Tag: pubmed

BMC Health Serv Res. 2026 Feb 20. doi: 10.1186/s12913-026-14203-z. Online ahead of print.

ABSTRACT

BACKGROUND: Patient safety culture and climate are essential for improving healthcare quality and reducing harm. An organization’s culture reflects its long-term values and norms, and climate captures employees’ current perceptions and experiences. In Estonia, these aspects have not yet been comprehensively studied. This study aims to assess patient safety culture and climate in Estonian hospitals from the perspective of employees and to examine the relationship with employee background characteristics.

METHODS: A cross-sectional study was conducted in three Estonian hospitals during 2022. Data were collected using the Estonian and Russian language versions of HSOPSC 2.0 and SAQ. Descriptive statistics, chi-square tests, and regression analyses were performed.

RESULTS: A total of 594 (31%) hospital employees responded, with 51% completing the survey in Estonian and 49% in Russian. The highest ratings for patient safety culture and climate were observed in the subscales ‘Job satisfaction’ (85%) and ‘Teamwork climate’ (79%), lowest ratings were reported for ‘Staffing and work pace’ (55%) and ‘Response to error’ (55%). Perceptions of safety culture and climate were significantly associated with language group, membership in a leadership position, department work experience, and whether the employee was a healthcare professional, emerging as the most influential factors.

CONCLUSIONS: Differences across language groups, leadership position, department work experience, and healthcare professional positions should be considered when developing strategies to strengthen patient safety culture and climate. Using HSOPSC 2.0 and SAQ together may offer complementary perspectives on the dimensions of patient safety culture and climate in Estonia.

PMID:41721383 | DOI:10.1186/s12913-026-14203-z

Eur J Med Res. 2026 Feb 20. doi: 10.1186/s40001-026-03999-5. Online ahead of print.

ABSTRACT

BACKGROUND: Biodegradable polymer (BP) and polymer-free (PF) drug eluting stents were designed to reduce late adverse events linked to durable-polymer coatings. However, concerns remain regarding the efficacy of PF-DES particularly due to variations in drug-release mechanisms.

METHODS: RCTs comparing PF-DES and BP-DES in patients undergoing percutaneous coronary interventions were included. Primary endpoints were Target lesion revascularization (TLR), Target vessel revascularization (TVR), definite stent thrombosis, Cardiac death (CD), angiographic outcomes and optical coherence tomography (OCT) findings. Risk of bias was assessed using Cochrane’s ROB 2.0 and meta-analysis performed using RevMan 5.4.

RESULTS: Ten RCTs including 9020 patients (4043 PF-DES; 4977 BP-DES) were included. At 12 months, PF-DES showed a significantly higher TLR rate (2.08% vs. 1.36%; RR 1.55, 95% CI 1.087-2.21; P = 0.02), persisting at 24 months (RR = 2.01, 95% CI 1.46-2.77, P < 0.0001). At 1-3 months, OCT-derived analyses demonstrated no statistically significant differences in uncovered struts or neointimal thickness between stent types, while findings related to malapposed struts were heterogenous and dependant on sensitivity analyses. Angiographically, PF-DES showed greater in-stent late lumen loss at 6-8 months ([MD]: 0.24 mm, 95% CI 0.17-0.30, P < 0.00001), whereas minimal lumen diameter was comparable. However, no significant differences were found in target vessel revascularization (TVR), stent thrombosis, myocardial infarction, or mortality at 1- or 2-year follow-up.

CONCLUSIONS: PF-DES were associated with comparable safety to BP-DES; however, it exhibited higher rates of target lesion revascularization and greater late lumen loss were observed. OCT-derived findings were heterogenous and should be interpreted cautiously. Further RCTs with standardized imaging protocols and longer follow-up are warranted.

PMID:41721379 | DOI:10.1186/s40001-026-03999-5

BMC Oral Health. 2026 Feb 20. doi: 10.1186/s12903-026-07811-y. Online ahead of print.

ABSTRACT

AIM: This study aimed to evaluate the clinical and radiographic success rate of the Premixed MTA versus conventional powder/liquid MTA in indirect pulp capping of immature permanent carious mandibular molars.

METHODOLOGY: A randomized clinical trial with a parallel group design and an allocation ratio of 1:1 was conducted at the outpatient clinic at the Pediatric Dentistry and Public Health Department, Faculty of Dentistry, Cairo University. The study included 24 pediatric patients aged 6-8 years, randomly assigned to either the premixed MTA (Well-Root™ PT) (n = 12) group or the conventional MTA (Cerkamed MTA+) (n = 12) group. Both groups underwent similar clinical procedures, including caries removal, indirect pulp capping, and restoration. Postoperative pain was assessed using a visual analogue scale (VAS). The pulp sensibility was tested using electrical pulp testing and radiographic evaluation for furcal radiolucency and root resorption using digital intraoral radiographs. Collected data were statistically analyzed at P < 0.05.

RESULTS: Premixed MTA group showed overall success (100%) while the conventional MTA group showed a success rate of 91.6%, at 3-month, 6-month, and 1-year follow-ups, with no significant difference between both groups (P > 0.05). Regarding the postoperative pain, patients who received premixed MTA showed no pain, while in the conventional MTA group, only one patient experienced pain (P > 0.05). No furcal radiolucency or root resorption was observed in participants from both groups during the follow-up periods.

CONCLUSION: Both premixed MTA and conventional MTA demonstrated comparable clinical and radiographic success rates in indirect pulp capping of immature permanent molars.

TRIAL REGISTRATION: The full trial protocol and statistical analysis plan can be accessed on December 2, 2022, on the clinical trial registry page at www.

CLINICALTRIALS: gov (ID: NCT05597553), retrospectively registered.

PMID:41721378 | DOI:10.1186/s12903-026-07811-y

Eur J Med Res. 2026 Feb 20. doi: 10.1186/s40001-026-04017-4. Online ahead of print.

ABSTRACT

BACKGROUND: Dual targeting with onabotulinumtoxinA and anti-CGRP monoclonal antibodies has emerged as a potential option for patients with chronic migraine who respond incompletely to single-agent preventive therapy. Evidence from individual observational reports suggests benefit, but the magnitude, consistency, and methodological quality of available studies remain unclear.

METHODS: A systematic search identified observational studies evaluating combination therapy with onabotulinumtoxinA plus an anti-CGRP monoclonal antibody. Ten studies met inclusion criteria, of which six provided extractable quantitative data for meta-analysis. Outcomes included monthly headache days (MHD), ≥ 50% and ≥ 75% responder rates, headache-related disability (MIDAS, HIT-6), and acute medication use. Random-effects models were applied, and heterogeneity, subgroup patterns, and publication bias were assessed. Of the ten eligible studies, only six provided extractable quantitative data for combination therapy and were included in pooled analyses.

RESULTS: Across six studies, combination therapy reduced MHD by a pooled – 7.9 days (95% CI – 10.2 to – 5.7). The pooled ≥ 50% responder rate was 0.51 (95% CI 0.37-0.66), and the ≥ 75% responder rate was 0.19 (95% CI 0.10-0.34). Disability measures improved, with MIDAS decreasing by – 47.4 points (95% CI – 65.7 to – 29.1) and HIT-6 by – 8.2 points (95% CI – 10.9 to – 5.5). Acute medication use declined by – 4.3 days per month (95% CI – 6.1 to – 2.5). Heterogeneity across outcomes was moderate to high. Subgroup analyses by age and sex showed generally consistent directionality, though several strata were represented by only one or two studies. Funnel plot inspection and Egger testing did not indicate marked publication bias.

CONCLUSIONS: Combination therapy with onabotulinumtoxinA and an anti-CGRP monoclonal antibody demonstrates clinically meaningful reductions in headache frequency, disability, and medication use across observational cohorts. Interpretation should remain cautious given high heterogeneity, the absence of controlled comparative designs, and limited subgroup data. Because dispersion measures were imputed in several studies, statistical precision may be overestimated, and effect sizes should be interpreted as approximate rather than definitive. Larger prospective studies are needed to clarify patient selection, durability of benefit, cost-effectiveness, and equity of access.

PMID:41721358 | DOI:10.1186/s40001-026-04017-4

BMC Public Health. 2026 Feb 20. doi: 10.1186/s12889-026-26601-3. Online ahead of print.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) face distinct external and internal stressors that substantially affect their mental health, leading to higher rates of depression and engagement in risky behaviors. Geosocial networking apps provide new perspectives to assess and promote the mental health of MSM. This study aims to examine the emotions and sentiments of MSM in Shenzhen, China, using data from a Chinese MSM geosocial networking app, and to explore the characteristics, temporal trends, and associated factors of emotions and sentiments.

METHODS: This cross-sectional study collected data from the geosocial networking app Blued using a web crawler, focusing on users in Shenzhen who posted more than 15 updates between September and October 2020. Natural language processing techniques, including word segmentation and sentiment analysis, were applied to assess emotional and sentiment patterns. Univariate and multivariate logistic regression analyses were used to identify associated factors with these patterns.

RESULTS: The study included 7,537 users with a mean age of 28.7. We found significant emotional fluctuations, particularly negative emotions, during early morning hours. Factors such as body mass index, social media engagement, and the frequency of health-related words were significantly associated with emotional and sentiment trends. Users who posted more frequently and had fewer blacklist entries exhibited more positive emotions.

CONCLUSIONS: Social media provides valuable insights into the mental health patterns of MSM. This study highlights the potential for real-time monitoring and targeted interventions tailored to the unique needs of sexual minorities. The findings underscore the importance of culturally relevant and LGBT-affirmative online mental health services.

PMID:41721351 | DOI:10.1186/s12889-026-26601-3

BMC Med. 2026 Feb 20. doi: 10.1186/s12916-026-04714-1. Online ahead of print.

ABSTRACT

BACKGROUND: Adherence to antihypertensive medication, alongside lifestyle modifications, is fundamental to managing hypertension and reducing the risk of cardiovascular disease. Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with a range of cardiovascular diseases, including hypertension. ADHD medication has also been associated with hypertension. However, the influence of ADHD and ADHD medication on discontinuation and adherence to antihypertensive treatments is unknown.

METHODS: We conducted a multinational cohort study using electronic health databases from seven countries, which included adults who initiated antihypertensive medication between 2010 and 2020. ADHD was identified by a diagnosis of ADHD or dispensation of ADHD medications. The outcomes were (1) time to the first discontinuation of antihypertensive medication and (2) poor adherence, defined as the proportion of days covered (PDC) below 80% during 1-, 2-, and 5-year follow-up periods. We used Cox proportional hazards models and logistic regression to estimate associations, adjusting for age, sex, and calendar year of antihypertensive medication initiation. We pooled results from different countries via random-effects meta-analysis.

RESULTS: We identified 12,174,321 adults who initiated antihypertensive medication during the study period, including 320,691 (2.6%) with ADHD. In the pooled analysis across all countries, ADHD was associated with an increased rate of discontinuation in 5-year follow-up of antihypertensive medication (hazard ratio [HR] 1.14; 95% CI, 1.02-1.27). In age-stratified analyses, ADHD was associated with a higher rate of antihypertensive medication discontinuation in middle-aged (HR, 1.11; 95% CI, 1.01-1.23) and older adults (HR, 1.14; 95% CI, 1.01-1.29), but not in young adults. Individuals with ADHD also had higher odds of poor adherence across 1 year after treatment initiation (odds ratio [OR] 1.45, 95% CI 1.26-1.67) to 5 years (OR 1.64, 95% CI 1.34-2.00). Among those with ADHD, use of ADHD medications was associated with lower odds of poor adherence (1 year OR 0.66, 95% CI 0.60-0.73; 5 years OR 0.58, 95% CI 0.46-0.72).

CONCLUSIONS: Adults with ADHD are more likely to discontinue antihypertensive treatment and exhibit poor medication adherence. However, ADHD medication use appears to be associated with better adherence among individuals with ADHD.

PMID:41721349 | DOI:10.1186/s12916-026-04714-1

BMC Public Health. 2026 Feb 20. doi: 10.1186/s12889-026-26547-6. Online ahead of print.

NO ABSTRACT

PMID:41721335 | DOI:10.1186/s12889-026-26547-6

BMC Pediatr. 2026 Feb 20. doi: 10.1186/s12887-026-06633-9. Online ahead of print.

ABSTRACT

BACKGROUND: Pain is a common health problem and a leading reason for hospital admissions in children. Rational drug use is crucial in pediatric pain management, especially for young children who rely on their parents.

PURPOSE: This study aimed to determine the attitudes of mothers of children aged 0-6 years toward rational drug use in pain management.

METHODS: This descriptive, cross-sectional, and correlational study involved 403 mothers attending pediatric outpatient clinics at a university hospital. Data collection took place between April and June 2024 using a personal information form and the Parental Attitude Scale Towards Rational Drug Use (PASRDU). Data analysis included the Mann-Whitney U test for pairwise comparisons, the Kruskal-Wallis H test for groups larger than two, and Spearman Correlation analysis for variable relationships.

RESULTS: The mean age of the mothers was 31.60 (± 5.328) years; 45.4% had one child, and 50.9% held a university degree or higher. The mean PASRDU score was 174.01 ± 17.225. A statistically significant positive attitude towards rational drug use was linked to younger mothers, those with fewer children, and those with higher education and socioeconomic status (p < .005). PASRDU scores were also higher among mothers who reported greater self-efficacy in relieving their child’s pain and those who did not administer non-prescribed analgesics (p < .005).

CONCLUSIONS: Mothers generally exhibited high attitudes toward rational drug use in pain management. Attitudes varied by age, education, number of children, socioeconomic status, self-perceived competence in pain management, and use of non-prescribed medications. Nurse-led assessment and tailored education may support rational drug use in pediatric pain management.

TRIAL REGISTRATION: Not applicable.

PMID:41721334 | DOI:10.1186/s12887-026-06633-9

BMC Public Health. 2026 Feb 20. doi: 10.1186/s12889-026-26496-0. Online ahead of print.

NO ABSTRACT

PMID:41721333 | DOI:10.1186/s12889-026-26496-0

BMC Public Health. 2026 Feb 21. doi: 10.1186/s12889-026-26346-z. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood obesity is a rising worldwide health issue with significant physical, psychological, and social implications. Beyond physical health, obesity has profound psychological effects, particularly on body image perception and self-esteem, which can be exacerbated by bullying and social stigmatization.

AIM: To assess body image perception among bullied obese children in Egypt and to examine the relationship between obesity, bullying experiences, and body image dissatisfaction.

METHODS: This case-control study was conducted on 86 Egyptian children aged 5 to 10 years who attended the outpatient nutrition and immunity clinic at the Medical Research Centre of Excellence (MRCE). A comprehensive, structured questionnaire and clinical examination were used and analyzed to assess participants.

RESULTS: The study included 86 children; 40 males and 46 females. Out of 86 children, 44 children were obese with mean of age (8.16 ± 1.78 y) and 42 were healthy children as controls with mean of age (7.69 ± 1.8. 55 y). A total of 27 children (34.6%) in the study population displayed acanthosis nigricans. Students in the obesity group reported higher rates of school bullying (36.4%) as compared to controls (11.9%). The family bullying was significantly higher in the obesity group at 40.9% compared to the control group at 7.1% (p = 0.001). A significant difference (p = 0.000) in sadness feeling was reported in obese children (56.8%) as compared with controls (11.9%). Children with family refusal showed statistically significant higher occurrences of expressing low self-esteem by refusing to be photographed (50%) and showing sadness (75%), especially in females.

CONCLUSION: This study highlights the obesity and its association with obesity-related health risks and emotional distress. School refusal was strongly linked to bullying and academic pressure. Negative school interactions affected family relationships, while family denial increased bullying and emotional distress. Females showed greater vulnerability to sadness than males.

PMID:41721328 | DOI:10.1186/s12889-026-26346-z