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Nevin Manimala Statistics

Decoding Anti-Substance Use Public Service Announcements: Content Analysis Grounded in the Elaboration Likelihood Model and Extended Parallel Process Model

JMIR Form Res. 2026 May 14;10:e85703. doi: 10.2196/85703.

ABSTRACT

BACKGROUND: Tobacco, alcohol, and illicit drug use continue to pose substantial public health challenges in China. Although public service announcements (PSAs) are widely used for prevention, little is known about how these messages are constructed or the extent to which they draw on established health communication theories.

OBJECTIVE: This exploratory study aimed to characterize the design features of anti-substance use PSAs in China, assess their use of constructs from the extended parallel process model (EPPM) and the elaboration likelihood model (ELM), and compare patterns across anti-substance use PSAs.

METHODS: We conducted a content analysis of 89 publicly available anti-substance use PSAs produced in mainland China. Messages were identified via major Chinese video platforms and institutional websites and then screened using predefined eligibility criteria. Variables captured message source, intended audience, framing, substance depiction, cultural appeals, and EPPM and ELM components. Frequencies and proportions were calculated, and χ2 tests were used to examine differences by PSA type. To account for multiple comparisons, P values were adjusted using the Holm-Bonferroni correction.

RESULTS: Most PSAs did not identify a target audience (54/89, 60.7%), and public security departments were the most common sponsors (n=37, 41.2%), while none were sponsored by public health agencies. Theory use was selective: response efficacy (n=63, 70.8%) and perceived severity (n=55, 61.8%) appeared more often than self-efficacy (n=45, 50.6%) and perceived susceptibility (n=34, 38.2%); peripheral cues (n=79, 88.8%) were more common than central route cues (n=16, 18%). Differences across PSA types were observed in sponsorship, message features, and theoretical constructs. After adjustment for multiple comparisons, associations involving sponsoring organizations (public security departments and Chinese media) and perceived susceptibility remained statistically significant (all adjusted P=.01). Antidrug PSAs were predominantly associated with public security sponsorship, whereas antialcohol and antitobacco PSAs were more frequently linked to Chinese media sources. Perceived susceptibility cues were more common in antismoking PSAs than in antidrug PSAs, while other differences in framing, substance cues, cultural appeals, and ELM or EPPM constructs were not statistically significant after adjustment.

CONCLUSIONS: Anti-substance use PSAs in China were characterized by limited audience segmentation and uneven use of theory-based persuasive strategies. Observed differences across alcohol-, tobacco-, and drug-focused messages suggest that PSA design may be shaped not only by partial application of communication theory but also by institutional influences and substance-specific contexts. These findings highlight the need for more context-sensitive and theory-informed approaches to anti-substance use PSA design in China.

PMID:42133889 | DOI:10.2196/85703

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Nevin Manimala Statistics

Neighborhood Revitalization and Cardiovascular Disease Outcomes in Midlife and Older Adults Living in Low-Income Neighborhoods in the Bronx, New York: Protocol for a Natural Experiment and Multimethod Community-Based Study

JMIR Res Protoc. 2026 May 14;15:e89056. doi: 10.2196/89056.

ABSTRACT

BACKGROUND: Neighborhood revitalization is a process through which land use rezoning and capital investment can spur new resources, such as access to healthful food and amenities for physical activity. While revitalization efforts may promote cardiovascular health, their benefits may not be distributed equally across sociodemographic groups.

OBJECTIVE: The objective of the study is to apply a socioecological framework that uses a multimethod approach incorporating quantitative data (longitudinal electronic health records and cross-sectional surveys) and qualitative data (longitudinal “walk-a-long” interviews) to examine the short-term effect of neighborhood land use rezoning and revitalization efforts on cardiovascular disease (CVD), CVD-related health behaviors, and access to and utilization of health care. System science methods, namely microsimulation modeling and system dynamics modeling, will be used to assess the long-term effects of land use rezoning policy and revitalization efforts on cardiovascular health and ways to sustain priority health equity goals in revitalized neighborhoods.

METHODS: We leverage a land use rezoning initiative in the Bronx, New York, where a largely commercial area is being rezoned along with capital investments to expand healthful neighborhood resources. Using electronic health records from a single hospital system, we will follow cohorts of midlife and older adults (≥50 y) residing in both the rezoned area and a comparison area. We will assess clinically measured incident CVD and other CVD risk factors to evaluate changes in cardiovascular health over time. In parallel, we will conduct a cross-sectional survey and a purposive sampling of patients for in-person “walk-a-long” qualitative interviews to understand how residents perceive neighborhood access to healthful resources after land use rezoning. To estimate long-term effects, we will use a validated microsimulation model to project CVD outcomes and costs. Finally, we will use system dynamics modeling to integrate quantitative and qualitative findings to inform future revitalization and public health strategies.

RESULTS: Midlife and older adult patients (N=10,813) in the intervention area and the comparison area will be followed for approximately 7 years following land use rezoning and revitalization efforts to compare CVD risk between neighborhoods. The cross-sectional survey (n=300) and qualitative assessment (n=36) will increase understanding of perceptions of access to healthful resources and related health behaviors among residents. Systems science approaches will estimate long-term CVD risk and related costs associated with revitalization efforts. An advisory committee of clinical and community stakeholders will assist in interpreting results and developing dissemination strategies for their constituents. This study was funded from January 2023 until December 2026.

CONCLUSIONS: This study uses a socioecological framework to provide a novel, transferable method for evaluating the impact of neighborhood revitalization efforts on cardiovascular health by combining methods to examine short- and long-term effects across individual, neighborhood, and structural (system) levels over time. Findings will inform policies aimed at reducing CVD through equitable urban revitalization.

PMID:42133886 | DOI:10.2196/89056

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Nevin Manimala Statistics

Turkish Version of the Unfinished Nursing Care Survey: Validity and Reliability Data

J Nurs Manag. 2026;2026(1):e4585472. doi: 10.1155/jonm/4585472.

ABSTRACT

BACKGROUND: Measuring unfinished nursing care (UNC) with valid and reliable instruments is essential for identifying systemic issues and improving patient safety and outcomes. The Unfinished Nursing Care Survey (UNCS) was developed as a comprehensive, valid, and reliable tool. This study aimed to examine the validity and reliability of the Turkish version of the UNCS (UNCS-TR).

METHODS: This validation study established the linguistic equivalence of the UNCS-TR using the translation and back-translation method. Content validity was evaluated based on expert opinions. Construct validity, internal consistency, hypothesis testing, and criterion validity were examined among 422 nurses in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.

RESULTS: The overall content validity index of the UNCS-TR was 0.98. Mokken Scale Analysis for Part A demonstrated strong scalability (H = 0.616) and excellent internal consistency (Molenaar-Sijtsma statistic = 0.966; Cronbach’s alpha = 0.964; Guttman’s lambda 2 = 0.965). All 21 items reflecting elements of unfinished care loaded onto a unidimensional structure in Part A. For Part B, which measures reasons for UNC, confirmatory factor analysis supported an 18-item, six-factor structure with acceptable to good fit indices and excellent internal consistency (Cronbach’s α = 0.950). Nurses with greater professional experience reported significantly lower perceptions of UNC. No significant differences were found between bedside nurses and nurse managers. Nurses over 30 years of age perceived significantly fewer instances of UNC compared to younger nurses, and intensive care nurses reported significantly fewer instances than those working in medical-surgical units.

CONCLUSION: The Turkish version of the UNCS (UNCS-TR) is a valid and reliable instrument for measuring UNC.

PMID:42132010 | DOI:10.1155/jonm/4585472

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Nevin Manimala Statistics

University students’ acceptance of medication vending machines: A cross-cultural study in South Korea and the UAE

Work. 2026 May 14:10519815261450932. doi: 10.1177/10519815261450932. Online ahead of print.

ABSTRACT

BackgroundMedication vending machines (MVMs) have emerged as a convenient and technology-driven solution for improving access to over-the-counter medications on university campuses.ObjectiveThis study investigates the cultural determinants of MVM acceptance among university students in South Korea and the United Arab Emirates (UAE), providing cross-cultural insights into their attitudes and functional preferences.MethodsA cross-sectional survey was conducted with 48 participants (24 from each country). The questionnaire measured demographic characteristics, familiarity with vending machines, acceptance of MVMs, and the perceived importance of various MVM features.ResultsThe results indicate that both Korean and UAE students expressed positive attitudes toward the installation of MVMs (Mean on a 5-point Likert scale = 3.88 and 4.17, respectively), and the between-group difference was not statistically significant (F = 1.306, p = 0.259). However, cross-cultural differences emerged in functional preferences: UAE students prioritized ease of use (χ2 = 5.42, p = 0.020), while Korean students valued convenient location, diverse medication availability, and secure identification features.ConclusionsThese findings underscore the importance of culturally sensitive deployment strategies for autonomous healthcare technologies. This study contributes to the growing literature on technology acceptance in healthcare by highlighting how cultural and behavioral factors shape the adoption of MVMs. Practical recommendations for universities and policymakers include emphasizing usability in UAE campuses and strategic placement, diversity, and security features in Korean campuses to maximize acceptance.

PMID:42132008 | DOI:10.1177/10519815261450932

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Nevin Manimala Statistics

Nutritional Status as a Severity Predictor in Critical Pediatric Patients With COVID-19

Pediatr Pulmonol. 2026 May;61(5):e71662. doi: 10.1002/ppul.71662.

ABSTRACT

INTRODUCTION: Nutritional status plays an important part in the health of children and teenagers. It also has an impact on the clinical outcomes of disease situations. This paper’s objective is to evaluate the impact of nutritional status in the clinical outcomes of critically ill children diagnosed with COVID-19.

METHODS: This is an observational, longitudinal, and multicentric study, developed between March 2020 and December 2021, in 36 Pediatric Intensive Care Units in Brazil. The patients included were between the ages of 1 month old and 18 years old, with the diagnosis of COVID-19, confirmed by RT-PCR, from nasopharyngeal and oropharyngeal swabs, tracheal aspirates, or blood serology for the detection of IgA/IgM/IgG antibodies. Nutritional status was evaluated based on the z-score of the body mass index for age (BMI/A), weight for age (W/A), and stature for age (S/A). The outcomes evaluated included final clinical diagnosis of respiratory syndromes, need for ventilatory support, prolonged length of hospital stay, and mortality. A model of regression linear analysis was used to evaluate the independent association with the nutritional status.

RESULTS: Four hundred and thirty-two patients were included in the study. The average age was 30 months (IQR, 11-85); 200 (46.3%) were under 24 months old, and 29 (6.7%) had comorbidities. There were 302 (69.9%) patients with average weight, 54 (12.5%) were underweight, 76 (17.6%) were overweight, and 44 (23%) had short stature. The underweight category presented independent association with the outcomes of Acute Respiratory Distress Syndrome (ARDS) (RR 2.12; 95% CI 1.01-4.46; p = 0.04), need for invasive mechanical ventilation (IMV) (RR 1.8; 95% CI 1.1-3.1; p = 0.02), prolonged length of stay (LOS) (RR 1.5; 95% CI 1.01-2.1, p = 0.03), and mortality (RR 8; 95% CI 1.9-36; p = 0.005).

CONCLUSION: Independent association was identified between low weight in children with COVID-19 in Pediatric Intensive Care Units and longer length of hospital stay, need for IMV, ARDS and higher risk of mortality.

PMID:42132001 | DOI:10.1002/ppul.71662

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Nevin Manimala Statistics

Maternal β-hCG and neonatal hormone profiles as predictors of anogenital distance: assessing the fetal reproductive axis

J Pediatr Endocrinol Metab. 2026 May 15. doi: 10.1515/jpem-2026-0108. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the association of maternal β-human chorionic gonadotropin (β-hCG), neonatal thyroid hormones including free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH), and neonatal serum testosterone with anogenital distance (AGD) in term male and female newborns, and to assess sex-related differences.

METHODS: This hospital-based cross-sectional study included 133 term newborns (90 males and 43 females) delivered between 37 and 40 weeks of gestation. Maternal serum β-hCG levels were measured before delivery. Cord blood samples were analyzed for fT3, fT4, TSH, and neonatal venous blood samples for serum testosterone. AGD and neonatal anthropometric parameters were measured shortly after birth. Sex-wise comparisons and correlation analyses were performed.

RESULTS: Mean AGD was significantly greater in male newborns than in females (2.62 ± 0.09 cm vs. 1.15 ± 0.05 cm; p = 0.001). Maternal β-hCG levels differed between mothers of male and female newborns (p<0.05). Neonatal serum testosterone levels were higher in males, though not statistically significant (p=0.16). AGD showed positive correlations with maternal β-hCG and neonatal serum testosterone levels. Among thyroid hormones, mean fT3 levels were significantly higher in females (p=0.0001), while fT4 and TSH were comparable.

CONCLUSIONS: AGD at birth shows marked sexual dimorphism and is associated with maternal β-hCG and neonatal serum testosterone measured at birth. These findings provide reference data from an Indian newborn population. Given the timing of measurements, results should be interpreted with caution, and further longitudinal studies are required to clarify developmental determinants of AGD.

PMID:42131996 | DOI:10.1515/jpem-2026-0108

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Nevin Manimala Statistics

The DSM needs more than revision: five blind spots and a case for dialogical redesign

Psychol Med. 2026 May 14;56:e153. doi: 10.1017/S0033291726104644.

ABSTRACT

BACKGROUND: Recent proposals for revising the Diagnostic and Statistical Manual of Mental Disorders (DSM) aim to improve psychiatric diagnosis. While these efforts reflect substantial ambition, they continue to operate within assumptions embedded in the DSM’s underlying classificatory logic. This editorial examines whether such incremental revision is sufficient.

METHODS: We provide a critical analysis of the recently published DSM roadmap and accompanying subcommittee commentaries. Drawing on contemporary literature, we identify five structural blind spots in the current reform agenda: public mental health, scientific inference, lived experience, epistemic governance, and the function of diagnosis. Based on this analysis, we propose an alternative dialogical redesign for the DSM.

RESULTS: We argue that current revision considerations risk increasing complexity without resolving fundamental limitations in psychiatric classification. Specifically, our analysis highlights several areas that warrant further consideration, including the relationship between diagnostic expansion and societal conditions, the applicability of group-level scientific findings to individual care, the incorporation of experiential knowledge, participatory governance in revision processes, and the identity-related implications of diagnosis. In response, we propose redesigning the DSM as a hybrid dialogical system that retains coarse-grained classificatory categories for pragmatic purposes while shifting diagnostic practice toward contextual interpretation, collaborative meaning-making, relational understanding, and individualized care formulation.

CONCLUSIONS: The challenges facing psychiatric diagnosis require more than incremental refinement. We therefore argue for a dialogical redesign of the DSM that better reflects the context-dependent, experiential, and relational nature of mental health conditions, positioning diagnosis as a starting point for collaborative inquiry.

PMID:42131991 | DOI:10.1017/S0033291726104644

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Nevin Manimala Statistics

A Rapid Scoping Review of Resilience Facilitators and Barriers among Black Children and Young People in Canada

Can J Nurs Res. 2026 May 14:8445621261451565. doi: 10.1177/08445621261451565. Online ahead of print.

ABSTRACT

Background and PurposeDespite pervasive structural and systemic adversities, Black children and youth in Canada demonstrate significant resilience. However, mainstream discourse often privileges deficit-based narratives, marginalizing these strengths. This rapid scoping review identifies and synthesizes the breadth and depth of available evidence on resilience among Black young people in Canada to counter these stereotypes and inform culturally responsive interventions.MethodsThis rapid scoping review utilized four electronic databases, ProQuest (gray literature), and a supplemental Google Scholar search. Two independent reviewers performed screening and data extraction. Findings were synthesized using descriptive statistics and narrative description.ResultsA total of 24 reports, including 23 peer-reviewed articles, and one thesis met the inclusion criteria. Our findings reveal: (a) geographic (Ontario-centric) and methodological imbalances; (b) that most studies contextualized resilience around intersecting structural and systemic adversities, including anti-Black racism in schools, socioeconomic hardship, and mental health barriers; (c) that research primarily explored resilience capacities and processes, with less attention given to outcomes; (d) that resilience was supported by a dynamic combination of individual, relational, and community-level factors; and (e) that barriers to resilience spanned systemic, interpersonal, and individual levels, with racial discrimination and structural racism acting as pervasive obstacles.ConclusionsResilience among Black youth is a dynamic process of resistance to structural racism, not just a personal trait. While matrifocal networks and spirituality are powerful facilitators, they are frequently hindered by systemic exclusion in education and healthcare. Future efforts must prioritize structural reforms and relational nursing care.

PMID:42131960 | DOI:10.1177/08445621261451565

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Nevin Manimala Statistics

Structural variation of the pineal gland in shift workers from neuroimaging evidence

Chronobiol Int. 2026 May 14:1-7. doi: 10.1080/07420528.2026.2674041. Online ahead of print.

ABSTRACT

Night work disrupts the circadian system, alters melatonin signaling, and is associated with sleep and mental health disturbances. The pineal gland is central to circadian regulation. However, structural neuroimaging evidence of pineal adaptation to chronic circadian disruption in humans remains limited. This cross-sectional neuroimaging study included 110 healthcare workers, 32 night workers and 78 day workers. High-resolution T1- and T2-weighted magnetic resonance imaging was used to quantify total pineal gland volume, parenchymal volume, and cyst prevalence. Circadian-related sleep disturbance was assessed using the General Sleep Disturbance Scale. Associations with night-work exposure and sleep domains were examined using nonparametric statistical methods. Total and parenchymal pineal volumes did not differ between both workers. However, the pineal cyst prevalence was higher among night workers. Within the night-work group, a greater pineal parenchymal volume correlated positively with sleep-maintenance disturbance. Pineal volume increased during early night-work exposure and subsequently stabilized with longer exposure. Night work was associated with distinct pineal structural features, potentially reflecting morphological adaptations of the human circadian system to chronic disruption. These preliminary findings suggest that pineal morphology could serve as a circadian strain structural marker, but longitudinal studies incorporating direct circadian and hormonal measures are required to establish its biomarker potential.

PMID:42131956 | DOI:10.1080/07420528.2026.2674041

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Nevin Manimala Statistics

Effectiveness of erector spinae plane block combined with physical therapy in adult degenerative scoliosis: A randomized controlled trial

J Back Musculoskelet Rehabil. 2026 May 14:10538127261451748. doi: 10.1177/10538127261451748. Online ahead of print.

ABSTRACT

BackgroundAdult degenerative scoliosis is a common condition in the aging population, and conservative treatment approaches are often used as the first-line management for symptom control.ObjectiveTo evaluate the efficacy of the erector spinae plane block, when administered in conjunction with physical therapy, on pain severity, disability, and quality of life in patients diagnosed with degenerative lumbar scoliosis.MethodsA total of 26 patients aged 60 and older were randomized into two groups: Group 1 received physical therapy, while Group 2 received physical therapy plus an erector spinae plane block. The severity of pain was evaluated using the Numeric Rating Scale, while disability and quality of life were assessed using the Oswestry Disability Index and the SRS-22 questionnaire.ResultsThe severity of pain was statistically diminished in the 1st week, 1st month, and 3rd month after treatment in both groups (p < 0.01). Oswestry Disability Index and SRS-22 total scores showed notable improvements at each time point in both groups (p < 0.01). However, except for pain scores at 3 months, no statistically significant differences were observed between the two groups in terms of pain, disability, or quality of life scores.ConclusionPhysical therapy is an effective method for controlling pain, improving functionality, and improving quality of life in patients with adult degenerative scoliosis. The rapid, short-term pain relief achieved through erector spinae plane block may encourage patient adherence to treatment and enhance the effectiveness of rehabilitation. Future studies with larger samples are needed to evaluate long-term effects of these interventions and personalized treatment strategies.

PMID:42131955 | DOI:10.1177/10538127261451748