BackgroundHypertension is a critical modifiable risk factor for mortality in the elderly, yet optimal systolic blood pressure (SBP) targets for older adults remain unclear. This study examined the association between SBP trajectories and all-cause mortality in Chinese elderly individuals, aiming to identify age-adjusted SBP ranges for survival benefits.MethodsA population-based prospective cohort study was conducted in Luzhou, China (2017–2023). A total of 390,100 participants aged ≥65 years were followed for 1,994,050 person-years, with 48,013 deaths analyzed. Cox proportional hazards and restricted cubic spline (RCS) Cox regression models were used to evaluate baseline SBP categories, 7-year mean SBP, and longitudinal trajectories (Class 1: ideal to elevated; Class 2: normal-high to elevated; Class 3: mild hypertension to elevated).ResultsBaseline SBP: Lowest mortality risk at 100–139 mmHg (HR < 1). 7-year mean SBP: Optimal range at 120–159 mmHg. Trajectories: Class 2 (normal-high to elevated) had the lowest all-cause mortality (HR: 0.90, 95% CI: 0.88–0.92). Class 1 showed the lowest cardiovascular mortality. Class 3 exhibited the lowest non-cardiovascular/cancer mortality.ConclusionsGradual SBP increases from normal (≤160 mmHg) with age are associated with reduced mortality in the elderly. These findings challenge strict hypertension control guidelines, advocating for age-adjusted SBP targets to optimize survival outcomes. Further validation across different ethnic groups and regions will be needed in the future.

Healthcare workers, most notably nursing professionals, face high levels of recurrent stress that lead to symptoms of burnout and other negative mental health outcomes. This indicates the need for greater individual and organizational health system support, including implementation of effective, evidence-based interventions for burnout reduction in this population. Organizationally supported mindfulness-based interventions can be used to build individual resilience, buffering the detrimental effects of occupational stress and enhance professional well-being. Our aim was to evaluate the effect of an evidence-based mindfulness intervention on perceived stress, burnout, resilience, and work engagement in nursing professionals. A non-randomized single arm, pre/post design was used for this study. Healthcare workers (n = 631), including Registered Nurses and Advanced Practice Nurses (n = 128), physicians (n = 105), social workers (n = 21), pharmacists (n = 8), chaplains (n = 30), physician and occupational therapists (n = 39), patient care assistants (n = 13), other clinical staff (n = 26), non-clinical staff (n = 229), and 32 others participated in Mindfulness in Motion, an 8-week evidence-based worksite mindfulness intervention. Validated self-report measures assessing burnout (Maslach Burnout Inventory), perceived stress (Perceived Stress Scale), resilience (Connor Davidson Resiliency Scale), and work engagement (Utrecht Work Engagement Score) were given pre and post program. Total burnout was determined by scores on the subscales of emotional exhaustion, depersonalization, and personal accomplishment of the Maslach Burnout Inventory: Emotional exhaustion >27 or depersonalization >13 or personal accomplishment <31. Significant reductions in burnout (p < 0.00001), perceived stress (p < 0.00001), with significant increases in resilience (p < 0.00001), and work engagement (p < 0.00001) were observed among Registered and Advanced Practice Nurses comparing pre-post measures. Notably, the number of nursing professionals who no longer qualified as burned out was 10% higher than the other participants. Our results suggest that nursing professionals could greatly benefit from organizationally supported mindfulness-based interventions such as Mindfulness in Motion and may benefit them most compared to other health system employees.

The extensive impact of social media on communication of public health information is a growing concern. This is particularly worrying in the context of vaccination. Thus, we investigated the quality of TikTok videos regarding vaccination in Arabic, with examination of the association of video source and content type with the information quality and video engagement metrics. The final sample comprised a total of 129 TikTok videos in Arabic posted between January 2021 and July 2024. Videos were categorized based on the source [healthcare professional (HCPs), lay individuals, media], and content type (COVID-19 vaccination, childhood vaccination, general vaccination, others). We utilized a miniaturized version of the DISCERN instrument (mini-DISCERN) scale to evaluate information quality by two independent raters and assessed video engagement metrics (Likes, Comments, Shares, and Saves). The results indicated a statistically significant discrepancy in information quality, with videos from HCPs and media outlets scoring higher on the mini-DISCERN scale compared to those from lay individuals [mean: (4.818 ± 0.726) vs. (4.053 ± 1.441) vs. (2.003 ± 1.640), P < 0.001]. The highest information quality was found for videos on childhood vaccination, whereas content on COVID-19 vaccination was rated significantly lower on mini-DISCERN [mean: (4.510 ± 1.269) vs. (2.542 ± 1.827), P < 0.001]. Videos with higher engagement metrics, particularly those from lay individuals, were negatively correlated with information quality. Linear regression analysis confirmed the significant influence of the creator background (β = -0.618, P < 0.001) and video topic (β = 0.179, P = 0.009) on information quality. This study highlights the critical role of content creator background and topic on the quality of vaccination-related information on TikTok in Arabic. We emphasize the need for stringent verification of TikTok content, especially from lay individuals, as videos with higher engagement metrics often contained lower-quality information regarding vaccination. We recommend enhanced support for content from HCPs and targeted digital literacy programs to combat vaccine misinformation on TikTok effectively.

BackgroundPM2.5 is a key air pollutant that contributes to respiratory morbidity, especially in children. In Jakarta, Indonesia, PM2.5 levels often exceed safe thresholds. This study contributes local evidence from Indonesia, where research on the health effects of PM2.5 in children remains limited. To address this gap in the existing literature, particularly within the Indonesian context, this study offers novel insights by specifically investigating the association between ambient PM2.5 exposure and respiratory tract infections (RTIs) in school-aged children and further exploring this association within male and female subgroups, an aspect that has received limited attention in this setting.ObjectiveThis study aims to assess the association between ambient PM2.5 exposure and RTIs in school-aged children, and to explore this association within male and female subgroups.MethodsThis cross-sectional study was conducted among 107 children aged 6–12 years from two elementary schools: one in Jakarta (high PM2.5 exposure) and one in Bandung (low PM2.5 exposure). Data on PM2.5 levels were obtained from local air quality monitoring. RTI symptoms were assessed through structured interviews and physical examination. Participants were selected using random sampling. Chi-square tests and effect size calculations (phi coefficient) were used to compare groups. Potential confounders such as age, gender, and household smoke exposure were minimized through inclusion/exclusion criteria and the selection of demographically and environmentally similar school communities. Multiple binary logistic regression adjusting for confounders was also performed to assess the independent association between PM2.5 exposure and RTIs.ResultsThe Chi-square test indicated a significant association between PM2.5 levels and the occurrence of RTI (χ² = 22.154, df = 1, p < 0.001, φ = 0.475). Given the potential low expected counts in some cells, the statistical significance was further evaluated using Fisher's Exact Test, which also showed a significant association (p < 0.001). The prevalence of RTI was significantly higher in the high exposure group (71.43%) compared to the low exposure group (25.86%) (p < 0.001). Further analysis did not reveal significant differences in the proportion of each age group between the high and low PM2.5 exposure groups [χ²(1) = 0.093, p = 0.761]. Similarly, no significant differences were found in the proportion of gender between the high and low PM2.5 exposure groups [χ²(1) = 1.611, p = 0.204] in the total sample. Likewise, there were no significant differences in the proportion of RTI across different age groups [χ²(6) = 5.327, p = 0.503] or between genders [χ²(1) = 0.008, p = 0.928] in the total sample. However, further analysis examining the association between PM2.5 exposure and RTI within gender subgroups revealed a significant association in both male [χ²(1) = 10.873, p = 0.001] and female [χ²(1) = 11.755, p = 0.001] children. The estimated prevalence ratio (PR) was 2.76 (95% CI: 1.68–4.54), indicating that children in the high PM2.5 exposure area had approximately 2.76 times higher prevalence of RTI compared to those in the low exposure area. The absolute prevalence difference (PD) was 45.57% (95% CI: 25.9%–65.2%). Binary logistic regression analysis showed that children in the high PM2.5 exposure group had significantly higher odds of having RTI (OR = 7.167, 95% CI: 3.050–16.837, p < 0.001). Further analysis examining the association between maternal socioeconomic factors and both PM2.5 exposure and RTI occurrence revealed no statistically significant relationships. Chi-square tests showed no significant association between maternal education level (low vs. medium) and PM2.5 exposure group [χ²(1) = 0.045, p = 0.833], nor between maternal occupation (blue collar vs. semi-professional) and PM2.5 exposure group [χ²(1) = 0.006, p = 0.937]. Similarly, no significant associations were found between maternal education level and RTI [χ²(1) = 0.233, p = 0.629] or between maternal occupation and RTI [χ²(1) = 0.447, p = 0.504]. Crucially, after adjusting for potential confounders including gender, age, maternal education, and maternal occupation in a multivariate logistic regression model, the odds of having RTI remained significantly higher in children with high PM2.5 exposure (adjusted OR = 7.883, 95% CI: 3.228–19.250, p < 0.001).ConclusionsChildren exposed to higher levels of PM2.5 had significantly more respiratory tract infections. These findings highlight the need for targeted public health interventions in polluted urban areas. This study is among the first to quantify this association in the Indonesian context and provides a newly developed and validated instrument (RAAEC-C instrument) for future research. These findings should be interpreted as preliminary evidence and require replication in future longitudinal studies before firm conclusions can be drawn. Further research using longitudinal designs is needed to understand the long-term impacts of PM2.5 exposure on children's respiratory health and to inform appropriate mitigation strategies.

Nursing handover is essential in clinical practice across various healthcare settings and can significantly impact nurses' mental health. This scoping review aimed to explore and map these implications using the JBI methodology and PRISMA ScR Checklist. It included 11 studies published between 1988 and 2022 from the UK, Australia, USA, South Korea, and Hong Kong, involving over 122 nurses in acute care settings. The findings reveal three major themes: source of psychological discomfort, coping resource, and peer support and cohesion. Negative emotions such as stress, anxiety, dissatisfaction, and tension are linked to handovers, particularly bedside handovers, which raise confidentiality issues and induce scrutiny among nurses. The lack of standardized training and consistent procedures also contributes to stress, especially for newly graduated and less experienced nurses. Conversely, handovers function as structured rituals providing peer support and a sense of control, helping nurses manage psychological demands. To mitigate negative impacts, implementing standardized handover procedures and comprehensive training programs for new nurses is essential. Encouraging open communication and fostering a supportive environment can enhance team cohesion and reduce stress. Future research should measure the impact of different handover practices on nurses' mental health and explore their supportive, social, protective, and restorative functions. This review highlights the critical role of nursing handovers in supporting nurses' mental health and underscores the need for standardized practices to improve the well-being of nursing professionals and the quality of patient care.

Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease in the United States and healthcare resources used to manage the disease are disproportionately consumed by a small subset of users. Consequently, there is a potential to reduce the healthcare costs and to improve the health outcomes through the early detection and consistent management of high-cost users. The objectives of this study were to characterize the pattern of medical utilization and cost of commercially-insured people with type 2 diabetes (T2DM) in Texas and to identify predictors of high-cost users. Using claims data from a large commercial insurance plan spanning the period from 2016 to 2019, the total medical costs of a randomly selected 12-month period were analyzed for eligible commercially-insured people with T2DM, and the patients were categorized into the top 20% of high-cost users and the bottom 80% of lower-cost users. Descriptive analyses were conducted to describe the baseline characteristics of the people with T2DM, the patterns of healthcare utilization, and the costs of the two types of users. Multivariate logistic regression models were estimated to identify the predictors of being a high-cost T2DM user. The top 20% of high-cost users accounted for 83% of the total medical cost, with an average cost of $41,370 as compared to only $2064 for the bottom 80% of lower-cost users. Several chronic conditions were identified to be strong predictors of being a high-cost patient. Rural high-cost users had, on average, fewer specialist visits but more inpatient stays compared to the urban high-cost users. Healthcare utilization and expenditures among commercially insured individuals with T2DM followed the 80-20 rule. High-cost users were strongly associated with worse health status. Residential rurality was not associated with high-cost use, though the patterns of resource utilization differed between urban and rural high-cost users.

BackgroundThe term “Phubbing” has been defined as a behavior in which a person snubs another in a social setting by focusing on their phone instead of having a conversation. Phubbing is a common phenomenon and reduces the quality of social interactions in people, particularly those in adolescence.ObjectiveWe aimed to validate in Italian, the Generic Scale of Phubbing (GSP), and Generic Scale of Being Phubbed (GSPB), in order to measure the experiences of phubbing, and being phubbed, through confirmatory factor analysis (CFA).MethodsWe investigated whether the factor structure of GSP and GSBP may be replicated for the Italian sample, through confirmatory factor analysis (CFA). For the assessment, we used the Generic Scale of Being Phubbed, the Generic Scale of Phubbing, the Internet Addiction Test, and Brief COPE.ResultsWe found that four important factors of phubbing are nomophobia, interpersonal conflict, self-isolation, and acknowledgement of problems, and phubbing behavior is predictive of social disconnectedness.ConclusionThe GSP and GSBP instruments can be useful in the clinical setting to identify specific psychological dimensions associated with phubbing, such as nomophobia and social isolation.

Recent studies have considered the psychological resilience and growth experienced by healthcare professionals, particularly those facing stressors and traumatic events. To study post-traumatic growth in healthcare workers caring for patients, determine the internal consistency of the Post-traumatic Growth Inventory (PTGI) and PTGI-Short Form (PTGI-SF) instruments, and carry out confirmatory analyses of their five-factor structures. Healthcare workers based in Greece. Cross-sectional design. Linear regression analysis with tested independent variables consisting of demographic, professional, health facility, and patient contact data. Confirmatory five-factor analyses of PTGI and PTGI-SF results were performed to validate their associated factors. Unidimensional reliability of the PTGI and PTGI-SF results was calculated. The final regression model included sex and whether the internet was the source of health-related knowledge (F 2102 = 11.979, p < 0.0001). The confirmatory factor analysis of the PTGI confirmed its five-factor structure (χ2 189 = 1233.642, p < 0.0001), root mean square error of approximation (RMSEA = 0.229, p < 0.0001), and internal consistency (Cronbach α = 0.971). Similarly for the PTGI-SF (χ2 35 = 535.965, p < 0.0001; RMSEA = 0.369, p < 0.0001; Cronbach α = 0.935). Being female and not using the internet as the principal source of information about diseases were each associated with increased post-traumatic growth. The internal consistencies of both the PTGI and the PTGI-SF were confirmed, as were the robustness of the five-factor structure of each instrument.

Understanding the impact of work attitudes on occupational stress is essential to promote employee wellbeing and productivity. This study investigates the associations between different work attitudes (work annoyance, individual social capital, overcommitment, and work engagement) and the perceived stress. A cross-sectional survey conducted among 1290 employees from various occupational sectors assessed their attitudes and stress levels using validated psychometric scales. Statistical analyses, including a hierarchical regression and a moderation analysis, examined the predictive value of each attitude and the potential buffering role of social capital. The results indicate that work annoyance and overcommitment are positively associated with stress, which suggests that perceiving job conditions as frustrating and investing excessive effort without the appropriate rewards contribute to psychological strain. Conversely, social capital and work engagement exhibit a protective effect, with workplace relationships and a positive approach to work mitigating stress levels. Moreover, social capital moderates the relationship between overcommitment and stress, thus highlighting its buffering effect. These findings emphasize the importance of fostering a supportive work environment that reduces negative attitudes while promoting engagement and social cohesion. Organizational interventions aimed at improving workplace relationships, recognizing employees' contributions, and encouraging a balanced work culture could be effective strategies to enhance the workers' wellbeing and mitigate occupational stress.