Workplace-related depression, anxiety, and stress significantly affect the wellbeing and job performance of nurses and may compromise the quality of healthcare delivery. The demanding nature of healthcare environments, particularly shift work and excessive workload, has been identified as a major contributor to mental health problems among nurses.To examine factors associated with workplace depression, anxiety, and stress among nurses in Ghana, and to assess the mediating and moderating role of coping strategies in the relationship between work schedule and mental health outcomes.The study employed a cross-sectional design with a quantitative approach using multistage sampling. Data were collected using a structured questionnaire and the DASS-21 scale via KoboCollect. Descriptive statistics and binary logistic regression analyses were conducted using Stata version 17.0, while mediation and moderation analyses were performed in RStudio using PROCESS Macro Models 4 and 1.The prevalence of depressive symptoms, anxiety symptoms, and stress symptoms among the respondents was 20.0
Abstract Introduction Bidi is the most prevalent form of smoked tobacco in India and is often perceived as less harmful than cigarettes. While evidence on bidi-related cancers is growing, the burden of non-cancer health outcomes remains poorly quantified and largely dependent on secondary estimates. This study aimed to generate national and subnational estimates of mortality and disability attributable to bidi consumption for major non-cancer diseases in India. Methods A two-phase methodology was employed. First, a meta-analysis of Indian studies published between 2000 and 2022 was conducted to estimate pooled odds ratios and population attributable fractions (PAFs) for major diseases resulting from bidi consumption. These PAFs were applied to state-wise mortality and disability-adjusted life years (DALYs) from the Global Burden of Disease 2021 database. Next, a country-wide cross-sectional hospital-based survey was conducted across 21 healthcare facilities in 11 states/UTs, enrolling patients diagnosed with the selected diseases to estimate disease-specific bidi exposure and derive primary burden estimates. Results The highest PAF was observed for TB (0.21), followed by COPD (0.19), IHD (0.17), and CVD (0.03). Secondary analysis estimated 568,453 annual deaths and 14.8 million DALYs attributable to bidi consumption. Primary data indicated a higher burden, with 757,590 annual deaths and 20.2 million DALYs lost. Uttar Pradesh, Maharashtra, Tamil Nadu, Gujarat, and West Bengal, accounted for nearly half of the national burden. Conclusion Bidi consumption contributes substantially to non-cancer mortality and disability in India, highlighting the urgent need for strengthened surveillance, non-cancer registries, and targeted tobacco control interventions.
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can occur following traumatic events. Healthcare professionals working in post-war settings, including Tigray, may face an increased risk of PTSD because of exposure to conflict-related trauma and ongoing insecurity. Despite the importance of developing targeted supportive initiatives for the health workforce, empirical evidence on the magnitude of probable PTSD remains scarce. To assess the prevalence and factors associated with probable PTSD among healthcare professionals working in selected public hospitals in post-war Tigray, Ethiopia, in 2025. We conducted a facility-based cross-sectional study from April to June 2025. We used simple random sampling to recruit 423 healthcare professionals from six public hospitals. We collected data using a pretested standardized questionnaire through the ODK Collect mobile application and analyzed them in Stata version 19. Probable PTSD was defined as a PCL-5 total score of ≥ 33. Multivariable logistic regression was used to assess factors associated with probable PTSD. We used adjusted odds ratios (AORs) with 95
Abstract Background Nigeria, like much of sub-Saharan Africa, faces a double burden of malnutrition in which undernutrition persists alongside rising overweight and obesity. Evidence on whether nutritional knowledge translates into better dietary practice among adults, and whether socioeconomic context modifies this relationship, remains inconsistent, particularly for paired urban and rural communities within the same state. Objective This study determined the association of nutritional knowledge and socioeconomic position with household dietary diversity and the double burden of malnutrition among adults in one urban community (Ado-Ekiti) and one rural community (Epe-Ekiti) in Ekiti State, Southwest Nigeria. Methods A comparative cross-sectional study was conducted between January and April 2025 among 350 adults aged 20 years and above (250 urban; 100 rural) selected through multistage sampling. A structured interviewer-administered questionnaire captured socioeconomic characteristics, household dietary diversity (Food and Agriculture Organization 12 food groups), seven-day food consumption frequency, and nutritional knowledge. Weight and height were measured directly and body mass index (BMI) was classified using World Health Organization criteria. Associations were examined using Pearson’s chi-square tests with Cramér’s V, and odds ratios (OR) with 95% confidence intervals (CI) for binary comparisons, at p < 0.05. Results Rural respondents had markedly lower socioeconomic position: 62.0% earned below ₦70,000 per month (≈ US$47; urban, 28.4%) and 24.0% had tertiary education (urban, 48.8%). High dietary diversity (≥ 6 food groups) was recorded in 69.2% of urban and 33.0% of rural respondents. A double burden of malnutrition was present in both settings: underweight affected 20.4% (urban) and 22.0% (rural), while combined overweight and obesity affected 18.4% and 25.0%, respectively. In the urban community, reported formal nutrition education was inversely associated with high dietary diversity (χ²(1) = 4.668, p = 0.031; OR 0.51, 95% CI 0.27–0.94), whereas belief in the preventive role of nutrition (χ²(2) = 7.526, p = 0.023; OR 2.08, 95% CI 1.20–3.60) and correct identification of a nutrition-related condition (χ²(3) = 18.667, p < 0.001; V = 0.273) were positively associated. In the rural community, perceived importance of balanced nutrition (χ²(2) = 21.836, p < 0.001; V = 0.467), the food-group item (χ²(2) = 14.130, p = 0.001; V = 0.376), and belief in disease prevention (χ²(2) = 15.823, p < 0.001; V = 0.398) were associated with dietary diversity, each in inverse or non-monotonic patterns. In adjusted logistic regression, the inverse urban education association attenuated to the null, whereas tertiary education (pooled adjusted OR 3.60, 95% CI 1.89–6.85) and urban residence (pooled adjusted OR 0.25, 95% CI 0.12–0.48) remained independently associated with high dietary diversity. Daily meal frequency was associated with BMI category in both settings (urban χ²(6) = 22.790, p < 0.001, V = 0.213; rural χ²(3) = 13.739, p = 0.003, V = 0.371). Conclusion Nutritional knowledge showed weak, inconsistent, and partly inverse associations with dietary diversity in both settings, whereas the large urban–rural gap in dietary diversity followed the socioeconomic divide. These findings suggest that knowledge alone may not translate into better eating and that interventions may need to combine food-based nutrition education with structural socioeconomic measures. Because the study was cross-sectional, causal inference is precluded.
Childhood and adolescent diabetes mellitus (DM) present public health challenges. Schools are central to DM management, but inadequate readiness, staff training, and coordination may compromise care quality. Thus, this study aims to systematically review the literature to identify the risk factors, institutional barriers, and management needs of children and adolescents with Diabetes Mellitus (DM) within the school context. A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251111805). Searches were conducted in August 2025 across PubMed, Scopus, Web of Science, ScienceDirect, and Virtual Health Library. Included were observational and qualitative studies published between 2019 and 2025 addressing DM management in schools. Methodological quality was assessed via JBI critical appraisal checklists, and the certainty of evidence was evaluated using the GRADE system. Data were synthesized narratively. A total of 28 studies comprised the final sample. Methodological quality varied, and the overall certainty of evidence ranged from moderate to very low. Findings demonstrate that inadequate glycemic control is significantly associated with poorer academic performance and absenteeism. Furthermore, schools present major gaps in preparedness, often lacking trained staff and clear protocols for glycemic monitoring, which negatively correlates with student safety and parental satisfaction. DM management in schools is hampered by structural barriers, insufficient staff training, and technological conflicts. Effective management requires robust intersectoral policies; however, the predominance of cross-sectional designs limits causal inferences, underscoring the need for longitudinal studies to strengthen the certainty of evidence.
