Google Advanced Search Research Articles

The relationship between homeworking during COVID-19 and both, mental health, and productivity: a systematic review

BackgroundAs of March 2020, the UK public were instructed to work from home where possible and as a result, nearly half of those in employment did so during the following month. Pre-pandemic, around 5% of workers chose to work from home; it was often seen as advantageous, for example due to eliminating commuting time and increasing flexibility. However, homeworking also had negative connotations, for example, blurred boundaries between work and home life due to a sense of constant connectivity to the workplace. Understanding the psychological impact of working from home in an enforced and prolonged manner due to the COVID-19 pandemic is important. Therefore, this review sought to establish the relationship between working from home, mental health, and productivity.MethodsIn January 2022, literature searches were conducted across four electronic databases: Medline, Embase, PsycInfo and Web of Science. In February 2022 grey literature searches were conducted using Google Advanced Search, NHS Evidence; Gov.uk Publications and the British Library directory of online doctoral theses. Published and unpublished literature which collected data after March 2020, included participants who experienced working from home for at least some of their working hours, and detailed the association in terms of mental health or productivity were included.ResultsIn total 6,906 citations were screened and 25 papers from electronic databases were included. Grey literature searching resulted in two additional papers. Therefore, 27 studies were included in this review. Findings suggest the association between homeworking and both, mental health and productivity varies considerably, suggesting a complex relationship, with many factors (e.g., demographics, occupation) having an influence on the relationship.ConclusionWe found that there was no clear consensus as to the association between working from home and mental health or productivity. However, there are indications that those who start homeworking for the first time during a pandemic are at risk of poor productivity, as are those who experience poor mental health. Suggestions for future research are suggested.

An examination of the psychosocial consequences experienced by children and adolescents living with congenital heart disease and their primary caregivers: a scoping review protocol

BackgroundThe chronicity of congenital heart disease (CHD) comes with significant psychosocial consequences for both children and adolescents living with CHD and their primary caregivers. Children and adolescents living with CHD undergo multiple traumatizing invasive surgical and medical procedures, struggle with disabilities resulting from their CHD, face unfair scrutiny and marginalization, and are at risk for mental health issues. Primary caregivers of children and adolescents living with CHD deal with increased stress, fear, anxiety, depression, and financial burden. The overarching objectives of this scoping review are to (1) determine the current state of knowledge on negative psychosocial consequences experienced by children and adolescents living with CHD and their primary caregivers in high-income countries and (2) inform research aimed at developing interventions in high-income countries to decrease the negative psychosocial consequences experienced by children and adolescents living with CHD and their primary caregivers.MethodsDatabases and grey literature searched will include MEDLINE, CINAHL, EMBASE, PsycINFO, CENTRAL, Scopus, ProQuest Theses and Dissertations, and Google advanced search. Citation mining of included studies and relevant review articles will be completed. Studies will be screened by title and abstract and then full text by two independent reviewers, using pre-defined inclusion and exclusion criteria. Quality analysis will be conducted on all included studies by two reviewers using MMAT Version 2018. Studies will not be excluded due to quality assessment. Data from all eligible studies will be independently extracted by the two reviewers and verified by consensus. Data will be presented and synthesized in evidence tables to examine potential patterns.DiscussionThe results of this review will provide recognition of the psychosocial impact of CHD and its treatments on children and adolescents living with CHD and their primary caregivers. It will also highlight interventions that have been developed to decrease these psychosocial consequences. The results from this review will inform a future integrated knowledge translation study by the first author aimed at decreasing one or more of the negative psychosocial consequences experienced by children or adolescents living with CHD and their primary caregivers.Systematic review registrationOpen Science Framework (OSF) Registration, https://doi.org/10.17605/OSF.IO/ZXYGW

Preconception health and care policies, strategies and guidelines in the UK and Ireland: a scoping review protocol

IntroductionPreconception care can significantly improve maternal and infant outcomes, and thus optimise intergenerational health. The aims of this scoping review are to (1) provide an up-to-date summary of preconception health...

Hemoglobin Variants in Patients With Microcytic Hypochromic Anemia: A Review of Indian Studies.

Microcytic hypochromic (MCHC) anemia with hemolytic components is common in clinical practice. Hemoglobinopathies and variants are one of the important underlying causes of MCHC anemia. The Indian population, by large, as various studies reported, showed a plethora of hemoglobinopathies with regional predilections for its types. The present systematic review is carried out for the evaluation of MCHC anemia for its underlying causes of hemoglobinopathies and their loco regional comparisons. The review was carried out by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method with selected keywords through the Google advanced search matchable to the objectives of the present systematic review. Upon the systematic review, it was observed that β thalassemia trait (βTT) remained the highest reported hemoglobinopathy. The other abnormal hemoglobin variants, though rare, also have been reported in the reviewed articles. It is concluded that patients with MCHCrefractory to its regular treatment should be subjected to high-performance liquid chromatography (HPLC) in exclusion of underlying hemoglobinopathy and abnormal hemoglobin variants.

Policy approaches to nutrition-focused food banking in industrialized countries: a scoping review.

This review aims to synthesize the literature describing policy approaches to nutrition-focused food banking in industrialized countries, spanning the period 2000 to October 2021. The charitable food system provides food assistance to increasing numbers of people experiencing food insecurity in industrialized countries. Calls to improve the nutrition quality of foods provided by foods banks, pantries, and shelves have increased, yet little is known about the challenges faced when initiating policy in this setting. A protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews Guidelines was developed and registered with Open Science Framework. Four electronic databases (MEDLINE [Ovid], Global Health, ProQuest, and Scopus) were searched for peer-reviewed articles published in English. A gray literature search was conducted using Google Advanced Search. Of 642 peer-reviewed articles screened, 15 were eligible for inclusion. In addition, 24 gray literature documents were included. These 39 papers were assessed against the Iron Triangle of Hunger Relief and the Campbell et al framework of organizational factors. Six themes were identified: (1) there is a moral imperative to take action to ensure the provision of appropriate and nutritious food for vulnerable clients; (2) nutrition policies are unlikely to be formalized; (3) the unpredictability of donated food is a barrier to providing healthy foods; (4) reliance on donations affects the sector's willingness to reduce the unhealthy inventory for fear of losing donors, and the challenges of managing donor relationships were emphasized; (5) organizational capacity (volunteer workforce, executive leadership support) must be considered; (6) the existing measure of success is a weight-based metric that does not support food banks' prioritizing of healthy foods. These, and other characteristics, were incorporated into an adapted framework. There is a need and opportunity for nutrition-focused food banking. A priority action area is the adoption of an outcome metric that is based on nutritional quality, to reorient the charitable food system.

Conceptual approaches in combating health inequity: A scoping review protocol.

What are the different ways in which health equity can be sought through policy and programs? Although there is a central focus on health equity in global and public health, we recognize that stakeholders can understand health equity as taking different approaches and that there is not a single conceptual approach. However, information on conceptual categories of actions to improve health equity and/or reduce health inequity is scarce. Therefore, this study asks the research question: "what conceptual approaches exist in striving for health equity and/or reducing health inequity?" with the aim of presenting a comprehensive overview of approaches. A scoping review will be undertaken following the PRISMA guidelines for Scoping Reviews (PRISMA-ScR) and in consultation with a research librarian. Both the peer-reviewed and grey literatures will be searched using: Ovid MEDLINE, Scopus, PAIS Index (ProQuest), JSTOR, Canadian Public Documents Collection, the World Health Organization IRIS (Institutional Repository for Information Sharing), and supplemented by a Google Advanced Search. Screening will be conducted by two independent reviewers and data will be charted, coded, and narratively synthesized. We anticipate developing a foundational document compiling categories of approaches and discussing the nuances inherent in each conceptualization to promote clarified and united action.

A systematic appraisal of the information, engagement, aesthetic and functional quality of nutrition-related smartphone apps for children and adolescents.

Nutrition-related smartphone applications (apps) could improve children's nutrition knowledge and skills. However, little is known about the quality of nutrition-related apps for children. This study aimed to identify and evaluate the quality of nutrition-related smartphone apps designed for children ages 4-17. This systematic appraisal is guided by the Protocol for App Store Systematic Reviews. Using Google's Advanced Search, we identified 1814 apps/1184 additional apps in an updated search on iOS, of which twenty-four were eligible. The apps' objective and subjective quality were evaluated using the twenty-three-item, five-point Mobile App Rating Scale. The objective quality scale consists of four subscales: engagement, functionality, aesthetics and information. Most of the apps (75 %) focussed solely on promoting nutrition skills, such as making food dishes, rather than nutrition knowledge. Of the twenty-four apps, 83 % targeted children 4-8 years old. The app objective quality mean score was 3·60 ± 0·41. The subscale mean scores were 3·20 ± 0·41 for engagement, 4·24 ± 0·47 for functionality, 4·03 ± 0·51 for aesthetics and 2·94 ± 0·62 for information. The app subjective quality mean score was 2·10 ± 0·90. More robust approaches to app development leveraging co-design approaches, including involving a multidisciplinary team of experts to provide evidence-based nutrition information, are warranted.

Quality assessment of online information on orthodontic Web sites in the United States

The objective of this study was to assess the quality of online information on orthodontic treatment provided by orthodontic Web sites in the United States and investigate their claims. Three hundred and one American orthodontic Web sites were identified after an advanced Google search. Data collection included: the location of the clinic, treatment options offered, quality-of-information assessment using the DISCERN tool, and finally, claims when promoting 1 treatment option against another, as well as the presence of information on relapse risk and retention needs. All Web sites belonged to private clinics, with more than half (60.5%) in a single location. Invisalign (Align Technology, Santa Clara, Calif) was the most commonly promoted treatment option (94%), followed by the full fixed appliance (FFA) (92%). The mean DISCERN total score was poor (36.78 out of 80.00), whereas the mean reliability (questions 1-8) and quality-of-information (questions 9-15) scores were 17.06 out of 40.00 and 16.85 out of 35.00, respectively. Almost one-third (28%) of the Web sites compared aligners to FFA, whereas 25% claimed that aligners are less painful than FFA, faster than FFA (14%), or give better results than FFA (1%). Almost half of the Web sites (47%) failed to display information on relapse risk and retention needs after orthodontic treatment (41%). The Web sites that displayed such info had higher DISCERN total scores (P<0.001). Invisalign seems to be the treatment modality most commonly mentioned online. According to DISCERN, U.S. orthodontic Web sites display poor or fair quality information. On many Web sites, aligner treatment was compared with FFA, with some stating that aligners cause less pain than FFA or are more efficient/faster than FFA. Moreover, almost half of the American orthodontic Web sites failed to display information on the relapse risk or retention need. Display of such information can be an indicator of better-quality Web sites. There is ample room for improvement in the online information American orthodontists provide to potential patients.

Exploring online oral health misinformation: a content analysis.

Considering the unfavorable implications of health falsehoods and the lack of dental research into information disorder, this study aimed to identify and characterize online oral health misinformation. A total of 410 websites published in English were retrieved using Google Advanced Search and screened by two independent investigators to compile falsehoods through thematic content analysis. Afterward, 318 pieces of misinformation were consensually divided into four groups concerning their informational interest (G1), financial, psychological, and social interests produced/disseminated by non-dental professionals (G2) or by dental professionals (G3), and political interests (G4). Social media (Facebook and Instagram) and fact-checking tool (Snopes) were also screened to determine the spread of falsehoods by identifying corresponding posts and warnings. As a result, misinformation was mainly associated with gum diseases (12.0%), root canal treatment (11.6%), toothache (10.4%), fluoride (10.4%), and dental caries (9.8%), with a special highlight on recommendations for the usage of natural products, toxicity concerns, and anti-fluoridation propaganda. Additionally, most misinformation was allocated in G3 (41.9%), which presented a statistically higher frequency of financial interests than G4. Finally, falsehoods were considerably identified on Facebook (62.9%) and Instagram (49.4%), especially G3 and G4. Nevertheless, Snopes has debunked only 5.9% of these content items. Therefore, misinformation was predominantly produced or disseminated by dental professionals mainly motivated by financial interests and usually linked to alternative/natural treatments. Although these items were shared on social media, fact-checking agencies seemed to have limited knowledge about their dissemination.

Transitional care programs in Canada for older adults transitioning from hospital to home: protocol for a systematic review of text and opinion.

The objective of this systematic review is to identify what transitional care programs exist across Canada, including the characteristics and outcomes of these programs. There is growing evidence of the benefits of transitional care programs to support older adults moving from hospital to home. However, there is limited literature identifying the types of transitional care programs that exist internationally and little evidence available within Canada. Sources of gray literature published from 2016 that focus on older adults receiving services from transitional care programs to move from hospital to home in Canada will be considered for inclusion. Sources of gray literature will be excluded if interventions are targeted at adults younger than 65 years, Indigenous adults younger than 55 years, or if the primary discharge destination is not an independent community dwelling. Interventions designed for older adults waiting in hospital for long-term care placement will also be excluded from this review. An initial limited search of Canadian national gray literature resources will be undertaken, followed by an advanced Google search of Canadian resources and news media reports. Lastly, an advanced search of Google for all 10 provinces and 3 territories will be undertaken to target examples of local transitional care programs that may not be found through a national search, such as local pilot projects, health region-specific programs, and provincial organizations. All identified sources will be retrieved and full text review of selected citations assessed in detail by 2 independent reviewers. Data about the characteristics and outcomes of transitional care programs and results will be extracted and synthesized, with a meta-aggregation approach for grading according to JBI ConQual method. PROSPERO CRD42022298821.

P030 A systematic review of the influence of nature play and exposure on sleep measures in children aged 3-13 years old

Abstract Introduction There are significant benefits to exposing children to nature, including reduced risk of mental illness, enhanced attentional capacity, and greater circadian synchronisation. Furthermore, recent findings indicate exposure to greenspace is positively associated with improved sleep quality and quantity in adults. However, there is conflicting evidence regarding the impact of nature exposure and outdoor play on sleep measures for children. This systematic review aims to investigate whether nature experience through play or education has a significant effect on sleep measures in children. Methods Articles were searched for using 7 databases and Google Advanced Search for grey literature searching. The review is in accordance with PRISMA guidelines and is registered with PROSPERO. Articles were screened using Covidence. The target population included children aged 3 to 13 years old. The main outcome was sleep measures (i.e., sleep latency, duration, and/or quality), and the intervention was (including, but not limited to) outdoor play, nature exposure, or/and nature education. Results The article search returned 2538 articles; 9 of those articles contained adequate results for direct inclusion and analysis. The majority of the 9 articles demonstrated no association between increased outdoor play or nature exposure and sleep outcomes. However, the results are not yet finalised with further data to potentially be included. Discussion Preliminary observations posit there is insufficient literature to determine the influence of nature play and education on children’s sleep outcomes. It may be suggested that future research focuses more directly on the relationship between nature and children’s sleep.

An Update on Acute Coronary Syndrome and Myocardial Infarction Registries among Member Countries of the Asian Pacific Society of Cardiology

Background: Cardiovascular disease is the leading cause of mortality globally, with most deaths occurring in low- and middle-income countries. The present study aims to provide an overview of the characteristics of the national registries managed by member societies of the Asian Pacific Society of Cardiology (APSC). Methods: The APSC website was searched to identify member countries of the society. Using a combination of keywords, PubMed and Google advanced search were trawled to identify cardiovascular registries from each member country and publications generated from these registries. The number of citations each publication received was identified and correlated with the characteristics of each registry. Results: The search found 12 of the 23 member countries (52.2%) had developed a national cardiovascular registry; seven had acute coronary syndrome (ACS) registries and five had acute myocardial infarction (AMI) registries. The registries were primarily established to assess and improve cardiovascular care, and generated a total of 318 articles, a median of 11 articles per registry. There were variations in numbers of articles produced as well as in citations received, with more publications from high-income countries than middle-income countries. Conclusion: The majority of member countries of the APSC have established national ACS and AMI registries. While there were some inherent differences between countries in terms of output, these registries provide an invaluable resource for benchmarking cardiovascular care and could help contribute to local guidelines development.

Integrating Health Into the Urban Master Plan of Vic, Barcelona: A Comprehensive Approach

Planning healthier cities is essential for public health. However, there is a gap between the insights from public health research and applications to planning practice. Based on a scoping review and in cooperation with urban planners and public health professionals, this study developed evidence-based tools and a comprehensive approach to help urban planners integrate health into the urban master plan (2017–2020) of a medium-sized city named Vic (Barcelona). The scoping review included a systematic review of the literature (PubMed, PRISMA protocol) and an advanced Google search for gray literature (2015–2017). The systematic review identified significant associations between urban planning attributes (n = 16) and health outcomes (n = 21). After critical appraisal with stakeholders, an urban and health association matrix was developed to help urban planners understand the connection between urban planning and health. The advanced Google search identified urban planning actions (n = 117) that had an impact on health outcomes. After critical appraisal with stakeholders, a healthy urban planning actions checklist (n = 68) was developed to help urban planners’ decision-making on the inclusion of locally tailored health-enhancing urban planning actions into the urban master plan. From the reviewed evidence and tools, a comprehensive approach delineated a series of steps that successfully led urban planners to incorporate health-enhancing urban actions (n = 112) into the urban master plan. This translational research developed a comprehensive approach to include health in local urban planning. This might scale up to other European medium-sized cities to maximise the effectiveness of built environment interventions and monitor their health impact.

Workplace physical activity practices in real life: a scoping review of grey literature for small- and medium-sized enterprises

BackgroundThere is a need to scale-up effective physical activity (PA) programmes for small- and medium-sized enterprises (SMEs), where the uptake of PA interventions is low. Identifying real-life workplace practices in PA could contribute to a better understanding of what PA programmes might be most grounded in the ‘real world’. However, there is a scarcity of evidence showing what gets done. This study aimed to identify, describe and comprehensively summarize the real-life implementations of workplace PA initiatives, particularly in Europe, as a prior step to disseminating future feasible PA practices for SMEs.MethodsA scoping review of grey literature included a systematic search in the Google advanced search platform that permuted a combination of key concepts (PA, workplace, interventions/programmes), internet domains, and search operators in six different languages (Catalan, Finnish, French, Dutch, English and Spanish) between 2015 and November 2020. The analysis process was iterative, and multiple methods were used to sort, group and categorize the initiatives.ResultsThere were a total of 713 real-life workplace PA initiatives from different-sized organizations identified. These were categorized into five themes: active work and living, exercise and fitness programs, management and leadership, communication and dissemination, and facilities. Finally, feature trees showing a menu for real-life workplace PA practices were implemented.ConclusionsIdentifying real-life practice providing a state-of-the-art snapshot of current PA practices in workplaces, which is a starting point to better understand feasible practices in the context of small- and medium-sized workplaces.

Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis.

Background Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. Methods This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I2 and Egger's test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. Result A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13–46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. Conclusion The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.

271 Search Solutions: Investigation into CTSA Hubs COVID-19 Vaccine Information

OBJECTIVES/GOALS: While CTSA hubs have contributed to the successes in COVID-19 clinical research, understanding the role of the CTSA consortium in translating vaccine efficacy and availability to awareness and implementation. The goal of this study is to quantitatively assess the use of social media in the dissemination of COVID 19 vaccine content across 60+ CTSA Hubs. METHODS/STUDY POPULATION: Structured search terms in the CTSA Search Solutions database were used to identify CTSA Hub website pages highlighting “COVID-19 Vaccination Information.” Each link identified was manually reviewed for vaccination content. The links and content identified by CTSA Search Solutions were then validated by advanced Google search operator “vaccine site” and manual review of CTSA Hub websites. Official CTSA Hub social media platforms were searched for vaccine proliferation content from January 1, 2020 to November 11, 2021. Data points collected included Community Targeted Vaccine Content, Vaccine Awareness, Vaccine Distribution, Vaccine Clinical Trial, Vaccine Related Media, Social Media Presence, and Social Media Vaccine Proliferation. RESULTS/ANTICIPATED RESULTS: In examining content, of the 64 listed CTSA Hubs, 52 of (67.2%) hosted one or more categories of COVID-19 vaccine information, and 16 (25%) hosted three or more categories. The most common category was “Community Targeted Information” with 27 (42.2%) hubs; the least common category was “Vaccine Distribution” with 5 (7.8%) hubs. Examining social media for vaccine proliferation, 41 (64.1%) hubs had connected social media and 23 (35.9%) hubs had vaccine proliferation posts. The most common platform was Twitter with 37 hubs; the least common platform was Instagram with 5 hubs. DISCUSSION/SIGNIFICANCE: Our investigation demonstrated varying Phase 4 translational efforts via social media among the CTSA Hubs for COVID-19 vaccine implementation. These novel findings identify promising opportunities for enhancement while emphasizing proven strategies from CTSA hubs nationwide. Further research will elucidate granular trends among CTSA hubs.

Multimedia Knowledge Translation Tools for Parents About Childhood Heart Failure: Environmental Scan.

BackgroundChildhood heart failure is a factor in many hospital admissions each year. It can impose a steep learning curve for parents who need to learn the key information to care for their child at home. In this study, we conducted an environmental scan to identify and assess web-based knowledge translation tools about childhood heart failure for parent audiences developed within North America.ObjectiveThe aim of this study is to inventory tools publicly available to parents about childhood heart failure from popular web-based venues, assess how each tool communicates health information, and explore how they were developed.MethodsOur search strategy included two commonly used multimedia-based platforms: two app stores (Google Play and Apple App Store) and one search engine (Advanced Google Search). Common search terms were used, and results were uploaded to Microsoft Excel for screening between 2 reviewers. The inclusion criteria for the tools were as follows: content focused on educating parents about their child’s heart failure, developed in the English language, and originating within Canada and the United States. A total of 2 reviewers screened the app store and internet search results for relevant tools. Each tool was assessed using the Suitability Assessment of Materials (SAM), a validated tool that objectively assesses the suitability of how health information is communicated to a particular audience. Key informants who were involved in tool development were identified and invited for a qualitative interview using a semistructured format to provide data about the development process. Key themes were identified in the semistructured interview process.ResultsFrequencies and SAM percent ratings of eligible tools were reported. No apps exist for parents relating to pediatric heart failure. Overall, 17 relevant internet tools were identified, and their suitability was assessed for the parent audience. Most tools scored well in layout and type, but they scored lower in readability and graphics. Qualitative interviews with key informants revealed three key themes: timely and introductory knowledge, credible and trustworthy knowledge, and challenges and evolution in knowledge.ConclusionsThis is the first environmental scan looking for parent tools relating to childhood heart failure in Canada and the United States. Findings from this study reveal that there are no apps on this topic and there is a small number of tools for parents on the internet (n=17). Using the SAM, no tools scored in the superior range, and further work in knowledge translation strategies needs to be done in this area to improve more effective education to parents and caregivers who have a child with heart failure. These findings will inform the development of a new resource on children’s heart failure that targets parents and caregiver audiences.

Priapism, a symptoms of claudication of the cauda equina in spinal stenosis

Keywords: Priapism, Cauda Equina Syndrome, Spinal Stenosis Purpose: This paper was written following the authors clinical management of a patient whom had features of incomplete CES in combination with the symptom priapism. The literature regarding this phenomenon appeared sparse therefore the authors sought to improve their own understanding and share their findings. The aim was to discuss the relationship between spinal stenosis, cauda equina syndrome and priapism using available literature. The objective was to contribute to the evidence base and raise awareness of this rare clinical finding. Methods: A narrative review was completed with a structured search by a clinical librarian. A structured search of Medline, Embase and CINAHL was undertaken by a clinical librarian. In addition, the following resources were searched; BMJ Case Reports, UpToDate, BMJ Best Practice, TRIP Database, NHS Evidence and Google Advanced Search. The following search terms were utilised; cauda equine, cauda equina syndrome, spin* stenosis, lumbar stenosis, priapism and erection. For quality assurance, the authors used the revised SANRA tool. Results: This revealed 40 cases of intermittent priapism reported in the English literature. There appears to be an association with lumbar spine stenosis and priapism but there is a paucity of literature documenting cases of priapism as a feature of CES. Priapism can be an atypical presentation of lumbar spine stenosis/transient cauda equina compression. Increased intrathecal pressure secondary to direct compression and/or local nerve root ischemia at a stenotic level of the sacral cauda equina, this may lead to parasympathetic hyperactivity and subsequent priapism. Albeit transient, the manifestation of priapism suggests that the patient is experiencing sexual dysfunction from cauda equina compression and patients should be appropriately safety netted and managed depending upon their overall clinical picture. The literature appears to demonstrate decompressive surgery is a viable treatment option. Conclusion(s): Cases of priapism secondary to transient ischemia of the cauda equina nerve roots exist. Greater awareness of this clinical finding may help clinicians in their contextual reasoning in patients with suspected CES particularly in patients with suspected spinal stenosis. There is a paucity of literature on sexual dysfunction in patients with acute CES. It could also be beneficial for further research looking at the correlation between imaging and sexual dysfunction and priapism. Impact: This project may raise awareness of patients with priapism may have subcritical compression of the cauda equina; and that the increased mechanical pressure on the cauda equina induced by walking in patients with spinal stenosis may contribute to priapism as a transient autonomic disorder. These patients should be appropriately safety netted and managed according to their overall clinical picture. Funding acknowledgements: This work was not funded.

Adapting systematic scoping study methods to identify cancer-specific physical activity opportunities in Ontario, Canada

BackgroundIdentifying cancer-specific physical activity programs and post-secondary courses targeting students in academic settings (i.e., “real world” opportunities) may promote physical activity behaviors among cancer survivors. Using knowledge synthesis methods such as systematic scoping study methods may facilitate knowledge tool development and guide evidence-based practice to improve knowledge transfer. However, identifying these opportunities poses a challenge as systematic scoping study methods have yet to be applied and adapted to this context. Thus, to extend systematic scoping study methods, the purpose of the current investigation is to describe the adaptation of systematic scoping study methods in the context of cancer-specific “real world” opportunities in Ontario, Canada.MethodsSystematic scoping study methods were adapted to develop a knowledge tool, which was a credible resource website for researchers, clinicians, and survivors. Three search strategies including Advanced Google Search, targeted website search, and consultations with experts were used to identify eligible (e.g., appropriate for cancer survivors, offered in the community) cancer-specific physical activity programs. Only the targeted website search was used to search post-secondary institutions because they are centralized onto one government website.ResultsFifty-eight programs and 10 post-secondary courses met the eligibility criteria. Relevant data from these opportunities were extracted, charted, synthesized, and uploaded onto the resource website. The most successful search strategy for cancer-specific physical activity programs was the targeted website search followed by Google Advanced Search and consultations with content experts.ConclusionsChallenges were experienced due to lack of standard reporting among opportunities, bias of potentially relevant records, and changing nature of resulting records. The current investigation demonstrated that systematic scoping study methods can be applied to cancer-specific physical activity programs and post-secondary courses in the context of cancer survivorship in Ontario yielding robust results. The method can be further adapted and updated in future knowledge syntheses in health-related contexts.Systematic review registrationThe systematic scoping review method protocol has not been registered.

Karen Ever After: The Career &amp; Legal Consequences of being the Racist White Lady in an Internet Meme

With the coupled crises of the COVID-19 pandemic and racial protest movements in 2020, the “Karen” meme gained national attention as more incidents were posted online. These incidents have shown to be destructive to all parties involved as victims often experience negative health effects while “Karens” experience doxing. This study investigated the defaming career and legal consequences following the release of video content on social media in which a white woman dubbed as a “Karen” displays racist behaviors. Utilizing a directed qualitative content analysis, the sourcing of incident content came from a study by Been Verified that evaluated 150 incidents. A 2-part data-collection was implemented utilizing Advanced Google Search Engine and Chan McNamarah’s research on racialized police communication. Incidents were subsequently processing using a selection criterion to be considered for consequence assessment. Out of 56 qualified incidents, 27% had discovered career consequences and 27% had discovered legal consequences. This research contributes to a largely undiscussed field in academia by providing an in-depth assessment on defaming Internet trends. It has implications for HR specialists and policymakers in making appropriate decisions to ensure accountability is taken in online matters. It also holds significance for Internet-users in understanding how one’s digital footprint can be perceived online.