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Nevin Manimala Statistics

Work-life balance and occupational well-being: A validated scale for Sri Lankan bus conductors

Work. 2026 Mar 10:10519815261427709. doi: 10.1177/10519815261427709. Online ahead of print.

ABSTRACT

BackgroundWork-life balance (WLB) is crucial for occupational health, especially for bus conductors, who face high levels of stress and irregular schedules. Despite the extensive exploration of WLB across occupations globally, a pronounced research gap exists for bus conductors, notably in the Sri Lankan context.ObjectiveThe objective of this study was to develop and validate a context-specific WLB tool for Sri Lanka Transport Board (SLTB) bus conductors.MethodsThe tool was developed via qualitative methods (in-depth interviews, focus group discussions, and key informant interviews) and a review of existing tools, followed by pilot testing. Statistical analyses were conducted for exploratory factor analysis (EFA), whereas confirmatory factor analysis (CFA) was performed using the lavaan package in R. The sample sizes for the factor analyses adhered to the established subject-to-item ratio guidelines, ensuring the statistical robustness of the psychometric validation.ResultsThe tool showed high reliability (Cronbach’s α = 0.784) and strong construct validity, as supported by EFA with 147 bus conductors and CFA with a separate sample of 100. It comprises 10 items with three dimensions, namely, work-family integration, institutional support and work satisfaction, and health and work interference, collectively explaining 75.7% of WLB variance.ConclusionThis study provides a validated, context-specific instrument to measure the WLB of bus conductors, which can be used by relevant stakeholders to assess, compare, and improve WLB following targeted interventions, thereby enhancing the efficiency of public transportation bus services.

PMID:41804531 | DOI:10.1177/10519815261427709

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Knowledge, attitude and behavior of nursing students about needlestick and sharps injuries

Work. 2026 Mar 10:10519815261426994. doi: 10.1177/10519815261426994. Online ahead of print.

ABSTRACT

BackgroundNursing students who are majoring to become nurses are under risk with regards to complications and injuries due to practice lack and insufficient clinical experience.ObjectiveThis research was conducted to determine the knowledge, attitude, and behaviors of nursing faculty students regarding needlestick and sharps injuries.MethodsThis research was planned in a descriptive and correlational study. Attitude 447 students who accepted to take part in the research and suitable to the criterions of inclusion accounted for the sampling of the research. Scale oriented to “Attitude Scale for Safe Use of Sharps by Healthcare Workers” and “Student Information Form” were used in the gathering of data.ResultsIt was seen that 29.5% of the students experienced at least one NSSIs during their education life and the most common injuries were in the 4th year. Overall score point average of “Attitude Scale for Safe Use of Sharps” was found to be 118.11 ± 7.33 and according to age, gender, wounding case, wounding area and wounding reason, statistically significant differences were determined as regards to total scale and subscale score averages.ConclusionsAs a result, although the scores that the students knowledge, attitude and behaviours were high, it was seen that there were injuries. The sustenance of trainings oriented to preventing injuries can be suggested.

PMID:41804530 | DOI:10.1177/10519815261426994

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Effectiveness and Safety of Different Dressing and Securement Methods for Peripheral Intravenous Catheters: A Systematic Review and Meta-Analysis

Int Wound J. 2026 Mar;23(3):e70875. doi: 10.1111/iwj.70875.

ABSTRACT

Peripheral intravenous catheters (PIVCs) are widely used in hospital settings but are associated with high failure rates and patient safety risks. Various dressing and securement methods have been implemented to mitigate these complications. This systematic review aimed to systematically review the effectiveness and safety of different dressing and securement methods for PIVCs in hospitalised adult and paediatric patients. Randomised controlled trials (RCTs) published between 1959 and 2024 were identified through searches of CENTRAL, CINAHL, Ovid EMBASE, and Ovid MEDLINE. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was evaluated using GRADE. Outcomes included PIVC failure, dislodgement, occlusion, infiltration, extravasation, phlebitis, and catheter-related bloodstream infection (CRBSI), analysed using risk ratios where meta-analysis was feasible. Dwell time was reported descriptively as mean or median values. Fifteen RCTs involving 5542 participants evaluated eight PIVC dressing and securement methods. In adult populations, tissue adhesive significantly reduced PIVC failure compared with transparent polyurethane dressing (risk ratio [RR] 0.83, 95% confidence interval [CI] 0.73-0.95), as well as dislodgement (RR 0.60, 95% CI 0.42-0.84) and occlusion (RR 0.73, 95% CI 0.57-0.94). Transparent polyurethane dressing was associated with lower dislodgement rates compared with gauze in adults. Other comparisons showed no statistically significant differences or were informed by single studies only, limiting the strength of conclusions. Evidence in paediatric populations was sparse and predominantly derived from individual trials. Tissue adhesive appears effective in reducing PIVC failure and mechanical complications in adults. Its effectiveness in pediatric patients remains uncertain, highlighting the need for further adequately powered trials.

PMID:41804526 | DOI:10.1111/iwj.70875

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Applying evidence-to-decision to construction safety: A review of safety culture evidence in Taiwan

Work. 2026 Mar 10:10519815261428096. doi: 10.1177/10519815261428096. Online ahead of print.

ABSTRACT

BackgroundThe construction industry internationally and in Taiwan experiences high rates of injury, and fatalities. Worker behaviour is frequently associated with construction site accidents. The paper examines evidence on the effectiveness of a safety culture focus in improving safety behaviour on Taiwanese construction sites.ObjectiveTaking a public health approach, the research systematically evaluates safety culture focused initiatives to enhance construction site safety in Taiwan, with a particular focus on SMEs, given their overrepresentation in accident statistics.MethodsInformation from a systematic review of safety culture research in construction published between 2014 and 2024, combined with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision (EtD) process, was used to assess the evidence supporting safety culture improvements. The combination of methods provides a systematic framework with a novel perspective on safety culture initiatives to improve safety behaviour in construction.ResultsEvidence from 99 articles shows that emphasising safety climate can improve construction workers’ safety behaviour. Nonetheless, key questions around resourcing, acceptability, and feasibility remain, particularly for small and medium enterprises. Benefits may include reduced government compensation costs and better health equity in the industry.ConclusionThis review using EtD offers a new perspective on international safety-climate research and highlights key gaps in construction safety. The findings suggest that EtD supports comprehensive evidence assessment for practical and policy use. Limited data in many areas points to the need for more holistic, public health-focused research to help achieve construction safety policy goals in Taiwan.

PMID:41804525 | DOI:10.1177/10519815261428096

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Nurse Practitioner Contribution to Shortening the Time from Angiography Suite Entry to Puncture in Mechanical Thrombectomy for Acute Ischemic Stroke

J Neuroendovasc Ther. 2026;20(1):2025-0130. doi: 10.5797/jnet.oa.2025-0130. Epub 2026 Mar 4.

ABSTRACT

OBJECTIVE: Minimizing the time to reperfusion is a critical determinant of the prognosis of acute ischemic stroke (AIS). To reduce the workload of neurosurgeons, improve efficiency, and shorten the time required for AIS management delivered by the neurosurgical department, a nurse practitioner (NP) was introduced in April 2019. However, the effect of NP involvement on post-door-to-needle (D2N) intervals, particularly time to reperfusion, has not been clarified. This study examined whether NP participation was associated with shorter post-D2N time metrics in patients with AIS undergoing mechanical thrombectomy (MT).

METHODS: This study included all consecutive patients with AIS due to intracranial large vessel occlusion who underwent MT between April 2019 and March 2024 at our institution. Patients with NP involvement were assigned to the NP group, and those without NP involvement were assigned to the non-NP group. NP participation was randomly determined according to their duty schedule. The primary outcomes were the median times from angiography suite entry-to-puncture (E2P) and from suite entry-to-recanalization (E2R). Secondary outcomes included onset-to-puncture (O2P), puncture-to-recanalization (P2R), door-to-entry (D2E), door-to-puncture (D2P), and the proportion of patients with a modified Rankin Scale (mRS) score of 0-2 at discharge. Statistical analyses included univariate and multivariate linear regression analysis, with significance set at p <0.05.

RESULTS: In total, 115 patients were included: 44 in the NP group and 71 in the non-NP group. The baseline patient characteristics were comparable. The median E2P was significantly shorter in the NP group (15 vs. 21 min; p <0.05), representing a 6-min reduction (28.6%). The median E2R was 73 vs. 76.5 min, showing a nonsignificant 3.5-min decrease. Among the secondary metrics, D2P was shorter in the NP group, whereas the O2P, P2R, and D2E levels did not differ significantly. In the multivariate linear regression analyses, only E2P remained independently associated with NP involvement. The proportion of patients with favorable outcomes (mRS 0-2) at discharge was higher in the NP group (27.3% vs. 19.7%), although the difference was not significant.

CONCLUSION: NP participation significantly reduced E2P time. These findings suggest that NP involvement contributes to shortening the treatment time in the post-D2N phase and may have a crucial role in promoting efficient team-based care in AIS management.

PMID:41804504 | PMC:PMC12967338 | DOI:10.5797/jnet.oa.2025-0130

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Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders Among Dockworkers: The Role of Psychosocial Stress and Physical Demands in an Iranian Port

Health Sci Rep. 2026 Mar 8;9(3):e71840. doi: 10.1002/hsr2.71840. eCollection 2026 Mar.

ABSTRACT

BACKGROUND AND AIM: With the development of trade between countries, the transportation of goods has increased, and ports struggle to accommodate the demands of unloading and loading operations. Seaport workers may experience work-related musculoskeletal disorders (WMSDs), which in many cases result in disabilities. Few studies have investigated the prevalence of work-related musculoskeletal disorders (WMSDs) and associated psychological factors among dock workers in Iran. Existing findings indicate a high prevalence of WMSDs in these settings, primarily attributed to adverse working conditions such as repetitive movements, awkward postures, heavy lifting, and excessive physical strain. Moreover, there is a scarcity of research examining the impact of psychological factors on musculoskeletal disorders within this occupational group. This study investigated the relationship between work-related psychological factors and job characteristics and WMSDs at the Port of Shahid Rajaee in Bandar Abbas, Iran, from December 2023 to April 2024.

METHODS: In this cross-sectional study, all 351 dock workers were enrolled as research subjects. Dock workers in our study encompassed four distinct occupational roles with different physical and postural demands, including Trans Trainer Operators, Gantry Crane Operators, Tractor Drivers, and warehouse workers. To collect data, the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ) were used. The sampling method used in this study was a census approach, encompassing all eligible workers at Sina port and Marine Service Development Company. Statistical analyses included descriptive statistics, independent t-tests, Pearson’s correlation coefficients, and one-way analysis of variance (ANOVA).

RESULTS: The NMQ scores across the four groups were highest for the neck, shoulder, and upper back regions, with a mean score of 38.02, and lowest for the upper limb region, with a mean score of 10.40. Trans trainer and gantry crane operators and warehouse workers had significantly higher WMSDs in neck, shoulder, and upper back than tractor drivers (p < 0.001). Additionally, NMQ scores for the lower back were significantly correlated with the job type (p < 0.001), with warehouse workers having the highest MSD scores (22.85). Higher psychological job demands and psychosocial and physical stress were associated with more severe WMSDs for the workers. In addition, type of the job, age, work experience, marital status, and high job insecurity were significant factors influencing WMSDs.

CONCLUSION: Work-related psychosocial factors play an important role in the development of work-related musculoskeletal disorders (WMSDs) among port workers. To mitigate these risks, it is essential to address psychological stress and job demands. Additionally, improving communication between port workers and management may contribute to a healthier and more supportive work environment.

PMID:41804502 | PMC:PMC12967559 | DOI:10.1002/hsr2.71840

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Appropriateness of Indications and Factors Associated With Abnormal Findings in Upper Gastrointestinal Endoscopy at the National Referral Hospital, Bhutan: A Cross-Sectional Study

Health Sci Rep. 2026 Mar 8;9(3):e71961. doi: 10.1002/hsr2.71961. eCollection 2026 Mar.

ABSTRACT

INTRODUCTION: Upper gastrointestinal endoscopy (UGIE) is a commonly performed procedure for evaluating complaints related to the upper gastrointestinal tract. It serves both diagnostic and therapeutic purposes. Over the last decade, there has been an increasing demand for UGIE, and selecting patients for the procedure according to standard guidelines is essential to enhance the quality of healthcare, reduce costs, and avoid unnecessary workload. This study was conducted to assess the appropriateness of indications for UGIE and the factors associated with abnormal findings in endoscopy among patients at the National Referral Hospital, Bhutan.

METHODS: A cross-sectional study was conducted at the Endoscopy Unit of the Surgical Department, National Referral Hospital, Bhutan. All patients aged > 12 years who underwent UGIE during the study period were included. Data were collected using a standard pro forma developed for the study, and statistical analysis was performed using SPSS software, version 23 (IBM Corp., Armonk, NY, USA).

RESULTS: A total of 200 patients underwent UGIE, of whom 50.5% (101/200) had the procedure performed for inappropriate indications. The majority of UGIE referrals originated from medical officers and residents.Among the appropriate indications, the most common was chronic liver disease with suspected portal hypertension (33.3%), followed by new-onset abdominal symptoms in patients over 50 years of age (25.3%).Abnormal endoscopic findings were detected in approximately two-thirds of cases (65.5%). The most frequently observed abnormality was esophageal varices (30.5%), followed by atrophic gastritis (26.7%) and erosive gastritis (16.0%). Esophageal and gastric growths were identified in 1.5% of cases.Notably, referrals for UGIE by medical specialists were nearly 14 times more likely to yield abnormal findings (adjusted odds ratio [aOR]: 13.5; 95% CI: 3.69-49.57; p < 0.001).

CONCLUSION: Approximately half of the UGIE indications were found to be inappropriate, with more than half of these cases showing normal findings on endoscopy. These results underscore the importance of adhering to standardized guidelines when recommending UGIE, to minimize unnecessary procedures, mitigate patient risks, and ensure the optimal use of healthcare resources.

PMID:41804497 | PMC:PMC12967617 | DOI:10.1002/hsr2.71961

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Nevin Manimala Statistics

Evaluation of Anticancer Therapy-Related Tumor Flare Reaction: Insights From Food and Drug Administration’s Adverse Event Reporting System Dataset

Cancer Med. 2026 Mar;15(3):e71660. doi: 10.1002/cam4.71660.

ABSTRACT

AIM: Tumor flare reaction (TFR) is characterized by an increase in tumor size during immunotherapy, often resembling disease progression. This study explores the relationship between anti-tumor drugs and tumor flare reaction (TFR) through the FAERS database to assist clinicians in better patient management.

METHODS: We analyzed the FAERS database to identify TFR cases reported from Q1 2004 to Q3 2024. For signal detection, we employed disproportionality analysis with four algorithms-reported odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM). These algorithms assessed statistical correlations between anticancer drugs and TFR, based on a 2 × 2 contingency table framework.

RESULTS: From Q1 2004 to Q3 2024, 566 TFR cases were recorded in the FAERS database. The incidence of TFR peaked in 2023, with the highest increase in cases from 2021 to 2022, at 4.9%. A total of 28 anticancer drugs were identified as strongly associated with TFR, of which only 4 are explicitly listed in the medication instructions as having TFR-related adverse reactions. Lenalidomide was the most frequent drug causing TFR, accounting for 38% of all TFR reports.

CONCLUSIONS: Our findings highlight the key associations between treatment drugs and TFR, particularly targeted therapies such as Rituximab, which are not explicitly marked for this side effect in the FAERS database. The study emphasizes the need for clinicians to closely monitor TFR in patients receiving certain cancer treatments and improve therapeutic strategies to mitigate TFR risks, ensuring safer cancer treatment outcomes.

PMID:41803028 | DOI:10.1002/cam4.71660

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Single-Visit Long-Acting Reversible Contraception (LARC) Insertion Practices Before and After Implementation of Practice Changes Including Telehealth Due to the COVID-19 Pandemic in North Carolina

N C Med J. 2025 Jun 26;86(3). doi: 10.18043/001c.141315.

ABSTRACT

BACKGROUND: We sought to characterize changes in single-visit long-acting reversible contraception (LARC) placement before and after the start of the COVID-19 pandemic in North Carolina.

METHODS: We utilized an interrupted time series analysis to characterize single-visit LARC placement after the start of the pandemic across a state-wide health care system.

RESULTS: Within our cohort of 4591 patients receiving a LARC, 70.36% received single-visit LARC before and 66.98% after the start of the pandemic (odds ratio [OR] = 0.85; 95% confidence interval [CI], 0.75 – 0.97). There was a slight monthly decrease in the likelihood of single-visit LARC after the pandemic started (0.001, 95% CI: -0.004 – 0.005).

LIMITATIONS: Limitations include the electronic health record data-based abstraction of variables, as well as the inability to assess patient preferences in visit scheduling.

CONCLUSIONS: Rapid increases in telehealth were associated with slight decreases in single-visit LARC placement. Further study is needed to better understand patient goals and experiences, as well as clinical and public health impacts surrounding the use of telehealth for contraceptive care.

PMID:41802991 | DOI:10.18043/001c.141315

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Impact of p16 Status on the Efficacy of Pembrolizumab Combined Nimotuzumab in Recurrent/Unresectable/Metastatic Head and Neck Squamous Cell Carcinoma Patients

Oral Dis. 2026 Mar 9. doi: 10.1111/odi.70259. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the real-world efficacy of combining Pembrolizumab with Nimotuzumab in patients with Recurrent/Unresectable/Metastatic HNSCC and to analyze the impact of p16 expression on treatment outcomes.

METHODS: The study included 86 patients: 41 received Pembrolizumab monotherapy, and 45 received Pembrolizumab plus Nimotuzumab. Patients were divided into four groups based on treatment and p16 status, analyzing OS, PFS, and ORR.

RESULTS: With a median follow-up of 30.2 months, the combination therapy showed a significantly higher 6-month ORR, longer 1-year PFS and OS compared to monotherapy. Additionally, the combination therapy group notably improved 6-month ORR, 1-year PFS rate, and 1-year OS rate in p16-negative patients when compared to monotherapy. However, there was no significant improvement in ORR, PFS, or OS in p16-positive patients. Adverse events occurred in 61 patients (70.93%), with incidences of 68.29% in the monotherapy and 73.33% in the combination group, showing no statistically significant difference (p > 0.05).

CONCLUSION: The combination of Pembrolizumab and Nimotuzumab demonstrates a notable enhancement in ORR and OS, maintaining a dependable safety profile. Differential p16 expression in HNSCC patients may influence the efficacy of immune-combined targeted therapy, highlighting the importance of considering p16 in the formulation of therapeutic strategies.

PMID:41802984 | DOI:10.1111/odi.70259