Assessment Checklist Research Articles

Effect of acupressure on the anxiety and pain of patients undergoing cardiac catheterization: A systematic review

The objective of this systematic review was to examine the influence of acupressure on the levels of anxiety and pain among individuals undergoing cardiac catheterization. An extensive search was carried out across global electronic databases, encompassing Scopus, PubMed, and Web of Science, along with Iranian databases like Iranmedex, spanning from the earliest available date to October 1, 2023. The search utilized keywords derived from Medical Subject Headings, encompassing terms like "acupressure", "anxiety", "pain", and "cardiac catheterization". The quality evaluation of randomized controlled trials and quasi-experimental studies was performed utilizing the critical assessment checklist from the Joanna Briggs Institute. A total of 781 patients participated in nine studies, with 59.60% being female, and 57.11% assigned to the intervention group. The participants had a mean age of 55.72 years (SD=9.13), and the average duration of the intervention was 12.78 minutes. The findings of this systematic review suggest that health professionals, including nurses, can effectively utilize acupressure to mitigate both pain and anxiety in patients undergoing cardiac catheterization. As a recommendation, it is advised that healthcare managers and policymakers create supportive environments within hospitals, enabling healthcare professionals to incorporate acupressure techniques. This proactive approach may contribute to the reduction of anxiety and pain experienced by patients undergoing cardiac catheterization.

IJCM_328A: Operational Research on Capacity Building of Community Health Workers in Screening for Depression and Suicide risk

Background: The basic training for ASHA workers in Tamil Nadu include a module on Non-Communicable diseases with inadequate focus on Mental Health. As a part of the Community Based Assessment Checklist, ASHAs are trained in administration of Patient Health Questionnaire-2 to screen for depression. However, there is significant gap in the primary prevention of depression in the communities in terms of screening, basic counselling services and knowledge and attitude among community health workers Objective: This study aimed to assess the feasibility of capacity building of Community Health Workers in screening for depression and suicide risk and provision of Psychological First Aid Services Methodology: 117 Community Health Workers including ASHAs, AWWs, ANMs, WHVs, VHNs and UHNs were trained in WHO Psychological First Aid, PHQ-9 administration and WHO MhGAP 10 questions on suicide risk screening in Thiruvannamalai, Vellore and Tiruvallur District of Tamil Nadu Results: Of the 1371 individuals screened, 13.18% were positive for depression and 38% were positive for atleast one suicide risk. The most common suicide risk observed was chronic pain followed by extreme hopelessness. PHQ-9 and Suicide risk assessment was easy to administer among ANM, VHN and UHNs. However, ASHAs and Women Health Volunteers reported that PHQ-2/WHO Wellbeing Index was an easier tool to use in the field. Psychological First Aid training can be easily delivered by non-medical professionals to health workers. Conclusion: Community Health Workers can provide primary prevention in mental health by provision of Psychological First Aid to their community. Depression screening should be simplified by PHQ-2/WHO Well being index

Development of an integrated milestone assessment tool across multiple early-adopter programs for breaking bad news: a pilot project

BackgroundThe transition of the Accreditation Council for Graduate Medical Education (ACGME) to milestone assessment creates opportunities for collaboration and shared assessments across graduate medical programs. Breaking bad news is an essential communication skill that is a common milestone across almost every medical specialty. The purpose of this study was to develop and pilot an integrated milestone assessment (IMA) tool for breaking bad news using ACGME milestone criteria and to compare the IMA tool with the existing SPIKES protocol.MethodsThe IMA tool was created using sub-anchors in professionalism and interpersonal communication skills that are applicable to every specialty and to the ability to break bad news. Two cases of breaking bad news, designed to be “easy” and “intermediate” in difficulty, were used to assess basic skills in breaking bad news in first-year medical residents from six residency specialties. Eight standardized patients were trained to portray the cases in sessions held in November 2013 and May 2014. Standardized patients completed an assessment checklist to evaluate each resident’s performance in breaking bad news based on their use of the SPIKES protocol and IMA tool. Residents answered post-encounter questions about their training and comfort in breaking bad news. The association between SPIKES and IMA scores was investigated by simple linear regression models and Spearman rank correlations.ResultsThere were 136 eligible medical residents: 108 (79.4%) participated in the first session and 97 (71.3%) participated in the second session, with 96 (70.6%) residents participating in both sessions. Overall, we were able to identify residents that performed at both extremes of the assessment criteria using the integrated milestone assessment (IMA) and the SPIKES protocol. Interestingly, residents rated themselves below “comfortable” on average.ConclusionWe developed an integrated milestone assessment (IMA) that was better than the SPIKES protocol at assessing the skill of breaking bad news. This collaborative assessment tool can be used as supplement tool in the era of milestone transformation. We aim assess our tool in other specialties and institutions, as well as assess other shared milestones across specialties.

Exploring networks of complex developmental trauma symptomatology among children and adolescents involved in child welfare.

Clinical presentations of child and adolescent psychopathology can vary systematically for boys and girls. While network analysis is increasingly being applied to explore psychopathology in adults, there is a dearth of network studies considering differences in symptoms for boys and girls, particularly in developmental trauma-related symptomatology. This study involves rural children (n=375, 39.47% girls) and adolescents (n=291, 51.20% girls) involved with child protection services in Ontario, Canada. Caregivers completed the Assessment Checklist for Children or Adolescents within the first 6months of care. Psychometric network analyses were conducted using subscales for boys and girls. Differences were examined via network comparison permutation tests, moderated network models, and independent t-tests. Attachment-related interpersonal difficulties were the most central nodes in the child and adolescent networks for both boys and girls. Emotional dysregulation also had high strength centrality for adolescents. While network comparison tests found the overall network structures and global network strength to be invariant between boys and girls for children and adolescents, moderated network models and independent t-tests revealed several differences with regards to the expression of specific symptoms. Among children, girls exhibited more indiscriminate and pseudomature interpersonal behaviors, whereas boys expressed significantly more non-reciprocal interpersonal behaviors and self-injury. Adolescent girls exhibited more behavioral dysregulation and suicide discourse in the moderated network model; t-tests also indicated higher levels of emotional dysregulation, negative self-image, and other items considered clinically important complex trauma symptoms (e.g., distrust of adults, confused belonging). This study supports evidence of differences in the expression of complex trauma symptomatology for boys and girls. Additionally, girls exhibit more symptoms, in general. Consistent with the transdiagnostic conceptualization of the consequences of developmental trauma, findings demonstrate the primacy of attachment-specific difficulties and emotion dysregulation.

The Relationship Between Serum Folate and Homocysteine with Head and Neck Cancer: A Systematic Review and Meta-analysis

Context: Early diagnosis of head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine levels in patients with HNSCC and healthy controls through a systematic review and subsequent meta-analyses. Evidence Acquisition: The research question was: Is there a difference between serum folate and homocysteine levels (O) of patients with HNSCC (E) compared to healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the period from January 2000 to November 2023. The searched studies were screened based on inclusion and exclusion criteria, and after assessing the quality of the selected articles using the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random-effects model. Several meta-analyses were carried out because the selected articles were not uniform regarding smoking habits. Results: Regardless of smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than those of the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups compared to the control groups. Conclusions: The meta-analyses in this study showed an association between serum folate and homocysteine levels with HNSCC, indicating their possible use as biomarkers for the early detection of HNSCC.

Health Disparities in Young Adults: A Direct Comparison of Distress and Unmet Needs Across Cancer Centers.

Information on concerns that young adults (YAs) with cancer face when receiving care outside of specialized treatment centers is needed to increase equitable care to YAs at greater risk of marginalization by the health care system. The current study compared distress and unmet needs at the time of clinic visit between YAs receiving care from three different cancer clinics: (1) a National Cancer Institute-designated center, (2) a community-based clinic, and (3) a county hospital outpatient clinic. The Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST) was administered to measure distress and cancer-related concerns of YAs in active treatment. A one-way analysis of variance (ANOVA) compared distress scores by treatment site. A Fisher's exact test compared the number of participants endorsing each item on the Needs Assessment Checklist from each site. A simple linear regression determined the association between distress and number of items endorsed on the Needs Assessment Checklist. Ninety-seven participants completed the AYA-POST, endorsing, on average, 11 concerns. Fisher's exact test showed significant differences between sites in the proportion of participants endorsing eight items: boredom (P < .001), eating/appetite (P < .001), nausea/vomiting (P < .001), financial concern (P = .002), hopelessness/helplessness (P = .03), confidentiality (P = .04), sibling concern (P = .04), and insurance (P = .05). The simple linear regression model was significant (F(1, 94) = 39.772, P < .001, R2 = 0.297), indicating the number of unmet needs accounted for almost 30% of the variance in distress. The one-way ANOVA was not significant (F(2, 93) = 1.34, P = .267). Social determinants of health can influence the number and type of unmet needs experienced, affecting distress and other outcomes and underscoring the importance of timely, effective, age-appropriate screening and intervention for distress and unmet needs in YAs with cancer.

Antimicrobial stewardship hindered by inadequate biosecurity and biosafety practices, and inappropriate antibiotics usage in poultry farms of Nepal-A pilot study.

Nepal's poultry industry has experienced remarkable growth in the last decade, but farm biosafety and biosecurity measures are often overlooked by farmers. As a result, farms often suffer from sporadic and regular outbreaks of many diseases, impacting production and creating public health challenges. Poor management practices, including overuse of antibiotics for prophylaxis and therapeutics, can enhance the spread of poultry diseases by propagating antimicrobial resistance (AMR) that is threatening poultry and human health. We assessed biosafety, biosecurity risks and AMR stewardship in sixteen poultry farms located in four districts: Ramechhap, Nuwakot, Sindhupalchowk, and Kavre. Risk assessment and AMR stewardship evaluation questionnaires were administered to formulate biosafety and biosecurity compliance matrix (BBCM). Risk assessment checklist assessed facility operations, personnel and standard operating procedures, water supply, cleaning and maintenance, rodent/pest control and record keeping. Oral and cloacal samples from the poultry were collected, pooled, and screened for eight poultry pathogens using Polymerase Chain Reaction (PCR) tests. Based on BBCM, we identified the highest BBCM score of 67% obtained by Sindhupalchowk farm 4 and the lowest of 12% by Kavre farm 3. Most of the farms (61.6%) followed general poultry farming practices, only half had clean and well-maintained farms. Lowest scores were obtained for personnel safety standard (42.4%) and rodent control (3.1%). At least one of the screened pathogens were detected in all farms. Mycoplasma gallisepticum was the most common pathogen detected in all but three farms, followed by Mycoplasma synoviae. More than half of the farmers considered AMR a threat, over 26% of them used antibiotics as a preventive measure and 81% did not consider withdrawal period for antibiotics prior to processing of their meat products. Additionally, antibiotics classified as "Watch" and "Restrict" by the WHO were frequently used by the farmers to treat bacterial infections in their farms.

Self and Peer Assessment Based on Storytelling: Implementation on Islamic Education Learning

This study aims to find out the techniques of self-assessment and peer assessment through the storytelling method as well as the benefits of the storytelling-based self-assessment and friend process for students and teachers. This article uses qualitative research methods to explore a deep understanding of self-assessment and peer judgment based on storytelling. Data were collected through self-assessment and in-depth interviews that allowed researchers to explore the rich perspectives of the participants directly. Data analysis is carried out thematically, by highlighting patterns that emerge from the data and providing a holistic interpretation of the phenomenon being studied. The results of the study show that self-assessment and peer assessment using storytelling in Islamic religious education learning can be done in several steps, namely determining the competencies or aspects to be assessed, determining the assessment criteria to be used, formulating an assessment format, and in the form of assessment guidelines, checklists, or assessment scales, asking students to do self-assessments, teachers reviewing evaluation samples at random, encourage students to always conduct careful and objective self-assessments. The second technique can be done by providing some narrative questions. In this case, students will be asked to share the results of their assessment in front of teachers and friends in turn

Implementation of peer-to-peer oral care objective structured clinical examination-based learning for nursing students.

Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer-to-peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). A pre- and post-survey of 97 nursing students from a nursing school in Japan was conducted as a peer-to-peer oral health education training program that included an assessment and performance checklist. Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0-25) of the first, second, third, and fourth participants in the four-student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p < .01). Fifty-two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE-style delivery.

THE COMMUNITY HEALTH NURSING ASSESSMENT OF TUNJUNGSARI SUBURBAN, BANTUR VILLAGE, MALANG DISTRICT: A CASE STUDY

Background: The community health nursing assessment is a process to understand the health problems that are often found in such location including health behavior problems, environmental problem, also health services utilization problem which will cause various effect among age group population Purpose: Researcher would like to perform nursing process to the community health problems at the Tunjungsari Suburban, Bantur Village, Malang District. Methods: The case study with a cross sectional approach used as research design. The nursing community assessment checklist delivered to 641 respondents who lives at 217 households around Tunjungsari Suburban, Bantur Village. The data then analyzed using descriptive statistical analysis based on community nursing approach using community as partner theory. Results: The results showed that the community had a risky health behaviour marked by 47% adult were smoking inside the house, 73% of the elders never performing any health check, 89% of the elder’s never to come to the Posyandu. 38,27% of the total population experienced acute inflammatory respiratory disease during the past 6 months, and failed to managing the household waste due to limited facilities. Conclusion: Based on the result of this study, it is recommended for the stakeholders to improve the community health services, increases the health promotion programs distribution especially targeting the elder’s population. For the government providing final waste management in this community will help to increases the community health. Keywords: Case study; community health; nursing process.

Impact of chronic diseases on the periapical health of endodontically treated teeth: A systematic review and meta-analysis.

Systemic diseases affecting the immune system can influence the body's response time to endodontic treatment, potentially necessitating a longer duration for the complete resolution of existing infections when compared to healthy controls. This systematic review aims to evaluate the association between the presence of chronic diseases and periapical status after endodontic treatment through a systematic and comprehensive assessment of existing literature on this topic. The search strategy covered seven electronic databases and grey literature, encompassing articles published until October 2023. Two reviewers independently assessed potentially eligible studies based on the following criteria: Included were studies involving populations exposed to pre-existing chronic diseases who underwent endodontic treatment in permanent teeth. These studies evaluated periapical health status, making comparisons with healthy individuals. There were no language or publication date restrictions. Additionally, two reviewers independently extracted data regarding the characteristics of the included studies. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. Meta-analysis was conducted using random effects models. The certainty of evidence was assessed using the GRADE tool. Twenty-three studies were included in the synthesis. Patients with diabetes were found to have about half the odds of having periapical health compared to non-diabetic patients (OR = 0.46; 95% CI = 0.30-0.70%; I2 = 58%) in teeth that underwent endodontic treatment. On the other hand, other systemic diseases like HIV, cardiovascular disease, and rheumatoid arthritis did not demonstrate significant differences concerning the outcome. In conclusion, diabetic patients showed a lower likelihood of maintaining periapical health. Conversely, patients with HIV, cardiovascular disease, and rheumatoid arthritis did not exhibit significant differences, although the existing evidence is still considered limited. It is crucial to manage these patients in a multidisciplinary manner to provide appropriate care for this population.

CONTENT EVALUATION OF DIAGNOSTIC AND TREATMENT INFORMATION QUALITIES OF YOUTUBE VIDEOS ON CARPAL TUNNEL SYNDROME

Introduction: One of the leading video sharing platforms is YouTube (YT). Due to their increased use, these can possibly create misconceptions about the condition, especially the associated treatment and signs and symptoms of carpal tunnel syndrome. Thus, this evaluates the information quality of YT videos about carpal tunnel syndrome (CTS). Methods: This is a descriptive-evaluated study focused on assessing the information qualities of CTS videos on YT. Using Macleod et al. information quality index (2015), modified Diagnostic Information Quality Assessment Checklist (DIQAC) and Treatment Information Quality Assessment Checklist (TIQAC) were utilized. DIQAC measures the elements explanation, history, physical examination and ancillary procedures; while TIQAC, presurgical, surgical procedure, rehabilitation and complication elements. YT videos from 2020 onwards were searched using keywords "carpal tunnel syndrome", "diagnosis" and "treatment", and screened for duplicates, non-related to topic and without audio. Out of 31 videos retrieved, 11 YT videos on CTS were evaluated by physical therapists to determine the reliability of YT videos on CTS. Results: Results showed that YT-CTS videos are highly reliable in the elements explanation (45%) and history (36.36%), moderate to reliable in ancillary procedure (54.54%) and moderately reliable in physical examination (36%), in terms of DIQAC scoring. Whereas in TIQAC scoring, YT-CTS videos obtained a highly reliable presurgical scoring (45.45%). Surprisingly, it is poorly reliable in complication scoring (45.45%), very poorly to poor reliable in rehabilitation scoring (72.72%), and very poorly reliable in surgical scoring (45.45%). Overall, diagnosis information quality is high (65%), but low treatment information quality (32%). Discussion: This demonstrates that YT videos are technological tool that a physical therapist or a clinicians can utilize to educate and diagnose. Treatment information can hardly be explained in videos, which can vary form case to case, and is best explained through medical advice of a doctor to his patient with CTS.

Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis

ObjectivesOccupational moral injury and post-traumatic embitterment disorder (PTED) describe the psychological distress caused by exposure to injustice at work. This meta-analysis aims to determine the prevalence of occupational moral injury...

A meta-analysis of diabetes risk prediction models applied to prediabetes screening.

To provide a systematic overview of diabetes risk prediction models used for prediabetes screening to promote primary prevention of diabetes. The Cochrane, PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases were searched for a comprehensive search period of 30 August 30, 2023, and studies involving diabetes prediction models for screening prediabetes risk were included in the search. The Quality Assessment Checklist for Diagnostic Studies (QUADAS-2) tool was used for risk of bias assessment and Stata and R software were used to pool model effect sizes. A total of 29 375 articles were screened, and finally 20 models from 24 studies were included in the systematic review. The most common predictors were age, body mass index, family history of diabetes, history of hypertension, and physical activity. Regarding the indicators of model prediction performance, discrimination and calibration were only reported in 79.2% and 4.2% of studies, respectively, resulting in significant heterogeneity in model prediction results, which may be related to differences between model predictor combinations and lack of important methodological information. Numerous models are used to predict diabetes, and as there is an association between prediabetes and diabetes, researchers have also used such models for screening the prediabetic population. Although it is a new clinical practice to explore, differences in glycaemic metabolic profiles, potential complications, and methods of intervention between the two populations cannot be ignored, and such differences have led to poor validity and accuracy of the models. Therefore, there is no recommended optimal model, and it is not recommended to use existing models for risk identification in alternative populations; future studies should focus on improving the clinical relevance and predictive performance of existing models.

P500 Systematic review of sexual function measurement instruments in the context of pelvic and perineal surgery for Inflammatory Bowel Disease

Abstract Background Sexual dysfunction after Inflammatory Bowel Disease (IBD), pelvic and perineal surgery is common but poorly discussed, investigated and treated in the peri-operative period. There remains no standardised measurement tool to assess sexual function in routine use for patients undergoing benign pelvic colorectal surgery. The necessity for open dialogue regarding sexual dysfunction was evidenced in a patient-led study conducted by Dames et al. Our primary objective was to undertake a systematic review of sexual function measurement instruments, to identify the need for a novel sexual function patient-reported outcome measure (sex-PROM) that may be used in the context of pelvic and perineal surgery for IBD e.g. fistula surgery, defunctioning ostomy formation, ileo-anal pouch formation and proctectomy. Methods We performed a systematic review according to Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria (Prospero registration: CRD42023403396). Embase, Medline and PubMed Databases were searched for previously validated patient-reported outcome measures that could be used in the assessment of sexual function. These instruments were evaluated for their psychometric properties, in addition to their overall quality, utility and suitability in the context of IBD and other benign surgery. A global rating was attained according to COSMIN criteria. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) checklist was applied to evaluate the quality of evidence. In addition, patient involvement in instrument development was assessed. Results Some 2331 articles were screened, 305 full-text studies were assessed for eligibility and 56 measurement instruments were identified and evaluated. All studies showed limited psychometric validation. The Female Sexual Function Index and the International Index of Erectile Function were among the highest-scoring instruments, however conveyed significant limitations, including an anatomical focus, limited exploration of quality of life and relationship satisfaction, and a lack of significant patient involvement in their development. All identified measurement instruments carried limited specific clinical utility for patients after IBD surgery. Conclusion Sexual dysfunction after pelvic surgery for inflammatory bowel pathology is multi-factorial. It can result from anatomical nerve damage but can also occur secondary to the psychological impact of altered body image, sexual self-esteem, and relationships and intimacy. We recommend the development of a novel patient-centred sexual function measurement instrument that may be used after benign pelvic/perineal colorectal surgery to be used in the clinical and research settings.

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis.

This study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa. This systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger's regression test were used to assess the publication bias. A total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46-26.97) and 36.02% (CI: 26.68-45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6-3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8-4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9-4.1), male sex (OR: 1.2, 95% CI: 1.1-1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5-3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4-5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01-10.9), parity (OR: 0.5, 95% CI: 0.3-0.7), prolonged labor (OR: 3.4, 95% CI: 1.6-6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3-14.3) were significantly associated with maternal sepsis. The prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.Systematic review registration: PROSPERO (ID: CRD42022382050).

Evaluation Of The Implementation Process Of PSAP 16 Service Concession Agreement – Grantor On Toll Roads At The Ministry Of Public Works And Housing

This research aims to evaluate the process of implementing PSAP 16 in toll road service concession agreements at the Ministry of Public Works and Housing and the obstacles in implementing accounting by applicable regulations. This research uses qualitative methods through a case study approach by analyzing documentation data, process assessment checklists, and semi-structured interviews. The research results show that the implementation process of PSAP 16 has several obstacles, including the computerized accounting calculation system that does not fully accommodate the calculation of service concession assets, especially for service concession agreements that were in place before PSAP 16 came into effect and the need for internal control to separate the portion of capital expenditure and operating expenditure in service concession assets so that it can be presented under economic substance. This research recommends that coordination is needed to develop an integrated accounting system for recording service concession assets, optimize effective internal control over service concession agreements, and adequate measurement mechanisms so that service concession assets shall be accounted for in accordance with PSAP 16.

Osteoporosis and Leptin: A Systematic Review.

Leptin has a great effect on bone through direct or indirect involvement in bone remodeling. Considering the ambiguities that exist regarding the effect of leptin on bone and bone-related diseases including osteoporosis, in this study, we aimed to conduct a systematic review of various studies on the effect of leptin on osteoporosis, which may find an answer to the existing ambiguities. The search was performed to review studies on the effects of leptin on osteoporosis by using several databases including Scopus, PubMed, Web of Science, and Google Scholar. Electronic searches were conducted on 5 Jan 2023. There was no limit on the publication date of the articles. The risk of bias for the animal study was assessed with the CAMARADES checklist, and the study quality assessment was also assessed based on the guidelines for in vivo experiments (ARRIVE). In this study, the risk of bias (quality) of human studies was assessed using the quality assessment checklists by NHLBI. Overall, 34 articles were included for data extraction and quality assessment. Overall, 27 human studies and seven animal studies were included in the article. The results of most of the studies conducted in this study showed that leptin has a physiological role in maintaining bone mass and better bone quality and reduces bone marrow adipogenesis and increases bone mineral density (BMD). As plasma leptin levels increased, BMD values or bone formation biomarkers increased. Leptin has an inhibitory role against bone resorption and increasing osteoprotegerin (OPG) levels, which, as a result, maintains bone density and reduces osteoclast activity, and has a positive relationship with increasing osteocalcin.

Evaluation of Quantitative Pupillometry in Acute Postinjury Pediatric Concussion

BackgroundAlthough millions of children sustain concussions each year, a rapid and objective test for concussion has remained elusive. The aim of this study was to investigate quantitative pupillometry in pediatric patients in the acute, postinjury setting. MethodsThis was a prospective case-control study of concussed patients presenting to the emergency department within 72 hours of injury. Pupillary measurements were gathered using NeurOptics’ PLR 3000; evaluation included a symptom checklist and neurocognitive assessment. Data were analyzed using descriptive statistics and regression models. ResultsA total of 126 participants were enrolled. One significant difference in pupillometry between concussed and control participants was found: left minimum pupil diameter in 12- to 18 year-olds (P = 0.02). Models demonstrating odds of a concussion revealed significant associations for time to 75% recovery (T75) of the left pupil in five- to 11-year-olds and average dilation velocity of the left pupil in 12- to 18-year-olds (P = 0.03 and 0.02 respectively). Models predicting symptom improvement showed one significant association: percent change of the right pupil in five-to-11-year-olds (P = 0.02). Models predicting neurocognitive improvement in 12- to 18-year-olds demonstrated significant association in T75 in the left pupil for visual memory, visual motor processing speed, and reaction time (P = 0.002, P = 0.04, P = 0.04). ConclusionsThe limited statistically significant associations found in this study suggest that pupillometry may not be useful in pediatrics in the acute postinjury setting for either the diagnosis of concussion or to stratify risk for prolonged recovery.

Mapping Respiratory Health Digital Interventions in South and Southeast Asia: Protocol for a Scoping Review.

The last 2 decades have been a time of exponential growth and maturation for digital health, while the global burden of respiratory disease continues to grow worldwide. Leveraging digital health interventions (DHIs) to manage and mitigate respiratory disease and its adverse health effects presents itself as an obvious path forward. We aimed to understand the current digital landscape and enabling environment around respiratory health to reduce costs, avoid duplication, and understand the comprehensiveness of DHIs. This study will follow a scoping review methodology as outlined by Arksey and O'Malley, the Joanna Briggs Institute, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, PakiMedNet, and MyMedR databases will be searched along with key websites, repositories, and gray literature databases. The terms "respiratory health," "digital health," "South Asia," and "Southeast Asia," as well as related terms will be searched. The results will be screened for duplicates and then against the inclusion and exclusion criteria. For the studies included, data will be extracted, collated, and analyzed. The scoping review was started in July 2023 and will be finalized by February 2024. Results will be presented following the World Health Organization's classification of DHIs to categorize interventions in a standardized format and the mobile health evidence reporting and assessment checklist to report on the effectiveness of interventions. Further exposition of the evidence extracted will be presented through narrative synthesis. As DHIs continue to proliferate, the need to understand the current landscape becomes more pertinent. In this scoping review, we will seek to more clearly understand what digital health tools and technologies are being used in the current landscape of digital health in South and Southeast Asia for respiratory health and to what extent they are addressing the respiratory health needs of the region. The results will inform recommendations on digital health tools for respiratory health in South and Southeast Asia will help funders and implementers of DHIs leverage existing technologies and accelerate innovations that address documented gaps in the studied countries. DERR1-10.2196/52517.