bluuebunny/crossref_metadata_2025 huggingface dataset:
Potent 3CLpro inhibitors effective against SARS-CoV-2 and MERS-CoV in animal models by therapeutic treatment
Authors: Li Pengfei , Kim Yunjeong , Dampalla Chamandi S. , Nhat Nguyen Harry , Meyerholz David K. , Johnson David K. , Lovell Scott , Groutas William C. , Perlman Stanley , Chang Kyeong-Ok
Published: December 2023

Human coronaviruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Middle East respiratory syndrome coronavirus (MERS-CoV) continue to have a significant impact on public health. A limited or lacking therapeutic arsenal for SARS-CoV-2 and MERS-CoV infections calls for an expanded and diversified portfolio of antivirals against these coronavirus infections. We have previously reported a series of small-molecule 3C-like protease (3CLpro) inhibitors against human coronaviruses. In this report, we demonstrated the
in vivo
efficacy of 3CLpro inhibitors for their broad-spectrum activity against both SARS-CoV-2 and MERS-CoV infections using the fatal animal models. The results suggest that these are promising candidates for further development as broad-spectrum direct-acting antivirals against highly virulent human coronaviruses.
Transcriptional pathways across colony biofilm models in the symbiont
Vibrio fischeri
Authors: Vander Griend Jacob A. , Isenberg Ruth Y. , Kotla Ketan R. , Mandel Mark J.
Published: December 2023

Beneficial microbial symbionts that are horizontally acquired by their animal hosts undergo a lifestyle transition from free-living in the environment to associating with host tissues. In the model symbiosis between the Hawaiian bobtail squid and its microbial symbiont
Vibrio fischeri
, one mechanism used to make this transition during host colonization is the formation of biofilm-like aggregates in host mucosa. Previous work identified factors that are sufficient to induce
V. fischeri
biofilm formation, yet much remains unknown regarding the breadth of target genes induced by these factors. Here, we probed two widely used
in vitro
models of biofilm formation to identify novel regulatory pathways in the squid symbiont
V. fischeri
ES114. We discovered a shared set of 232 genes that demonstrated similar patterns in expression in both models. These genes comprise multiple exopolysaccharide loci that are upregulated and flagellar motility genes that are downregulated, with a consistent decrease in measured swimming motility. Furthermore, we identified genes regulated downstream of the key sensor kinase RscS that are induced independent of the response regulator SypG. Our data suggest that transcriptional regulator VpsR plays a strong role in expression of at least a subset of these genes. Overall, this study adds to our understanding of the genes involved in
V. fischeri
biofilm regulation while revealing new regulatory pathways branching from previously characterized signaling networks.

IMPORTANCE

The
V. fischeri-
squid system provides an opportunity to study biofilm development both in the animal host and in culture-based biofilm models that capture key aspects of
in vivo
signaling. In this work, we report the results of the transcriptomic profiling of two
V. fischeri
biofilm models followed by phenotypic validation and examination of novel signaling pathway architecture. Remarkable consistency between the models provides a strong basis for future studies using either approach or both. A subset of the factors identified by the approaches were validated in the work, and the body of transcriptomic data provides a number of leads for future studies in culture and during animal colonization.
Pregnancy complicated by massive incisional hernia: challenges in management and review of literature
Authors: Suleman Kiran , Wokoh Uloma , Iyer Priyanka , Yoong Wai
Published: December 2023

Pregnancy complicated by incisional hernia is rare but can become an obstetric challenge if the gravid uterus becomes displaced or incarcerated into the hernial sac or if there is ulceration of the overlying dermis as a result of increased intra-abdominal pressure being transmitted to the skin. We report a case of a pregnant woman presenting with a large incisional hernia at 19 weeks of gestation and discuss how problems encountered with progressing pregnancy were managed conservatively by adopting a multidisciplinary team approach (which included surgeons and radiologists). She underwent a caesarean section at 35 weeks of gestation due to active bleeding from the ulcerated skin and foetal growth restriction with subsequent staged secondary hernia repair at a tertiary centre. Close surveillance is mandatory, and a decision on the mode and timing of delivery as well as when to perform the surgical repair of the fascial defect should be team based.
Retained foreign body post-PCNL: an unusual complication and endoscopic management
Authors: Bhargava Priyank , Kudunthail Jeena , Choudhary Gautam Ram , Navriya Shiv Charan
Published: December 2023

During this era of advanced and minimally invasive procedures for treating urolithiasis, percutaneous nephrolithotomy (PCNL) remains the primary choice for removing large renal calculi. While there are various known complications associated with PCNL, such as bleeding, sepsis and injury to neighboring organs, the occurrence of retained foreign bodies as a result of the procedure is rarely reported. In this case report, we present a unique instance of encrustation involving a retained guidewire sheath following PCNL, which was initially mistaken for a residual stone fragment in imaging studies. Fortunately, the foreign body was successfully removed using retrograde intrarenal surgery.
Surgical retrieval of transected umbilical vein catheter in an extremely preterm neonate
Authors: Jensen Rahbek Louise Sofie , Hjortdal Anders , Rawashdeh Yazan F
Published: December 2023

Umbilical catheters are used in the care of critically ill neonates for intravenous treatment. It is generally considered a safe procedure, although complications can occur. Of these, catheter breakage and intravenous migration are rare but potentially life-threatening events. Due to the low frequency of which these events occur, obtaining detailed descriptions of removal techniques can pose a challenge. Here, we describe a case of a broken umbilical vein catheter and the surgical retrieval of the retained fragment. We also present a thorough literature search of cases of broken umbilical catheters and the method by which they were removed.
Retail demand for emergency contraception in United States following New Year holiday: time series study
Authors: Wagner Brandon , Cleland Kelly
Published: December 2023

Objective

To estimate the increase in sales of emergency contraception following the New Year’s Eve/New Year’s Day holiday.

Design

Time series analysis using autoregressive integrated moving average (ARIMA) model.

Setting

Traditional (that is, “bricks and mortar”) retail outlets—grocery stores, drug stores, mass merchandisers, club stores, dollar stores, and military outlets—in the United States from 2016 to 2022.

Data source

Marketing data on weekly aggregated sales of items classified as emergency contraception gathered between 2016 and 2022 (n=362). On the basis of dates, weeks were classified as following the New Year holiday (n=6) or not (n=356).

Main outcome measure

Weekly sales of levonorgestrel emergency contraception per 1000 women of reproductive age in the US population.

Results

Sales of levonorgestrel emergency contraception significantly increased after the New Year holiday (0.63 (95% confidence interval 0.58 to 0.69) unit increase per 1000 women aged 15-44). Holidays that share some aspects of the elevated risks of unprotected sexual intercourse with the New Year holiday (Valentine’s Day, St Patrick’s Day, US Independence Day) were associated with increased sales, albeit to a lesser degree, with respective sales increases per 1000 women aged 15-44 of 0.31 (0.25 to 0.38), 0.14 (0.06 to 0.23), and 0.20 (0.11 to 0.29). Holidays without these expectations (Easter, Mother’s Day, Father’s Day) were not significantly associated with sales of levonorgestrel emergency contraception.

Conclusions

Increased sales of emergency contraception following the New Year’s holiday suggest that this period is associated with increased risks of unprotected vaginal intercourse compared with other holidays. Targeting behavioral risks, prevention strategies to mitigate sexual violence, and improving access to contraception around holidays may limit the risks associated with unprotected vaginal intercourse.
Cost of inaction: a framework to estimate the economic cost of missing a patient with tuberculosis in the Indian context
Authors: Brooks Meredith B , Pingali Viswanath , Nicholson Tom , Keshavjee Salmaan
Published: December 2023

Objectives

To estimate the economic impact of failure to find and treat tuberculosis disease and prevent tuberculosis infection from progressing to active disease.

Design

Estimating the economic cost of not finding and treating a patient suffering from tuberculosis.

Setting

Estimation methodology is developed in the Indian context, as informed by local costs and reported tuberculosis epidemiology.

Participants

No individual participants were included.

Primary and secondary outcome measures

The primary outcome measure is the total cost of patients with drug-susceptible and drug-resistant tuberculosis who are and are not found and treated by tuberculosis programmes, including costs for medications, lost productivity, healthcare services and furthered transmission. We calculate the economic burdens by varying the number of individuals a person sick with tuberculosis infects (10 or 15 people) and the risk of progression to tuberculosis disease if infected (5 or 8%). The secondary outcome measure is the amount saved by finding a patient early or who would not have otherwise been found. All costs are presented in US dollars (exchange rate: 72 Indian rupees/1 US$).

Results

By finding and treating a patient early before furthered transmission occurs—or stopping progression of tuberculosis infection to tuberculosis disease with preventive therapy—the Indian health system can save US$5502 to US$15 825 and US$5846 to US$25 575, foreachindividual with drug-susceptible and drug-resistant tuberculosis, respectively, across scenarios.

Conclusions

These estimates provide crude, lower bounds for the potential costs of not appropriately diagnosing and treating a single patient with active tuberculosis in a timely manner, or preventing a patient with tuberculosis infection from progressing to active disease. The actual financial burden on society is far higher than estimated using this simple, short-term cost-effective analyses. Our results highlight the limitations of tuberculosis costing models to date, and demonstrate the importance of accounting for airborne transmission of tuberculosis.
Experiences of individuals with rheumatoid arthritis interacting with health care and the use of a digital self-care application: a qualitative interview study
Authors: Viberg Johansson Jennifer , Blyckert Hanna , Schölin Bywall Karin
Published: December 2023

Objectives

Over the last few decades, there have been significant improvements in the treatment of rheumatoid arthritis (RA), with the development of new treatments and guidelines for teamwork and patient self-care and access to digital tools. This study aimed to explore the experiences of individuals with RA interacting with healthcare. It also looked at how a self-care application, an educational programme called the ‘healthcare encounter’, improved patient–doctor communication.

Design

Semistructured interviews were conducted, and qualitative content analysis was performed.

Setting

The potential participants, individuals with established, or under investigation for, RA diagnosis at rheumatology clinics in Sweden, were asked to participate in the study via a digital self-care application called the Elsa Science Self-care app.

Participants

Ten interviews were performed with participants from nine clinics following a meeting with the rheumatologist or other healthcare personnel between September 2022 and October 2022. Phrases, sentences or paragraphs referring to experiences from healthcare meetings and opinions about the digital programme were identified and coded. Codes that reflected similar concepts were grouped; subcategories were formulated, and categories were connected to their experiences and opinions.

Results

Among our participants, three main categories emerged: the availability of healthcare, individual efforts to have a healthier life and personal interaction with healthcare. Participants described that the ‘healthcare encounter’ educational programme can be a source of information, which confirms, supports and creates a sense of control.

Conclusion

The participants valued being seen and taking part in a dialogue when they had prepared themselves (observed symptoms over time and prepared questions). The implementation of digital self-care applications might need to be incorporated into the healthcare setting, so that both the patients and the healthcare personnel have a shared understanding. Collaboration is essential in this context.
Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
Authors: Wu Lifeng , Ji Weidan , Huang Yumao , Zeng Huanxuan , Chen Jie , Zou Yueling , Lin Weiguo , Lin Yuzhan
Published: December 2023

Introduction

Paediatric myocarditis, a rare inflammatory disease, often presents without clear early symptoms. Although cardiac troponin I levels can aid in diagnosing myocarditis, they are not definitive indicators. Troponin I levels frequently fluctuate within and outside the reference range, potentially causing misinterpretations by clinicians. Although a negative troponin I result is valuable for excluding myocarditis, its specificity is low. Moreover, the clinical diagnosis of paediatric myocarditis is exceptionally challenging, and accurate early-stage diagnosis and treatment pose difficulties. Currently, the Dallas criteria, involving cardiac biopsy, serves as the gold standard for myocarditis diagnosis. However, this method has several drawbacks and is unsuitable for children, resulting in its limited use.

Methods and analysis

In this study, we will employ multiple logistic regression analysis to develop a predictive model for early childhood myocarditis. This model will assess the patient’s condition at onset and provide the probability of a myocarditis diagnosis. Model performance will be evaluated for accuracy and calibration, and the results will be presented through receiver operating characteristic (ROC) curves and calibration plots. Clinical decision curve analysis, in conjunction with ROC curve analysis, will be employed to determine the optimal cut-off value and calculate the net clinical benefit value for assessing clinical effectiveness. Finally, internal model validation will be conducted using bootstrapping.

Ethics and dissemination

Approval from the Clinical Research Ethics Committee of The Third Affiliated Hospital of Wenzhou Medical University has been obtained. The research findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.
Self-Management Analysis in Chronic Conditions (SMACC) checklist: an international consensus-based tool to develop, compare and evaluate self-management support programmes
Authors: Moreels Timothy , Cruyt Ellen , De Baets Stijn , Andries Lore , Arts-Tielemans Magelien , Rodriguez-Bailon Maria , Bergström Aileen , Boete Kyara , Bormans Iris , Costa Ursula , Declercq Hanne , Dekelver Sari , Dekyvere Virginie , Delooz Eva , Engels Cynthia , Helderweirt Sam , Jarrey Mike , Lenaerts Anneleen , Leyman Anneleen , Lim Kee Hean , Meynen Louise , Satink Ton , Schoenmakers Freya , Senn Daniela , Slembrouck Lise , Van Meensel Emma , Vangenechten Dani , Van Paepeghem Bram , De Vriendt Patricia , Van de Velde Dominique
Published: December 2023

Objectives

The Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version.

Design

A two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers’ networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement.

Results

Fifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback.

Conclusions

The SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.
Prevalence, awareness, treatment and control of dyslipidaemia and their determinants: results from a population-based survey of 60 283 residents in eastern China
Authors: Chen Yijia , Du Jinling , Zhou Nan , Song Yingqian , Wang Weiwei , Hong Xin
Published: December 2023

Objectives

To investigate the prevalence, awareness, treatment and control of dyslipidaemia and its associated factors in eastern China.

Design

Cross-sectional study.

Setting

Data were collected from the 2017 Nanjing Chronic Disease and Risk Factor Surveillance.

Participants

This study included 60 283 participants aged ≥18 years.

Outcome measures

Prevalence of dyslipidaemia was defined as self-reported history of dyslipidaemia and/or the use of lipid-lowering medication, and/or meeting at least one of the following during on-site investigation: total cholesterol ≥6.2 mmol/L, triglyceride ≥2.3 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L and high-density lipoprotein cholesterol <1.0 mmol/L. Dyslipidaemia awareness was defined as the proportion of patients with dyslipidaemia who explicitly indicate their awareness of having a diagnosis of dyslipidaemia. Treatment was based on medication use among individuals with dyslipidaemia. Control was defined as having dyslipidaemia, receiving treatment and achieving serum lipid control to the standard level.

Analysis

Complex weighting was used to calculate weighted prevalence. A two-level logistic regression model determined the influencing factors for dyslipidaemia prevalence, awareness, treatment and control.

Results

The crude prevalence rate of dyslipidaemia was 28.4% (17 093 of 60 283). Among 17 093 patients with dyslipidaemia, the crude rates of awareness, treatment and control were 40.0% (n=6830), 27.5% (n=4695) and 21.9% (n=3736), respectively. The corresponding weighted prevalence rates were 29.8%, 41.6%, 28.9% and 22.9%. Older age (OR 2.03, 95% CI 1.82 to 2.23), urban residence (1.24, 1.19 to 1.31), higher education level (1.31, 1.21 to 1.42), current smoking (1.22, 1.15 to 1.29), alcohol consumption (1.20, 1.14 to 1.26), obesity (2.13, 1.99 to 2.29), history of hypertension (1.64, 1.56 to 1.71) and diabetes (1.92, 1.80 to 2.04) were identified as independent risk factors for dyslipidaemia (all p<0.001). Participants who were older, female, living in urban areas, had higher education levels, did not smoke or drink alcohol, had central obesity, had hypertension or had diabetes were more likely to be aware of their dyslipidaemia conditions, receive treatment and achieve serum lipid control to a standard level than their comparators (all p<0.05).

Conclusions

The prevalence of dyslipidaemia is relatively high in eastern China; however, awareness, treatment and control levels are relatively low.
Self-reported condom use among Washington State residents prior to and during the COVID-19 pandemic: a cross-sectional analysis of BRFSS data
Authors: Jewell Mary , Jampel Sonya M , Casagrande Mary Grace , Ásbjörnsdóttir Kristjana , Littman Alyson J
Published: December 2023

Objectives

COVID-19 significantly impacted healthcare access and sexual behaviour, but little is known about how COVID-19 affected condom use. This study aimed to investigate whether self-reported condom use and sex in Washington State changed during pandemic restrictions compared with prepandemic.

Design

Cross-sectional survey data from the Behavioral Risk Factor Surveillance System.

Setting

Washington State.

Participants

11 684 participants aged 18–65.

Primary and secondary outcome measures

The primary outcome was changes in the prevalence of condom use by time of interview pre-COVID-19, before the Washington State lockdown (1 January 2019 to 23 March 2020, n=7708) and during COVID-19, after the first state lockdown (24 March 2020 to 31 December 2020, n=3976). The secondary outcome was changes in the prevalence of reported sex during the same periods. We assessed whether associations differed by rurality and HIV risk behaviour.

Results

Condom use was similar during COVID-19 (37.3%) compared with pre-COVID-19 (37.8%) (adjusted prevalence ratio (PR): 0.98, 95% CI 0.89, 1.01). Associations did not differ by rurality or HIV risk behaviour. Compared with pre-COVID-19 (83.0%), a smaller proportion of respondents reported having sex in the last 12 months during COVID-19 (80.5%), a relative decrease of 3% (PR: 0.97, 95% CI 0.96, 0.99; p<0.001).

Conclusions

The prevalence of reported sex declined during COVID-19, but condom use remained steady in Washington. As our reproductive health system faces increased challenges, these results may inform future sexual health services.
Cohort profile: COBLAnCE: a French prospective cohort to study prognostic and predictive factors in bladder cancer and to generate real-world data on treatment patterns, resource use and quality of life
Authors: Lebret Thierry , Bonastre Julia , Fraslin Aldéric , Neuzillet Yann , Droupy Stéphane , Rebillard Xavier , Vordos Dimitri , Guy Laurent , Villers Arnauld , Schneider Marc , Coloby Patrick , Lacoste Jean , Méjean Arnaud , Lacoste Jacques , Descotes Jean-Luc , Eschwege Pascal , Loison Guillaume , Blanché Hélène , Mariani Odette , Ghaleh Bijan , Mangin Anthony , Sirab Nanor , Groussard Karine , Radvanyi François , Allory Yves , Benhamou Simone
Published: December 2023

Purpose

Bladder cancer is a complex disease with a wide range of outcomes. Clinicopathological factors only partially explain the variability between patients in prognosis and treatment response. There is a need for large cohorts collecting extensive data and biological samples to: (1) investigate gene-environment interactions, pathological/molecular classification and biomarker discovery; and (2) describe treatment patterns, outcomes, resource use and quality of life in a real-world setting.

Participants

COBLAnCE (COhort to studyBLAdderCancEr) is a French national prospective cohort of patients with bladder cancer recruited between 2012 and 2018 and followed for 6 years. Data on patient and tumour characteristics, treatments, outcomes and biological samples are collected at enrolment and during the follow-up.

Findings to date

We describe the cohort at enrolment according to baseline surgery and tumour type. In total, 1800 patients were included: 1114 patients with non-muscle-invasive bladder cancer (NMIBC) and 76 patients with muscle-invasive bladder cancer (MIBC) had transurethral resection of a bladder tumour without cystectomy, and 610 patients with NMIBC or MIBC underwent cystectomy. Most patients had a solitary lesion (56.3%) without basement membrane invasion (71.7% of Ta and/or Tis). Half of the patients with cystectomy were stage ≤T2 and 60% had non-continent diversion. Surgery included local (n=298) or super-extended lymph node dissections (n=11) and prostate removal (n=492). Among women, 16.5% underwent cystectomy and 81.4% anterior pelvectomy.

Future plans

COBLAnCE will be used for long-term studies of bladder cancer with focus on clinicopathological factors and molecular markers. It will lead to a much-needed improvement in the understanding of the disease. The cohort provides valuable real-world data, enabling researchers to study various research questions, assess routine medical practices and guide medical decision-making.
Health service factors affecting the COVID-19 vaccination campaign in a Ghanaian metropolis: A qualitative exploratory study
Authors: Abraham Susanna Aba Aba , Amoah John Oti , Agyare Dorcas Frempomaa , Sekimpi Deogratias Kaheeru , Bosomtwe-Duker Diana , Druye Andrews Adjei , Osei Berchie Gifty , Obiri-Yeboah Dorcas
Published: December 2023

Objective

The study sought to explore the perspectives of vaccinators on the health system factors that impacted the COVID-19 vaccination campaign.

Design

The study employed an exploratory-descriptive qualitative design. Key-informants’ interviews were conducted using semi-structured guide to gather the data. Thematic analysis following the steps of Braun and Clark was conducted using ATLAS.ti software.

Setting

The study setting was the Cape Coast Metropolis where the Central Regional Health Directorate is located. The Directorate initiates and implements policy decisions across the region. It is also the only metropolis in the region that recorded about 5970 of the total COVID-19 cases recorded in Ghana.

Participants

Eleven vaccinators who had been trained for the COVID-19 vaccination and had participated in the campaign for at least 6 months were purposively sampled through the Regional Public Health Unit.

Results

Four themes were derived from the data after analysis; ‘vaccine-related issues’; ‘staffing issues’; ‘organising and planning the campaign’ and ‘surveillance and response systems’. Subthemes were generated under each major theme. Our results revealed the health service promoted the COVID-19 vaccination campaign through public education and ensured access to COVID-19 vaccines through the use of community outreaches. Also, the health service ensured adequate logistics supply for carrying out the campaign as well as ensured vaccinators were adequately equipped for adverse incidence reporting and management. Dissatisfaction among COVID-19 vaccinators attributed to low remuneration and delays in receiving allowances as well as shortfalls in efforts at securing transportation and a conducive venue for the vaccination exercise also emerged. Other challenges in the vaccination campaign were attributed to poor data entry platforms and limited access to internet facilities.

Conclusion

This study highlights the health system’s strategies and challenges during the COVID-19 vaccination campaign, emphasising the need for critical interventions to prevent low vaccination rates.
Long COVID in long-term care: a rapid realist review
Authors: Fyffe Ian , Sorensen Janice , Carroll Simon , MacPhee Maura , Andrews-Paul Alison , Crooks Valorie A , Freeman Shannon , Davison Karen , Walls Jennifer , Berndt Annette , Shams Benajir , Sivan Manoj , Mithani Akber
Published: December 2023

Objectives

The goals of this rapid realist review were to ask: (a) what are the key mechanisms that drive successful interventions for long COVID in long-term care (LTC) and (b) what are the critical contexts that determine whether the mechanisms produce the intended outcomes?

Design

Rapid realist review.

Data sources

Medline, CINAHL, Embase, PsycINFO and Web of Science for peer-reviewed literature and Google for grey literature were searched up to 23 February 2023.

Eligibility criteria

We included sources focused on interventions, persons in LTC, long COVID or post-acute phase at least 4 weeks following initial COVID-19 infection and ones that had a connection with source materials.

Data extraction and synthesis

Three independent reviewers searched, screened and coded studies. Two independent moderators resolved conflicts. A data extraction tool organised relevant data into context-mechanism-outcome configurations using realist methodology. Twenty-one sources provided 51 intervention data excerpts used to develop our programme theory. Synthesised findings were presented to a reference group and expert panel for confirmatory purposes.

Results

Fifteen peer-reviewed articles and six grey literature sources were eligible for inclusion. Eleven context-mechanism-outcome configurations identify those contextual factors and underlying mechanisms associated with desired outcomes, such as clinical care processes and policies that ensure timely access to requisite resources for quality care delivery, and resident-centred assessments and care planning to address resident preferences and needs. The underlying mechanisms associated with enhanced outcomes for LTC long COVID survivors were: awareness, accountability, vigilance and empathetic listening.

Conclusions

Although the LTC sector struggles with organisational capacity issues, they should be aware that comprehensively assessing and monitoring COVID-19 survivors and providing timely interventions to those with long COVID is imperative. This is due to the greater care needs of residents with long COVID, and coordinated efficient care is required to optimise their quality of life.
Research priorities for children’s cancer: a James Lind Alliance Priority Setting Partnership in the UK
Authors: Aldiss Susie , Hollis Rachel , Phillips Bob , Ball-Gamble Ashley , Brownsdon Alex , Chisholm Julia , Crowther Scott , Dommett Rachel , Gower Jonathan , Hall Nigel J , Hartley Helen , Hatton Jenni , Henry Louise , Langton Loveday , Maddock Kirsty , Malik Sonia , McEvoy Keeley , Morgan Jessica Elizabeth , Morris Helen , Parke Simon , Picton Sue , Reed-Berendt Rosa , Saunders Dan , Stewart Andy , Tarplee-Morris Wendy , Walsh Amy , Watkins Anna , Weller David , Gibson Faith
Published: December 2023

Objectives

To engage children who have experienced cancer, childhood cancer survivors, their families and professionals to systematically identify and prioritise research questions about childhood cancer to inform the future research agenda.

Design

James Lind Alliance Priority Setting Partnership.

Setting

UK health service and community.

Methods

A steering group oversaw the initiative. Potential research questions were collected in an online survey, then checked to ensure they were unanswered. Shortlisting via a second online survey identified the highest priority questions. A parallel process with children was undertaken. A final consensus workshop was held to determine the Top 10 priorities.

Participants

Children and survivors of childhood cancer, diagnosed before age 16, their families, friends and professionals who work with this population.

Results

Four hundred and eighty-eight people submitted 1299 potential questions. These were refined into 108 unique questions; 4 were already answered and 3 were under active study, therefore, removed. Three hundred and twenty-seven respondents completed the shortlisting survey. Seventy-one children submitted questions in the children’s surveys, eight children attended a workshop to prioritise these questions. The Top 5 questions from children were taken to the final workshop where 23 questions in total were discussed by 25 participants (young adults, carers and professionals). The top priority was ‘can we find effective and kinder (less burdensome, more tolerable, with fewer short and long-term effects) treatments for children with cancer, including relapsed cancer?’

Conclusions

We have identified research priorities for children’s cancer from the perspectives of children, survivors, their families and the professionals who care for them. Questions reflect the breadth of the cancer experience, including diagnosis, relapse, hospital experience, support during/after treatment and the long-term impact of cancer. These should inform funding of future research as they are the questions that matter most to the people who could benefit from research.
Examining the extent, forms and factors influencing multiple job holding among medical doctors, professional nurses and rehabilitation therapists in two South African provinces: a cross-sectional study
Authors: Matiwane Busisiwe Precious , Blaauw Duane , Rispel Laetitia Chairmaine
Published: December 2023

Objective

Multiple job holding (MJH), or working in more than one paid job simultaneously, is a common characteristic of health labour markets. The study examined the extent (prevalence), forms and factors influencing MJH among public sector medical doctors, professional nurses and rehabilitation therapists in two South African provinces.

Design

A cross-sectional, analytical study.

Setting

29 public sector hospitals in the Gauteng and Mpumalanga provinces of South Africa.

Participants

Full-time public sector medical doctors, professional nurses and rehabilitation therapists.

Results

We obtained an overall response rate of 84.3%, with 486 medical doctors, 571 professional nurses and 340 rehabilitation therapists completing the survey. The mean age was 39.9±9.7 years for medical doctors, 43.7±10.4 years for professional nurses and 32.3±8.7 years for rehabilitation therapists. In the preceding 12 months, the prevalence of MJH was 33.7% (95% CI 25.8% to 42.6%) among medical doctors, 8.6% (95% CI 6.3% to 11.7%) among professional nurses and 38.7% (95% CI 31.5% to 46.5%) among rehabilitation therapists. Medical doctors worked a median of 20 (10–40) hours per month in their additional jobs, professional nurses worked 24 (12–34) hours per month and rehabilitation therapists worked 16 (8–28) hours per month. Private practice was the most prevalent form of MJH among medical doctors and rehabilitation therapists, compared with nursing agencies for professional nurses. MJH was significantly more likely among medical specialists (OR 4.3, p<0.001), married professional nurses (OR 2.4, p=0.022) and male rehabilitation therapists (OR 2.4, p=0.005).

Conclusion

The high prevalence of MJH could adversely affect the care of public sector patients. The study findings should inform the review and revision of existing MJH policies.
Impact of a pharmacy-led screening and intervention in people at risk of or living with chronic kidney disease in a primary care setting: a cluster randomised trial protocol
Authors: Tesfaye Wubshet , Krass Ines , Sud Kamal , Johnson David W. , Van Connie , Versace Vincent L. , McMorrow Rita , Fethney Judith , Mullan Judy , Tran Anh , Robson Breonny , Vagholkar Sanjyot , Kairaitis Lukas , Gisev Natasa , Fathima Mariam , Tong Vivien , Coric Natali , Castelino Ronald L.
Published: December 2023

Introduction

Chronic kidney disease (CKD) is increasingly recognised as a growing global public health problem. Early detection and management can significantly reduce the loss of kidney function. The proposed trial aims to evaluate the impact of a community pharmacy-led intervention combining CKD screening and medication review on CKD detection and quality use of medicines (QUM) for patients with CKD. We hypothesise that the proposed intervention will enhance detection of newly diagnosed CKD cases and reduce potentially inappropriate medications use by people at risk of or living with CKD.

Methods and analysis

This study is a multicentre, pragmatic, two-level cluster randomised controlled trial which will be conducted across different regions in Australia. Clusters of community pharmacies from geographical groups of co-located postcodes will be randomised. The project will be conducted in 122 community pharmacies distributed across metropolitan and rural areas. The trial consists of two arms: (1) Control Group: a risk assessment using the QKidney CKD risk assessment tool, and (2) Intervention Group: a risk assessment using the QKidney CKD plus Point-of-Care Testing for kidney function markers (serum creatinine and estimated glomerular filtration rate), followed by a QUM service. The primary outcomes of the study are the proportion of patients newly diagnosed with CKD at the end of the study period (12 months); and rates of changes in the number of medications considered problematic in kidney disease (number of medications prescribed at inappropriate doses based on kidney function and/or number of nephrotoxic medications) over the same period. Secondary outcomes include proportion of people on potentially inappropriate medications, types of recommendations provided by the pharmacist (and acceptance rate by general practitioners), proportion of people who were screened, referred, and took up the referral to visit their general practitioners, and economic and other patient-centred outcomes.

Ethics and dissemination

The trial protocol has been approved by the Human Research Ethics Committee at the University of Sydney (2022/044) and the findings of the study will be presented at scientific conferences and published in peer-reviewed journal(s).

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN12622000329763).
Cost-effectiveness of occupational therapy for older adults: a protocol for an updated systematic review
Authors: Kaneko Takao , Nagayama Hirofumi , Ikeda Kohei , Nakamura Takuto , Niimi Ayaka , Inoue Natsuki , Takeda Taisei , Uchida Junya
Published: December 2023

Introduction

The ageing populations in developed countries are a global concern, with increasing numbers of older adults facing physical, cognitive and psychological challenges, resulting in reduced quality of life and higher healthcare costs. Healthcare expenditure worldwide has been on the rise, especially among older adults, emphasising the importance of enabling independent living while reducing healthcare costs. Occupational therapy holds promising outcomes in promoting functional independence and enhancing the quality of life for older adults, but research on its cost-effectiveness remains limited. This systematic review aims to evaluate the recent evidence on the cost-effectiveness of occupational therapy interventions for older adults from a pragmatic perspective.

Methods and analysis

This systematic review will cover full economic evaluations, including cost-effectiveness, cost-utility and cost–benefit analyses, by reviewing randomised and cluster randomised controlled trials. The participants will be aged over 65 years without disease or disability restrictions. Primary outcomes will be assessed using functional status and quality-of-life assessments. Studies published before July 2023 will be searched in PubMed, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, with no language restrictions.

Ethics and dissemination

Ethical approval is not required for this literature-based systematic review. The study’s findings will update the evaluation of occupational therapy’s cost-effectiveness in older adults and will be made public by publishing them in scholarly journals.

PROSPERO registration number

CRD42023453558.
Self-reported engagement in everyday activities following bilateral lung transplantation in paediatric cystic fibrosis: a single centre study
Authors: Marshall Jenny-Maree , Schneider Emma , O’Mahony Shenae , Lannin Natasha , Westall Glen Phillip , Bhopti Anoo
Published: December 2023

Introduction

Following lung transplantation, it is unknown how children/adolescents self-assess their performance in everyday activities, importance of these activities, and whether resumption of everyday activities influences self-reported quality of life. The aim was to examine the effect of bilateral lung transplantation on children’s/adolescent’s perception of engagement in everyday activities over the first 18 months post-transplant.

Methods

A multiple-single-case-study pre–post test design was conducted at a National Paediatric Lung Transplant Service. Participants were aged under 18 years and were 3 months post first bilateral lung transplant at the time of recruitment. Outcomes were self-reported quality of life (Paediatric Quality of Life Inventory (PedsQL), Transplant Module and engagement in meaningful life roles (Child Occupational Self-Assessment (COSA) Scale) measured at 3 months and 18 months post-transplant from participants, and their parent(s) (PedsQL). Analysis included paired between-time differences and descriptive analysis.

Results

Seven participants were recruited to the trial with a mean age of 13 (SD 4) years and a diagnosis of cystic fibrosis. The total mean scores on PedsQL remained stable between 3 months and 18 months for both participants and parents. The PedsQL transplant module total mean scores of participants significantly increased from 3 months (M=66.58, SD=11.83) to 18 months (M=80.25, SD=11.56), t(5) = 2.91, p=0.03 whereas parents’ scores remained stable. COSA responses reported ‘big problems’ with self-care tasks, family engagement and coping with worries at 3 months. At 18 months, the ‘big problem’ activities shifted to community engagement and independence.

Conclusion

Time influences self-reported quality of life and engagement in meaningful life roles for children/adolescents and their parents 3 months to 18 months post-lung transplant. Our findings highlight the importance of focusing on occupational roles and occupational performance of children and adolescents when designing post-transplant interventions, suggesting a key role for occupational therapy after transplantation.
Turning hierarchy on its head: are parallel learning partnerships the solution to creating inclusive cultures in healthcare?
Authors: Clifford Naomi , Clarke Martin , Conchar Catherine
Published: December 2023

Background

It is important that NHS Trusts create inclusive and compassionate organisational cultures in which black and minority ethnic (BME) staff can progress equitably. Race equality and development initiatives can be implemented to address this. The introduction of reverse and reciprocal mentoring programmes in numerous organisations has had varying levels of success. These programmes can emphasise and perpetuate hierarchical differences in pairs, causing barriers to creating mutually beneficial partnerships.

Objectives

This paper reports the evaluation findings of a race equality and professional development initiative: the Parallel Learning Partnerships (PLP) Programme. Launched in April 2021, 27 of the Trust’s Executive and senior leadership team members were paired with 27 BME colleagues for 1 year. The authors aimed to determine the efficacy of the initiative’s design and implementation, and partner experiences and outcomes, particularly in relation to learning and any evidence of genuinely equal partnerships.

Participants

Twenty-six programme participants responded to an online survey. One-to-one semistructured interviews were conducted with 12 programme participants.

Results

Findings revealed that the majority of participants developed effective and highly valued non-hierarchical learning partnerships. This was despite impacts of the COVID-19 pandemic creating additional pressures and affecting partnership meetings and activities. Partner outcomes included greater understanding and awareness around race equity matters, improved confidence and motivation, and enhanced leadership skills in relation to inclusivity and compassion.

Conclusion

The pilot programme has been largely successful in providing an effective mechanism for BME staff to engage and connect with the Trust’s executive and senior leaders on a reciprocal, equal and mutually beneficial basis. PLP resulted in a variety of beneficial outcomes for both groups of partners which may not have been possible within comparable mentoring models. Additional positive impacts to the wider organisation are anticipated to be evident in time with the programme’s continuation.
NLRP12-associated autoinflammatory disease in Chinese adult patients: a single-centre study
Authors: Miao Junke , Zhang Jingyuan , Huang Xin , Wu Na , Wu Di , Shen Min
Published: December 2023

Background

NLRP12-associated autoinflammatory disease (NLRP12-AID) is an autosomal dominant autoinflammatory disorder caused by variants ofNLRP12gene. We aimed to report a cohort of Chinese adult patients withNLRP12-AID and summarised phenotypes and genotypes.

Methods

Twenty patients were diagnosed withNLRP12-AID after performing whole-exome sequencing and were included in our cohort. Demographic information, clinical data and treatment response were collected and evaluated. A literature review ofNLRP12-AID was performed, and the clinical features and mutated sites were summarised and compared with our cohort.

Results

Among the 20NLRP12-AID patients, the main clinical features ofNLRP12-AID included fever, cutaneous rash, arthralgia/arthritis, pharyngitis/tonsillitis, lymphadenopathy, myalgia and abdominal pain/diarrhoea. ThirteenNLRP12variants were detected as F402L, G39V, R1030X, R7G, E24A, Q90X, A218V, A259V, W581X, G729R, R859W, c.-150T>C and c.*126G>C. Glucocorticoids were used in 14 patients, immunosuppressive agents in 13, and tocilizumab in 2. Seventeen patients had good responses to therapy. When compared with 50NLRP12-AID patients from other countries, Chinese patients had fewer variants in exon 3, higher incidences of cutaneous rash, pharyngitis/tonsillitis and lymphadenopathy. Among all these 70NLRP12-AID patients, patients carrying non-exon-3 variants had higher frequencies of ocular involvement, pharyngitis/tonsillitis, headache and lymphadenopathy than those with exon-3 variants.

Conclusion

This is the largest cohort ofNLRP12-AID in the world and seven novel variants ofNLRP12were identified. Chinese adult patients ofNLRP12-AID had more non-specific symptoms such as pharyngitis/tonsillitis and lymphadenopathy when compared with patients from other countries, for which the less occurrence of exon-3 variants might be one possible reason.