Conectar
by Zoya Waqas, Aisha Irum, Muhammad Ibrahim, Maheen Sughra, Sanaa Khan, Ayesha Khan, Adnan Ahmad Khan
IntroductionUnintended pregnancies remain a major public health concern globally and in Pakistan, where family planning (FP) uptake continues to be hindered by entrenched social and behavioral barriers. This study applies the Theory of Planned Behavior (TPB) to examine how attitudes, subjective norms, and perceived behavioral control (PBC) shape women’s contraceptive intentions in Pakistan.
MethodsWe analyzed data from 13,335 non-pregnant women aged 15–49 using the Pakistan Demographic and Health Survey (PDHS) 2017–18. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to test TPB pathways. Model reliability, validity, and fit were assessed using Composite Reliability, Average Variance Extracted, discriminant validity indices, and bootstrapped estimates to ensure analytical rigor.
ResultsOver half of respondents lacked formal education, and most (84%) were unemployed. Only 23% had FP knowledge, and 96% were unaware of contraceptive side effects. Subjective norms negatively influenced contraceptive intentions (β = −0.056, p Conclusion
The study demonstrates the applicability of TPB for understanding contraceptive intentions in a collectivist, patriarchal context. Subjective norms and PBC emerge as critical determinants, underscoring the need for interventions that engage families, strengthen women’s autonomy, and improve access to FP services. The findings offer a theoretically grounded and policy-relevant framework for designing behaviorally informed family planning programs in Pakistan.
Stroke is one of the top causes of disability in Malaysia, yet caregivers have limited access to structured, culturally tailored education to support poststroke care.
To develop and validate the CaknaStrok Education Package (CEP), a blended learning intervention comprising a printed guidebook and a trilingual mobile health application for informal stroke caregivers in Malaysia.
Methodological study involving the development and validation of a caregiver education programme guided by the Analyse, Design, Develop, Implement, Evaluate (ADDIE) instructional design framework.
Development and validation were conducted in Malaysia between January 2022 and December 2023. Both experts and caregivers were recruited from two tertiary hospitals on the East Coast of Malaysia, with caregivers identified from inpatient wards and outpatient clinics at these hospitals.
Content validation involved 10 multidisciplinary experts. Face validation involved 14 informal stroke caregivers who met eligibility criteria, and all completed the study.
CEP was developed based on prior needs assessment and expert input. Content validation was undertaken using the Content Validity Index (CVI) and face validation using the Face Validity Index (FVI), both assessed on a four-point Likert scale. Qualitative feedback was also obtained from the participants.
CEP consists of six modules delivered via a printed guidebook and a trilingual app with videos, assessment tools and local resources. Experts rated the content highly valid (Scale-level (S)-CVI/the average method (Ave): 0.97–0.99 across domains). Caregivers reported strong acceptability (S-FVI/Ave: 0.95–0.99). Qualitative feedback from experts and caregivers informed refinements to content clarity, usability and presentation, including improved navigation, consistent language use and enhanced visual design. Suggestions requiring substantial structural changes were documented for future iterations.
The CEP shows strong content and face validity as a blended caregiver education tool. By combining printed and digital formats, CEP addresses cultural and access challenges and provides a scalable model for stroke caregiver education in Malaysia. Further pilot or feasibility studies are warranted to evaluate usability, engagement and implementation in real-world settings prior to effectiveness evaluation.
Older adults face growing risks of depression and anxiety, yet stigma, comorbidities, cost, and limited access impede receipt of conventional care. Digital mental health interventions (DMHIs), including immersive virtual reality (VR), exergaming, and mobile apps, may reduce these barriers.
To evaluate the efficacy of DMHIs in reducing depressive and anxiety symptoms among adults aged ≥ 50 years.
We conducted a PRISMA adherent systematic review and meta-analysis of randomized controlled trials. Interventions included immersive VR, exergaming/physical digital platforms, mobile applications, and digital cognitive training. Standardized mean differences (SMDs) were pooled with random effects models; heterogeneity was assessed with I 2.
Nineteen RCTs (n = 718; mean ages 50.9–84.7 years) met inclusion criteria. Across studies, DMHIs significantly reduced depressive symptoms (SMD = −0.656, 95% CI = −0.932 to −0.380; p < 0.001) and anxiety symptoms (SMD = −0.559, 95% CI = −0.740 to −0.380; p < 0.0001). Immersive and physically engaging modalities (e.g., VR, exergaming) outperformed app-based approaches. Heterogeneity ranged from moderate to high (I 2 ≈ 69.6%–97%).
Offer DMHIs: especially VR or exergaming when access to in-person therapy is limited or as an adjunct to usual care. Provide brief onboarding and, when feasible, caregiver support to boost adherence and confidence with technology. Select or configure age-friendly interfaces (e.g., large fonts, simple navigation) to address common usability barriers. Integrate DMHIs into stepped-care or rehabilitation pathways and monitor outcomes with validated tools (e.g., GDS, STAI). Address equity by supplying devices/connectivity solutions and consider cost-effectiveness and long-term engagement in implementation plans.
Trial Registration: PROSPERO ID: CRD420250655153
Non-communicable diseases (NCDs) are rapidly escalating in developing countries and social factors such as the dynamics of the family play an important part in the lifestyle choices that lead to the onset and maintenance of chronic illness. There remains a gap in Malaysia as the majority of the studies were focused on the normal population rather than directly towards persons having NCDs. This study aimed to examine emerging risk factors such as family functionality and its association with NCD.
A cross-sectional survey was conducted using a multistage random sampling method.
Urban residential areas in Selangor, Malaysia.
A total of 2542 adults residing in urban areas of Selangor were recruited.
Family functionality was measured using the APGAR (Adaptation, Participation, Gain or Growth, Affection and Resources) scale and multiple logistic regression was performed to measure the association between emerging risk factors and NCD.
The prevalence of diabetes mellitus and hypertension was 10.8% and 6.1%, respectively. Widowed/separated status (adjusted OR (AOR) 41.53, 95% CI 19.06 to 90.48, p value=0.001) was reported to be a predictor of diabetes. As for hypertension, familial functionality (AOR 4.2, 95% CI 1.11 to 14.50, p value
There is a growing concern that family functionality is an emerging risk factor for NCDs. Future family-centred health promotion programmes should be incorporated to improve self-management behaviours and health outcomes.
by Yu Wang, Filzani Illia Ibrahim, Junlin Chang, Siti Norzaini Zainal Abidin
The issue of stress among urban residents is becoming increasingly serious, affecting both physical and mental health in cities in China. Pocket parks serve as essential green spaces for people’s well-being in high-density urban environments. However, limited empirical research has examined how plant landscape components support stress recovery among urban residents, particularly in the context of pocket parks in China. This study investigated the effects of plant species richness and plant landscape types on stress recovery, with a focus on the mediating role of perceived aesthetic quality. A pre-test and post-test design were conducted in six selected pocket parks with different landscape characteristics using questionnaire surveys. A total of 605 urban residents were recruited using a random sampling method at different sites. The results indicated that medium plant species richness (t = −10.502, p pby Fahad Saleem, Fazal ur Rehman Khilji, Sajjad Haider, Qaiser Iqbal, Baharudin Ibrahim, Fatiha Hana Shabaruddin, Mohammad Bashaar
Terrorism-related disasters (TRDs) continue to exert profound and recurring pressures on healthcare systems, particularly in vulnerable regions like Pakistan. Although pharmacists are increasingly recognized as an essential component of disaster management, there is a clear gap in the literature regarding their preparedness, experience, and specific roles in responding to TRDs particularly in low and middle-income countries. This study aimed to explore the preparedness, experiences, and response strategies of pharmacists managing TRDs at the Trauma Centre of Sandeman Provincial Hospital, Quetta, Pakistan. A qualitative design was adopted, guided by the Consolidated Criteria for Reporting Qualitative Research. Semi-structured, face-to-face interviews were conducted with pharmacists (n = 10) providing services at the Trauma Centre. Data were audio-recorded, transcribed verbatim, validated by participants, and analyzed using thematic content analysis. Analysis revealed five overarching themes: (1) pharmacists’ experiences with terrorism-related incidents and existing response mechanisms; (2) professional and personal responses to emergencies, reflecting both commitment and psychological burden; (3) preparedness challenges, including lack of disaster management training, limited awareness of policies and protocols, and inadequate understanding of triage and coordination; (4) barriers such as security risks, pharmacy curriculum deficiencies, insufficient experiential learning, and minimal involvement in planning and management activities; and (5) recommendations for strengthening capacity, including revising curricula, implementing structured training programs, conducting regular disaster drills, and expanding pharmacists’ roles in preparedness and response. Findings revealed a pronounced lack of formal training in disaster management, limited awareness of protocols and triage systems, and minimal involvement of pharmacists in planning and coordination activities. Despite strong professional commitment and frontline engagement, pharmacists’ contribution remain constrained by educational, structural, and policy-level shortcomings. The study highlights the urgent need for integrating disaster management into pharmacy curricula, implementing structured training programs and regular disaster drills, and expanding pharmacists’ roles within institutional and national disaster preparedness frameworks.by Ibrahim Abdalla Alfaki, Michal Grivna, Mohamed El Sadig
Despite significant progress in road safety in developed countries, it remains a persistent and critical challenge in the developing world. This study investigates the long- and short-term relationships between socio-economic conditions and road safety performance in affluent developing countries, using the United Arab Emirates (UAE) as a case study. Employing an autoregressive distributed lag (ARDL) cointegration error-corrected model with data from 1980 to 2024 (sourced from the UAE Federal Government, the World Bank, and UN World Population Prospects), the analysis examines the link between the road crash severity index (fatalities to total injuries) and core socio-economic variables—GDP per capita, unemployment rate, and population density—while controlling for traffic law enforcement via fines. The findings confirm a long-term equilibrium, with an error correction term indicating road safety adjusts to socio-economic shocks at a rapid annual rate of 60%. Granger-causality tests further establish that these socio-economic factors significantly influence road safety outcomes, a concern underscored by an identified upward trend in crash severity. We conclude that socio-economic conditions are a fundamental determinant of road safety, highlighting the necessity for policy interventions that move beyond traditional engineering solutions. Consequently, road safety must be reframed not solely as a transportation concern but as an integral objective of public health and socioeconomic policy, which requires a collaborative, multi-sectoral approach to forge a resilient, safe system.To determine the prevalence of internet addiction and examine its association with psychological factors specifically depression, anxiety and loneliness among Malaysian public university students.
Cross-sectional study.
All public universities in Malaysia, 20 universities.
The study included 7278 students from 20 public universities in Malaysia.
Statistical analyses were performed usingSTATA V.17 software. Descriptive statistics summarised participants’ demographic characteristics, prevalence of internet addiction and psychological distress (depression, anxiety and loneliness). Pearson’s correlation was used to assess bivariate relationships between internet addiction and psychological variables, while multiple logistic regression identified independent factors associated with internet addiction after adjusting for significant confounders.
The study found that 38.6% of the students showed signs of internet addiction, along with a high level of psychological distress; 24.8% had depressive symptoms, 32.4% experienced anxiety and 35.5% reported loneliness. Moderate positive correlations were observed between internet addiction and depression, anxiety and loneliness (p
The findings indicate significant associations between internet addiction and psychological factors such as depression, anxiety and loneliness. A comprehensive, multifaceted approach is essential to address psychological distress among university students and reduce the risk of internet addiction.
To examine the association between workplace sexual harassment and post-traumatic stress disorder (PTSD) symptoms among nurses in southeast Iran.
Cross-sectional study.
Four teaching hospitals affiliated with Kerman University of Medical Sciences, Iran.
A total of 283 female nurses with at least 1 year of clinical experience participated in the study.
Data were collected using convenience sampling and assessed using a demographic questionnaire, the Nurses’ Sexual Harassment Questionnaire, and the Impact of Event Scale-Revised (IES-R). Non-parametric tests, Spearman’s rho correlation and multivariate logistic regression were used for analysis.
Overall, 39.1% of nurses reported experiencing sexual harassment sometimes to always. A total of 13.4% screened positive for PTSD. Sexual harassment was significantly associated with PTSD symptoms (OR: 1.26; 95% CI 1.164 to 1.364). Younger, single and less experienced nurses reported higher harassment levels, though sociodemographic variables were not associated with PTSD.
Workplace sexual harassment was significantly associated with increased PTSD symptoms among nurses. While demographic factors were related to harassment exposure, they were not linked to PTSD. Findings highlight the importance of preventive organisational strategies to mitigate harassment and protect nurses’ mental well-being.
by Qian Yue Tan, Kinda Ibrahim, Helen C. Roberts, Khaled Amar, Simon D.S. Fraser
BackgroundPeople with Parkinson’s (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes.
ObjectiveTo assess the extent of treatment burden in Parkinson’s disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden.
MethodsA mixed-methods study was conducted consisting of: 1) a UK-wide cross-sectional survey for PwP and caregivers using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden levels and associated factors and 2) focus groups with key stakeholders to discuss survey findings and develop recommendations.
Results160 PwP (mean age = 68 years) and 30 caregivers (mean age = 69 years) completed the surveys. High treatment burden was reported by 21% (N = 34) of PwP and 50% (N = 15) of caregivers using the MTBQ. Amongst PwP, higher treatment burden was significantly associated with advancing PD severity, frailty, a higher number of non-motor symptoms, and more frequent medication timings (>3 times/day). Caregivers reporting higher treatment burden were more likely to care for someone with memory issues, had lower mental well-being scores and higher caregiver burden. Three online focus groups involved 11 participants (3 PwP, 1 caregiver and 7 healthcare professionals) recruited from the South of England. Recommendations to reduce treatment burden that were discussed in the focus groups include improving communication. clear expectation setting, and better signposting from healthcare professionals, increasing education and awareness of PD complexity, flexibility of appointment structures, increasing access to healthcare professionals, and embracing the supportive role of technology.
ConclusionsTreatment burden is common amongst PwP and caregivers and could be identified in clinical practice using the MTBQ. There is a need for change at individual provider and system levels to recognise and minimise treatment burden to improve health outcomes in PD.
The effectiveness of humanitarian health and nutrition programmes in Somalia is critically dependent on seamless collaboration and coordination among a diverse array of actors. While existing literature acknowledges broad challenges to coordination such as insecurity, resource competition and fragmentation, a significant gap remains in understanding how these barriers and their corresponding enablers actively manifest in the daily operations and decision-making processes of frontline practitioners.
This study aims to provide a systematic, in-depth exploration of the barriers and enablers influencing collaboration and coordination mechanisms from the perspective of those directly involved in the response.
A qualitative study was conducted using semi-structured, in-depth interviews. Data were analysed using a deductive thematic approach guided by the Consolidated Framework for Implementation Research.
The study was conducted across the entire territory of Somalia, encompassing its five member states, the capital city Mogadishu, and the self-declared independent state of Somaliland.
A total of 26 participants, including executive directors, health and nutrition programme managers, coordinators from international and national non-governmental organisations (NGOs), government officials and community members, were interviewed.
Key barriers included poor adaptability and high complexity related to collaborative initiatives (intervention characteristics); armed conflicts, climatic shocks, deeply ingrained sociocultural practices and restrictive government policies (outer setting); inadequate information technology infrastructure and hierarchical communication (inner setting); high staff turnover (individual characteristics). Key enablers included strong inter-agency partnerships (outer setting); supportive organisational culture (inner setting); competent and motivated staff (individual characteristics); and robust planning, engaging and evaluation processes (process).
The study highlights the complex contextual factors that impact the effectiveness of collaboration and coordination mechanisms among humanitarianorganisations operating in Somalia. Policymakers should unify governance, agencies prioritise localisation and donors allocate quotas to local NGOs to enhance aid delivery.
Epilepsy prevalence varies widely across Nigeria, with rates ranging from 3.1 to 37.0/1000 population. There have been no studies on epilepsy prevalence and treatment gap in the Northeast Region of Nigeria. This study aimed to study epilepsy prevalence and the epilepsy treatment gap (ETG) in an urban and a rural community in Northeast Nigeria.
Cross-sectional, community-based survey.
Epilepsy screening of residents in two communities in Northeast Nigeria using a WHO screening tool and a validated study questionnaire from 1 March to 10 June 2022.
8599 community residents aged ≥2 years.
Prevalence of epilepsy, active epilepsy, ETG and associated factors.
We screened 8599 residents, of whom 88 had epilepsy. Crude epilepsy prevalence was 10.2 per 1000 and was three times higher in the rural than in the urban community (18.5 vs 6.4; 2=26.79, p2=0.087, p=0.768). Logistic regression analysis showed that the ETG was associated with a lack of counselling (OR 15.8, 95% CI 3.5 to 70.7, p
The prevalence of epilepsy in Bauchi State was within the range reported in Nigeria but three times higher in the rural than in the urban community. A high ETG was associated with poor counselling of people with epilepsy. Epilepsy counselling, health education and wider access to neurology services could reduce the burden of epilepsy in Northeast Nigeria.
by Nadeen Ibrahim, Shaifer Jones, Katherine Rich, Lisandra Alvarez, Carolina Price, Natalie Kil, Frederick L. Altice, Jaimie P. Meyer
BackgroundPeople who inject drugs (PWID) experience high risk for HIV and HCV infection, which can be mitigated by harm reduction strategies, including syringe service programs (SSP). Understanding individuals’ patterns of substance use and SSP utilization is important for optimizing harm reduction strategies and disease prevention for PWID.
MethodsWe evaluated demographic characteristics and service utilization from the New Haven Syringe Services Program (NHSSP), a low-threshold service delivery site in New Haven, Connecticut that provides fully integrated harm reduction and primary healthcare services to PWID. Site-specific data were extracted from the e2ctprevention database, managed by the Connecticut Department of Public Health, and EvaluationWeb from January 2017 to October 2023. We conducted a descriptive analysis of basic demographic and social characteristics of SSP clients, transaction characteristics, and service utilization. Statistical analyses were conducted using STATA v 16.1 and IBM SPSS Statistics (v 29.0.2.0).
ResultsAmong 1,189 unique individuals utilizing SSP during the observation period, most (65.2%) identified as men and white (73.3%), consistent with SSP clients regionally and nationally. The mean age of clients was 41 years (SD = 9.8); approximately half of participants were unstably housed and 80% were unemployed at intake. From June 2020 to October 2023, there were 7,238 transactions, which increased throughout the COVID-19 pandemic period. During this period, the program dispensed 1,860,621 syringes, in addition to other materials, including overdose education and naloxone distribution (OEND), and provided patient education on safer injecting techniques and wound care.
ConclusionIn this first comprehensive analysis of a large SSP since its inception and through the COVID-19 pandemic, we described important client characteristics and utilization of an array of syringe services from an integrated SSP. Findings suggest the SSP attracts a high volume of clients, provides on-demand services, and reaches a wide range of clients. Future research is needed to evaluate the impact of the program’s home-delivery service and increased outreach efforts. Despite limitations, the program’s success demonstrates the SSP can serve as a model for other harm reduction programs nationally.
This study aims to identify the impact of climate change anxiety and asthma control on asthmatics' quality of life and examine the moderating role of climate change anxiety in this linkage.
A multi-national cross-sectional study was conducted in four Arabian countries on 1266 asthmatics selected by convenience sampling. Data were collected from November 2023 to February 2024 using a climate anxiety scale, mini-asthma quality of life questionnaire, and an asthma control questionnaire.
Climate anxiety was higher among middle-aged participants, as well as those with longer disease durations and previous hospitalisations. Climate anxiety showed strong negative correlations with asthma control (r = −0.704, p ≤ 0.05) and asthma quality of life (r = − 0.638, p ≤ 0.05). Climate anxiety and asthma control are powerful predictors of quality of life among asthmatics. Climate anxiety moderates the relationship between asthma control and quality of life, making it less positive (B = −0.094, p > 0.001). Covariates such as gender, age, comorbidities, employment status, disease duration, and previous hospitalisation showed significant associations with asthma quality of life.
Assessment and mitigation of climate anxiety among asthmatics is a key strategy for controlling asthma and improving the quality of life. So, nurses must incorporate climate anxiety assessment into the care plan for asthmatics.
Climate change is a global concern, and insights into how climate-related psychological stressors exacerbate asthma symptoms and overall health outcomes are necessary. The findings provide actionable data for healthcare professionals to underscore the need for integrated healthcare approaches considering environmental and psychological factors.
This study adheres to strengthening the reporting of observational studies in epidemiology (STROBE) statement.
Clients with asthma across multiple nationalities actively contributed to our paper.
Despite efforts to improve feeding practices globally, 48% of children do not meet the recommended minimum meal frequency. Thus, the aim of this study was to assess minimum meal frequency and its associated factors in children aged 6–23 months in cash crop districts of Kercha, Southern Ethiopia.
A community-based cross-sectional design was used to conduct this study from 29 February 2024 to 29 March 2024.
Kercha district, Southern Ethiopia
A total of 543 children aged 6–23 months were selected using a multistage sampling technique.
The primary outcome of this study was minimum meal frequency, defined as the percentage of children aged 6–23 months who consumed solid, semisolid or soft foods (including milk for non-breastfed children) at least the required number of times for their age in the previous day.
The secondary outcome of this study was factors associated with minimum meal frequency. Bivariable and multivariable multilevel mixed-effect logistic regression analyses were performed to find factors related to minimum meal frequency. Adjusted ORs (AORs) with 95% CIs and p values
A total of 539 (99.3%) children aged 6–23 months and their mothers participated in this study. The prevalence of minimum meal frequency was 62.3% (95% CI 58.1% to 66.4%) among children in the cash crop district of Kercha. The final model yielded an intracluster correlation coefficient of 7.3%, reflecting unexplained variations in the prevalence of minimum meal frequency among children at the kebele level. Factors associated with higher odds of meeting minimum meal frequency included being a first-born child (AOR 2.91, 95% CI 1.06 to 8.05), mothers (AOR 2.66, 95% CI 1.48 to 4.76) and fathers (AOR 3.43, 95% CI 1.98 to 5.95) with primary education, having mother attending postnatal visits (AOR 2.74, 95% CI 1.52 to 4.94), introducing additional food at 6 months (AOR 4.71, 95% CI 2.79 to 7.94), good maternal knowledge on child feeding (AOR 1.98, 95% CI 1.21 to 3.22) and living in the household with medium (AOR 2.98, 95% CI 1.59 to 5.53) and rich (AOR 2.39, 95% CI 1.37 to 4.18) wealth status.
The study revealed that only three-fifths of children met the recommended minimum meal frequency. Birth order, introducing additional foods at 6 months, parental education, maternal postnatal visits, good maternal knowledge on child feeding and wealth were linked to minimum meal frequency. To improve child nutrition, it is crucial to enhance maternal education, increase access to postnatal healthcare and educate parents about the importance of introducing additional foods at 6 months.
To examine whether emotional intelligence mediates the relationship between gender role conflict and turnover intentions among nurses in university medical clinics.
Cross-sectional correlational study using structural equation modelling.
Total-population sampling was used to invite all registered nurses employed at King Faisal University medical clinics (Eastern Province, Saudi Arabia). Participants completed Arabic versions of the Gender Role Conflict Scale, Wong and Law Emotional Intelligence Scale and Turnover Intention Scale-6. Data collection occurred in February 2025. Confirmatory factor analyses supported construct validity. Mediation was tested with bootstrapped indirect effects (5000 samples).
Ninety nurses participated (63.3% women; mean age 27.3 years). Gender role conflict correlated positively with turnover intentions (r = 0.47, p < 0.01) and negatively with emotional intelligence (r = −0.42, p < 0.01). Emotional intelligence correlated negatively with turnover intentions (r = −0.39, p < 0.01). The structural model showed good fit (CFI = 0.92, TLI = 0.91, RMSEA = 0.043, SRMR = 0.039). Gender role conflict had a direct positive association with turnover intentions (β = 0.33, p < 0.01) and an indirect effect via reduced emotional intelligence (indirect estimate = 0.18; 95% CI 0.12–0.26), supporting partial mediation.
Emotional intelligence partially explains how gender role conflict relates to nurses' intentions to leave. Targeted development of emotional competencies, alongside organisational strategies that address gendered role expectations, may help reduce turnover.
Findings identify a modifiable psychological pathway linking gendered stressors and turnover. Embedding emotional intelligence training in education and practice and addressing gender role conflict through inclusive policies may improve retention and quality of care.
STROBE.
None.
This study aimed to translate and validate the Malay version of the Patient Measure of Safety-10 (M-PMOS-10) for use in Malaysian healthcare settings. The study also sought to establish its content and face validity to ensure cultural relevance, psychometric validity and reliability in assessing patient perceptions of safety.
A cross-sectional validation study.
The study was conducted in tertiary-level care at a teaching hospital in Kelantan, Malaysia.
30 hospitalised patients participated in face validity assessment, while another 100 patients were involved in confirmatory factor analysis (CFA) for construct validation. Eligible participants were adults aged 18–60, fluent in Malay, clinically stable and without a formally diagnosed psychiatric illness.
The primary outcome was the psychometric validation of the M-PMOS-10, assessed through CFA and internal consistency reliability (Raykov’s rho). Content validity was determined using expert evaluations, and face validity was assessed through cognitive interviews with patients. Secondary outcomes included descriptive statistics of patient safety perceptions.
The M-PMOS-10 demonstrated excellent internal consistency (Raykov’s rho=0.929) and strong factor loadings (majority >0.70). CFA supported a revised single-factor structure (Comparative Fit Index=0.986, Root Mean Square Error of Approximation=0.067). Scale-Level Content Validity Index/Average method (Ave) (0.96) confirmed the relevance of the translated items, while Scale-Level Face Validity Index/Ave (0.87) indicated that patients found the questionnaire items clear and comprehensible. The mean total M-PMOS-10 score was 42.98 (SD=6.14), indicating positive patient safety perceptions, though communication regarding care plans showed room for improvement.
The validated M-PMOS-10 is a reliable and culturally appropriate tool for assessing patient safety perceptions in Malaysia. Its strong content and face validity reinforce its utility in patient safety research and clinical applications. Implementing this tool can help healthcare institutions identify safety gaps, refine staff training and improve communication strategies. Future studies should explore its applicability in different healthcare settings and assess its responsiveness to interventions to enhance patient safety.
Explore and describe the triggers, preventive strategies, and sociocultural dynamics of violence in healthcare settings, focusing on the experiences and perspectives of nurses Damietta Governorate, Egypt.
A cross-sectional design.
A stratified random sampling approach was followed to ensure representation from all departments by recruiting 424 nurses from several hospitals in Egypt. Self-administered questionnaires were applied, using validated instruments such as the Hospital Safety Climate Scale, the Coping Strategies Inventory, the Maslach Burnout Inventory, the Perceived Causes of Workplace Violence Questionnaire, and the Workplace Violence Scale to collect data. Data analysis using SPSS version 26 was carried out with descriptive statistics including means and standard deviations. STROBE reporting guidelines were followed.
Nurses had a moderate level of verbal abuse (mean 3.50) and bullying/harassment (mean 3.00) and lesser incidences of physical violence (mean 2.80) and sexual harassment (mean 2.70). The most common cause was perceived as organisational factors (mean 3.80) and then environmental (mean 3.60) and sociocultural (mean 3.40). Problem-focused coping strategies, which were used mostly (mean 3.45), emotional exhaustion (mean 4.20), making the overall burnout level moderate (mean 3.83). The safety climate had positive perceptions concerning management support (mean 3.80), an area needing improvement in safety communication (mean 3.70) and staff training (mean 3.60).
The study underscores the prevalent issues of workplace violence and emotional exhaustion among nurses, highlighting the need for targeted interventions and support systems to address these challenges.
Implementing comprehensive support programs, enhancing safety protocols, and focusing on both problem-focused and emotional support strategies are essential for improving nurse well-being and reducing workplace violence. These measures will contribute to a safer working environment and better patient care outcomes.
What problem did the study address? The study explored and described the high incidence of workplace violence and its impact on nurses' emotional well-being and job satisfaction in Egyptian healthcare settings.
What were the main findings? Prevalent verbal abuse and bullying were noted in the study, with the organisational factors identified as the most important cause. High levels of emotional exhaustion and moderate burnout, coupled with positive but improvable perceptions of safety climate, were reported.
Where and on whom will the research have an impact? Impacts from the research would touch every nurse working in hospitals around the cities of Damietta Governorate in Egypt, including Damietta General Hospital, Central Hospital in Faraskour, Elzarqa General Hospital, and probably other healthcare settings in the locale. It is anticipated that the results will give way to new hospital policies and practices on improving nurse safety and job satisfaction, which could lead to enhanced overall patient care.
The STROBE checklist was followed.
No patient or public contribution.
To evaluate temporal trends in the epidemiology of hip osteoarthritis (OA) in the USA from 1990 to 2019, with stratification by sex and geographic region.
Cross-sectional time-series analysis using secondary data from the Global Burden of Disease (GBD) study.
US population-based analysis, stratified by the four US Census Bureau regions: Northeast, Midwest, South and West.
De-identified, aggregate population-level data representing all adults in the USA from 1990 to 2019, drawn from the GBD database.
Age-standardised rates per 100 000 population for years lived with disability (YLDs), prevalence and incidence of hip OA. Outcomes were stratified by sex and region. Statistical significance was defined as p
Between 1990 and 2019, hip OA in the USA increased by 23.91% in YLDs, 24.67% in prevalence and 25.22% in incidence. In 2019, the mean YLDs were 28.30 in women versus 25.48 in men; prevalence was 49.55 versus 41.08; and incidence was 919.29 versus 818.10 (all p
There has been a substantial rise in the burden of hip OA in the USA over the past three decades. Women and residents of the Northeastern USA are disproportionately affected. These findings underscore the need for targeted public health strategies that account for geographic and sex-based disparities in hip OA burden.
Lower gastrointestinal symptoms attributed to colorectal disease are common. Early diagnosis of serious colorectal disease such as colorectal cancer (CRC), precancerous growths (polyps) and inflammation is important to ensure the best possible outcomes for a patient. The current ‘gold standard’ diagnostic test is colonoscopy. Colonoscopy is an invasive procedure. Some people struggle to cope with it and require intravenous sedation and/or analgesia. It is also resource-intensive, needing to be performed in specialist endoscopy units by a trained team. Across the UK, the demand for colonoscopy is outstripping capacity and the diagnosis of colorectal disease is being delayed. A colon capsule endoscope (CCE) is an alternative colorectal diagnostic. It is a ‘camera in a pill’ that can be swallowed and which passes through the gastrointestinal tract, obtaining visual images on the colon. There is now established experience of CCE in the UK. CCE might provide a less invasive method to diagnose colorectal disease if found to be accurate and effective and provide a means by which to increase the National Health Service (NHS) diagnostic capacity.
The aim of this study is to determine the diagnostic accuracy of CCE when compared with colonoscopy in representative and clinically meaningful cohorts of patients. An evaluation of the experiences of CCE for the patient and clinical team and an assessment of cost effectiveness will be undertaken.
We will undertake three research workstreams (WS). In WS1, we shall perform a paired (back-to-back) study. Each participant will swallow the CCE and then later on the same day they will have a colonoscopy. The study has been designed in collaboration with our Patient Advisory Group and as closely mirrors standard care as is possible. 973 participants will be recruited from three representative clinical contexts; suspected CRC, suspected inflammatory bowel disease and postpolypectomy surveillance. Up to 30 sites across the UK will be involved to maximise inclusivity. Measures of diagnostic accuracy will be reported along with CCE completion rates, number of colonoscopy procedures potentially prevented and adverse events, such as capsule retention. A nested substudy of intraobserver and interobserver agreement will be performed. WS2 will develop models of cost-effectiveness and WS3 will evaluate the patient and clinician experience, with reference to acceptability and choice.
The study findings will provide the evidence base to inform future colorectal diagnostic services.
The study has approval from the North East—Tyne and Wear South research ethics committee (REC reference 24/NE/0178, IRAS 331349). The findings will be disseminated to the NHS, National Institute for Health and Care Excellence, other clinical stakeholders and participants, patients and the public.
FreshRSS 