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"Add More Arrows to Your Quiver": The Role of Adding Another Chemotherapy Drug to Fluoropyrimidine and Long Term Radiotherapy in Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis.

Objectives: Despite optimal local control obtained with neoadjuvant chemoradiotherapy (CRT), data on overall survival (OS) and disease-free survival (DFS) of local advanced rectal cancer patients are still equivocal. This meta-analysis aimed to estimate the pathological complete response (pCR), regression rate, DFS, and OS probabilities of rectal cancer patients treated with a second chemotherapy drug added to fluoropyrimidine and long-term radiotherapy. Methods: Computerized bibliographic searches of MEDLINE, PUBMED, Web of Science and the Cochrane Central Register of Controlled Trials databases (1970-2023) were supplemented with hand searches of reference lists. Studies were included if they were randomised controlled trials (RCTs) comparing intensified chemotherapy with CRT to preoperative CRT and if they had patients with resectable, histologically proven rectal adenocarcinoma without metastases. Results: Eighteen RCTs (7695 patients) were analysed. Data on population, intervention, and outcomes were extracted from each RCT, following the intention-to-treat method, by three independent observers and combined using the DerSimonian and Laird methods. A chemotherapy with two drug and long-term radiotherapy CRT, compared to preoperative CRT (fluoropyrimidine and long-term radiotherapy), significantly increases the rate of pathological complete response (OR 1.37 (95% CI, 1.16-1.63) p = 0.0003) and the regression rate (OR 1.57 (95% CI, 1.16-2.14) p < 0.00001). Furthermore, it increases DFS (HR 0.87 (95% CI, 0.79 to 0.95) p = 0.002 and OS HR 0.84 (95% CI, 0.74 to 0.95) p = 0.007). The risk of severe adverse events (≥G3) is increased OR 1.96 (95% CI 1.35-2.85), p = 0.0005. Conclusions: In patients with resectable rectal cancer, intensified chemotherapy can reduce by 13% the risk of disease progression and by 16% the risk of death.

Evidence-based Interventions for Youth With Concurrent Mental Health and Substance Use Disorders: A Scoping Review: Interventions fondées sur des données probantes pour les jeunes atteints de troubles concomitants de santé mentale et liés à l'usage de substances psychoactives : une étude de la portée.

Mental health and substance use disorders typically onset during youth and commonly co-occur. Integrated treatment of two or more co-existing mental health and substance use disorders (i.e., concurrent disorders) is increasingly prevalent in real-world clinical settings. However, the depth of the evidence base on best practices remains unclear. This scoping review aimed to identify, map and summarize peer-reviewed studies of interventions for concurrent disorders in youth. Six electronic health databases were systematically searched, in addition to a hand search of the reference lists of relevant systematic reviews. Only peer-reviewed studies of interventions treating concurrent disorders (i.e., simultaneous treatment of two or more disorders) in youth (10-29 years old) were eligible. Two independent reviewers conducted screening and data extraction. Results were charted according to studies employing pharmacological and non-pharmacological interventions. Thirty peer-reviewed studies were included, 19 (63.3%) were randomized controlled trials (RCTs). Most studies enrolled participants with an unspecified substance use disorder (n=17, 56.7%), while alcohol use was the primary substance use disorder in seven (23.3%) studies, followed by cannabis use disorder in six (20.0%) studies. Mood disorders (e.g., depression, dysthymia) were the most common concurrent mental health disorders comprising 15 (50%) studies, followed by nine (30.0%) studies of behavioural disorders (e.g., ADHD) and five (16.7%) studies of unspecified psychiatric disorders. Eighteen (60.0%) studies (n=1,699 participants) investigated the effectiveness of various non-pharmacological interventions, while 12 (40.0%) studies examined pharmacotherapies (n=765 participants). Although several RCTs were identified, substantial clinical and methodological heterogeneity was evident among the studies (e.g., patients with multiple disorders, and multi-faceted interventions). Smaller systematic reviews focused on specific interventions (e.g., behavioural therapies) and concurrent disorders (e.g., depression and substance use) may be warranted. Due to considerable heterogeneity, more RCTs are needed before conducting larger systematic reviews or meta-analyses.

The Effectiveness of Video Animations as a Tool to Improve Health Information Recall for Patients: Systematic Review.

Access to clear and comprehensible health information is crucial for patient empowerment, leading to improved self-care, adherence to treatment plans, and overall health outcomes. Traditional methods of information delivery, such as written documents and oral communication, often result in poor memorization and comprehension. Recent innovations, such as animation videos, have shown promise in enhancing patient understanding, but comprehensive investigations into their effectiveness across various health care settings are lacking. This systematic review aims to investigate the effectiveness of animation videos on health information recall in adult patients across diverse health care sectors, comparing their impact to usual information delivery methods on short-term and long-term recall of health information. We conducted systematic searches in PubMed, CINAHL, and Embase databases, supplemented by manual searches of reference lists. Included studies were randomized controlled trials involving adult participants (≥18 years) that focused on the use of animation videos to provide health information measured against usual information delivery practice. There were no language restrictions. Out of 2 independent reviewers screened studies, extracted data, and assessed the risk of bias using the Revised Cochrane risk-of-bias tool for randomized trials (RoB2), Covidence was used to handle screening and risk of bias process. A narrative synthesis approach was applied to present results. A total of 15 randomized controlled trials-3 in the United States, 2 in France, 2 in Australia, 2 in Canada, and 1 in the United Kingdom, Japan, Singapore, Brazil, Austria, and Türkiye, respectively-met the inclusion criteria, encompassing 2,454 patients across various health care settings. The majority of studies (11/15, 73%) reported statistically significant improvements in health information recall when animation videos were used, compared with usual care. Animation videos ranged from 1 to 15 minutes in duration with the most common length ranging from 1 to 8 minutes (10/15) and used various styles including 2D cartoons, 3D computers, and whiteboard animations. Most studies (12/15) assessed information recall immediately after intervention, with only 3 studies including longer follow-up periods. Most studies exhibited some concerns related to the risk of bias, particularly in domains related to deviations from intended interventions and selection of reported results. Animation videos appear to significantly improve short-term recall of health information among adult patients across various health care settings compared with usual care. This suggests that animation videos could be a valuable tool for informing patients in different health care settings. However, further research is needed to explore the long-term efficacy of these interventions, their impact on diverse populations, and how different animation styles might affect information recall. Future studies should also address methodological limitations identified in current research, including the use of validated outcome measures and longer follow-up periods. PROSPERO CRD42022380016; http://crd.york.ac.uk/prospero/display_record.php?RecordID=380016.

Uncovering the boundary conditions of the association between concerns about falling and physical activity in adult populations: a scoping review protocol

IntroductionDespite evidence of variation in how concerns about falling influence physical activity, many of the currently available knowledge syntheses merely assume that this relation is uniform across populations and contexts....

Hearing problems in humans and mouse models with rare copy number variants associated with schizophrenia: a scoping review protocol

Background Hearing loss is a risk factor for developing auditory hallucinations and other psychosis symptoms. To date, very little research has investigated hearing loss in individuals with a high genetic risk of developing schizophrenia and other types of psychosis. 13 copy number variant (CNV) loci are robustly associated with an increased risk of schizophrenia. Of these, microdeletions at 22q11.2 often lead to some hearing loss, and mouse models of this CNV display impaired auditory functioning. We hypothesise that individuals who have a high genetic risk of schizophrenia may also experience hearing problems. This scoping review will explore whether the 13 schizophrenia-associated CNVs are related to hearing problems, including peripheral hearing loss and other auditory problems, in humans and related mouse models. Methods Our scoping review will follow guidelines provided by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A systematic search will be completed using PubMed (MEDLINE), Embase, PsychINFO, and Cochrane Library databases, as well as other sources to identify relevant grey literature. Search terms will include all commonly used synonyms for hearing loss and problems with auditory perception, and both human and mouse studies that describe relevant CNVs will be included. Search lists will be screened by two authors independently, according to eligibility criteria, and data will be extracted and summarised using a narrative approach. Conclusions To our knowledge, this will be the first scoping review to explore auditory functioning across all CNVs that confer high schizophrenia risk. Looking ahead, if hearing problems are a clinical feature in these groups (including humans and related mouse models), they may serve as useful genetic models for future mechanistic studies.

Artificial intelligence in the care of children and adolescents with chronic diseases: a systematic review

The integration of artificial intelligence (AI) and machine learning (ML) has shown potential for various applications in the medical field, particularly for diagnosing and managing chronic diseases among children and adolescents. This systematic review aims to comprehensively analyze and synthesize research on the use of AI for monitoring, guiding, and assisting pediatric patients with chronic diseases. Five major electronic databases were searched (Medline, Scopus, PsycINFO, ACM, Web of Science), along with manual searches of gray literature, personal archives, and reference lists of relevant papers. All original studies as well as conference abstracts and proceedings, focusing on AI applications for pediatric chronic disease care were included. Thirty-one studies met the inclusion criteria. We extracted AI method used, study design, population, intervention, and main results. Two researchers independently extracted data and resolved discrepancies through discussion. AI applications are diverse, encompassing, e.g., disease classification, outcome prediction, or decision support. AI generally performed well, though most models were tested on retrospective data. AI-based tools have shown promise in mental health analysis, e.g., by using speech sampling or social media data to predict therapy outcomes for various chronic conditions. Conclusions: While AI holds potential in pediatric chronic disease care, most reviewed studies are small-scale research projects. Prospective clinical implementations are needed to validate its effectiveness in real-world scenarios. Ethical considerations, cultural influences, and stakeholder attitudes should be integrated into future research.What is known:• Artificial Intelligence (AI) will play a more dominant role in medicine and healthcare in the future and many applications are already being developed.What is new:• Our review provides an overview on how AI-driven systems might be able to support children and adolescents with chronic illnesses. • While many applications are being researched, few have been tested on real-world, prospective, clinical data.

Validation of the rates of adverse event incidence in administrative healthcare data through patient chart review: A scoping review protocol

Background Patient safety is a key issue for health systems and a growing global public health challenge. Administrative healthcare data provide a coded summary of a patient and their encounter with the healthcare system. These aggregated datasets are often used to inform research and decisions relating to health service planning and therefore it is vital that they are accurate and reliable. Given the reported inaccuracy of these datasets for detecting and recording adverse events, there have been calls for validation studies to explore their reliability and investigate further their potential to inform research and health policy. Researchers have since carried out validation studies on the rates of adverse events in administrative data through chart reviews therefore, it seems appropriate to identify and chart the evidence and results of these studies within a scoping review. Methods The scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. A search of databases such as PubMed, CINAHL, ScienceDirect and Scopus will be conducted in addition to a search of the reference lists of sourced publications and a search for grey literature. Following this, Covidence will be used to screen the sourced publications and subsequently extract data from the included sources. A numerical summary of the literature will be presented in addition to a charting based on the qualitative content analysis of the studies included. Conclusions This protocol provides the structure for the conduct of a review to identify and chart the evidence on validation studies on rates of adverse events in administrative healthcare data. This review will aim to identify research gaps, chart the evidence of and highlight any flaws within administrative datasets to improve extraction and coding practices and enable researchers and policy makers to use these data to their full potential.

Cancer Nursing Frameworks to Guide Clinical Capability, Education and Careers: A Scoping Review of the International Literature.

This review aimed to provide a current global profile of all existing cancer nursing competency, capability, education and career frameworks and map capabilities and competencies to the clinical, facilitation of education, management and research pillars of practice. Scoping review. Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Epistemonikos, Google Scholar, Medline, and PubMed. Gray literature searches and reference list searches were also performed. This review was guided by Arksey and O'Malley's method and followed PRISMA guidelines for reporting. Screening and data extraction was conducted independently by two or more authors. The quality of frameworks were assessed using The Joanna Briggs Institute (JBI) critical appraisal checklist for textual evidence: policy/consensus guidelines. Data were analyzed and narratively synthesized by experienced cancer nurse researchers. Thirty-four articles were included, comprising of 29 cancer nursing frameworks. Frameworks were categorized as competency frameworks, career and education frameworks, education/learning pathways, and career/professional development frameworks. Competencies and capabilities described in the frameworks were mapped to the four pillars of practice including clinical (n = 27), facilitation of learning (n = 20), leadership and management (n = 23), and research and scholarship (n = 24). Comprehensive cancer nursing frameworks are pivotal in enabling nurse leaders to grow and develop the cancer nursing workforce globally. They are also integral to support cancer nurses in providing high-quality, effective, and safe care for patients and their families across the cancer continuum. This is the first review to comprehensively capture and synthesize the capabilities, educational components, and career pathways outlined in existing cancer nursing frameworks worldwide and highlights where areas of improvement are needed to support professional growth, job satisfaction and retention of cancer nurses. This article is a review of frameworks and does not include patient or public contribution.

Interventions to Enhance Facility Deliveries in Low- and Middle-Income Countries: A Scoping Review.

The objectives of this review were to identify and map evidence of interventions to enhance facility deliveries in low- and middle-income countries (LMICs). A search for all relevant existing reports in the literature was conducted in December 2020 using the following online bibliographic databases: PubMed, EMBASE, and CENTRAL. A manual search of the reference lists of relevant systematic reviews and all identified studies was performed to identify additional studies. Two reviewers independently screened the titles and abstracts of the retrieved studies, and then screened the full text identified as inclusion in the initial screening. The search of electronic databases and hand searching identified a total of 6682 articles. A total of 40 reports were identified for full-text review, and 31 reports were excluded. Finally, nine trials were included in the scoping review, and a total of 29,892 women were included in this review. Of nine trials, one was conducted in Nepal, and the other eight trials were performed in Africa: Kenya, Uganda, Nigeria, Tanzania, and Zambia. Our review found the following effective interventions to enhance facility deliveries: group antenatal care (ANC), birth plans, full vouchers, conditional cash transfers (CCTs), non-monetary incentives, and short message service (SMS). Women who received group ANC, promotion of birth plans, full vouchers, CCTs, non-monetary incentives, and SMS were significantly more likely to deliver at a facility.

Теоретические и прикладные проблемы признания граждан безвестно отсутствующими или объявления их умершими (применительно к лицам, объявленным в розыск как безвестно исчезнувшие и за преступления)

The article identifies the gaps in the legal framework governing the declaration of citizens as missing or deceased in accordance with the Civil Procedure Code of the Russian Federation, particularly in cases where they are put on the search list as missing or declared wanted for crimes. It supports the conclusion that the placement of the accused on the wanted list should not impede the recognition of such individuals as missing and validates the necessity for amendments to the relevant laws. Considering the correlation between the expressions "search for a missing person" and "search for a person wanted for a crime", the author demonstrates that the latter is a legal confirmation of the missing person's disappearance through criminal procedure and investigative means. The analysis of judicial practice yields the conclusion that court decisions to dismiss missing person applications, in cases of deliberate concealment of absence and/or in cases of persons declared wanted for crimes, demonstrate the absence of pertinent grounds in the law. Consequently, the motivation of court decisions is not without flaws and necessitates improvement.

Regional hospice and palliative care networks worldwide: scoping review

BackgroundRegional hospice and palliative care networks (RHPCNs) are increasingly being established to improve integrative care for patients with life-limiting illnesses. This scoping review aimed at identifying and synthesising international literature...

Choice of primary healthcare providers among population in urban areas of low- and middle-income countries—a protocol for systematic review of literature

IntroductionStrengthening and reforming the urban primary healthcare (PHC) system is essential to efficiently deliver need-based healthcare services to the rapidly increasing urban poor population. Such reforms of PHC system need to emphasize the opinion of patients in co-designing services in order that delivery of services can be accessed effectively by the urban population in a timely and low-cost way. Hence, it is important to identify the preference of urban population while choosing healthcare providers. The aim of this proposed protocol is to summarize a planned systematic review of existing evidence on the attributes considered for choosing PHC providers in urban settings of low- and middle-income countries (LMICs), as classified by the World Bank.Methods and analysesAn inclusive literature search will be conducted in electronic databases including Pubmed/MEDLINE, Embase, Global Health, Cochrane Library, Web of Science, and Scopus. Databases will be searched from the earliest date of entry until March 30, 2024. Database search will be supplemented by manual search of citations, reference lists, and grey literature sources. Following the pre-set inclusion and exclusion criterion, two researchers will independently screen all the retrieved studies in Covidence. Any discrepancies will be resolved through a discussion between two researchers, and if disagreements persist, a third reviewer will be consulted. The methodological quality of included studies will be appraised using checklist for Conjoint Analysis studies and the Mixed Methods Appraisal Tool (MMAT). An Excel-based data extraction table will be developed, piloted, and refined during the review process. Preference attributes will be identified and analyzed according to their types. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines.DiscussionThe identification of attributes, their influence on preference, and heterogeneity with socioeconomic characteristics of the population will help the policymakers and researchers to design targeted PHC interventions. Such evidence will be also useful to design choice experiment studies to quantify the preferred attributes of PHC providers in urban context of LMICs.Systematic review registrationPROSPERO CRD42023409720.

Mental health challenges faced by foreign nurses: a scoping review

PurposeForeign nurses encounter various challenges that impact their mental health, but there is a lack of comprehensive evidence on these difficulties and the strategies to address them. This study aims to synthesize the available evidence to identify these challenges and the strategies to support foreign nurses.Design/methodology/approachA scoping review framework was used with an exploration of seven databases (CINAHL, Embase, MEDLINE, PsycINFO, Web of Science, PubMed and ProQuest Central) to search for primary studies. Quantitative, qualitative and mixed-methods research were considered for inclusion, with manual searches of reference lists for potential additions. Studies published between 2013 and September 2023, and written in English were considered for inclusion.FindingsAbout 22 of 1,077 identified studies were finally included in this review. Three distinct themes were identified as contributors to the nurses’ mental health challenges, and one theme emerged to highlight strategies to overcome the challenges. These contributors included the influences of diverse cultures, dynamics within the work environment, language barriers, separation from family and friends, heavy workloads and pressures, disparities in health-care systems and experiences of discrimination. Strategies identified to overcome the challenges were at individual, organizational and policy levels to support foreign nurses in navigating and mitigating stressors.Originality/valueThis study highlights the importance of targeted interventions to assist foreign nurses in overcoming challenges that may affect their mental health and well-being. Moreover, strategic interventions are crucial to support them in addressing the barriers they faced.

Respiratory disease in people with bipolar disorder: a systematic review and meta-analysis.

People with bipolar disorder (BD) have an increased risk of premature mortality and the respiratory mortality rate is higher than those of the general population. To date, however, the evidence on respiratory disease in this population has not been meta-analyzed. We systematically review and meta-analyze the frequency of respiratory diseases in patients with BD and to compare prevalence and odds ratio (OR) with the general population. The systematic literature search was conducted in Pubmed, PsycINFO, Scielo and Scopus, with snowball search of reference and citation lists. Inclusion criteria were studies reporting diagnoses of respiratory diseases (asthma, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer and tuberculosis) in people with BD according to operationalized criteria and where possible, control group. Of the 2158 articles screened, 20 including 962,352 people with BD and 37,340,405 control group, met the inclusion criteria. In people with BD, the prevalence of COPD was 9.14% (95%CI: 6.61-12.5%), asthma 6.4% (95%CI: 4.56-8.91%), pneumonia 2.78% (95%CI: 2.51-3.08%) and lung cancer 0.44% (95%CI:0.23-0.84%). Compared to the general population, people with BD had significantly higher rates of COPD (OR: 1.73; 95% CI: 1.40-2.14), showing an increased rate in younger and female patients; asthma (OR: 1.91, 95% CI: 1.25-2.94), with a greater rate in younger patients; and pneumonia (OR: 2.82, 95% CI: 1.33-5.99). In the first meta-analysis on the topic, BD was associated with an increased risk of respiratory illness versus the general population. In COPD and asthma, young people and women are at particular risk. Prevention programs are urgently needed.

HPB SO45 - Level 1 evidence comparing aggressive versus non-aggressive intravenous fluid therapy in acute pancreatitis

Abstract Background Fluid balance in the management of acute pancreatitis (AP) is challenging and has been described as a “double-edged sword” whereby adequate fluids are required to counteract systemic hypovolaemia whilst excessive fluids may exacerbate systemic oedema. Given that data generated from randomised studies are conflicting, the optimal rate and type of fluid resuscitation for AP are yet to be determined. We aimed to perform a comprehensive meta-analysis of all existing randomized controlled trials (RCTs) to evaluate comparative outcomes of aggressive versus non-aggressive intravenous fluid (IVF) therapy in patients with AP. Method A systematic search of electronic data sources and bibliographic reference lists were conducted. All RCTs reporting outcomes of aggressive versus non-aggressive IVF therapy in AP were included and their risk of bias were assessed. Effect sizes were determined for overall mortality, systemic inflammatory response syndrome (SIRS), sepsis, respiratory failure, pancreatic necrosis, severe pancreatitis, clinical improvement, AKI, and length of stay using random-effects modelling. Trial sequential analysis was conducted to determine risk of types 1 or 2 errors. Results Ten RCTs enrolling 993 patients with AP who received aggressive (n = 475) or non-aggressive (n = 518) IVF therapy were included. Aggressive IVF therapy was associated with significantly higher rate of sepsis (OR:2.68, P=0.0005) and longer length of stay (MD:0.94, P&amp;lt;0.00001). There was no statistically significant difference in mortality (RD:0.02, P=0.31), SIRS (OR:0.93, P=0.89), respiratory failure (OR:2.81, P=0.07), pancreatic necrosis (OR:1.98, P = 0.06), clinical improvement (OR:1.12, P=0.83), severe pancreatitis (OR:1.31, P=0.38) or AKI (OR:1.06, P=0.91). Subgroup analysis demonstrated higher morbidity and mortality with aggressive fluids in severe AP. Trial sequential analysis detected risk of type 2 error. Conclusion Aggressive IVF therapy may be associated with higher morbidity in patients with acute pancreatitis compared with the non-aggressive approach, particularly in patients with more severe disease. It may also prolong length of hospital stay. The available evidence is subject to type 2 error indicating the need for adequately powered RCTs.

HPB SO43 - Meta-analysis of completion pancreatectomy for local recurrence of pancreatic cancer after the index pancreatectomy

Abstract Background Poor prognosis post-resection of pancreatic cancer is owed to a high rates of cancer recurrence (approximately 80%) despite complete surgical resection being achieved. The role of surgical re-resection in patients with recurrent pancreatic cancer is unclear. Several studies have reported survival benefit of repeat pancreatectomy for selected patients with local recurrence in the remnant pancreas after the index pancreatectomy. We aimed to conduct a comprehensive systematic review and meta-analysis of best available evidence to evaluate survival outcomes of completion pancreatectomy for locally recurrent pancreatic cancer following index pancreatectomy. Method A systematic search of electronic data sources and bibliographic reference lists were conducted. Proportion meta-analysis model was constructed to quantify 1- to 5-year survival after pancreatic re-resection for locally recurrent pancreatic cancer. Random-effects modelling was applied to calculate pooled outcome data. Results Fifteen retrospective studies were included reporting a total of 250 patients who underwent completion pancreatectomy for locally recurrent pancreatic cancer following their index pancreatectomy. Completion pancreatectomy was associated with 1-year survival of 70.6% (95% CI 65.0%-76.2%), 2-year survival of 38.8% (95% CI 28.6%-49.0%), 3-year survival of 20.2% (95% CI 13.8%-26.7%), and 5-year survival of 9.2% (95% CI 5.5%-12.8%). The between-study heterogeneity was insignificant in all outcome syntheses. Conclusion Repeat pancreatectomy for local recurrence of pancreatic cancer in the remnant pancreas following the index pancreatectomy is associated with acceptable overall patient survival. We recommend selective re-resection of such recurrences in younger patients with favourable tumour size and location. Our findings may encourage conduction of better-quality studies in this context to provide stronger evidence.

How to combat stigma surrounding mental health disorders: a scoping review of the experiences of different stakeholders

BackgroundThe stigma associated with mental health disorders (MHDs) results in delayed help-seeking, limited access to health services, suboptimal treatment, poor treatment outcomes, and an increased risk of human rights violations. This scoping review summarizes qualitative research on the lived experiences of different stakeholders regarding strategies and interventions to combat stigma for people with MHDs.MethodsThis study was a six-step scoping review using the Arksey and O’Malley framework. A comprehensive search of the following electronic databases was conducted to identify relevant records: PubMed, Scopus, Web of Science (WoS) and Google Scholar, as well as a manual search of the reference lists. All steps, including screening of eligible studies, data extraction, and analysis, were performed independently by multiple reviewers, with disagreements resolved by discussion. The data were synthesized based on the for-content synthesis guidelines.ResultsA total of 25 studies were included in this review of the 32,976 initial identified citations. The included studies were from all countries (low, middle, and high income), stigmatized disorders (e.g., schizophrenia, bipolar disorder, etc.) and target populations (e.g., people with MHDs and their families, health care providers, the general community, and students and school members). The thematic synthesis revealed six types of interventions and strategies and 17 themes related to reducing stigma in patients on MHDs. Strategies and interventions were classified by patient (self-stigma), family (family stigma), healthcare professionals’ stigma, workplace stigma, public/societal stigma, and structural type of stigma (institutional stigma).ConclusionsThis review contributes new evidence that should be considered in future interventions and policies to reduce stigma against MHDs. Multilevel and multistakeholder strategies and interventions are needed to reduce the stigmatization of MHDs.

Interventions for improving health literacy among older people: a systematic review

BackgroundHealth literacy(HL) is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions. Effective interventions to improve older people’s HL have become increasingly important. The purpose of this study is to conduct a review of interventions aimed at enhancing the HL of older people.MethodologyRelevant information was gathered from various databases including PubMed, Scopus, Cochrane Library, Science Direct, and Web of Science. Additionally, a manual search of related journals and Google Scholar, a search of the reference lists of selected articles, and a search of unpublished sources were also conducted up to 30 August 2024. Reporting quality assessment was performed using CONSORT: 2010, JBI Critical Appraisal Checklist for Quasi-Experimental Studies, and “Quality Assessment Criteria for Survey Research Reports”.ResultsA total of 21 articles were included in this study. The interventions conducted in high-income countries were found to be more effective compared to those conducted in middle and low-income countries. Furthermore, interventions carried out at the community level were more effective than those performed in nursing homes. Educational interventions were more effective than lifestyle modification interventions, and interventions carried out in a single dimension were more effective than multidimensional interventions. Additionally, interventions that utilized technology were found to be more effective.ConclusionBased on the findings, community-based interventions that encompass a one-dimensional approach, incorporating the use of technology and considering the duration of the intervention, are more recommended.

Covid-19 Related Seizures

Background: The Coronavirus (Sars-CoV-2, COVID-19) has been evolving its viral strains, prevalence, symptomatology, and sequelae of disease for the past three years. Although the most recognized COVID-19 symptoms involve the respiratory tract; neurological symptoms have been documented. Specifically, seizures have specifically been discussed in the literature but remain both under-recognized and under-reported in clinical practice. Aim: To review of the literature of adult patients with COVID-19 and seizures and integrate into clinical practice in the acute care environment; from presentation to the emergency Department to discharge. Methods: A narrative literature review was conducted to identify all reported clinical studies involving adult patients with COVID-19 and de novo seizures from MEDLINE, yielding 108 relevant publication titles and abstracts. Additional three relevant studies were discovered through manual search of reference lists of included studies. After excluding non-related publications, 58 publications underwent full-text review. Reporting of results was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Results: Data was organized into the following themes in the literature: prevalence of seizure occurrence in patients with COVID-19; pathophysiology discussing possible cause; CSF and EEG findings in these patients, and outcomes both in and out of hospital. Conclusion: Seizures were reported as both the presenting symptom of COVID-19 infection and a sequelae of the disease. Heterogeneity identified in both severity and pathogenesis of disease may partly account for the variability in reporting. Seizures may occur as single incidences, with no further implication to the patient or they may occur in the context of New Onset Refractory Status Epilepticus. Patients may require critical care for management of Status Epilepticus or encephalopathy with accompanying seizures. Clinician vigilance is essential in identifying COVID-19 infection in patients presenting to Emergency Services with seizures. Early recognition impacts patient care both in-hospital and at post-discharge follow-up.

Information consistency and inhibition impact on diffusion in networks

This paper introduces the Principal-Agent mechanism to study the diffusion of information in complex networks. Hot list information is defined as principal information, information that is homogeneous with hot list information is defined as homogeneous agent information, and information that is heterogeneous with hot list information is defined as heterogeneous agent information. The theory of diffusion dynamics is used to study the phenomenon that homogeneous information promotes each other and heterogeneous information inhibits each other in the process of competitive diffusion of network information. Based on the traditional SIR model, this paper introduces the Principal-Agent mechanism, establishes the PA_SIR diffusion model and studies the mutual influence of information in the process of competitive diffusion of multiple information. The research shows that in the process of competitive diffusion of multiple information, principal information has a positive incentive effect on homogeneous agent information through people’s interest orientation, herd mentality and topic public opinion and has a negative incentive effect on heterogeneous agent information. Therefore, if you want your published information to attract more attention, the best release time is when homogeneous information is on the hot search list, which will help to attract people’s attention more quickly.