bluuebunny/crossref_metadata_2025 huggingface dataset:
School-based MHPSS interventions in humanitarian contexts: a realist review
Authors: Lasater Molly E , Flemming Jennifer , Bourey Christine , Nemiro Ashley , Meyer Sarah R
Published: May 2022

Objective

The aim of this review is to elucidate the characteristics of school-based mental health and psychosocial support (MHPSS) interventions in humanitarian contexts and the hypothesised mechanisms by which they influence well-being or learning outcomes.

Methods

We conducted a realist review and searched PubMed, Embase, Global Health, CINAHL, PsychInfo, PILOTS and grey literature through January 2022. Eligible studies included children age 6–12 years, were conducted in humanitarian contexts in low-income or middle-income countries, and focused on universal MPHSS prevention in an educational setting, using any study design. Data were extracted and analysed using narrative synthesis and realist analysis techniques to create ‘context–mechanism–outcome’ configurations that were iteratively developed to modify, refine and substantiate programme theories.

Results

Twenty-seven articles, representing 19 studies, were included in the review. We analysed data from 26 articles. Eleven evidenced-informed programme theories were developed at the levels of the child (n=4), teacher (n=3), caregiver (n=2), school environment (n=1) and school managers/administrators (n=1). At the child level, mechanisms related to strengthening coping skills, emotion regulation, interpersonal relationships led to improved psychosocial well-being or learning outcomes. At the teacher level, coping skills and the provision of support to students were linked to psychosocial well-being and learning outcomes. At the caregiver level, strengthening interpersonal bonds trigger improved psychosocial well-being, and at the school environment level, fostering feelings of security was linked to psychosocial well-being and learning outcomes. We did not find any evidence supporting the programme theory at the school managers/administrators level. We found limited evidence of positive impacts of the included interventions to support these programme theories.

Conclusions

These programme theories are a promising start towards ensuring school-based MHPSS interventions in humanitarian contexts better address the well-being and learning needs of children. Future research is needed to support these programme theories and enhance the evidence base.
Effect of hyperbaric oxygen therapy on cognitive dysfunction induced by nitrous oxide abuse: protocol of a randomised, double-blinded, placebo-controlled trial
Authors: Luo Dan , Tan Lu , Shen Danling , Lai Mingfeng , Tang Qiao , Xu Jiajun , Li Jing
Published: May 2022

Introduction

The cognitive dysfunction associated with nitrous oxide abuse is gradually becoming a major global public health concern. Despite the increasing prevalence of nitrous oxide abuse, there are currently no authorised/approved treatment options. Hyperbaric oxygen therapy (HBOT) has been proven to be an efficient method to improve cognitive function. The current randomised, double-blinded, placebo-controlled trial will explore the effect of HBOT on cognitive dysfunction induced by nitrous oxide abuse.

Methods and analysis

Eighty participants who abuse nitrous oxide and have cognitive dysfunction, including memory decline, disorientation, attention deficits, slower reactions and learning disabilities, will be included in the trial. They will be randomly assigned to receive either HBOT or sham-HBOT 90–120 min once daily for 5 days per week for 2 weeks. The primary outcome will be the improvement in the total score of the MATRICS Consensus Cognitive Battery, which will measure comprehensive cognitive function between the two groups. Additionally, attention will be measured by integrated visual and auditory continuous performance tests, executive function will be measured by the Wisconsin card sorting test, intelligence will be measured by Raven’s standard progressive matrices and cognitive control will be measured by the Stroop colour word interference test.

Ethics and dissemination

This protocol was approved by the West China Hospital of Sichuan University Biomedical Research Ethics Committee. The report of the study will be disseminated via scientific forums including peer-reviewed publications and presentations at national and international conferences.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2100047111).
Cohort profile: the Olmsted County hypertensive disorders of pregnancy (HDP) cohort using the Rochester Epidemiology Project
Authors: Vaughan Lisa , White Wendy M , Tobah Yvonne S Butler , Kattah Andrea , Parashuram Santosh , Gunaratne Madugodarlalalage D , Vermunt Jane V , Mielke Michelle , Milic Natasa M , Suvakov Sonja , Bielinski Suzette , Chamberlain Alanna M , Garovic Vesna D
Published: May 2022

Purpose

The Olmsted County hypertensive disorders of pregnancy (HDP) cohort is a population-based retrospective study designed to compare the incidence of HDP on a per-pregnancy and per-woman basis and to identify associations between HDP with ageing-related diseases, as well as accumulation of multimorbidity.

Participants

Using the Rochester Epidemiology Project (REP) medical records-linkage system, a cohort was collected consisting of women who gave birth in Olmsted County between 1976 and 1982. After exclusions, a per-pregnancy cohort of 7544 women with 9862 pregnancies between 1976 and 1982 was identified, and their delivery information was manually reviewed. A subset of these women comprised the per-woman cohort of 4322 pregnancies from 1839 women with delivery information available throughout the entirety of their childbearing years, along with decades of follow-up data available for research via the REP.

Findings to date

By constructing both per-pregnancy and per-woman cohorts, we reported a doubling of HDP incidence rates when assessed on a per-woman basis compared with rates observed on a per-pregnancy basis. Moreover, in addition to finding that women with a history of HDP developed specific diseases at higher rates and at early ages, we also discovered that a history of HDP is associated with accelerated ageing, through accumulation of multimorbidity.

Future plans

In addition to these outcomes described above, many other potential outcomes of interest for studies of HDP can be ascertained from accessing the electronic health records (EHR) and billing systems available through the REP. These data can include all International Classification of Diseases (ICD)-9 and ICD-10 and Current Procedural Terminology coded diagnoses and procedures, healthcare utilisation, including office visits, hospitalisations and emergency room visits, and full text of the EHR that is available for chart abstraction or for natural language processing of the clinical notes.
Factors influencing the prescription pattern of essential medicines from the perspectives of general practitioners and patients: a qualitative study in China
Authors: Chen Xiaolei , Zhang Tiancheng , Wang Huanling , Feng Zhengwen , Jin Guanghui , Shao Shuang , Du Juan
Published: May 2022

Objectives

This qualitative study aimed to explore the factors influencing the prescription patterns of essential medicines (EMs) from the perspectives of general practitioners (GPs) and patients in Beijing, China.

Design

The qualitative study was conducted using individual in-depth interviews.

Setting

This study was conducted from January to August 2020, in community health service centres (CHSCs) across six urban districts of Beijing, China.

Participants

A total of 17 GPs from 17 CHSCs in 6 urban districts and 22 patients with non-communicable diseases from three CHSCs in the three urban districts of Beijing were recruited using the purposive sampling method and a three-stage sampling strategy, respectively.

Results

Five major themes were identified among factors influencing the prescription pattern of EMs: (1) efficacy and safety of medicines, (2) prescription recommendations from physicians in tertiary or secondary hospitals, (3) patients’ medication preference, (4) financial status of patients and (5) minimum requirement for the prescription of EMs.

Conclusion

The findings of this study contribute to our understanding of the factors influencing the prescription patterns and utilisation of EMs from the perspectives of GPs and patients, respectively. Policymakers should implement policies and measures to promote the National Essential Medicines System in China.
Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic
Authors: Niyigena Anne , Girukubonye Ignace , Barnhart Dale A , Cubaka Vincent K , Niyigena Pierre Celestin , Nshunguyabahizi Marcel , Mukamana Beatrice , Kateera Fredrick , Bitalabeho Florence A
Published: May 2022

Objective

During the COVID-19 pandemic, community health workers (CHWs) served as front-line workers in the COVID-19 response while maintaining community health services. We aimed to understand challenges faced by Rwanda’s CHWs during a nationwide COVID-19 lockdown that occurred between March and May 2020 by assessing the availability of trainings, supplies and supervision while exploring perceived needs and challenges.

Design and setting

This study was a mixed-method study conducted in three Rwandan districts: Burera, Kirehe and Kayonza.

Main outcome and measure

Using data collected via telephone, we assessed the availability of trainings, supplies and supervision during the first national lockdown, while exploring perceived needs and challenges of CHWs who were engaged in COVID-19 response, in addition to their existing duties of delivering health services in the community.

Results

Among the 292 quantitative survey participants, CHWs were responsible for a median of 55 households (IQR: 42–79) and visited a median of 30 households (IQR: 11–52) in the month prior to the survey (July 2020). In the previous 12 months, only 164 (56.2%) CHWs reported being trained on any health topic. Gaps in supply availability, particularly for commodities, existed at the start of the lockdown and worsened over the course of the lockdown. Supervision during the lockdown was low, with nearly 10% of CHWs never receiving supervision and only 24% receiving at least three supervision visits during the 3-month lockdown. In qualitative interviews, CHWs additionally described increases in workload, lack of personal protective equipment and COVID-specific training, fear of COVID-19, and difficult working conditions.

Conclusion

Many challenges faced by CHWs during the lockdown predated COVID-19 and persisted or were exacerbated during the pandemic. To promote the resilience of Rwanda’s CHW system, we recommend increased access to PPE; investment in training, supervision and supply chain management; and financial compensation for CHWs.
US emergency care patterns among nurse practitioners and physician assistants compared with physicians: a cross-sectional analysis
Authors: Mafi John N , Chen Alexander , Guo Rong , Choi Kristen , Smulowitz Peter , Tseng Chi-Hong , Ladapo Joseph A , Landon Bruce E
Published: May 2022

Objectives

Nurse practitioners and physician assistants (NPs/PAs) increasingly practice in emergency departments (EDs), yet limited research has compared their practice patterns with those of physicians.

Design, setting and participants

Using nationally representative data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), we analysed ED visits among NPs/PAs and physicians between 1 January 2009 and 31 December 2017. To compare NP/PA and physician utilisation, we estimated propensity score-weighted multivariable regressions adjusted for clinical/sociodemographic variables, including triage acuity score (1=sickest/5=healthiest). Because NPs/PAs may preferentially consult physicians for more complex patients, we performed sensitivity analyses restricting to EDs with >95% of visits including the NP/PA–physician combination.

Exposures

NPs/PAs.

Main outcome measures

Use of hospitalisations, diagnostic tests, medications, procedures and six low-value services, for example, CT/MRI for uncomplicated headache, based on Choosing Wisely and other practice guidelines.

Results

Before propensity weighting, we studied visits to 12 410 NPs/PAs-alone, 21 560 to the NP/PA–physician combination and 143 687 to physicians-alone who saw patients with increasing age (41, 45 and 47 years, p<0.001) and worsening triage acuity scores (3.03, 2.85 and 2.67, p<0.001), respectively. After weighting, NPs/PAs-alone used fewer medications (2.62 vs 2.80, p=0.002), diagnostic tests (3.77 vs 4.66, p<0.001), procedures (0.67 vs 0.77, p<0.001), hospitalisations (OR 0.35 (95% CI 0.26 to 0.46)) and low-value CT/MRI studies (OR 0.65 (95% CI 0.53 to 0.80)) than physicians. Contrastingly, the NP/PA–physician combination used more medications (3.08 vs 2.80, p<0.001), diagnostic tests (5.07 vs 4.66, p<0.001), procedures (0.86 vs 0.77, p<0.001), hospitalisations OR 1.33 (95% CI 1.17 to 1.51) and low-value CT/MRI studies (OR 1.23 (95% CI 1.07 to 1.43)) than physicians—results were similar among EDs with >95% of NP/PA visits including the NP/PA–physician combination.

Conclusions and relevance

While U.S. NPs/PAs-alone used less care and low-value advanced diagnostic imaging, the NP/PA–physician combination used more care and low-value advanced diagnostic imaging than physicians alone. Findings were reproduced among EDs where nearly all NP/PA visits were collaborative with physicians, suggesting that NPs/PAs seeing more complex patients used more services than physicians alone, but the converse might be true for more straightforward patients.
Comparative clinical studies of primary chemoradiotherapy versus S-1 and nedaplatin chemotherapy against stage IVb oesophageal squamous cell carcinoma: a multicentre open-label randomised controlled trial
Authors: Liu Yun , Beeraka Narasimha M , Liu Junqi , Chen Kuo , Song Bo , Song Zhang , Luo Jianchao , Liu Yang , Zheng Anping , Cui Yanhui , Wang Yang , Jia Zhenhe , Song Xiangyu , Wang Xiaohong , Wang Hongqi , Qi Xuefeng , Ren Jinshan , Wu Liping , Cai Jixing , Fang Xainying , Wang Xin , Sinelnikov Mikhail Y , Nikolenko Vladimir N , Greeshma M V , Fan Ruitai
Published: May 2022

Introduction

Oesophageal squamous cell carcinoma (OSCC) is one of the most commonly occurring devastating tumours worldwide, including in China. To date, the standard care of patients with stage IV OSCC is systemic chemotherapy and palliative care, which results in poor prognosis. However, no consensus has been established regarding the role of radiotherapy in targeting the primary tumour in patients with stage IVa OSCC. Thus, the aim of this study is to assess the effectiveness of primary radiotherapy combined with S-1 and nedaplatin (NPD) chemotherapy in the patients with stage IV OSCC.

Methods and analysis

The study is a multicentre, open-label, randomised controlled trial. A total of 180 eligible patients with stage IV OSCC will be randomised into a study group (90 patients) and a control group (90 patients). Patients in the study group will receive radiotherapy to the primary tumour at a dose of 50.4 Gy combined with 4–6 cycles of S-1 and NPD chemotherapy. In the control group, patients will only receive 4–6 cycles of S-1 and NPD chemotherapy. The primary and secondary outcomes will be measured. The differences between the two groups will be statistically analysed with regard to overall survival, the progression-free survival and safety. All outcomes will be ascertained before treatment, after treatment and after the follow-up period.

The results of this study will provide evidence on the role of radiotherapy in patients with stage IV OSCC in China, which will show new options for patients with advanced oesophageal cancer.

Ethics and dissemination

This study was approved by the Institutional Ethics Committee of The First Hospital Affiliated of Zhengzhou University (approval number: SS-2018–04).

Trial registration

The trial has been registered at the Chinese Clinical Trial Registry (ChiCTR1800015765) on 1 November 2018; retrospectively registered,http://www.chictr.org.cn/index.aspx.
Empirical comparisons of meta-analysis methods for diagnostic studies: a meta-epidemiological study
Authors: Rosenberger Kristine J , Chu Haitao , Lin Lifeng
Published: May 2022

Objectives

Several methods are commonly used for meta-analyses of diagnostic studies, such as the bivariate linear mixed model (LMM). It estimates the overall sensitivity, specificity, their correlation, diagnostic OR (DOR) and the area under the curve (AUC) of the summary receiver operating characteristic (ROC) estimates. Nevertheless, the bivariate LMM makes potentially unrealistic assumptions (ie, normality of within-study estimates), which could be avoided by the bivariate generalised linear mixed model (GLMM). This article aims at investigating the real-world performance of the bivariate LMM and GLMM using meta-analyses of diagnostic studies from the Cochrane Library.

Methods

We compared the bivariate LMM and GLMM using the relative differences in the overall sensitivity and specificity, their 95% CI widths, between-study variances, and the correlation between the (logit) sensitivity and specificity. We also explored their relationships with the number of studies, number of subjects, overall sensitivity and overall specificity.

Results

Among the extracted 1379 meta-analyses, point estimates of overall sensitivities and specificities by the bivariate LMM and GLMM were generally similar, but their CI widths could be noticeably different. The bivariate GLMM generally produced narrower CIs than the bivariate LMM when meta-analyses contained 2–5 studies. For meta-analyses with <100 subjects or the overall sensitivities or specificities close to 0% or 100%, the bivariate LMM could produce substantially different AUCs, DORs and DOR CI widths from the bivariate GLMM.

Conclusions

The variation of estimates calls into question the appropriateness of the normality assumption within individual studies required by the bivariate LMM. In cases of notable differences presented in these methods’ results, the bivariate GLMM may be preferred.
Predicting diagnoses from illness experiences with common cold symptoms before physician consultation: a mixed-methods research
Authors: Mizoe Atsushi , Isse Naohi
Published: May 2022

Objectives

We aimed to explore whether patients’ illness experiences with common cold symptoms could help with predicting the final diagnosis before consultation.

Design

Exploratory sequential design of mixed methods: Qualitative and quantitative studies used inductive qualitative content analysis and multinomial regression analysis, respectively.

Setting

Consecutive patients at the primary care clinic of a general hospital.

Participants

New patients aged 15 years or older were included in the study. Of the 1512 eligible patients who received the questionnaire sheet, 408 selected the common cold as their reason for visiting. All 408 patients responded to the questionnaire.

Main outcome measures

First, factors representing illness experiences in patients with common cold symptoms were explored. Second, variables with significant relative risk ratio (RRR) were used to diagnose common cold, influenza or other diseases.

Results

A total of 171 codes were identified from the responses of 408 patients, which were visually mapped to show their frequencies and occurrence in the same person according to their final diagnoses. Of the 171 codes, 22 found in over nine patients represented the variables for the three independent final diagnoses. The adjusted final model revealed that (1) ‘worry about influenza infection’, ‘want influenza test’ and ‘transmission from a colleague at school or workplace’ predicted the influenza rather than the common cold, when other predicting variables were constant (RRR, 6.20 p<0.001; RRR, 26.1 p<0.01; and RRR, 4.69 p<0.05, respectively); (2) ‘want further examination’ predicted other diseases (RRR, 2.84 p<0.05); and (3) the combination of ‘worry about influenza infection’ and ‘want influenza test’, which predicted the opposite diagnosis: the common cold rather than influenza (RRR, 0.01 p<0.001).

Conclusion

These findings provide useful information on how illness experiences before consultation can predict final diagnoses for patients with common cold symptoms.

Trial registration number

UMIN000030697.
SPACE FOR COPD delivered as a maintenance programme on pulmonary rehabilitation discharge: protocol of a randomised controlled trial evaluating the long-term effects on exercise tolerance and mental well-being
Authors: Alqahtani Khaled A , Gerlis Charlotte , Nolan Claire M , Gardiner Nikki , Szczepura Ala , Man William , Singh Sally J , Houchen-Wolloff Linzy
Published: May 2022

Introduction

The benefits achieved during pulmonary rehabilitation (PR) are known to be sustained for 6–12 months after the initial programme. Several maintenance trials have been conducted but were heterogeneous in terms of duration, frequency and labour cost. There is no consensus on one best strategy. SPACE FOR COPD (Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease) is a home-based self-management programme, which has been shown previously to be effective in primary and secondary care settings and is to be tested here as a maintenance programme. The aim is to evaluate the efficacy of the SPACE FOR COPD programme (manual and group sessions), on exercise tolerance and mental well-being, compared with usual care following PR in patients with COPD.

Methods and analysis

A prospective, multicentre, single-blinded randomised controlled trial requiring 116 participants with a clinical diagnosis of COPD who have finished PR within 4 weeks will be randomised 1:1 to either a usual care group or a SPACE FOR COPD programme group. The intervention comprises a home-based manual and 4, 2-hour group sessions adopting motivational interviewing techniques over 12 months. The primary outcome is endurance capacity measured by the Endurance Shuttle Walking Test at 12 months. Secondary outcomes are: maximal exercise capacity, health-related quality of life, mood, patient activation, physical activity, lung function and healthcare costs. The measures will be taken at baseline, 6 and 12 months. Patient interviews and staff focus groups will be conducted to explore barriers, facilitators and views about the intervention at the end of the study. A framework analysis will be used for the interpretation of qualitative data.

Ethics and dissemination

The trial was granted ethical approval from Health Research Authority and Health and Care Research Wales (HCRW19/EM/0267 on 10 October 2019). Results will be made available to all stakeholders through a dissemination event, conferences and peer-reviewed publications.

Trial registration number

ISRCTN30110012.
Glial-modulating agents for the treatment of pain: protocol for a systematic review
Authors: Gilron Ian , Xiao Maggie Z X , Balanaser Marielle , Carley Meg , Ghasemlou Nader , Salter Michael W , Hutchinson Mark R , Moulin Dwight E , Moore R Andrew , Ross-White Amanda
Published: May 2022

Introduction

Evidence suggests a role for Central nervous system glia in pain transmission and in augmenting maladaptive opioid effects. Identification of drugs that modulate glia has guided the evaluation of glial suppression as a pain management strategy. This planned systematic review will describe evidence of the efficacy and adverse effects of glial-modulating drugs in pain management.

Methods and analysis

A detailed search will be conducted on the Cochrane Central Register of Controlled Trials, Medline, and Embase from their inception until the date the final searches are run to identify relevant randomised controlled trials. The reference lists of retrieved studies, as well as online trial registries, will also be searched. English language, randomised, double-blind trials comparing various glial-modulating drugs with placebo and/or other comparators, with participant-reported pain assessment, will be included. Two reviewers will independently evaluate studies for eligibility, extract data and assess trial quality and potential bias. Risk of bias will be assessed using criteria outlined in theCochrane Handbook for Systematic Review of Interventions. Primary outcomes for this review will include any validated measure of pain intensity and/or pain relief. Dichotomous data will be used to calculate risk ratio and number needed to treat or harm. The quality of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation.

Ethics and dissemination

This systematic review does not require formal ethics approval. The findings will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number

CRD42021262074.
The CLASS Study (Circadian Light in Adolescence, Sleep and School): protocol for a prospective, longitudinal cohort to assess sleep, light, circadian timing and academic performance in adolescence
Authors: Stone Julia E , Wiley Joshua , Chachos Evangelos , Hand Anthony J , Lu Sinh , Raniti Monika , Klerman Elizabeth , Lockley Steven W , Carskadon Mary A , Phillips Andrew J K , Bei Bei , Rajaratnam Shantha M W
Published: May 2022

Background

During adolescence, sleep and circadian timing shift later, contributing to restricted sleep duration and irregular sleep-wake patterns. The association of these developmental changes in sleep and circadian timing with cognitive functioning, and consequently academic outcomes, has not been examined prospectively. The role of ambient light exposure in these developmental changes is also not well understood. Here, we describe the protocol for the Circadian Light in Adolescence, Sleep and School (CLASS) Study that will use a longitudinal design to examine the associations of sleep-wake timing, circadian timing and light exposure with academic performance and sleepiness during a critical stage of development. We also describe protocol adaptations to enable remote data collection when required during the COVID-19 pandemic.

Methods

Approximately 220 healthy adolescents aged 12–13 years (school Year 7) will be recruited from the general community in Melbourne, Australia. Participants will be monitored at five 6 monthly time points over 2 years. Sleep and light exposure will be assessed for 2 weeks during the school term, every 6 months, along with self-report questionnaires of daytime sleepiness. Circadian phase will be measured via dim light melatonin onset once each year. Academic performance will be measured via national standardised testing (National Assessment Program-Literacy and Numeracy) and the Wechsler Individual Achievement Test—Australian and New Zealand Standardised Third Edition in school Years 7 and 9. Secondary outcomes, including symptoms of depression, anxiety and sleep disorders, will be measured via questionnaires.

Discussion

The CLASS Study will enable a comprehensive longitudinal assessment of changes in sleep-wake timing, circadian phase, light exposure and academic performance across a key developmental stage in adolescence. Findings may inform policies and intervention strategies for secondary school-aged adolescents.

Ethics and dissemination

Ethical approval was obtained by the Monash University Human Research Ethics Committee and the Victorian Department of Education. Dissemination plans include scientific publications, scientific conferences, via stakeholders including schools and media.

Study dates

Recruitment occurred between October 2019 and September 2021, data collection from 2019 to 2023.
Hospital-based patient navigation programmes for patients who experience injury-related trauma and their caregivers: a scoping review protocol
Authors: Doucet Shelley , Luke Alison , Anthonisen Grailing , Witherspoon Richelle , MacNeill A Luke , MacNeill Lillian , Kelly Katherine J , Fearon Taylor
Published: May 2022

Introduction

Patients who experience injury-related trauma tend to have complex care needs and often require support from many different care providers. Many patients experience gaps in care while in the hospital and during transitions in care. Providing access to integrated care can improve outcomes for these patients. Patient navigation is one approach to improving the integration of care and proactively supporting patients and their caregivers as they navigate the healthcare system. The objective of this scoping review is to map the literature on the characteristics and impact of hospital-based patient navigation programmes that support patients who experience injury-related trauma and their caregivers.

Methods and analysis

This review will be conducted in accordance with Joanna Briggs Institute methodology for scoping reviews. The review will include primary research studies, unpublished studies and evaluation reports related to patient navigation programmes for injury-related trauma in hospital settings. The databases to be searched will include CINAHL (EBSCO), EMBASE (Elsevier), ProQuest Nursing & Allied Health, PsycINFO (EBSCO) and MEDLINE (Ovid). Two independent reviewers will screen articles for relevance against the inclusion criteria. Results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Reviews (PRISMA-ScR) flow diagram and follow the PRISMA-ScR checklist. The extracted data will be presented both tabularly and narratively.

Ethics and dissemination

Ethics approval is not required, as the scoping review will synthesise information from publicly available material. To disseminate the findings of this review, the authors will submit the results for publication in a medical or health sciences journal, present at relevant conferences and use other knowledge translation strategies to reach diverse stakeholders (eg, host webinars, share infographics).
Ability of the National Early Warning Score and its respiratory and haemodynamic subcomponents to predict short-term mortality on general wards: a prospective three-centre observational study in Finland
Authors: Loisa Eetu , Kallonen Antti , Hoppu Sanna , Tirkkonen Joonas
Published: May 2022

Objectives

To validate the ability of the National Early Warning Score (NEWS) to predict short-term mortality on hospital wards, with a special reference to the NEWS’s respiratory and haemodynamic subcomponents.

Design

A large, 1-year, prospective, observational three-centre study. First measured vital sign datasets on general wards were prospectively collected using a mobile solution system during routine patient care. Area under receiver operator characteristic curves were constructed, and comparisons between ROC curves were conducted with Delong’s test for two correlated ROC curves.

Setting

One university hospital and two regional hospitals in Finland.

Participants

All 19 001 adult patients admitted to 45 general wards in the three hospitals over the 1-year study period. After excluding 102/19 001 patients (0.53%) with data on some vital signs missing, the final cohort consisted of 18 889 patients with full datasets.

Primary and secondary outcome measures

The primary outcome measure was 1-day mortality and secondary outcomes were 2-day and 30-day mortality rates.

Results

Patients’ median age was 70 years, 51% were male and 31% had a surgical reason for admission. The 1-day mortality was 0.36% and the 30-day mortality was 3.9%. The NEWS discriminated 1-day non-survivors with excellent accuracy (AUROC 0.91, 95% CI 0.87 to 0.95) and 30-day mortality with acceptable accuracy (0.75, 95% CI 0.73 to 0.77). The NEWS’s respiratory rate component discriminated 1-day non-survivors better (0.78, 95% CI 0.72 to 0.84) as compared with the oxygen saturation (0.66, 95% CI 0.59 to 0.73), systolic blood pressure (0.65, 95% CI 0.59 to 0.72) and heart rate (0.67, 95% CI 0.61 to 0.74) subcomponents (p<0.01 in all ROC comparisons). As with the total NEWS, the discriminative performance of the individual score components decreased substantially for the 30-day mortality.

Conclusions

NEWS discriminated general ward patients at risk for acute death with excellent statistical accuracy. The respiratory rate component is especially strongly associated with short-term mortality.

Trial registration number

NCT04055350.
Characteristics of participants who take up screening tests for diabetes and lipid disorders: a systematic review
Authors: Ding Hanyue , Huang Junjie , Deng Yunyang , Tin Sze Pui Pamela , Wong Martin Chi-Sang , Yeoh Eng-kiong
Published: May 2022

Objectives

To perform a systematic review on the characteristics of participants who attended screening programmes with blood glucose tests, lipid profiles or a combination of them, respectively.

Design

Systematic review following the Meta-analysis Of Observational Studies in Epidemiology checklist.

Data sources

PubMed and Medline databases for English literature from 1 January 2000 to 1 April 2020.

Eligibility criteria

Original observational studies that reported baseline characteristics of apparently healthy adult participants screening for diabetes and lipid disorders were included in this review.

Data extraction

We examined their sociodemographic characteristics, including age, gender, body mass index (BMI) and lifestyle habits. The quality of the included articles was evaluated by the Appraisal of Cross-sectional Studies.

Results

A total of 33 articles involving 38 studies in 22 countries were included and analysed in this systematic review. Overall, there was a higher participation rate among subjects who were female in all screening modalities (female vs male: 46.6%–63.9% vs 36.1%–53.4% for diabetes screening; 48.8%–58.4% vs 41.6%–51.2% for lipid screening; and 36.4%–76.8% vs 23.2%–63.6% for screening offering both). Compared with the BMI standard from the WHO, participants in lipid screening had lower BMI (male: 23.8 kg/m2 vs 24.2 kg/m2, p<0.01; female: 22.3 kg/m2 vs 23.6 kg/m2, p<0.01). Furthermore, it is less likely for individuals of lower socioeconomic status to participate in diabetes or lipid screening in developed areas.

Conclusions

We identified that individuals from lower socioeconomic groups were less likely to take up programmes for diabetes and/or lipid screening in developed areas. These populations are also likely to be at higher risk of non-communicable diseases. Future studies should investigate the barriers and facilitators of screening among non-participants, where targeted interventions to enhance their screening uptake are warranted.
Gender differences in sleep disruption during COVID-19: cross-sectional analyses from two UK nationally representative surveys
Authors: Ding Xuejie , Brazel David M , Mills Melinda C
Published: May 2022

Objective

COVID-19 related measures have impacted sleep on a global level. We examine changes in sleep problems and duration focusing on gender differentials.

Design

Cross-sectional analyses using two nationally representative surveys collected during the first and second month after the 2020 lockdown in the UK.

Setting and participants

Participants (age 17 years and above) from the first wave of the Understanding Society COVID-19 Study are linked to the most recent wave before the pandemic completed during 2018 and 2019 (n=14 073). COVID-19 Survey Data was collected from 2 to 31 May 2020 (n=8547) with participants drawn from five nationally representative cohort studies in the UK.

Analysis

We conducted bivariate analyses to examine gender gaps in change in sleep problems and change in sleep duration overall and by other predictors. A series of multivariate ordinary least squares (OLS) regression models were estimated to explore predictors of change in sleep problems and change in sleep time.

Results

People in the UK on average experienced an increase in sleep loss during the first 4 weeks of the lockdown (mean=0.13, SD=0.9). Women report more sleep loss than men (coefficient=0.15, 95% CI 0.11 to 0.19). Daily sleep duration on average increased by ten minutes (mean=−0.16, SD=1.11), with men gaining eight more minutes of sleep per day than women (coefficient=0.13, 95% CI 0.09 to 0.17).

Conclusion

The COVID-19 related measures amplified traditional gender roles. Men’s sleep was more affected by changes in their financial situation and employment status related to the crisis, with women more influenced by their emotional reaction to the pandemic, feeling anxious and spending more time on family duties such as home schooling, unpaid domestic duties, nurturing and caregiving. Based on our findings, we provide policy advice of early, clear and better employment protection coverage of self-employed and precarious workers and employer recognition for parents.
Compassion fatigue, burnout, compassion satisfaction and depression among emergency department physicians and nurses: a cross-sectional study
Authors: Ma Huan , Huang Shuang Quan , We Bo , Zhong Ying
Published: May 2022

Objectives

Emergency department physicians and nurses are at high risk of compassion fatigue, burnout and depression. The purpose of this study was to examine the inter-relationship between compassion fatigue, burnout, compassion satisfaction and depression in emergency department physicians and nurses.

Design

A cross-sectional study.

Setting

This study was conducted in five tertiary hospitals in five different cities across the province of Sichuan, China, in 2021.

Participants

A total of 342 emergency department physicians and nurses participated in the study.

Main outcome measures

Compassion fatigue, burnout, compassion satisfaction and depression scores.

Results

Among the study participants, 100% were found to have depressive symptoms, 27.8% had low compassion satisfaction, 2.3% had high burnout and 3.8% had compassion fatigue. In the final multiple linear regression model, marital status (p=0.008; 95% CI –5.205 to –0.789), history of chronic disease (p=0.003; 95% CI –6.461 to –1.386), compassion satisfaction (p<0.001; 95% CI 0.593 to 1.274), burnout (p=0.019; 95% CI 0.084 to 0.930) and compassion fatigue (p<0.001; 95% CI –1.527 to –1.053) among emergency department physicians and nurses were considered to be significant predictors of depression.

Conclusions

The prevalence of depression among emergency department physicians and nurses is high in the province of Sichuan, China. Compassion fatigue, burnout and compassion satisfaction were significantly associated with depression in emergency department physicians and nurses. Hospital administrations should consider these findings to develop appropriate psychological interventions and strategies, to prevent, alleviate or treat severe depression among emergency department physicians and nurses in the province of Sichuan.
Autotransfusion in low-resource settings: a scoping review
Authors: Palmqvist Maria , Von Schreeb Johan , Älgå Andreas
Published: May 2022

Introduction

Globally, haemorrhage is the leading cause of both maternal mortality and preventable trauma death. For patients suffering from haemorrhage, prompt blood transfusion can be life-saving; however, safe and sufficient blood is often lacking in low-resource settings (LRS). Autotransfusion (AT), in which the patient’s own blood is collected and transfused back, is an established alternative to donor blood transfusions, although one that is primarily performed with advanced AT systems. Research on basic AT in LRS is scarce. Therefore, we aimed to consolidate all available information on the current use of basic AT in LRS and to identify AT techniques and devices described for use in such settings.

Design

Scoping review.

Methods

We systematically searched four key databases: PubMed, Web of Science, Global Health and Cochrane Library as well as several grey literature databases and databases of relevant organisations. The final search was conducted on 22 April 2019. We included all types of studies referring to any information on basic AT used or sought to be used in LRS, published in English and dated after 31 December 2008. We synthesised the data from the included studies, results were charted or summarised narratively.

Results

Some 370 records were reviewed, yielding 38 included documents. We found a paucity of scientific evidence as well as contradictory information on the extent of AT use and that AT use is largely undocumented. The most commonly described indications were haemoperitoneum (primarily among obstetric patients) and haemothorax. We identified three AT techniques used in LRS. Additionally, two new devices and one filter are described for potential use in LRS.

Conclusions

Basic AT is practiced for certain obstetric and trauma indications. However, context-specific studies are needed to determine the technique’s safety and effectiveness. Extent of use is difficult to assess, but our results indicate that basic AT is not a widely established practice in LRS. Future research should address the bottlenecks hampering basic AT availability. New AT devices for use in LRS are described, but their utility and cost-effectiveness remain to be assessed.
Notion of a good death for patients with cancer: a qualitative systematic review protocol
Authors: Xiao Jinnan , Ding Jinfeng , Huang Chongmei
Published: May 2022

Introduction

Promoting the quality of death and achieving a good death is one of the most important goals of palliative care in cancer care. Few studies synthesised views of patients with cancer on the notion of a good death and its associated factors. By eliciting the core elements of a good death, the review aims to identify potential unmet needs of patients with cancer and reveal their common values and care preferences at the end of life. The review also has the potential to inform the development of guidelines for clinical care and shared decision-making in palliative care practice.

Methods and analysis

A qualitative systematic review will be conducted and reported according to the Joanna Briggs Institute (JBI) methodology for systematic review and synthesis of qualitative data and the Preferred Reporting Items for Systematic Review and Meta-Analysis. Comprehensive search will be performed in six English and two Chinese databases from inception to 30 April 2022 to retrieve relevant qualitative articles focusing on the notion of a good death from the perspective of patients with cancer. Data will be extracted using the JBI standardised data extraction tool for qualitative research. The quality of the included studies will be critically appraised using the JBI Qualitative Assessment and Review Instrument. Data extraction and quality appraisal will be conducted by two reviewers independently. A meta-aggregative approach and narrative summary will be used to synthesise data.

Ethics and dissemination

Ethical approval is not needed. We will disseminate the findings through international conferences related to cancer care or palliative care. The final review will be submitted and published in a peer-reviewed journal.

PROSPERO registration number

CRD42021266629.
Perspectives of structurally marginalised patients attending contextually tailored and integrated care practices in Canada: a focused ethnography study
Authors: Loignon Christine , Dupéré Sophie , Benhadj Lynda , Carru Diane , Dahrouge Simone
Published: May 2022

Objectives

To better understand the experience of patients attending community-based primary healthcare practices (CBPHCPs) aimed at improving equity and access to primary care for underserved patients, which have been implemented locally in several countries, including Canada. There are currently little data on how, or to what extent, they mitigate patients’ experience of social inequalities in care and improve their access to health. This study explored the impacts of the sociospatial characteristics of these practices on patients’ care experience.

Design and methods

Qualitative, multisite, focused ethnographic study based on in-situ observations and interviews, incorporating inductive and deductive analysis, and using the concept of sense of place.

Setting

Three CBPHCPs located in deprived urban areas in two provinces of Canada.

Participants

28 structurally marginalised persons (17 women) attending the clinics, ranging in age from 18 to 79 years, and 16 managers, clinicians and practitioners working in these clinics.

Results

Data underscored the importance of clinic proximity and accessibility in facilitating patients’ navigation of the health system. Patients appreciated the clinics’ positive sociospatial characteristics. Non-judgmental environments and informal spaces fostered patients’ empowerment and social interaction among themselves and with peer navigators and healthcare professionals. The experience of supportive continuity of care had a positive impact on patients’ sense of well-being and, for many, a positive ripple effect and long-term impact on their social integration.

Conclusion

These results have important implications for policy given the current context, in which governments are challenged to support primary healthcare that addresses the social determinants of health to achieve greater equity. We conclude that scaling up contextually tailored care and deploying humanistic innovative organisational practices into mainstream care will help narrow the equity gap and reduce current prevalent social inequalities in the health system.
Youth Culturally adapted Manual Assisted Problem Solving Training (YCMAP) in Pakistani adolescent with a history of self-harm: protocol for multicentre clinical and cost-effectiveness randomised controlled trial
Authors: Husain Nusrat , Tofique Sehrish , Chaudhry Imran B , Kiran Tayyeba , Taylor Peter , Williams Christopher , Memon Rakhshi , Aggarwal Shilpa , Alvi Mohsin Hassan , Ananiadou S , Ansari Moin Ahmad , Aseem Saadia , Beck Andrew , Alam Sumira , Colucci Erminia , Davidson Kate , Edwards Sarah , Emsley Richard , Green Jonathan , Gumber Anil , Hawton Keith , Jafri Farhat , Khaliq Ayesha , Mason Thomas , Mcreath Ann , Minhas Ayesha , Naeem Farooq , Naqvi Haider Ali , Noureen Amna , Panagioti Maria , Patel Anita , Poppleton Aaron , Shiri Tinevimbo , Simic Mima , Sultan Sarwat , Nizami Asad Tamizuddin , Zadeh Zainab , Zafar Shehla Naeem , Chaudhry Nasim
Published: May 2022

Introduction

Suicide is a global health concern. Sociocultural factors have an impact on self-harm and suicide rates. In Pakistan, both self-harm and suicide are considered as criminal offence’s and are condemned on both religious and social grounds. The proposed intervention ‘Youth Culturally Adapted Manual Assisted Problem Solving Training (YCMAP)’ is based on principles of problem-solving and cognitive–behavioural therapy. YCMAP is a brief, culturally relevant, scalable intervention that can be implemented in routine clinical practice if found to be effective.

Method and analysis

A multicentre rater blind randomised controlled trial to evaluate the clinical and cost-effectiveness of YCMAP including a sample of 652 participants, aged 12–18 years, presenting to general physicians/clinicians, emergency room after self harm or self referrals. We will test the effectiveness of 8–10 individual sessions of YCMAP delivered over 3 months compared with treatment as usual. Primary outcome measure is repetition of self-harm at 12 months. The seconday outcomes include reduction in suicidal ideation, hopelessness and distress and improvement in health related quality of life. Assessments will be completed at baseline, 3, 6, 9 and 12 months postrandomisation. The nested qualitative component will explore perceptions about management of self-harm and suicide prevention among adolescents and investigate participants’ experiences with YCMAP. The study will be guided by the theory of change approach to ensure that the whole trial is centred around needs of the end beneficiaries as key stakeholders in the process.

Ethics and dissemination

Ethics approval has been obtained from the Ethics Committee of University of Manchester, the National Bioethics Committee in Pakistan. The findings of this study will be disseminated through community workshops, social media, conference presentations and peer-reviewed journals.

Trial registration number

NCT04131179.