Esc Enferm USP. 2025 Jul 11;59:e20240407. doi: 10.1590/1980-220X-REEUSP-2024-0407en. eCollection 2025.

ABSTRACT

OBJECTIVE: To analyze the attitudes of nursing professionals towards structural and process factors that may predispose to adverse events in neonatal and pediatric intensive care units.

METHOD: Cross-sectional study carried out in two public hospitals in Northeast Brazil in 2019. A sociodemographic/professional questionnaire and the Adverse Events Predisposition Scale were applied to 100 nursing professionals. The tests ANOVA, Tukey and of Student’s t were used to compare the means of the ideal and real scales, according to the sociodemographic variables, adopting p < 0.05.

RESULTS: Most professionals demonstrated low and medium perception of structure and process factors. A statistically significant association was found in the process dimension with: age group of 40-49 years, neonatal unit/hospital 2, and relation with a cooperative.

CONCLUSION: Nursing professionals in neonatal/pediatric intensive care units have low and medium perception of factors predisposing to adverse events, which deserves investment from leaders to avoid that inadequate perceptions result in harm to patients.

PMID:40644518 | DOI:10.1590/1980-220X-REEUSP-2024-0407en

PLoS Comput Biol. 2025 Jul 11;21(7):e1012882. doi: 10.1371/journal.pcbi.1012882. Online ahead of print.

ABSTRACT

Trends in infectious disease incidence provide important information about epidemic dynamics and prospects for control. Higher-frequency variation around incidence trends can shed light on the processes driving epidemics in complex populations, as transmission heterogeneity, shifting landscapes of susceptibility, and fluctuations in reporting can impact the volatility of observed case counts. However, measures of temporal volatility in incidence, and how volatility changes over time, are often overlooked in population-level analyses of incidence data, which typically focus on moving averages. Here we present a statistical framework to quantify temporal changes in incidence dispersion and to detect rapid shifts in the dispersion parameter, which may signal new epidemic phases. We apply the method to COVID-19 incidence data in 144 United States (US) counties from January 1st, 2020 to March 23rd, 2023. Theory predicts that dispersion should be inversely proportional to incidence, however our method reveals pronounced temporal trends in dispersion that are not explained by incidence alone, but which are replicated across counties. In particular, dispersion increased around the major surge in cases in 2022, and highly overdispersed patterns became more frequent later in the time series. These increases potentially indicate transmission heterogeneity, changes in the susceptibility landscape, or that there were changes in reporting. Shifts in dispersion can also indicate shifts in epidemic phase, so our method provides a way for public health officials to anticipate and manage changes in epidemic regime and the drivers of transmission.

PMID:40644513 | DOI:10.1371/journal.pcbi.1012882

PLoS One. 2025 Jul 11;20(7):e0319628. doi: 10.1371/journal.pone.0319628. eCollection 2025.

ABSTRACT

According to the National Institute for Health and Care Excellence, motor neuron disease assessment and management should be a coordinated, clinic-based, multidisciplinary team approach. However, the wellbeing, work experiences, and the alignment with national frameworks and standards of the motor neuron disease (MND) nurses and allied health professionals’ workforce are severely underreported and under-researched within the literature. Therefore, this report aimed to capture the workforce and their alignment with national frameworks and standards, and to assess their experiences working as an MND health care professional. A pragmatic research paradigm and a mixed methods approach was employed using a cross-sectional questionnaire survey to collect, compare, and interpret quantitative and qualitative data points. Data was gathered under the remit of an audit and service evaluation under NHS Lothian. Demographics data and work-related characteristics were collected. Job experience and wellbeing were collected using Likert scales and open-ended questions. The level of burnout was assessed using the validated tool, the Burnout Assessment Tool (BAT). Compliance with national frameworks were based on the NICE guidelines and the Scottish MND Advanced Clinical Nurse Specialist Pillars of Practice Competencies. 64 HCPs completed the questionnaire, with the majority of respondents from England (54.7%) and Scotland (35.9%). Education level was mainly having a Bachelors (or equivalent) degree (40%) or a Masters (or equivalent) degree (31%), with the remaining having a diploma-based qualification (29%). The analysis revealed three key themes: the importance of the multi-disciplinary team (MDT), the roles and the level of competencies, and the benefits and challenges in providing direct care. This was associated with 14% and 12% of respondents being at medium and high risk of burnout, respectively. This report highlighted the importance of a collaborative MDT to support the needs of patients, their carers/ family members and HCPs themselves. The workforce found the flexibility, autonomy, and variety within their role beneficial where almost 80% of the respondents engaged in 8 of the 15 competencies. The benefits of providing direct care were found to be associated with feeling valued by the patients, their carers/ family members, and the core and extended MDT, and feeling satisfied about their work. The perceived challenges of providing direct care involved isolation, lack of direct funding, and a high caseload with complex needs and not enough time to provide quality care. It is recommended that a national competency programme or a Masters level course in MND care should be developed to maintain the quality of care, and future research should aim to evaluate the entire workforce longitudinally, address organisational barriers, and explore burnout preventative strategies to maintain a resilient workforce.

PMID:40644503 | DOI:10.1371/journal.pone.0319628

PLoS One. 2025 Jul 11;20(7):e0327612. doi: 10.1371/journal.pone.0327612. eCollection 2025.

ABSTRACT

STUDY DESIGN: A protocol for Delphi Consensus Study.

OBJECTIVES: To identify a top ten list of priorities for future nutrition research in individuals with spinal cord injury (SCI).

SETTING: The International Spinal Cord Society (ISCoS) Nutrition Specialist Interest Group (SIG) priority setting partnership was established in 2024 to conduct this international Delphi study through online surveys and a hybrid meeting.

METHODS: The study involves THREE key stages: topic generation, priority ranking, and consensus building. In phase 1, participants will generate potential research topics via an online survey. Phase 2 involves ranking the top 10 research priorities on a 9-point Likert scale. Phase 3 consists of a consensus meeting where stakeholders will engage in discussions and vote on the final priorities using interactive tools. For Phases 1 and 2, both ISCoS Nutrition SIG members and their professional contacts will be invited to participate, ensuring a diverse pool of expertise. Phase 3 will be limited to Nutrition SIG members to facilitate focused decision-making. Data will be collected through secure Qualtrics surveys and analysed using descriptive statistics in STATA or SPSS. The study adheres to the Conducting and Reporting of DElphi Studies (CREDES) recommendations and employs rigorous data management practices compliant with City St George’s, University of London standards.

ETHICS AND DISSEMINATION: Ethics approval has been granted (ref: ETH2425-0192, Health Services Research & Management Proportionate Review Committee, City St George’s, University of London). The findings will be disseminated through ISCoS website, professional conferences and a peer-reviewed journal.

PMID:40644469 | DOI:10.1371/journal.pone.0327612

PLoS One. 2025 Jul 11;20(7):e0327355. doi: 10.1371/journal.pone.0327355. eCollection 2025.

ABSTRACT

Negative beliefs and perceptions about one’s health and work participation can act as barriers to rehabilitation and returning to work following an injury, thus increasing the risk of long-term work disability. To prevent poor work and health outcomes it is necessary to be able to effectively measure such constructs. The aim of the present study was to perform a psychometric evaluation of the PositivumTM: Beliefs and Perceptions scales used with individuals with a musculoskeletal injury or condition receiving occupational rehabilitation (OR) services through a workers’ compensation or motor vehicle accident insurance scheme. Exploratory factor analysis, item response theory-based analyses, internal consistency analyses, and confirmatory factor analysis were conducted on data collected from January 2020 to April 2024 from a sample of 3,352 musculoskeletal injured individuals receiving OR services through their compensation scheme. The results of the current study demonstrated the psychometric robustness of a revised 12 item Positivum: Beliefs and Perceptions scale (PBPS), with two clear multi-item factors: Employer Perceptions and Health-related Work Beliefs as well as two single-item measures (expectations about, and perceived enjoyment of, working). Identifying those with negative beliefs and perceptions about working following an injury and at risk of prolonged work disability is the first critical step toward preventing prolonged work disability.

PMID:40644457 | DOI:10.1371/journal.pone.0327355