Relevant Websites Research Articles

Food environments in the Pacific Region and efforts to improve them: A scoping review.

To understand the characteristics of food environments in the Pacific region, and the broader economic, policy, and sociocultural surroundings that influence food choices and interventions to improve food environments for Pacific communities. Systematic searches were conducted for articles related to food environments or factors influencing food choices from 1993-2024 in five academic databases, Google, Google Scholar, and relevant organizations' websites. Studies were included if they meet the eligibility criteria. Two authors independently reviewed the title and abstract of identified articles. Full-text screening was conducted before data was extracted from eligible studies. A narrative analysis was informed by an existing food environments framework. Pacific Island countries or territories that are a member of the Pacific Community (SPC). Not Applicable. From the 66 included studies (of 2520 records screened), it was clear that food environments in the Pacific region are characterized by high availability and promotion of ultra-processed unhealthy foods. These foods were reported to be cheaper than healthier alternatives and have poor nutritional labelling. Food trade and investment, together with sociocultural and political factors, were found to contribute to unhealthy food choices. Policy interventions have been implemented to address food environments; however, the development and implementation of food environment policies could be strengthened through stronger leadership, effective multisectoral collaboration and clear lines of responsibility. Interventions focused on improving physical, economic, policy, and sociocultural influences on food choices should be prioritized in the Pacific region to improve the food environment and mitigate barriers to healthy eating.

Key considerations when implementing new diagnostic technologies in routine practice.

The field of pathology is evolving with the integration of advanced and artificial-intelligence-powered diagnostic technologies. However, there remains asignificant gap in clearly outlining the key considerations for the effective implementation of these innovations into clinical care. The aim of this review was to identify and address the essential aspects required to bridge the implementation gap of new diagnostic technologies in pathology. This review synthesizes key elements from relevant scientific journals, organizational websites, and practical examples from pathology practice. The findings are presented as astructured framework of six key elements, supported by an infographic and illustrative cases from clinical settings. The key elements are: (1)Innovation depends more on the people driving it than on the work it demands, highlighting the importance of team collaboration and communication; (2)in-depth knowledge of the delivery system emphasizing the importance of care, IT, and administrative layers is crucial; (3)data-driven decision-making in healthcare transformation is central, with an emphasis on the process of converting real-world data (RWD) into actionable real-world evidence (RWE); (4)aproven approach for practice transformation uses astructured (utilization management strategy, UMS) framework; (5)abalanced approach toward financial sustainability, including local and systemic financial strategies, is important; and (6) ensuring safe and effective progress requires a new, collaborative definition of regulatory science, aligning innovation with regulatory oversight to support technological advancements. These key aspects offer afoundational framework for integrating new technologies into healthcare. Although not exhaustive, overlooking them would miss asignificant opportunity to enhance patient care.

Clogging of Leachate Drains in Landfills due to Biochemical Precipitation: a Literature Review

Objective: Review the relevant literature and analyze the causes that lead to the clogging of leachate drains in landfills due to biochemical precipitation. Theoretical Framework: Although leachate drainage systems have greatly evolved in terms of performance, clogging can occur in all designs due to physical, biological, and chemical mechanisms. Method: To investigate the issue of clogging in leachate drainage systems, an extensive literature review was conducted through consultations on relevant websites. National and international technical papers were sought, as well as regulations from environmental agencies of different countries. Results and Discussion: The removal of Chemical Oxygen Demand (COD), primarily in the form of acetic acid, transforms this stronger acid into weaker acids such as carbonic acid, which results in an increase in the pH of the environment. The concentration of carbonate also increases, consequently accelerating the precipitation of calcium carbonate. These precipitates are usually mixed with the biofilm and exhibit very characteristic shapes and structures. Research Implications: The lifespan of a vertical landfill can be strongly determined by the clogging phenomena in the leachate drainage system. Therefore, the monitoring of this system must be carried out with great care. Originality/Value: This review stands out for addressing a relevant and underexplored topic, especially in the national technical literature. Understanding the processes that can lead to clogging of the leachate drainage system is of interest to everyone working in the field, particularly those who design and/or operate a landfill.

Types, design, implementation, and evaluation of nutrition interventions in older people in Africa: A scoping review protocol.

Africa's older population is increasing and this, necessitates the development of interventions to promote healthy ageing. Nutrition is a key determinant of healthy ageing and local contextual evidence is needed to inform nutritional intervention development in Africa. There are already reviews on nutritional status and food insecurity in older adults in Africa. However, a synthesis of nutrition interventions targeting older people specifically, is lacking. Therefore, this protocol describes a scoping review that aims to systematically synthesise current evidence on nutrition interventions for older people in Africa. The review will involve: a review of available reviews on nutrition in older people in Africa (Phase 1); a review of nutrition interventions developed or implemented among older people in Africa (Phase 2); and consultation with local nutrition stakeholders in Zimbabwe, and The Gambia to contextualise Phase 1 and 2 findings and solicit insights not in the published literature (Phase 3). Searches for Phases 1 and 2 will include bibliographic databases (MEDLINE, EMBASE, Web of Science, African Journals Online, African Index Medicus) and grey literature sources (i.e. relevant websites). Title, abstract, and full-text screening will be conducted in duplicate, data extracted using piloted tools and findings summarised using descriptive statistics and narrative text. Phase 3 will be conducted using hybrid workshops, audio-recorded, detailed notes taken, and findings combined with those from Phases 1 and 2. The findings of this review will summarise current evidence on nutrition in older people in Africa and inform nutrition intervention development. The findings will be presented in conferences, meetings, and published open access. This scoping review has been registered in OSF, registration DOI: https://doi.org/10.17605/OSF.IO/FH74T.

Predicting radiation pneumonitis in lung cancer using machine learning and multimodal features: a systematic review and meta-analysis of diagnostic accuracy.

To evaluate the diagnostic accuracy of machine learning models incorporating multimodal features for predicting radiation pneumonitis in lung cancer through a systematic review and meta-analysis. Relevant studies were identified through a systematic search of PubMed, Web of Science, Embase, and the Cochrane Library from October 2003 to December 2023. Additional studies were located by reviewing bibliographies and relevant websites. Two independent researchers screened titles, abstracts, and full-text articles according to predefined inclusion and exclusion criteria. Data extraction was performed using standardized forms, and study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The primary outcomes, including combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC), were calculated using STATA MP-64 software(Stata Corporation LLC, College Station, USA) with a random-effects model. Meta-analysis was conducted to synthesize diagnostic accuracy measures, and analyses of heterogeneity and publication bias were performed. A total of 1,406 patients with primary lung cancer were included in this systematic review, drawing data from 9 studies. The pooled analysis revealed a sensitivity of 0.74 [0.58-0.85] and a specificity of 0.91 [0.87-0.95] for machine learning models in diagnosing radiation pneumonitis. The positive likelihood ratio (PLR) was 8.69 [5.21-14.50], the negative likelihood ratio (NLR) was 0.28 [0.16-0.49], and the diagnostic odds ratio (DOR) was 30.73 [11.96-78.97]. The area under the curve (AUC) was 0.93 [0.90-0.95], indicating excellent diagnostic performance. Meta-regression analysis identified that the number of machine learning models, year of publication, and study design contributed to heterogeneity among studies. No evidence of publication bias was found. Overall, machine learning models incorporating multimodal characteristics demonstrated 75% accuracy in predicting moderate to severe radiation pneumonitis. In conclusion, by integrating the current machine learning (ML) algorithm's ability in big data mining, a predictive model can be constructed by combining multi-modal features such as genetics, imaging, and cell factors. By selecting multiple machine learning algorithm frameworks and competing for the best combination model based on research goals, the reliability and accuracy of the radiation pneumonitis prediction model can be greatly improved. PROSPERO (CRD42024497599).

The role of NGOs and humanitarian organizations in enhancing surgical capacity in Africa: lessons learned and future directions-a narrative review.

Significant inequities exist in surgical care accessibility across marginalized African communities. Non-governmental organizations (NGOs) and humanitarian groups are vital in supporting Africa's surgical infrastructure. This narrative review explores the current status of surgical care in Africa, highlighting NGO initiatives, past challenges, and future opportunities. A narrative review was conducted using PubMed/Medline, ScienceDirect, and other relevant organizational websites. Over 90% of patients in Africa lack access to proper surgical care due to funding shortages, inadequate resources, and a lack of skilled personnel. NGOs have addressed these gaps through successful initiatives, including fundraising and training, although past failures emphasize the need for clearer objectives and sustainable strategies. Future efforts should prioritize addressing cultural sensitivities, setting realistic goals, and leveraging telemedicine. NGOs and humanitarian organizations will remain critical to improving surgical care for underserved populations in Africa.

Quality appraisal of clinical guidelines for peripherally inserted central catheter-related thrombosis prophylaxis in patients: a systematic review.

To evaluate and analyse the quality of clinical practice guidelines for Peripherally Inserted Central Catheter-related thrombosis (PICC-related thrombosis) to identify the most current and effective prophylactic measures recommended in the guidelines. Scoring and analysis of the guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Cochrane Library, PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Chinese databases (China National Knowledge Infrastructure and Wan Fang) and the relevant websites of the guideline were searched through 8 August 2024. Studies that primarily clinical practice guidelines on the prevention of PICC-related thrombosis were included. Two reviewers independently screened the searched items and extracted data and scored documents using AGREE II. Findings were summarised in Grading of Recommendation, Assessment, Development and Evaluation (GRADE) evidence profiles and synthesised qualitatively. The analysis incorporated a total of nine guidelines, all rated as 'recommended' or 'recommended with modifications'. Standardised scores revealed elevated performance in the domains of Scope and Purpose, Clarity of Presentation and Editorial Independence. Conversely, the Stakeholder Involvement and Applicability domains yielded the lowest average standardised scores. Disparities in standardised scores across guidelines were particularly evident in the domains of Rigour of Development, Stakeholder Involvement and Applicability. The agreement between the two appraisers was almost perfect (intraclass correlation coefficients higher than 0.80). A considerable proportion of recommendations relied on evidence of low-quality, in certain instances, were derived from expert opinions within working groups. The review reveals that a significant portion of recommendations relies on low-quality evidence. Guideline developers are urged to prioritise methodological quality, with a specific focus on refining Stakeholder Involvement and Applicability domains. Addressing these aspects will enhance the overall quality and reliability of PICC-related thrombosis prevention guidelines. One potential way to mitigate these challenges is to endorse a standardised approach to guideline development and to synthesise reliable clinical evidence to reduce variation in recommendations. CRD42023495519.

Delirium and Cognitive Screening in National Hip Fracture Registries: Scoping Review Protocol

Background Delirium and cognitive impairment are common in hip fracture populations and are associated with significant adverse patient outcomes. National hip fracture registries facilitate improvements in patient outcomes and care quality, such as reduced mortality and the development of specialist multidisciplinary services. However, there is substantial variation in the data collected and reported in relation to delirium and cognition, which impedes international comparison and may reduce quality of care. Objective This scoping review aims to identify delirium and cognition data items currently collected by hip fracture registries internationally, to identify associated registry guidance that exists for the administration of delirium and cognitive screening tools, and report outcomes of these data items across the most recently published annual reports of identified hip fracture registries. Methods This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR). We will search the following databases: Medline Ovid; Embase; CINAHL EBSCOHost. Relevant websites such as the Fragility Fracture Network (FFN) will also be searched. Study selection and review will be carried out independently by two researchers, with discrepancies resolved by a third researcher. Data extraction and synthesis will be conducted by one reviewer and checked for accuracy and omissions by another. The scoping review findings will be informed and validated through engagement with the FFN Hip Fracture Audit Special Interest Group. Conclusion By identifying existing heterogeneity in delirium and cognitive screening tool use and administration, it is hoped that administration and specific screening tool use will become standardised to optimise comparability across countries and ensure that high quality and reliable data are included across international registry reports.

Scanning the horizon- environmental health indicator surveillance

Abstract Aim This work aimed to conduct a comprehensive literature review with narrative synthesis of evidence in relation to the surveillance of environmental health indicators by Public Health agencies internationally. This will strengthen the All-Hazards approach to Health Protection in Ireland. Methods The project proposal was registered on PROSPERO. Preferred Reporting Systems for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. A systematic search was conducted across five databases. In addition, relevant websites, reference lists and the grey literature were searched. Data were extracted following TIDieR-PHP guidelines. Risk of bias was considered and quality appraisal was performed using SANRA and AGREE-HS tools. A narrative synthesis of the evidence was completed. Results 12 papers were included in the final review. Four were narrative review articles describing European and worldwide initiatives and the remaining eight described a single health system. Only three papers were deemed high quality. The number of indicators monitored varied widely from one in Italy to over 400 in the USA. The most established programmes described the use of a framework such as Drivers-Pressures-States-Exposures-Effects-Actions (DPSEEA) and indicator selection criteria were applied. The papers described a variety of public health actions arising from the surveillance of environmental health indicators. The knowledge provided by this review can inform the implementation process. Establishment of a project team, and beginning with monitoring one domain is suggested. Air quality is the most frequently monitored domain internationally. The DPSEEA framework is recommended, and Briggs’ indicator selection criteria should be applied to any indicator under consideration. The system should measure both hazard and outcome measures. Finally, meaningful public health action should result from the monitoring. Key messages • Environmental health indicator surveillance is essential to all-hazards health protection. • Few public health agencies internationally are systematically monitoring environmental health outcomes.

An Analysis of Cost Variation Among Drugs Available in the Indian Market for the Treatment of Chronic Bone-Related Ailments.

Treating widely prevalent bone illnesses such as back and neck pain, osteoarthritis, rheumatoid arthritis, gout, and osteoporosis with pharmacological medication can be excessively costly for both the individual and their family. This study aimed to conduct a cost minimization analysis by comparing the prices of Jan Aushadhi (JA) medications with the most expensive and least expensive branded alternatives available in India. The prices of the most costly, least costly branded, and JA medicines were acquired from the relevant websites. The cost difference, cost ratio, and percentage of cost variation were determined based on the guidelines outlined in the cost minimization analysis research. A total of 67 drugs/combinations used to treat various chronic bone ailments were analyzed. With regard to analgesic/anti-inflammatory drugs, the most expensive brand of diclofenac sodium + serratiopeptidase (50mg + 10mg) tablet was 32.5 times more expensive than the cheapest and 10.5 times more costly than the JA brand. Also, the paracetamol 325mg + tramadol 37.5mg combination of the branded tablets was more expensive than JA. Branded cyclosporine was 2.3 times more expensive than JA among immunosuppressants in the disease-modifying antirheumatic drugs (DMARD) group. The most expensive immunomodulator, leflunomide, costs four times more than JA. Hydrocortisone injection, an adjuvant, costs 10.8 times more than the cheapest and 2.1 times more than JA. IL-1 inhibitor + nutraceutical combination costs 4.8 times more than the costliest JA brand. Zoledronic acid was 16.1 and 6.8 times more expensive than the cheapest branded and JA drugs. Xanthine oxidase inhibitor febuxostat, used to treat gout, costs 5.2 and 3.3 times more than JA and the cheapest brands. This cost minimization study, the first to the best of our knowledge in the field of chronic musculoskeletal ailments, indicates the usefulness of JA drugs in reducing the patient's financial costs for most drugs.

Inhaled Dimethyltryptamine (DMT): Use Patterns and Predictors of Consumption Frequency

ABSTRACT Despite increasing interest in psychedelics and their potential therapeutic effects, research on inhaled N,N-Dimethyltryptamine (DMT) remains limited. Inhaled DMT has a reputation for rapid, dramatic onset and a brief duration, but correlates of use frequency remain poorly understood. A sample recruited from relevant internet sites, including nearly 400 people who had inhaled DMT, reported substance use histories, motivations for use, DMT sources, risk perceptions, and other variables. Generally, participants reported initiation motivated by curiosity about DMT’s effects, interest in psychedelics more broadly, and potential spiritual benefits. Those who had used other psychoactive substances (especially ayahuasca) and who had extracted DMT themselves reported inhaled DMT more frequently. Most (>60%) reported obtaining DMT from a friend and claimed it was “slightly difficult” to procure. Participants most commonly inhaled DMT from a glass pipe, in private homes, frequently alone or in small groups. Salient positives associated with inhaling DMT included psychologically cleansing or cathartic experiences. Associated challenges concerned difficult integration, aversive experiences, or “bad trips.” Participants rated DMT as very or slightly safe. These data underscore the need for continued work on this topic to inform education and harm reduction efforts, particularly as the molecule’s reputation for ameliorative effects receives media coverage.

A scoping review on what constitutes a good research culture

Background The crisis in research culture is well documented, covering issues such as a tendency for quantity over quality, unhealthy competitive environments, and assessment based on publications, journal prestige and funding. In response, research institutions need to assess their own practices to promote and advocate for change in the current research ecosystem. The purpose of the scoping review was to explore ‘What does the evidence say about the ‘problem’ with ‘poor’ research culture, what are the benefits of ‘good’ research culture, and what does ‘good’ look like?’ Aims To examine the peer-reviewed and grey literature to explore the interplay between research culture, open research, career paths, recognition and rewards, and equality, diversity, and inclusion, as part of a larger programme of activity for a research institution. Methods A scoping review was undertaken. Six databases were searched along with grey literature. Eligible literature had relevance to academic research institutions, addressed research culture, and were published between January 2017 to May 2022. Evidence was mapped and themed to specific categories. The search strategy, screening and analysis took place between April-May 2022. Results 1666 titles and abstracts, and 924 full text articles were assessed for eligibility. Of these, 253 articles met the eligibility criteria for inclusion. A purposive sampling of relevant websites was drawn from to complement the review, resulting in 102 records included in the review. Key areas for consideration were identified across the four themes of job security, wellbeing and equality of opportunity, teamwork and interdisciplinary, and research quality and accountability. Conclusions There are opportunities for research institutions to improve their own practice, however institutional solutions cannot act in isolation. Research institutions and research funders need to work together to build a more sustainable and inclusive research culture that is diverse in nature and supports individuals’ well-being, career progression and performance.

DESEMPENHO E PRODUTIVIDADE DOS COLABORADORES EM HOME OFFICE

The Coronavirus pandemic has driven a technological revolution that has radically transformed work activities, solidifying telecommuting as a predominant and challenging practice. In this context, the restructuring of monitoring, performance evaluation, and motivation practices has emerged in response to the need for social distancing. The objective is to understand the interconnection between digital work and physical needs, and their influence on performance monitoring and worker motivation, as well as to identify strategies and tools adopted during this period to analyze their effectiveness. This is a qualitative, exploratory research using bibliographic and documentary methods, gathering data from scientific articles and relevant websites, as well as from databases like Google Scholar, Scielo, and Virtual Libraries such as Google Books. The results indicate that adapting to remote work requires a multifaceted approach, where effective communication, valuing employees, and balancing control and trust are essential for the success of remote work and the sustainability of organizational performance.

Using artificial intelligence (AI) to assess the prevalence of false or misleading health-related claims.

Complementary healthcare in the United Kingdom is subject to voluntary, publicly funded regulation. Many such practices include pseudoscience. There are concerns that regulated practitioners make misleading health claims. This study used an artificial intelligence (AI) tool to measure the prevalence of such claims. Websites operated by practitioners of pseudoscientific complementary and alternative medicine, registered with the Complementary and Natural Healthcare Council, were downloaded and assessed by the AI, which determined whether a website was relevant to the investigation and, if so, identified health-related claims that it judged as false or misleading, supplying a rationale. Of 6096 registrants, 1326 met the selection criteria, of which 872 clinics had 725 relevant and operational websites. The AI assessed text from 11 771 web pages, identifying false or misleading claims in 704 (97%) of the websites. The AI's performance was quality-assured by four human assessors, who manually reviewed 23 relevant web pages. Humans identified on average 39.5 claims likely to be judged false or misleading by advertising regulators, the AI identified 36. Humans misidentified an average of 4.8 claims, AI misidentified two. Most practitioners of pseudoscientific therapies registered with the Complementary and Natural Healthcare Council make misleading health claims online. AI could support regulator efficiency.

Colonial Echoes: Unraveling Economic Legacies and Geopolitical Shifts in the South Pacific Islands

Abstract The research delves into the intricate geopolitical dynamics underpinning the economy of the South Pacific region, focusing on attaining self-sufficiency and environmental sustainability amidst competing interests from global powers such as the United States, Australia, Japan, India, New Zealand, and China. It scrutinizes the geopolitical and geoeconomic factors influencing Pacific nations, curating data from academic papers, policy documents, media, and relevant websites. Challenges, opportunities, and concerns facing the region are discerned within historical and contemporary contexts, emphasizing the need for Pacific nations to integrate with China and India’s economies. Recommendations prioritize transparent, sustainable partnerships, advocating for alignment with Chinese and Indian economic prowess while safeguarding regional interests and values. A mixed-methods research framework is employed, upholding ethical standards and furnishing pragmatic recommendations for policymakers, international entities, and local stakeholders. Emphasizing reconciliation, community empowerment, and sustainable development, the research aims for a more equitable and resilient future. By illuminating the enduring imprint of colonialism on the region’s socio-economic trajectory and geopolitical dynamics, this study contributes to understanding and navigating the complexities of colonial legacies in the South Pacific Islands.

Dementia Friendly communities (DFCs) to improve quality of life for people with dementia: a realist review

BackgroundCurrently, there are more than 55 million people living with dementia worldwide. Supporting people with dementia to live as independently as possible in their communities is a global public health objective. There is limited research exploring the implementation of such interventions in the community context. The aim of the review was to create and refine programme theory – in the form of context mechanism-outcome configurations – on how the characteristics of dementia-friendly communities (DFCs) as geographical locations interact with their social and organisational contexts to understand what works for whom and why.MethodsThis realist review sourced literature from 5 electronic databases: Cochrane Library, CINAHL, Medline, Scopus, PsychINFO and Google Scholar, as well as relevant websites such as Alzheimer’s Society to identify grey literature. Methodological rigour was assessed using the Joanna Briggs Institute critical appraisal tool.ResultsSeven papers were included in this realist review that focused on DFCs in a geographical context The implementation of DFC interventions emerged as a process characterised by two pivotal implementation phases, intricately linked with sub-interventions. The first intervention, termed Hierarchy Commitment (I1a/b), involves the formalisation of agreements by businesses and organizations, along with the implementation of dementia-friendly action plans. Additionally, Educational Resources (I1c) play a significant role in this phase, engaging individuals with dementia and their caregivers in educational initiatives. The second phase, Geographical/Environmental Requirements (I2), encompasses the establishment of effective dementia-friendly signage, accessible meeting places, and community support.ConclusionsThis realist review highlighted a theoretical framework that might guide the development of dementia-friendly communities to enhance the experiences of individuals with dementia and their caregivers within DFCs. Emphasising the need for a theoretical framework in developing geographical DFCs, the review outlines contextual elements, mechanisms, and outcomes, providing a foundation for future studies. The ultimate goal is to establish a robust body of evidence for the sustainable implementation of dementia-friendly communities, thereby improving the quality of life for those with dementia.Study registrationThis study is registered as PROSPERO 2022 CRD42022317784.

Tools, techniques, methods, and processes for the detection and mitigation of fraudulent or erroneous data in evidence synthesis: a scoping review protocol.

This scoping review aims to identify, catalogue, and characterize previously reported tools, techniques, methods, and processes that have been recommended or used by evidence synthesizers to detect fraudulent or erroneous data and mitigate its impact. Decision-making for policy and practice should always be underpinned by the best available evidence-typically peer-reviewed scientific literature. Evidence synthesis literature should be collated and organized using the appropriate evidence synthesis methodology, best exemplified by the role systematic reviews play in evidence-based health care. However, with the rise of "predatory journals," fraudulent or erroneous data may be invading this literature, which may negatively affect evidence syntheses that use this data. This, in turn, may compromise decision-making processes. This review will include peer-reviewed articles, commentaries, books, and editorials that describe at least 1 tool, technique, method, or process with the explicit purpose of identifying or mitigating the impact of fraudulent or erroneous data for any evidence synthesis, in any topic area. Manuals, handbooks, and guidance from major organizations, universities, and libraries will also be considered. This review will be conducted using the JBI methodology for scoping reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Databases and relevant organizational websites will be searched for eligible studies. Title and abstract, and subsequently full-text screening will be conducted in duplicate using Covidence. Data from identified full texts will be extracted using a pre-determined checklist, while the findings will be summarized descriptively and presented in tables. https://osf.io/u8yrn.

Health visiting in the UK in light of the COVID-19 pandemic experience: (RReHOPE) findings from a realist review.

Child health programmes in the United Kingdom offer every child and their family an evidence-based programme to support child health and development. During the COVID-19 pandemic, health visiting services in many areas were reduced to a partial service, with significant variability between and within the four United Kingdom countries. This study investigated the impact of the pandemic on health visiting services and developed recommendations for policy and practice. Conduct a realist review of relevant literature. Engage with key stakeholders in policy, practice and research across the United Kingdom. Identify recommendations for improving the organisation and delivery of health visiting services, with a focus on services being equitable, effective and efficient. The realist review followed Pawson's five iterative steps and involved key stakeholder representatives at every step. We searched five electronic databases and references of included articles, as well as relevant organisational websites, to find quantitative, qualitative, mixed-methods and grey literature related to health visiting services in the United Kingdom during the COVID-19 pandemic. An assessment of their relevance to our initial programme theory determined inclusion in the review. Data were extracted, organised and presented as draft context, mechanism and outcome configurations. These were iteratively refined through meetings with 6 people with lived experience of caring for babies during the pandemic and 23 professional stakeholders. Context, mechanism and outcome configurations were then translated into findings and recommendations. One hundred and eighteen documents contributed to the review and collectively revealed the far-reaching, uneven and enduring impact of the COVID-19 pandemic on babies and families. Data uncovered significant concerns of families and practitioners amidst the pandemic, along with the service's corresponding actions. These concerns and responses underscored the critical importance of fostering and sustaining trusting relationships between health visitors and families, as well as conducting holistic assessments for early intervention. Although we found minimal evidence of decision-making within organisational/managerial levels, the data illustrated the diverse and complex nature of health visiting work and the need for flexibility and resourcefulness. The primary limitation of this review was a lack of specific evidence from the United Kingdom nations other than England. There was also a lack of data focusing on changes during the COVID-19 pandemic at a local management level. The needs of babies, children and families, and the delivery of services to support them, were not prioritised in the early phase of the pandemic response. Our data show that the health visiting service was concerned with maintaining visibility of all children, and especially supporting families with a new baby. Health visiting services adapted in numerous ways to respond to these concerns. Implications for policy and practice are presented, identified from our analysis and discussions with stakeholders. The RReHOPE study is part of a jigsaw of evidence, which will provide a much stronger evidence base for future policy and practice. This realist review presents several areas for future research, including how health visiting is organised at local management level; how to optimise limited resources; factors affecting differing uptake in different regions; and analysis of the effectiveness of health visiting using large cohort studies. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme under award number NIHR134986.

Impact of climate change on water-related physical events, consequent human migration, and burden of drowning in India: An evidence synthesis.

Disrupted weather patterns are associated with climate change. Between 2001 and 2018, nearly 74% of disasters were water-related, including floods and cyclones. Such water-related cataclysmic events increase the risk of drowning. We aimed to map evidence on the impact of climate change on water-related physical events, associated human migration, and drowning burden in India. We searched electronic databases, government reports, and relevant websites to map evidence on water-related physical events (including but not limited to sea-level rise, glacier bursts, lake bursts, floods, rainfall, cyclones, and droughts) and consequent human migration using narrative review approach, while drowning burden through scoping review approach. We summarized the results narratively. Evidence from 48 studies and seven reports suggest that India will witness the greatest sea-level rise, significantly impacting poor coastal communities. An increase in droughts, cyclonic rainfall, storms, and floods, with increasing surface rainwater and streamflow water, due to melting glaciers is expected. Climate change-triggered migration is expected notably in northeast and south India, making farmers, drivers, street vendors, women, and youth most vulnerable. No direct evidence was identified on the impact of climate change, water-related disasters, meteorological events, or seasonal variations on drowning from India. Our study highlights a significant gap in the availability of context-specific and localized data to improve disaster response and strengthen public health systems, especially for areas most vulnerable to climate change. There is an urgent need to generate new knowledge and understanding of climate change, water-related or meteorological events, and seasonal variations' impact on drowning burden as the level of risk remains unknown.

Government funded suicide prevention in Australia – an environmental scan

BackgroundSuicide is a worldwide public health problem. In response to this problem, Australia was one of the first countries to develop national suicide prevention policy. Guided by the National Suicide Prevention Office (NSPO), which was established in 2021, suicide prevention in Australia is in a period of reform. The NSPO is driving a nationally consistent and integrated approach to suicide prevention including leading the development of a new National Suicide Prevention Strategy. This article summarises findings from an environmental scan of government-led suicide prevention in Australia, conducted as an input for the development of the new Strategy.MethodsThe scan was conducted from August 2022 to January 2023. We searched relevant government websites and Google to identify policy documents and programs and services. We undertook a desktop review of documents and programs/services using coding templates developed to address the objectives of the scan. Qualitative information was extracted in a systematic manner using these templates.ResultsAustralia’s suicide prevention efforts are significant as demonstrated by activities ranging from policy documents intended to guide and plan activity, the National Mental Health and Suicide Prevention Agreement committing the Federal Government and jurisdictions to work together, and the availability of national, state, local area based, and digital services and programs. Suicide prevention approaches in Australia are mostly selective or indicated. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. In addition, there is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia. Findings should be interpreted in the context that suicide prevention in Australia is currently in a period of transition.ConclusionsCurrent government emphasis on and investment in suicide prevention activity, together with strong commitment to lived experience and cross sectorial collaboration, are substantial and appropriate. There are also many opportunities to further progress cross-portfolio and cross-jurisdiction suicide prevention and response efforts. This requires urgently adopting a shared understanding of suicide, which includes the diverse drivers of suicidal distress, and improving protective factors and social wellbeing.