Tag: pubmed

Disabil Rehabil Assist Technol. 2026 May 24:1-22. doi: 10.1080/17483107.2026.2671839. Online ahead of print.

ABSTRACT

INTRODUCTION: Personal technology might offer effective and efficient options for supporting successful self-management following mild traumatic brain injury (mTBI). Its use in UK rehabilitation remains unclear. This study explores healthcare professionals’ (HCPs) experience and attitudes towards using personal technology for self-management following mTBI.

METHODS: A cross-sectional online survey of UK HCPs working in mTBI services was conducted, recruiting via social media, professional networks and snowball sampling. Quantitative data were analysed using descriptive statistics and frequencies. Free text responses were analysed using inductive thematic analysis.

RESULTS: Ninety-two HCPs responded representing a range of professions and mTBI services; not all services were mTBI specific. A variety of self-management interventions and outcome measures were reported. Among HCPs who offered self-management interventions (n = 55), 75% reported developing their own materials instead of using evidence-based resources. Fewer than half (n = 43, 47%) reported using personal technology to support self-management. Of those who did, most emailed resources or signposted patients to websites. Most (95%) participants agreed personal technology should be used in rehabilitation. Barriers included cost to patients and services, HCP/patient confidence with technology and concerns about losing face-to-face interactions.

CONCULSIONS: Despite HCPs receptiveness to digital self-management interventions, findings suggest personal technology is not routinely used in UK mTBI services. Personal and organisational implementation barriers need to be addressed to ensure people with mTBI benefit from personal technology for self-management. Further work should identify and test adoption strategies.

PMID:42177775 | DOI:10.1080/17483107.2026.2671839

West Afr J Med. 2026 Apr 30;43(1):22-28.

ABSTRACT

BACKGROUND: In Nigeria, the burden of critical illness and risk factors for mortality remains poorly described. This study describes the epidemiology of patients admitted at the children’s emergency ward (EW) and risk factors for Paediatric intensive care unit (PICU) admission and in-hospital mortality (IHM).

METHODS: This was a retrospective study of patients admitted to the Children’s EW of the University College Hospital, Ibadan, Nigeria, from 1st December 2022 to 30th November 2023. Patient’s demographics, presenting clinical features and diagnosis at admission were extracted. The primary outcome was PICU admission. Secondary outcomes were duration of hospital stay and IHM.

RESULTS: There were 649 patients; 421(64.9%) were <5 years old. Median age was 2.3 (interquartile range 0.8-7.0) years. Most common presenting features were dyspnoea [269 (41.4%)], vomiting [182 (28%)] and hypoxaemia [188 (29%)]. At presentation, 51 (7.9%) and 63 (10.3%) had altered mental status and seizures, respectively, while the most common diagnoses were sepsis [250 (39%)], malaria [192 (30%)], and pneumonia [165(26%)]. At presentation, 217 (33.5%), 110 (16.9%), 48 (7.4%), and 32 (4.9%) required oxygen, blood transfusion, fluid bolus, and inotropes, respectively. Twenty (3.1%) patients required cardiopulmonary resuscitation (CPR), and 101 (15.6%) required PICU admission. Median duration of hospital stay was 5 (interquartile range 3-9) days, while IHM was 74 (6.6%) patients. On bivariate analysis, gender, dehydration, breathlessness, dyspnoea, cyanosis, cold extremities, thready pulses and altered mental state were associated with mortality, while breathlessness, hypoxaemia, dyspnoea, dehydration, cyanosis, thready pulses, cold extremities, convulsion and altered mental status were associated with PICU admission.

CONCLUSION: Shock state and hypoxaemia were associated with poor outcomes in paediatric emergencies. The introduction of basic critical care services will reduce the burden of adverse outcomes.

PMID:42177770

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