Tag: pubmed

J Aging Soc Policy. 2026 May 24:1-25. doi: 10.1080/08959420.2026.2673813. Online ahead of print.

ABSTRACT

Caregiver-employees provide unpaid adult care while simultaneously managing employment. The negative health and employment impacts incurred by caregiver-employees have drawn attention to caregiver-friendly workplace policies internationally, which is the focus of this research. Aging populations and changing workforce demographics present challenges for work-life balance. Using PRISMAs methodological guidelines, a comprehensive search strategy to explore the availability of carer-friendly workplace policies was implemented using 17 databases, as developed in consultation with a health science (SS) and a commerce (IP) librarian. Articles included in the review were published between May 1, 2019, and May 31, 2023, written or translated to English, and specifically discussed the provision of unpaid adult care. A total of 45 articles were included in the review, with 53 unique workplaces identified. Using descriptive statistics and content analysis, this study specifically names organizations, their location, and the carer-inclusive policies currently being offered. Workplaces in the finance, technology and healthcare industry/sectors offered the most caregiver-friendly accommodations. Web/App based supports are emerging rapidly among workplaces. Organizational culture change was found to be the most prominent transformative support. The results of this study can inform international policy in response to adapting labor markets to increasing demands of unpaid care.

PMID:42177768 | DOI:10.1080/08959420.2026.2673813

J Biopharm Stat. 2026 May 24:1-17. doi: 10.1080/10543406.2026.2676019. Online ahead of print.

ABSTRACT

In clinical studies involving paired organs (e.g. eyes or ears), correlated binary outcomes necessitate specialized statistical methods to account for intra-subject dependencies. This paper proposes a saddlepoint approximation (SA) method for constructing confidence intervals (CI) for risk differences in paired binary data under Donner’s correlation model. Compared to conventional approaches – Wald, likelihood ratio, score, and MOVER methods – the SA method explicitly incorporates higher-order moment information, offering improved accuracy in small-sample or rare-event settings. Simulation studies evaluate empirical coverage probability (ECP) and mean interval width (MIW) across varying correlation levels. Results demonstrate that SA consistently maintains ECPs near the nominal 95% level while achieving narrower intervals than competing methods, particularly under high correlation. In contrast, likelihood and score tests exhibit undercoverage, and Wald/MOVER intervals are overly conservative. An application to otitis media trial data further validates SA’s utility, yielding interpretable inferences for correlated bilateral outcomes. The proposed method bridges a critical gap in small-sample inference for risk differences, ensuring robustness without reliance on large-sample approximations.

PMID:42177767 | DOI:10.1080/10543406.2026.2676019

Aust Dent J. 2026 May 24. doi: 10.1111/adj.70054. Online ahead of print.

ABSTRACT

BACKGROUND: While limited research has explored the experiences of this workforce, oral health practitioners in rural areas face distinct cultural and personal challenges that influence workforce sustainability and delivery of care. This study aims to understand the cultural and personal experiences of oral health practitioners working in rural New South Wales and identify factors influencing their cultural capabilities, personal wellbeing and workforce sustainability.

METHODS: A cross-sectional survey was conducted among oral health practitioners across three rural Local Health Districts in New South Wales. The survey included items on sociodemographic characteristics, cultural capabilities and awareness, and personal experiences. Data was analysed using descriptive statistics and subgroup comparisons made based on profession (dentists vs. other oral health practitioners) and years of experience (less or more than 10 years).

RESULTS: Nineteen participants completed the survey, primarily dentists and oral health therapists, with few dental therapists. Most reported initial cultural awareness training; however, less than half reported ongoing training. Most participants reported personal growth associated with their role. Dentists reported greater access to support systems and training opportunities than other oral health practitioners.

CONCLUSION: There is need for continuous cultural capability training and equitable support systems to strengthen rural oral health workforce sustainability. Despite small participant numbers, this study provides valuable insight into practitioner experiences and identifies opportunities for a culturally safe and wellbeing-focused workforce in rural NSW.

PMID:42177765 | DOI:10.1111/adj.70054

Orv Hetil. 2026 May 24;167(21):811-823. doi: 10.1556/650.2026.33545. Print 2026 May 24.

ABSTRACT

INTRODUCTION: Falls and subsequent long lies lead to significant declines in quality of life and increased mortality among older adults. Physiotherapists play a key role in prevention; however, no validated tool has been available to assess their specific knowledge, attitudes, and practices in this field.

OBJECTIVE: This study aimed to develop and validate a questionnaire based on the Knowledge-Attitude-Practice (KAP) model regarding fall prevention.

METHODS: During questionnaire, items were generated through literature review and an expert panel, followed by the assessment of psychometric properties. To evaluate construct validity, a two-parameter logistic item response theory model was applied to the Knowledge domain, while exploratory factor analysis was conducted for the Attitude and Practice domains. Internal consistency was assessed using the Kuder-Richardson-20 (KR-20) coefficient for the Knowledge domain and Cronbach’s alpha for the Attitude and Practice domains. To assess reproducibility, 55 physiotherapists completed the questionnaire twice within a ten-day interval; kappa coefficients were calculated for the Knowledge domain, while intraclass correlation coefficients (ICC) were used for the Attitude and Practice domains, followed by Bland-Altman analysis.

RESULTS: The psychometric properties of the final questionnaire were evaluated based on 209 responses. Adequate internal consistency was demonstrated for the Knowledge domain (KR-20 = 0.702), and Attitude and Practice domains (Cronbach’s alpha = 0.778 and 0.864, respectively). The Attitude and Practice domains demonstrated a three-factor structure each, explaining 47.2% and 61.32% of the total variance, respectively. Test-retest reliability was excellent (ICC: 0.869-1.00), and Bland-Altman analysis showed minimal mean differences between test and retest scores.

DISCUSSION: The developed and validated instrument demonstrates sound psychometric properties; thus, it is suitable for assessing the knowledge, attitudes, and daily practices of physiotherapists and other geriatric care specialist regarding fall prevention.

CONCLUSION: This questionnaire may contribute to identifying potential areas for improvement in fall prevention, thereby facilitating the more effective clinical implementation of evidence-based fall prevention strategies. Orv Hetil. 2026; 167(21): 811-823.

PMID:42177757 | DOI:10.1556/650.2026.33545

West Afr J Med. 2026 Apr 30;43(1):14-21.

ABSTRACT

BACKGROUND: Self-medication with antibiotics is a threat to global health and is becoming increasingly observed in both developed and developing countries with prevalence of 32.5 – 81.5% worldwide. This study assessed the socio-demographic, economic factors and use of antibiotic self-medication among dwellers in River State, South-south, Nigeria.

METHOD: This was a cross-sectional study among 250 patients who attended the Family Medicine Clinic at the Rivers State University Teaching Hospital, Port Harcourt. Interviewer-administered questionnaires were used for data collection. The data was analyzed using SPSS version 23. Chi-Square test was used to assess the association between socio-demographic and economic characteristics with antibiotic self-medication. A p-value of <0.05 was considered statistically significant.

RESULTS: Majority of the respondents were females (65.2%), were within the age group of 20-39 years (59.2%) and had tertiary level of education (64.0%), while about 2.8% had no formal education. The overall prevalence of antibiotic self-medication was 75.2%, males (81.6%) self-medicated more than the females (71.8%) and all the respondents with no formal education (100%) practiced self-medication. The association between self-medication and educational status was statistically significant with a p-value of 0.004. The antibiotic most frequently used for self-medication in this study was Ampiclox (Ampicillin plus Cloxacillin) -an antibiotic class of the Penicillin.

CONCLUSION: Self-medication with antibiotics is still prevalent and was associated with a person’s educational level. There is need for tailored educational programs to advocate for appropriate antibiotic utilization to mitigate this prevalent misuse.

PMID:42177752

Clin Pharmacol Ther. 2026 May 24. doi: 10.1002/cpt.70326. Online ahead of print.

ABSTRACT

BRAF inhibitors and MEK inhibitors (MEKi) have reshaped the treatment of BRAF^V600-mutant malignancies; however, cutaneous adverse drug reactions (ADRs) remain a frequent and clinically impactful toxicity. Although clinical trials provide insight into their safety profiles, real-world data on dermatologic ADRs are limited. We conducted a retrospective pharmacovigilance analysis of the WHO VigiAccess database, examining individual case safety reports (ICSRs) for seven BRAF and MEKi up to May 2025. Disproportionality analyses (reporting odds ratio (ROR), proportional reporting ratio (PRR), with 95% confidence intervals (CIs)) were performed for high-frequency dermatologic ADRs. Shannon entropy was used to assess the diversity of toxicity profiles across agents. Among 72,720 ICSRs, skin-related ADRs accounted for 39.78% of reports with vemurafenib, 16.49% with dabrafenib, and 14.62% with encorafenib. Among MEKi, the proportion of skin-related ADRs was highest for selumetinib (40.03%) and cobimetinib (34.31%). Rash was the predominant ADR across agents, but selumetinib demonstrated a significant disproportionality for dermatitis acneiform (ROR = 6.46, 95% CI [5.10, 8.18]). Photosensitivity reactions were most frequently reported with vemurafenib (11.31%) and cobimetinib (12.02%). Shannon entropy analysis identified two groups with differing ADR profile diversity: a higher-diversity group (cobimetinib, H = 3.66; dabrafenib, H = 3.60) and a lower-diversity group (trametinib, H = 3.51; binimetinib, H = 3.47); all cross-group comparisons were statistically significant after Holm-Bonferroni correction (p < 0.05). Chi-squared tests confirmed significant differences in skin ADR frequencies among agents (BRAF inhibitors: χ²(2) = 1393.21, p < 0.001, Cramér’s V = 0.255; MEKi: χ²(3) = 1129.77, p < 0.001, Cramér’s V = 0.175), with effect sizes indicating clinical relevance. Cutaneous ADRs are a defining toxicity of MAPK pathway inhibitors, with substantial interagent variability in frequency and phenotype. Real-world pharmacovigilance data underscore the necessity for agent-specific dermatologic monitoring strategies. Clinical pharmacists play a pivotal role in early ADR detection and management, enhancing adherence and optimizing therapeutic outcomes.

PMID:42177750 | DOI:10.1002/cpt.70326

Pharmacoecon Open. 2026 May 24. doi: 10.1007/s41669-026-00661-y. Online ahead of print.

ABSTRACT

BACKGROUND: Economic models support healthcare decision makers to efficiently assess value and allocate resources; formal validation is critical to ensure confidence in model outputs. The Obesity Lifecycle Model is a patient-level simulation model capturing natural history, clinical complications, quality-of-life and economic outcomes associated with obesity; however, it has yet to undergo formal external and cross-validation.

OBJECTIVE: The aim of this study was to validate the Obesity Lifecyle Model as per best practice guidelines from the Professional Society for Health Economics and Outcomes Research (ISPOR) and the Society for Medical Decision Making (SMDM) Task Force.

METHODS: Relevant data sources and outcomes were identified for all validations. Selected validation studies informed the model to simulate study outcomes. The model was populated with study characteristics to reproduce studies used in model development (dependent validation), studies not used in model development (independent validation), or other published models (cross-validation). Accuracy between predicted and observed outcomes was assessed using standard statistical methods and mean error calculations.

RESULTS: The model demonstrated overall concordance with observed outcomes, supported by coefficient of determination (R²) and ordinary least squares linear regression line (OLS LRL) estimates generally close to 1.0. Independent validation showed an underprediction for cardiovascular disease (CVD) and mortality with an OLS LRL of 0.9309 and an R² of 0.8984 across all populations (normoglycaemic/prediabetic populations: OLS LRL = 0.9485, R² = 0.8854; T2DM populations: OLS LRL = 0.9208, R² = 0.9068).

CONCLUSIONS: The Obesity Lifecycle Model demonstrates favourable concordance with observed clinical and quality-of-life outcomes, supporting its use for evaluating obesity-related complications and informing healthcare decision making.

PMID:42177716 | DOI:10.1007/s41669-026-00661-y

Metabolomics. 2026 May 24;22(3):78. doi: 10.1007/s11306-026-02435-3.

ABSTRACT

INTRODUCTION: Reflux esophagitis (RE) is a common upper gastrointestinal disorder, and its diagnosis currently relies primarily on invasive endoscopic examination. The lack of reliable non-invasive biomarkers substantially limits early detection and large-scale screening. Saliva represents a promising biofluid for metabolomics research, as it can reflect metabolic alterations associated with upper gastrointestinal pathology.

OBJECTIVES: This study aimed to identify potential salivary lipid biomarkers associated with RE, and to develop a non-invasive diagnostic model using metabolomics and lipidomics.

METHODS: Saliva samples from patients clinically diagnosed with RE and healthy controls were analyzed. The analysis included a discovery cohort (n = 144) and an independent validation cohort (n = 146). Differential metabolites were screened using the untargeted metabolomics approach of ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS), and then quantitative verification was conducted using targeted lipidomics. Multivariate statistical analysis, random forest algorithms, and receiver operating characteristic (ROC) analysis were applied.

RESULTS: Untargeted metabolomics revealed significant metabolic differences between RE patients and healthy controls, with marked enrichment of sphingolipid and glycerophospholipid metabolism. Targeted lipidomics identified six consistently dysregulated salivary lipids: DAG (18:1_18:2), S-1-P, PE (P-16:0_18:1), DAG (16:0_18:2), DAG (18:1_18:1), and DAG (16:0_18:1). A multimetabolite model based on these lipids effectively distinguished RE patients from healthy controls, achieving an AUC of 99.45% in the discovery cohort and 97.17% in the validation cohort.

CONCLUSION: This study identified a salivary lipid signature associated with RE and supports the potential of this lipidomic approach as a non-invasive method to distinguish RE from healthy controls.

PMID:42177704 | DOI:10.1007/s11306-026-02435-3

Environ Monit Assess. 2026 May 24;198(6):646. doi: 10.1007/s10661-026-15489-6.

ABSTRACT

This study examines the air quality trends associated with COVID-19 lockdowns and the subsequent recovery on air quality in Tehran, employing an established XGBoost framework for de-weathering with daily data from 22 monitoring stations from 2019 to 2025. A comprehensive analysis was conducted on six principal pollutants (PM₂.₅, PM₁₀, NO₂, O₃, SO₂, and CO) across four distinct temporal phases: Pre-pandemic, Pandemic, Post-COVID, and After Termination. While the model effectively reduced meteorological bias, exhibiting strong efficacy for particulate matter (R = 0.78-0.88; IOA = 0.68-0.88; FAC2 > 0.95), we explicitly acknowledge less consistent outcomes for reactive gases such as O₃ (R < 0.75; NMGE > 0.30). The imposition of lockdown measures coincided with significant reductions in pollutants associated with vehicular traffic: NO₂ exhibited a decline of – 30 to – 36%, PM₂.₅ decreased by – 18 to – 22%, and CO diminished by – 20%. In contrast, O₃ experienced an increase of + 20-30%, indicative of diminished NO titration. Principal Component Analysis (PCA) corroborated these trends, with PC1 (NO₂, PM₂.₅, CO) accounting for approximately 60% of the variance throughout the pandemic. In subsequent phases, partial recoveries were noted: PM₂.₅ escalated by + 15-20%, NO₂ stabilized at around -10%, SO₂ consistently decreased (-30% by 2025), whereas O₃ surged by + 20% by 2025, clustering with PM₁₀ in PC2, thereby highlighting the impacts of dust and secondary formation processes. Lockdowns yielded transient enhancements in air quality, with restricted long-term advantages. Sustainable progress necessitates the adoption of comprehensive policies targeting traffic, industrial emissions, VOCs, and dust management.

PMID:42177702 | DOI:10.1007/s10661-026-15489-6

Metabolomics. 2026 May 24;22(3):81. doi: 10.1007/s11306-026-02466-w.

ABSTRACT

INTRODUCTION: TMEM18 has been indicated by genome-wide association studies as a key gene linked to obesity, yet its exact function and connections with major metabolic networks are unknown.

OBJECTIVES: The current study is aimed to determine whether the TMEM18 rs7561317 polymorphism linked with anthropometric indicators of obesity is accompanied with alterations in serum metabolites.

METHODS: This was a case-control study in which a total of 542 participants (Pakistani nationals) were involved including overweight or obese cases and those having normal body mass index (BMI). All participants provided blood samples which were utilized to extract serum and genomic DNA. The genomic DNA of all participants was genotyped for the TMEM18 rs7561317 variant while their serum samples were subjected to untargeted gas chromatography-mass spectrometry based metabolomics.

RESULTS: A total of 42 putatively annotated metabolites were selected for further statistical analyses. Analyses revealed that the TMEM18 gene variant (rs7561317) exhibited statistically significant association with five metabolites namely urea, eicosane, geraniol, pentadecanoic acid and porphine as well as with BMI, percent body fat, waist circumference and weight. The G allele of this variant appears to increase the risk of developing overweight or obesity and may be associated with metabolite alterations.

CONCLUSION: The findings highlight the role of metabolite alterations in the manifestation of obese phenotype among individuals carrying the GG genotype of the TMEM18 rs7561317 variant.

PMID:42177698 | DOI:10.1007/s11306-026-02466-w