Tag: pubmed

BMC Psychol. 2026 Apr 14. doi: 10.1186/s40359-026-04510-9. Online ahead of print.

ABSTRACT

BACKGROUND: Willpower and self-regulation are central developmental capacities associated with children’s academic success, psychosocial adjustment, and long-term well-being. Although these constructs have been widely studied in preschoolers and adults, limited research has explored how school-aged children themselves perceive and experience willpower in their everyday lives. This study aimed to explore school-aged children’s lived experiences of willpower and self-regulation, focusing on their emotional processes, strategies, role models, and metaphorical meanings.

METHODS: A qualitative phenomenological design was employed. The study was conducted with 21 children aged 6-12 years attending a public primary and secondary school in the Anatolia region of Türkiye. Participants were selected using purposeful criterion sampling. Data were collected between September and October 2025 through three focus group interviews using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s seven-step phenomenological analysis method. Sociodemographic data were analyzed using descriptive statistics. Trustworthiness was ensured following Lincoln and Guba’s criteria.

RESULTS: Four main themes emerged: (1) Being caught between desire and responsibility, (2) Persisting despite difficulty and associated emotions, (3) Perceptions of strong willpower and role models, and (4) Self-regulation strategies. Children described willpower as navigating internal conflicts between immediate desires (e.g., play, screen time) and responsibilities (e.g., studying, helping at home). Emotional experiences were central; persistence was initially accompanied by hesitation or discomfort but ultimately reinforced by pride and satisfaction. Children identified parents and teachers as key role models, emphasizing patience, planning, and consistency as indicators of strong willpower. They reported diverse self-regulation strategies, including planning, time management, goal setting, cognitive redirection, pairing tasks with enjoyable activities, and breaking tasks into smaller parts. Metaphorically, willpower was described as a “shield” or a “robot,” symbolizing protection, strength, and control.

CONCLUSIONS: School-aged children experience willpower and self-regulation as dynamic, emotionally charged, and socially shaped processes enacted through context-sensitive strategies. Understanding children’s subjective meanings may inform educational and pediatric nursing practices aimed at fostering flexible and developmentally appropriate self-regulatory capacities.

PMID:41981682 | DOI:10.1186/s40359-026-04510-9

Implement Sci Commun. 2026 Apr 14. doi: 10.1186/s43058-026-00941-y. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding how implementation strategies work is vitally important for the deployment of evidence-based practices (EPBs) in healthcare settings. Specifically, mechanistic inquiry provides information on specific targets (e.g., buy-in, saliency) that must be engaged for a strategy to be successful. We used mixed-methods to investigate mechanisms of facilitation as part of a trial to implement S.A.F.E. Firearm, a brief evidence-based practice which includes firearm storage counseling and offering free cable locks in pediatric primary care during well-child visits.

METHODS: We used a mixed-methods approach to ascertain mechanisms. Quantitative analyses determined whether clinic-level adaptive reserve (e.g., mechanism) mediated the impact of facilitation (e.g., strategy) on reach (e.g., primary outcome). Adaptive reserve, evaluated via clinician survey, refers to a clinic’s ability to broadly make and sustain change and includes multiple components (i.e., relationship infrastructure, facilitative leadership, sensemaking, teamwork, work environment, and culture of learning). Importantly, adaptive reserve is not the specific capacity to implement a given EBP. Second, qualitative interviews guided by the updated Consolidated Framework for Implementation Research, and analyzed using deductive and inductive approaches, were conducted with pediatric clinicians, clinic change agents, and health system leaders to ascertain other mechanisms. Mixed methods integration occurred at completion of both activities.

RESULTS: Quantitative analyses indicated that adaptive reserve did not mediate the effect of facilitation on reach. Qualitative findings illustrated other potential mechanisms of facilitation including: increasing buy-in and saliency to help overcome initial inertia and to support application of training principles in practice; strong collaborative relationships between facilitators and clinics to improve accountability; in-person visits or electronic communications that serve as reminders; reinforcing the why and how of the intervention (sensemaking); and fostering team collaboration to troubleshoot logistical barriers.

DISCUSSION: While prior studies have found that adaptive reserve was related to facilitation, our mediation analysis did not support this hypothesis. Contextual factors may offer potential explanations, particularly a lower-intensity facilitation in this context commensurate with a smaller practice change (e.g., a brief program intended to take < 1 min), but further study is needed. Our qualitative results offer a potentially new mechanistic model of facilitation to be investigated in future studies.

PMID:41981665 | DOI:10.1186/s43058-026-00941-y

BMC Nutr. 2026 Apr 14. doi: 10.1186/s40795-026-01322-3. Online ahead of print.

NO ABSTRACT

PMID:41981659 | DOI:10.1186/s40795-026-01322-3

Syst Rev. 2026 Apr 14. doi: 10.1186/s13643-026-03175-0. Online ahead of print.

ABSTRACT

BACKGROUND: Cancers of the oesophagus, gastroesophageal junction (GEJ), and proximal stomach share epidemiological, molecular, and therapeutic characteristics. Despite their similarities, treatment guidelines vary, and the classification of GEJ tumours remains debated. While multiple meta-analyses have addressed subsets of these malignancies, a comprehensive synthesis comparing all treatment modalities across this disease spectrum is lacking. This study aims to perform a systematic review and network meta-analysis (NMA) to compare the overall survival outcomes of different treatment modalities, including surgery, chemotherapy, chemoradiotherapy, immunotherapy, and multimodal approaches, in patients with oesophageal, GEJ, and gastric cancers.

METHODS AND ANALYSIS: We will conduct a systematic literature search in MEDLINE (PubMed) and The Cochrane Library (CENTRAL) without date restrictions. Randomised controlled trials (RCTs) comparing eligible treatments will be included. The primary outcome will be overall survival, defined as time from diagnosis to death from any cause. Secondary outcomes will include progression-free survival, disease-specific survival, dropout rates, treatment-related adverse effects, patterns of relapse, R0 resection rates, surgical morbidity, and mortality. We will look for individual patient data (IPD) from primary studies’ authors and registries. We will assess risk of bias with the Cochrane risk of bias RoB2 tool. We plan to present each pairwise comparison with risk ratios and 95% confidence intervals from random-effects meta-analysis. A random-effects NMA model will simultaneously compare all treatments in the network. We will rank interventions using P-scores. In case we manage to access IPD and we believe the transitivity assumption does not hold for a specific comparison (or we have a disconnected network), we will use population adjustment methods to estimate an indirect treatment comparison. We will apply CINeMA to assess confidence in the findings and we will report results according to PRISMA-NMA.

DISCUSSION: Neoplasms of the oesophagus, the gastroesophageal junction, and the stomach are increasingly being studied together in clinical trials, a trend driven by continuous research on their molecular characteristics and shared therapeutic patterns. This NMA aims to pool evidence employing recent advances in meta-analytic models and critically assess the confidence in the results by implementing the CINeMA approach.

SYSTEMATIC REVIEW REGISTRATION: Registered in PROSPERO (CRD42025634169).

PMID:41981647 | DOI:10.1186/s13643-026-03175-0

Arthroplasty. 2026 Apr 14;8(1):29. doi: 10.1186/s42836-026-00384-9.

ABSTRACT

BACKGROUND: Conventional robotic-assisted total knee arthroplasty (RA-TKA) relies on rigid limb fixation to suppress intra-operative motion, adding complexity and potential inefficiency. A novel motion-following control system dynamically compensates for limb movement, allowing real-time adjustment of the tool-bone relationship without immobilization. This study evaluated whether motion-following improves efficiency and osteotomy accuracy while preserving alignment and early function.

METHODS: Sixty consecutive primary RA-TKA cases performed with the SkyWalker robotic platform (MicroPort, Shanghai, China) between September 2022 and August 2024 were retrospectively reviewed. Thirty procedures used conventional rigid fixation (control group) and thirty employed motion-following tracking (motion-Following group). Primary endpoints were operative time and resection thickness error, measured intraoperatively with a caliper. Secondary outcomes included coronal alignment assessed by HKA (hip-knee-ankle angle), CFCA (coronal femoral component angle), and CTCA (coronal tibial component angle), as well as functional recovery assessed by WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) at 6 months. Values are expressed as mean ± standard deviation unless otherwise specified.

RESULTS: Mean operative time was shorter with motion-following (118.8 ± 9.3 min) than with conventional fixation (133.9 ± 11.9 min; p < 0.001). Mean resection-thickness error was lower with motion-following (0.53 mm vs 0.82 mm), with 93.9% versus 68.3% of cuts within ≤ 1 mm. At the plane level, motion-following achieved smaller errors on all six surfaces, with four planes: DF-M (distal femur medial), distal femur lateral (DF-L), posterior femur medial (PF-M), and tibial plateau lateral (TP-L) reaching statistical significance (p < 0.05). Post-operative coronal alignment closely reproduced the pre-operative plan in both groups, with mean deviations of approximately 1° across all parameters and no statistically significant between-group differences. WOMAC scores improved substantially in both groups, with no significant between-group difference (ΔWOMAC 32.8 ± 8.5 vs 30.1 ± 7.9; p = 0.21).

CONCLUSIONS: Motion-following robotic control streamlines TKA by eliminating rigid fixation, improving workflow efficiency, and slightly enhancing osteotomy precision without compromising alignment or recovery. This dynamic, real-time tracking approach refines execution of the surgical plan and may represent a meaningful evolution toward more efficient, surgeon-friendly robotic arthroplasty.

PMID:41981645 | DOI:10.1186/s42836-026-00384-9

BMC Womens Health. 2026 Apr 14. doi: 10.1186/s12905-026-04455-6. Online ahead of print.

NO ABSTRACT

PMID:41981623 | DOI:10.1186/s12905-026-04455-6

BMC Med Educ. 2026 Apr 14. doi: 10.1186/s12909-026-09163-1. Online ahead of print.

NO ABSTRACT

PMID:41981561 | DOI:10.1186/s12909-026-09163-1

BMC Health Serv Res. 2026 Apr 14. doi: 10.1186/s12913-026-14526-x. Online ahead of print.

NO ABSTRACT

PMID:41981551 | DOI:10.1186/s12913-026-14526-x

BMC Public Health. 2026 Apr 14. doi: 10.1186/s12889-026-27349-6. Online ahead of print.

NO ABSTRACT

PMID:41981550 | DOI:10.1186/s12889-026-27349-6

BMC Pulm Med. 2026 Apr 14. doi: 10.1186/s12890-026-04296-x. Online ahead of print.

NO ABSTRACT

PMID:41981536 | DOI:10.1186/s12890-026-04296-x