Review Protocol Research Articles

Identifying the impact of climate variables on biological and chemical contaminants of preharvest foods and their associated food safety risks: a scoping review protocol

BackgroundFoodborne and waterborne illnesses affect over four million Canadians annually and pose a preventable burden on the nation’s healthcare system. Climate change can increase the risk of such illnesses by...

Scoping review protocol: what is the state of evidence for the use of communication apps with immigrant seniors in long-term care and community settings?

First language care is critical for older immigrant adults with limited English proficiency, especially in long-term care settings where most residents require staff assistance and experience complex chronic conditions, resulting in multiple communication interactions where language poses a barrier. Although there are a myriad of cultural-language translation apps and devices available, there is a gap in both research and practice on the acceptability and feasibility of these digital resources within the context of long-term care and community settings for older immigrant adults, from a cultural relevance and digital health equity perspective. Our paper outlines a scoping review protocol to examine the state of the literature on the extent to which cultural-language translation apps are used in long-term care settings and community-based elder care. We will also examine the extent to which such apps bridge or further gaps in equitable, accessible and acceptable care for older immigrant adults with limited English language proficiency. This scoping review protocol will employ an adapted five-stage framework outlined by Arksey and O'Malley guided by enhancements recommended by Levac et al and Colquhoun et al. Using the Joanna Briggs Institute's population, concept and context framework, we defined the scope of the scoping review by identifying the target population, concepts for investigation and the context within which the research is situated. We will conduct a search of the literature from 2005 to 2024 using five bibliographic databases from health sciences (Healthstar OVID, MEDLINE OVID and Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO), engineering (Engineering Village Elsevier) and a cross-disciplinary database (Web of Science Clarivate). The research team will adopt a critical, equity-focused approach for the scoping review by integrating Richardson et al's framework for Digital Health Equity into our analysis of the findings. This will ensure that health and social equity perspectives are integrated within our methodology and analytical lens. Our analysis will specifically examine selected studies for their engagement with health equity and their ability to address issues such as ageism, ableism and the digital divide within geriatric care. Ethics approval is not required for this scoping review as it involves secondary analysis of published works and no primary data collection involving human subjects. Findings of the review will be shared with community partners and disseminated through publications, conferences and peer-reviewed publications.

Health Indicators of Families with under-age children: protocol for a scoping review

Health Indicators of Families with under-age children: protocol for a scoping review

Prevalence and incidence of peripheral neuropathy, peripheral artery disease, foot disease, and lower extremity amputation in people with diabetes in Ireland; a systematic review protocol.

Introduction Internationally, the prevalence of diabetes is increasing, and with this comes an increase in diabetes related complications. Diabetic foot disease is the most common lower extremity complication in people with diabetes causing 2% of the global disease burden. It, is associated with major morbidity, mortality, and costs to health services. Despite this burden, the incidence and prevalence of diabetic foot disease is unknown in Ireland. This paper presents a protocol for a systematic review to examine the incidence and prevalence of diabetic foot disease in the Irish population. Methods A systematic review will be performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Pubmed, EMBASE, and Lenus, the Irish Health Research repository, will be searched for publications in any language and without restrictions to date. Title, abstract, and full text screening will be carried out independently by two investigators. Publications reporting on the incidence or prevalence of peripheral neuropathy, peripheral artery disease, ulceration, or amputation in people with diabetes in Ireland, from a defined geographical catchment area of Ireland, will be included. Joanna Briggs Institute (JBI) Critical Appraisal tool will be used to assess included studies methodological quality. Results will be reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Conclusion The results of this systematic review can be used to inform appropriate stakeholders on the incidence and prevalence of diabetic foot disease in Irish populations, enabling decision making around appropriate use of resources to help prevent, and improve management of this disease. Systematic review registration CRD42023472904

Relevance of Mediterranean diet as a nutritional strategy in diminishing COVID-19 risk: A systematic review.

Mediterranean Diet has been reported to possess immunomodulatory and anti-inflammatory properties. These properties are closely associated with the immunopathogenesis of COVID-19. The present systematic review aimed to determine the association between Mediterranean Diet and COVID-19, COVID-19 symptoms, and COVID-19 severity. The protocol for this systematic review was registered in International Prospective Register of Systematic Reviews (PROSPERO) with identification number CRD42023451794. The literature search was conducted through Pubmed, Proquest, and Google Scholar on August 2023. The inclusion criteria were studies with a population of human subjects, reported the association between Mediterranean diet adherence with risk of COVID-19 infection, COVID-19 symptoms, or COVID-19 severity, and full text must be available in English. The exclusion criteria were reviews, editorials, letters, replies, systematic reviews, meta-analyses, studies on animals, and duplicates. Risk of bias in included studies was assessed using Newcastle Ottawa Scale (NOS). Data was synthesized narratively. Each study was compared and a structured summary was developed. After selection process, 6 articles were included, with a sample size of 55,489 patients. All studies were observational studies and assessed Mediterranean diet adherence using food frequency questionnaires (FFQ), with scoring system varied between each study. Four studies found a significant correlation between increased adherence to Mediterranean Diet and reduced COVID-19 risk, while one study indicated non-significant association. One study reported a significant association between higher adherence to Mediterranean Diet and COVID-19 symptoms, but three studies reported non-significant association. One study found that individuals with higher adherence to Mediterranean Diet had reduced likelihood of developing severe COVID-19, however, two studies yielded inconclusive findings. All studies used self-administrated food frequency questionnaires (FFQs), which were prone to biased responses, such as recall and estimation bias. Lower trends of odds ratios (ORs) were consistently observed in higher Mediterranean diet adherence. In every outcome of the included studies, ORs ranged between 0.06-0.992, however, differing levels of significance were reported in each outcome. Overall analyses suggest that high adherence to Mediterranean Diet is a protective factor against COVID-19, with unclear benefits against COVID-19 symptoms and severity.

Exploring community- and systemic-level gender-based violence in visible minority women across five countries from an intersectionality lens: protocol for a mixed-methods systematic review.

The intersection of sexism with racism and xenophobia disproportionately exposes visible minority women to gender-based violence (GBV) at the community and systemic levels. This study aims to understand the knowledge strengths and gaps on GBV against visible minority women with an intersectional lens, revealing systemic barriers to accessing support and how these barriers intensify GBV and its effects. It will also identify effective and ineffective policies and practices in the literature to develop strategies addressing the root causes of GBV and supporting survivors. We will conduct a mixed-methods systematic review using a convergent integrated approach to examine current literature on community- and systemic-level GBV against visible minority women. We will follow Joanna Briggs Institute's guidelines to converge data from both qualitative and quantitative studies to obtain an integrated qualitative synthesis on GBV in five countries: Canada, the USA, the UK, Australia and New Zealand. This analysis will be conducted following Thomas and Harden's thematic synthesis guidelines. Community members with lived experience of GBV will actively contribute to improving the relevance and interpretation of results, following a community-engaged research approach. Themes are expected to unveil various aspects of community- and systemic-level GBV due to the intersection of racism, xenophobia and sexism, alongside barriers in addressing GBV and research gaps. Since this study does not involve primary data collection or the use of identifiable human data, no ethical approval will be needed. Results will be disseminated through integrated knowledge translation, involving collaboration with participants who have lived experience of GBV. The findings will be used to identify specific areas of policy intervention, including adopting culturally sensitive approaches, improving school and workplace policies and promoting rights of visible minority women.

Oral health knowledge, attitudes, and practices of people living with mental illness: a mixed-methods systematic review

People living with mental illness experience poorer oral health outcomes compared to the general population, yet little is known about their oral health knowledge, attitudes, and practices. The aim of this mixed-methods systematic review was to synthesise evidence regarding oral health knowledge, attitudes, and practices of people living with mental illness to inform preventative strategies and interventions. Database searches were conducted in PubMed, MEDLINE, PsycINFO, CINAHL, ProQuest, and Scopus with no limitations placed on the year of study. All studies available in the English language, that explored the oral health knowledge, attitudes, and/or practices of people with a mental illness were included. Articles were excluded if they primarily pertained to intellectual disability, behavioural and psychological symptoms of dementia, drug and alcohol or substance use, or eating disorders. A thematic synthesis was undertaken of 36 studies (26 high-moderate quality), resulting in 3 themes and 9 sub-themes. Study participants ranged from n = 7 to n = 1095 and aged between 15–83 years with most having a diagnosis of schizophrenia, schizoaffective, or bipolar affective disorder. People diagnosed with a mental illness were found to have limited oral health knowledge, particularly regarding the effects of psychotropic medication. Various barriers to oral health care were identified, including high dental costs, the negative impact of mental illness, dental fears, lack of priority, and poor communication with dental and health care providers. Study participants often displayed a reduced frequency of tooth brushing and dental visits. The findings highlight the potential for mental health care providers, oral health and dental professionals, mental health consumers, and carers to work together more closely to improve oral health outcomes for people with mental illness. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), (registration ID CRD42022352122).

Topical Nasal Steroids for Allergic Rhinitis in Children. Is One Better Than the Others? Protocol for a Systematic Review and Network Meta-analysis.

Background The present protocol is registered in the International Prospective Register of Systematic Reviews PROSPERO under de ID code CRD42023476313, and adheres the PRISMA-P 2015 statement. The complete checklist can be consulted in the extended data section. Allergic Rhinitis (AR) is the most common chronic disease in children worldwide. According to many guidelines topical nasal steroids (TNS) are the first-line treatment for moderate/severe AR in children, nevertheless there is no conclusive evidence about which of them is superior in terms of efficacy and safety, including their impact on child’s growth. Methods We will conduct a systematic review of randomized controlled trials evaluating TNS in the treatment of children with moderate/severe AR. The primary outcome is the efficacy measured with the Total Nasal Symptom Severity Score (TNSS). Secondary outcomes are quality of life, adverse events (AE), and growth velocity. We will search Medline, Embase, CENTRAL, LILACS, clinicaltrials.gov, WHO trials database and grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information, and assess the risk of bias and the confidence in the estimate (with the grading of recommendations, assessment, development, and evaluation [GRADE] approach). We will conduct a random-effects NMA to combine the pooled direct and indirect treatment effect estimates for each outcome if adequate data is available and transitivity and coherence assumptions are considered justifiable. Subgroup and sensitivity analyses are planned to evaluate the impact of some potential effect modifiers such as doses, co-intervention with oral antihistamines, the type of AR (intermittent or persistent), sponsorship of the study, the time of outcomes measurement and the risk of bias. We will use GRADE approach to draw conclusions from NMA. Discussion This systematic review and network meta-analysis aims to determine the relative efficacy and safety of the TNS for treatment of children with moderate/severe AR. The results will provide valuable information to assist clinicians, guideline developers, patients, and policy makers about the management of these patients, based on the best available evidence. Systematic review registration: PROSPERO number: CRD42023476313.

A Scoping Review Protocol to Map Knowledge and Attitudes about Patient Safety among Students in Healthcare Undergraduate Courses.

Patient safety is a global challenge in healthcare, with adverse events representing a significant concern. The integration of patient safety education in undergraduate curricula is crucial in developing a culture of safety and safe practices among future professionals. However, there is a gap in research assessing the levels of knowledge and attitudes about patient safety among undergraduate students in healthcare using validated instruments. This scoping review aims to map the levels of knowledge and attitudes about patient safety among students in healthcare courses, allowing for national and international comparisons. The review will follow the methodological frameworks proposed by the Joanna Briggs Institute (JBI) for scoping reviews. The search will include published and unpublished studies in six databases, with no date or language restrictions. This scoping review was prospectively registered with the Open Science Framework on 17 July 2024. This scoping review will provide a comprehensive overview of knowledge and attitudes about patient safety among undergraduate students in healthcare, identifying gaps in patient safety education and areas for improvement in curricula. The results may guide teachers in creating teaching strategies to prepare future healthcare professionals, reducing knowledge gaps and improving the quality of care.

The nature of language impairments in children with cerebral palsy: A scoping review protocol

The nature of language impairments in children with cerebral palsy: A scoping review protocol

Subjective Cognitive Dysfunction in Chronic Illness: A Systematic Review and Meta-Synthesis.

Qualitative studies have examined the experiences of subjective cognitive dysfunction in specific populations or specific disease stages, but there has not yet been a systematic synthesis and evaluation of findings related to perceptions of subjective cognitive dysfunction in nondementia-related chronic illnesses. The aim of this study was 2-fold: (1) to undertake a systematic review of experiences of subjective cognitive dysfunction in people with nondementia-related chronic disease and (2) to develop an explanatory framework to describe the experiences of living with subjective cognitive dysfunction. Four databases were systematically searched for studies on subjective cognitive dysfunction up to June 2023. Qualitative synthesis was conducted on the final sample (N = 25) using Sandelowski's adaptation of Nobilt and Hare's reciprocal transactional analysis method. Critical appraisal was completed using the Critical Appraisal Skills Programme checklist. Through constant comparison of key concepts, findings were organized within 4 interrelated themes that informed a conceptual explanatory model of adapting to living with subjective cognitive dysfunction: (1) symptoms, (2) health care, (3) perceptions of self, and (4) relationships. Participants highlighted how subjective cognitive dysfunction affected interactions in health care settings and involved other symptoms that in turn complicated meaning, self-enhancement, and mastery. Our model of the process of adapting provides a new way to conceptualize cognitive dysfunction in chronic illness and suggests opportunities for health care professionals to support patients and their families. The results highlight the need for more research to better understand the role of subjective cognitive dysfunction in nondementia-related chronic illnesses.The review protocol was registered in PROSPERO (CRD42021231410).

Effects of calcium channel blockers in patients with heart failure with preserved ejection fraction: A protocol for systematic review and meta-analysis.

Nearly half of patients with heart failure (HF) have preserved ejection fraction (EF) and the mortality and morbidity of patients with HF with preserved EF (HFpEF) are high. Patients with HFpEF are often elderly and their primary chronic symptom is severe exercise intolerance. Due to the frequent coexistence of hypertension in HFpEF patients, the use of anti-hypertensive medications is common in their treatment. While many cohort studies and several randomized controlled trials (RCTs) have examined the effectiveness of various anti-hypertensive drugs such as beta-blockers and renin-angiotensin system inhibitors in HFpEF, the role of calcium channel blockers (CCBs) remains uncertain. Despite several RCTs and cohort studies exploring the effects of CCBs on prognosis and exercise capacity in HFpEF patients, the findings have been inconsistent, likely due to limited statistical power and/or variations in study design. Therefore, our aim is to conduct a systematic review and meta-analysis of studies on the effects of CCBs in these patients. This meta-analysis will include RCTs and cohort studies on the effect of CCBs in HFpEF patients. Information of studies will be collected from PubMed, Web of Science, and Scopus. The primary outcome of interest will be prognosis. The secondary outcome of interest will be exercise capacity. Synthesizing our meta-analytical results with expert consensus could contribute to the formulation of updated clinical guidelines. Our systematic review and meta-analysis will provide directions for future research on the use of CCBs in HFpEF patients. INPLASY202430097.

Non-pharmaceutical interventions and epigenetic aging in adults: Protocol for a scoping review.

Aging is the strongest risk factor for most chronic diseases. The rising burden of an aging population and non-communicable diseases (NCDs), contributes to escalating costs for society. Several non-pharmaceutical interventions can lower the risk of NCDs, including common mental disorders (CMDs), and may slow down biological aging, as evidenced by outcome markers such as epigenetic clocks. However, a comprehensive overview of whether and which non-pharmaceutical interventions may impact human epigenetic aging is missing. Synthesizing evidence of interventions on epigenetic aging that can be adopted by a wider population is key to guide healthy aging initiatives and to reduce the burden of NCDs and CMDs. This scoping review will identify and assess non-pharmaceutical interventions aimed to slow down epigenetic aging, including their intervention components, and the mode used for intervention delivery. This protocol will include single- and multicomponent intervention studies that target individuals ≥ 18 years of age and use epigenetic clocks as primary or secondary outcomes. Five electronic databases will be searched for studies between July 2011 until December 2023. The final search will include the search terms adults, non-pharmaceutical interventions, epigenetic aging and their respective synonyms. We will include randomized controlled trials, non-randomized controlled studies, cohort studies, and case-control studies. Additionally, the reference list of other reviews will be screened for relevant articles. Study selection is carried out based on the defined eligibility criteria by two authors. Quality and risk of bias for the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklist. Data extraction will include generic key information such as the research question and results, the intervention components, and specific epigenetic outcome measures used. Further data regarding the delivery mode of the treatment protocol will be collected. This scoping review will summarize the characteristics of non-pharmaceutical intervention studies on epigenetic aging. This review will be the first step to formally identify key intervention components and delivery modes to guide future research on healthy aging interventions. The results will be disseminated through a peer-reviewed publication and presented at relevant conferences. This review will synthesize information from available publications and does not require further ethical approval. Open Science Framework https://doi.org/10.17605/OSF.IO/FEHNB.

Impact of climate change on maternal health outcomes: An evidence gap map review.

Climate change poses unique challenges to maternal well-being and increases complications during pregnancy and childbirth globally. This evidence gap map (EGM) aims to identify gaps in existing knowledge and areas where further research related to climate change and its impact on maternal health is required. The following databases were searched individually from inception to present: Medline, EMBASE, and Global Health via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost; Scopus; and organizational websites. In this EGM, we integrated 133 studies published in English, including qualitative, quantitative, reviews and grey literature that examined the impact of climate change on maternal health (women aged 15-45). We used Covidence to screen studies and Evidence for Policy and Practice Information (Eppi reviewer)/Eppi Mapper software to generate the EGM. Data extraction and qualitative appraisal of the studies was done using critical appraisal tools. The study protocol was registered in International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) # INPLASY202370085. Out of 133 included studies, forty seven studies were of high quality, seventy nine moderate equality and seven low quality. This EGM found notable gaps in the literature regarding the distribution of research across regions. We found significant research in North America (51) and Asia (40 studies). However, Africa and the Caribbean had fewer studies, highlighting potential disparities in research attention and resources. Moreover, while the impact of extreme heat emerged as a prominent factor impacting maternal well-being, there is a need for further investigation into other climate-related factors such as drought. Additionally, while preterm stillbirth and maternal mortality have gained attention, there is an overlook of malnutrition and food insecurity indicators that require attention in future research. The EGM identifies existing research gaps in climate change and maternal health. It emphasizes the need for global collaboration and targeted interventions to address disparities and inform climate-responsive policies.

Personal and professional values of nurses in light of Schwartz's theoretical model: scoping review protocol

When considering the theme of values ​​as part of the field of interdisciplinarity, a broader discussion is encouraged regarding the conception of nurses' professional and personal values ​​and their relationship with one of the most renowned theories in social and transcultural psychology. Thus, this protocol aims to map, in the light of Schwartz's Refined Theory of Values, studies on the personal and professional values ​​of nurses in different health care scenarios. This is a protocol based on the recommendations of the Joanna Briggs Institute and the checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The research question was developed based on the Population, Concept and Context strategy. The databases used will be: Cochrane Library; BASIS; LILACS, MEDLINE via PubMed; Scopus; ScienceDirect; and WOS. The selection will take place by reviewers, using the EndNote Web® software. Data extraction will be recorded in a spreadsheet covering: author(s)/year/country/journal, title, objective, study design, evidence (value approach) and methodological quality of the study, the latter through JBI Critical Appraisal Checklist for Studies Reporting Prevalence. The results will be presented in tables with narrative discussion. Mapping the professional and personal values ​​that are related to nurses' performance in different health care scenarios in the light of Schwartz's Refined Values ​​Theory may lead to reflection on the fundamental values ​​of nursing and the ethical behavior of its professionals.

Evidence on psychometric properties of self-report questionnaires in evaluating blended learning in health sciences university students: research protocol for systematic review and meta-analysis

IntroductionDue to the COVID-19 outbreak, schools had to switch online. As universities ease face-to-face (F2F) schooling, blended teaching and learning (BTL) enables the continuous delivery of education. However, the sudden...

Barriers to and enablers of the transition from child and adolescent to adult mental health services for autistic young people and/or those with attention deficit hyperactivity disorder: protocol for a scoping review

IntroductionAutistic young people and/or those with attention deficit hyperactivity disorder (ADHD) who have co-occurring mental health conditions experience significant challenges when transitioning from child and adolescent mental health services (CAMHS)...

Economic evaluations of pancreatic cancer screening: a systematic review protocol

IntroductionThe early detection of pancreatic cancer is an important step in reducing mortality by offering patients curative treatment. Screening strategies in risk populations and by means of different detection methods...

Barriers and facilitators of cardiovascular disease prevention services for women with prior gestational diabetes or hypertensive disorders of pregnancy in low-income, middle-income and high-income settings: a scoping review protocol

IntroductionWomen with previous pregnancy-related cardiovascular risk indicators, including gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have an increased risk of future cardiovascular disease (CVD). Although CVD screening...

DOSage of Exercise for chronic low back pain disorders (DOSE): protocol for a systematic review with dose-response network meta-analysis

Chronic low back disorders are the leading cause of direct and indirect healthcare burden globally. Exercise training improves pain intensity, mental health and physical function. However, the optimal prescription variables...