Tag: pubmed

BMC Palliat Care. 2025 Mar 29;24(1):86. doi: 10.1186/s12904-025-01726-1.

ABSTRACT

BACKGROUND: Death anxiety in physicians is considered to be a possible factor affecting the quality of palliative care. As the reserve force of future medical careers, the level of death anxiety among clinical medical freshmen and its impact mechanism deserves attention. Previous studies have indicated that personality traits and self-efficacy may be factors influencing death anxiety. However, there is limited research on the current state of death anxiety among clinical medical freshmen, and the impact of health personality, death coping self-efficacy on death anxiety. The objectives of this study were to investigate the death anxiety levels of clinical medical freshmen, explore whether death anxiety is affected by health personality and death coping self-efficacy, and examine whether death coping self-efficacy mediates the association between health personality and death anxiety among clinical freshmen.

METHODS: A cross-sectional survey among 378 clinical medical freshmen was conducted at a university in Wuhan, Hubei Province, China between June and July 2023. Demographic questionnaire, the Chinese versions of the Health Personality Assessment (HPA), Death Coping Self-efficacy Scale (DCSS) and Death Anxiety Scale (DCS) were used. SPSS 25.0 statistical software was used for descriptive analysis, independent sample t-tests, one-way ANOVA, and Pearson correlation analysis. The mediating effect analysis was performed with PROCESS version 4.1 Model.

RESULTS: A total of 360 valid questionnaires were collected. Clinical medical freshmen exhibited high levels of death anxiety was (45.55 ± 7.57). Health neuroticism has a significant positive impact on death anxiety (β = 0.407, t = 2.323, P < 0.05). In contrast, death anxiety was significantly impacted negatively by death coping self-efficacy (β=-0.105, t=-3.441, P < 0.05). The association between health neuroticism and death anxiety was partially mediated by death coping self-efficacy; the mediating impact accounted for 18.44% of the total effect, with a 0.092 coefficient.

CONCLUSIONS: This study revealed that clinical medical freshmen had high levels of death anxiety. Health neuroticism and death coping self-efficacy directly affected clinical medical freshmen’ death anxiety. Death coping self-efficacy mediated the relationship between health neuroticism and death anxiety among clinical medical freshmen. Interventions by medical educators that focus on both individuals’ health personality and death coping self-efficacy may be most effective in reducing death anxiety among clinical medical freshmen.

PMID:40158159 | DOI:10.1186/s12904-025-01726-1

BMC Psychiatry. 2025 Mar 29;25(1):301. doi: 10.1186/s12888-025-06754-y.

ABSTRACT

BACKGROUND: The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) are widely used symptom-based instruments for screening depression and anxiety. However, their validation in Chinese children and adolescents remains insufficient. We aim to investigate the performance and optimal cut-offs of PHQ-9 and GAD-7 in Chinese children and adolescents in screening clinical depression and anxiety, and to discuss the influencing factors of the cut-offs.

METHODS: The study subjects were chosen from 3 sites of the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a total of 2,237 participants who had been screened positive by self-administered questionnaire and further diagnosed by using the gold standard were included in the final analysis. The Receiver Operating Characteristic (ROC) curves were used to determine the discriminative ability of the two instruments, measured by using the area under curve (AUC). The optimal cut-offs of the two instruments were determined by the maximum Youden’s index. A series of stratified analyses were performed to discover the best cut-offs for children and adolescents of different characteristics. Logistic regression models were adopted to evaluate the influence of self-harm (SH) on identified optimal cut-offs.

RESULTS: We found the performance was generally poor for both the PHQ-9 and GAD-7 in screening clinical depression and anxiety in our study sample, with the AUCs ranged only between 0.622-0.712. When using the two instruments for diagnosis purpose, 11 was the optimal cut-off for both clinical depression and anxiety (AUC for PHQ-9: 0.664, AUC for GAD-7: 0.669). For study subjects of different age, gender, race, and left-behind status, discordant cut-offs were identified. SH also showed conspicuous influence on the optimal cut-offs of PHQ-9 and GAD-7, and the combination of SH information can increase screening accuracy of PHQ-9 in some subgroups.

CONCLUSIONS: Both the PHQ-9 and GAD-7 showed poor performance in screening clinical depression and anxiety in our study sample. This crucial finding suggests that, despite the wide use of the two scales, they might be fundamentally inadequate for depression and anxiety screening in Chinese children and adolescents. Other screening tools of higher accuracy should be developed and used in this age group.

PMID:40158158 | DOI:10.1186/s12888-025-06754-y

BMC Public Health. 2025 Mar 29;25(1):1195. doi: 10.1186/s12889-025-22335-w.

ABSTRACT

BACKGROUND: The under-five child stunting has remained a public health problem in the world. In Rwanda, child stunting rates have fluctuated significantly and remained higher than the targets despite a continuing decline of the national average rate. The key drivers of the persistently high child stunting rates and their geographical variation in Rwanda are currently not well known. This study examined the spatial and temporal variation of the under-five child stunting rates and associated factors in Rwanda between 2010 and 2020.

METHODS: This study analysed data from the 2010 Rwanda Demographic and Health Survey (RDHS) (n = 4075), the 2014/15 RDHS (n = 3538), and the 2019/20 RDHS (n = 3809). A series of geo-additive binary logistic regression analyses were used to identify the key risk factors for child stunting and their variation in Rwanda between 2010 and 2020.

RESULTS: The results show significant variation in the key risk factors over the studied period. The child’s gender, birth order, age, and birth weight, mother’s height and marital status, number of antenatal care visits, household economic status, and altitude were consistently significant factors of child stunting in Rwanda. The influence of place of residence, mother’s education, water source, and type of toilet facility varied. The district-level spatial effects significantly attenuated in the Eastern province while they intensified in the Western and Northern provinces.

CONCLUSIONS: The key risk factors for the under-five child stunting and their importance varied considerably over time in Rwanda. The findings suggest the need to improve the household-level welfare by strengthening targeted and district-tailored intervention programs from a multi-sectorial perspective, and sustain the programs outcomes beyond the intervention period.

PMID:40158157 | DOI:10.1186/s12889-025-22335-w

BMC Oral Health. 2025 Mar 29;25(1):459. doi: 10.1186/s12903-025-05807-8.

ABSTRACT

BACKGROUND: The aim of this study is to evaluate the effect of different surface treatments and adhesives on shear bond strength (SBS) in the repair of composite resin restorations.

METHODS: In this study, 60 discs (2 mm x 10 mm) were prepared using a universal nanohybrid composite resin (GrandioSo, Voco, Germany). The discs were aged by exposure to 5000 thermal cycles between 5 and 55 °C for 30 s with an immersion procedure. Then samples were divided into 3 groups (n:20) according to the surface treatments (Group 1: no surface treatment, Group 2: roughening by bur, Group 3: roughening by Er, Cr: YSGG laser). Subsequently, the specimens were classified into two groups (n:10) according to the adhesive systems; a two-step self-etch adhesive (Clearfil SE bond (SE)), or a universal adhesive (Scotchbond Universal Plus (SB)). After surface treatments and adhesive applications, the same universal nanohybrid composite resin with a height of 2 mm and a diameter of 3 mm was placed in the center of the samples. The samples were then submitted to the SBS test using universal testing equipment (Autograph AGS-X; Shimadzu, Kyoto, Japan) with a crosshead speed of 1 mm/min. The failure modes were examined using a stereomicroscope. The surface topography of the roughened and fractured surfaces resin composite (n = 1) was assessed using scanning electron microscopy (SEM). Analyses were performed using IBM SPSS 25 programme (p < 0.05).

RESULTS: The highest bond strength was observed in the laser + SE group (22.69 ± 4.49), while the lowest was recorded in the control + SE group (14.12 ± 3.00). In the SE adhesive group, no significant difference was found between the laser + SE and bur + SE groups (p > 0.05). Similarly, in the SB adhesive group, there were no significant differences among the surface roughening procedures (p = 0.078). Additionally, no significant differences were observed between the adhesives according to various surface roughening procedures. The failure mode was predominantly cohesive in old composites.

CONCLUSION: The bond strength can be improved by surface treatments such as diamond burs, Er, Cr: YSGG laser application for better bonding strategies in the repair of nanohybrid resin composite restorations. There was no statistically significant difference in bond strength between the adhesives tested in this study.

PMID:40158155 | DOI:10.1186/s12903-025-05807-8

BMC Public Health. 2025 Mar 29;25(1):1196. doi: 10.1186/s12889-025-22371-6.

ABSTRACT

OBJECTIVES: To identify key demographic, socio-economic, and cultural determinants influencing the continuation of FGM/C and to evaluate its prevalence and associated factors utilizing the 2020 Somali Demographic and Health Survey (SDHS).

METHODOLOGY: A secondary analysis of the Somali Demographic Health Survey (SDHS) in 2020 was conducted, utilizing responses from 6,580 mothers of female children aged 0-14 years. Descriptive statistics, chi-square tests, and multi-nominal logistic regression were employed to analyze the prevalence and associated factors of FGM/C. The analysis incorporated sampling weights to ensure accurate population representation.

RESULTS: The prevalence of FGM/C among respondents was 99.6% (n = 6,553), with Pharaonic circumcision being the most prevalent type (76.7%), followed by Sunni (14.1%) and intermediate forms (8.8%). Demographically, 83.9% of respondents had no formal education, while only 0.99% attained higher education, and the majority resided in nomadic (37.7%) and rural (33.6%) areas. Regional variations were observed, with the highest support for FGM/C continuation in Sanaag (77.2%) and the lowest in Maroodi-jeeh (42.2%). Chi-square analysis revealed significant associations between attitudes toward FGM/C and age (X² = 57.12, p < 0.001), place of residence (X² = 299.45, p < 0.001), education (X² = 140.09, p < 0.001), and wealth (X² = 67.48, p < 0.001). Women in nomadic areas (76.1%) and those with no education (67.6%) were more likely to support continuation, compared to urban residents (53.5%) and those with higher education (24.6%). Multinomial logistic regression indicated that urban residents were 44.7% less likely to support continuation than nomadic residents (Exp(B) = 0.553, p < 0.001), and women with no formal education were 2.3 times more likely to support continuation than those with higher education (Exp(B) = 2.307, p = 0.025). Religious beliefs strongly influenced attitudes, with those considering FGM/C a religious requirement overwhelmingly supporting its continuation (Exp(B) ≈ 0, p < 0.001).

CONCLUSION: Notwithstanding the near-universal prevalence of FGM/C in Somaliland, attitudes toward its perpetuation are influenced by educational attainment, socioeconomic status, geographical location, and religious convictions. Targeted educational initiatives and culturally appropriate interventions are imperative for altering perceptions and mitigating the practice.

PMID:40158153 | DOI:10.1186/s12889-025-22371-6

World J Surg Oncol. 2025 Mar 29;23(1):111. doi: 10.1186/s12957-025-03762-w.

ABSTRACT

BACKGROUND: In primary cutaneous melanoma (CM) with metastatic sentinel lymph node(s) (SLNB), treatment strategies may include completing a regional lymph node dissection (CLND). The prognostic benefit of this therapeutic approach remains a topic of debate. This retrospective, population-based cohort study explores the prognostic impact of CLND in a real-world clinical setting.

METHODS: This study analysed 280 incident cases of AJCC stage III CM with metastatic SLNB, as recorded by the Veneto population-based Regional Cancer Registry in 2015, 2017, and 2019. The overall survival and CM-specific survival rates were compared between patients who underwent CLND and those who did not. Kaplan-Meier analysis, Cox regression, and Fine-Gray models for competing risks tested the relationship between lymphadenectomy and overall and CM-specific survival.

RESULTS: Among CM patients with metastatic SLNB, 199/280 (71.1%) proceeded with CLND. When compared to those who did not receive treatment, CLND did not demonstrate significant advantages in terms of overall survival and CM-specific survival rates. The cost analysis found no significant differences in treatment choice (estimated costs: €23,695.71 for the treated group and €25,003.55 for the untreated group [p = 0.69]).

CONCLUSIONS: The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.

PMID:40158137 | DOI:10.1186/s12957-025-03762-w

BMC Public Health. 2025 Mar 29;25(1):1201. doi: 10.1186/s12889-025-22317-y.

ABSTRACT

BACKGROUND: Although household disinfectant cleaners are used at home frequently, less research has focused on standardized assessment tools to measure public awareness and precautions in practice, especially during health crises. The COVID-19 pandemic highlighted the important role of household disinfectants-cleaners in preventing infections. However, poor public awareness and unsafe practices can undermine their effectiveness. This study indirectly addresses this lack by developing and validating the Household Disinfectants-Cleaners Questionnaire (HDCQ), to make available an evidence-based comprehensive tool to support future assessments, public health research, and policy development.

OBJECTIVE: To assess the validity and reliability of a questionnaire designed to measure public awareness and performance regarding the safe use of household disinfectants-cleaners in Abu Dhabi.

METHODS: A cross-sectional Google survey, involving a sample of 750 Abu Dhabi residents, was analyzed using IBM-SPSS (Version 27.0) and RStudio (Version 1.1.456, Inc., 2009-2018). Validity tests included face, content, and construct evaluations by nine academic experts based on seven parameters. Reliability was assessed through Cronbach’s alpha and inter-item correlation. Principal Factor Analysis (PFA), including the Kaiser-Meyer-Olkin (KMO) measure and Bartlett’s test, was conducted for each section in SPSS. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) in RStudio identified the underlying factors explaining item covariation.

RESULTS: Cronbach’s alpha values for the awareness and performance domains were 0.854 and 0.883, indicating high internal consistency. Expert ratings indicated high face validity, with importance levels ranging from 0.89 to 1.00. The average Content Validity Ratio (CVR) for the questionnaire was 0.95, indicating strong content relevance. The PFA results demonstrated adequate sampling adequacy, with a KMO measure values of 0.879 and 0.891 and Bartlett’s test was statistically significant (χ2 = 2,368, P < 0.001) and (χ2 = 3,274, P < 0.001) for each section respectively, confirming factorability and suitability for factor analysis. Both EFA and CFA indicated a good model fit with RMSEA of 0.077 for Sect. 1 and 0.090 for Sect. 2, CFI of 0.990 for Sect. 1 and 0.975 for Sect. 2, and TLI of 0.986 for Sect. 1 and 0.967 for Sect. 2, confirming the robustness of the factor structure and the questionnaire’s validity.

CONCLUSIONS: The findings demonstrate that this questionnaire is a valid and reliable tool for assessing public awareness and performance regarding the safe use of household disinfectants-cleaners for future pandemics. Recognizing inherent limitations, detailed in the conclusion section, is essential for effective application in public health contexts.

PMID:40158130 | DOI:10.1186/s12889-025-22317-y

BMC Public Health. 2025 Mar 29;25(1):1193. doi: 10.1186/s12889-025-22469-x.

ABSTRACT

BACKGROUND: Although experiences of violence are detrimental and may occur throughout the lifespan, few studies have examined the long-term health correlates of violence in both childhood and adulthood.

OBJECTIVE: To examine the association of exposure to child maltreatment (CM) as well as severe violence in adulthood with mental and physical health problems and health-related risk behaviors in adulthood.

METHODS: The study was cross-sectional and applied a novel survey instrument among a random sample of 10 337 Swedish women and men aged 18-74. Logistic regression was applied to calculate odds ratios.

RESULTS: Exposure to 0, 1, 2 or 3 or more types of CM showed graded associations for depression, anxiety, self-harm and PTSD in adulthood. Irritable bowel syndrome, fibromyalgia and obesity showed modest correlations. No significant associations were found between CM and ischemic heart disease (IHD), type 2 diabetes or cancer, although the ORs were in line with several previous ACE studies. When exposure to severe violence in adulthood was added to CM, odds ratios increased dramatically for mental health problems and health-related risk behaviors, suggesting that revictimization may moderate or mediate this relationship.

CONCLUSIONS: The results underscore the importance of studying violence exposure in a life-course perspective and suggest that the relationship between childhood adversities and long-term physical health problems in adulthood may be affected by the traumatic effects of revictimization in adult life. This points to the importance of early identification of child maltreatment and provision of robust services to protect children, treat symtoms of trauma, and enhance resilience to decrease the risk of poor health outcomes.

PMID:40158129 | DOI:10.1186/s12889-025-22469-x

Reprod Biol Endocrinol. 2025 Mar 29;23(1):50. doi: 10.1186/s12958-025-01384-1.

ABSTRACT

BACKGROUNDS: The study was designed to analyze early pregnancy loss rates in first-time fresh embryo transfer cycles in low prognosis patients according to the POSEIDON criteria.

METHODS: This was a retrospective cohort study, including patients with positive human chorionic gonadotropin after first fresh cycles in the Reproductive Center of Henan Province People’s Hospital from June 2018 to February 2023. A total of 2392 cycles were included in this study, which were divided into 4 groups according to the POSEIDON criteria. The general condition, laboratory indexes, and early pregnancy loss rates of patients were compared in each group and the prediction model was constructed in POSEIDON group 4.

RESULTS: The early pregnancy loss rate ranked from high to low in order of Group D (32.82%), Group B (23.31%), Group C (15.34%), and Group A (13.68%). After adjusting confounding factors, multivariate logistic regression analysis revealed that the early pregnancy loss rate was significantly higher in groups B and D than in groups A and C (all P < 0.05). The comparison between Group A and Group C, as well as between Group B and Group D, showed no statistical differences (both P > 0.05). Group D was randomly divided into training and validation cohorts according to 7:3. The prediction model was constructed based on risk factors. The AUC of the training cohort was 0.761(95% CI: 0.680-0.841), and the AUC of the validation cohort was 0.604(95% CI: 0.440-0.767).

CONCLUSIONS: Patients in POSEIDON group 4 have the highest early pregnancy loss rate, followed by group 2, while patients in groups 3 and 1 have the lowest rate in first-time fresh cycles. The prediction model was successfully established which can predict the occurrence of early pregnancy loss in first-time fresh cycles in POSEIDON group 4.

PMID:40158126 | DOI:10.1186/s12958-025-01384-1

Dementia (London). 2025 Mar 29:14713012251330689. doi: 10.1177/14713012251330689. Online ahead of print.

ABSTRACT

Dementia is a progressive and neurodegenerative condition that leads to a gradual deterioration of the individual’s functional capacity and social relations. Engaging in meaningful activities is considered an effective approach to maintaining and increasing the well-being of people living with dementia. Digital media has the potential to improve the quality of life for people living with dementia, allowing them to engage in activities that are personally meaningful. This study sought to understand the needs and preferences people with early-stage dementia living in Portugal have for receiving information on meaningful activities. It also explored their relationship with technologies and digital media. Focus groups and interviews were carried out with people living with dementia (n = 21), informal carers (n = 9) and healthcare professionals (n = 8). Descriptive statistics were used for sample characterization and the verbatim transcriptions of interviews and focus groups were subjected to inductive thematic analysis. We developed three main themes: (i) engagement of people living with dementia in meaningful activities; (ii) experiences of people living with dementia with technology and digital resources; and (iii) the importance of a support network. This last theme is associated with the first two. The study identified several meaningful activities, such as household chores and intellectual hobbies, some of which were mediated by technology. People living with dementia reported to primarily use digital media, particularly computers and smartphones, for socialization and entertainment. The barriers identified for technology use and engagement in meaningful activities were both related to mobility problems and cognitive complaints. The support network emerged as essential for the use of digital technologies and engagement in meaningful activities. This study highlights a need to further research and design digital media that offer the opportunity for people living with dementia to be informed and engaged in meaningful activities.

PMID:40156603 | DOI:10.1177/14713012251330689