Systematic Protocol Research Articles

Access to Health Care and Use of Health Care Services Among Males in Africa: Protocol for a Scoping Review.

There is a scarcity of data on males' health-seeking behavior, as well as their access to and use of health care services, in Africa. According to some studies, men are less likely than women to seek medical help for issues such as communicable and noncommunicable diseases, depression, substance abuse, physical disabilities, and stressful life events. The study of males' health-seeking behaviors is important, because it allows us to learn about male health, how masculinity encourages underuse of health care services, how this affects males' overall health and well-being, and how cultural values and backgrounds may impact older men's health-seeking behaviors. The objective of this review is to assess evidence on how males access and use health care services and their health knowledge, attitudes, and perceptions to identify gaps for targeted, context-specific strategies to improve males' health and outcomes, particularly in Africa. The scoping review process will be guided by the methodology frameworks of the Joanna Briggs Institute and Arksey and O'Malley and will follow the Preferred Reporting Items for Systematic reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched for evidence published between January 2010 and 2023: PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar. Two reviewers will independently screen full texts and chart the data; a third reviewer will be engaged in the event of disagreement between the 2 independent reviewers. The results of this scoping review will be summarized quantitatively through numerical counts and qualitatively through a narrative synthesis. The electronic database search was conducted between March and April 2023 and redone in April 2024 to include the most recent articles. A total of 114,737 articles were retrieved and 4258 removed as duplicates. After title screening, 337 results remained, and after abstract selection, 140 results remained. As of December 2024, the scoping review was in the full-text screening phase. We plan to complete data extraction, synthesis, and writing of the entire manuscript of the review in January 2025, and then submit it to a journal for peer review and publication in February 2025. The scoping review results will advance the current knowledge about health-seeking behavior and access to and uptake of health care services among African males. To our knowledge, this scoping review is the first on this topic, and it will identify vital information on the barriers to and facilitators of African males' health care access and uptake. It will also provide information on successful health care programs for males that may be tailored and adopted across different African contexts. OSF Registries https://osf.io/xz6sr. DERR1-10.2196/52351.

Restoring riparian habitats for benefits to biodiversity and human livelihoods: a systematic map protocol for riparian restoration approaches in the tropics

BackgroundRiparian zones are vital transitional habitats that bridge the gap between terrestrial and aquatic ecosystems. They support elevated levels of biodiversity and provide an array of important regulatory and provisioning ecosystem services, of which, many are fundamentally important to human well-being, such as the maintenance of water quality and the mitigation of flood risk along waterways. Increasing anthropogenic pressures resulting from agricultural intensification, industry development and the expansion of infrastructure in tropical regions have led to the widespread degradation of riparian habitats resulting in biodiversity loss and decreased resilience to flooding and erosion. Considering climate change and its associated effects on freshwater systems, the need to build resilience and adaptive capacities is pertinent. This has prompted the need to protect existing riparian habitats and the implementation of solutions to restore these degraded habitats to recover their functional capacity. This systematic map will aim to identify and collate existing literature on approaches for riparian restoration implemented in tropical regions and identify what indicators have been used to measure outcomes for biodiversity and human well-being. The resulting collation of evidence will help to identify current knowledge gaps and inform the direction of future research.MethodsTo address the aims of this systematic map, a search of pre-identified bibliographic databases will be undertaken using a set string of search terms. In addition to this, a grey literature search will be conducted using Google Scholar and by searching for references using specialist websites. All literature that is gathered will be screened by title, abstract and full text using a two-phase screening process which adheres to a pre-determined eligibility criteria. Data will then be coded from the collated group of articles using a pre-designed data coding sheet. Heterogeneity will likely be present in the data; therefore, studies will be grouped appropriately based on the restoration strategy implemented and, on the type of outcome measured. These will be presented as sub-groups. A narrative synthesis of map findings will be produced, this will outline the distribution and frequency of restoration interventions, and outcomes measured, and will highlight evidence gaps to direct future research.

Effect of active-duty military service on neonatal birth outcomes: a systematic review

IntroductionIncreasing numbers of women serve in the armed forces in countries worldwide. Stress experienced during pregnancy is associated with adverse birth outcomes including preterm delivery (PTD) and low birth weight...

GastroHUN an Endoscopy Dataset of Complete Systematic Screening Protocol for the Stomach

Endoscopy is vital for detecting and diagnosing gastrointestinal diseases. Systematic examination protocols are key to enhancing detection, particularly for the early identification of premalignant conditions. Publicly available endoscopy image databases are crucial for machine learning research, yet challenges persist, particularly in identifying upper gastrointestinal anatomical landmarks to ensure effective and precise endoscopic procedures. However, many existing datasets have inconsistent labeling and limited accessibility, leading to biased models and reduced generalizability. This paper introduces GastroHUN, an open dataset documenting stomach screening procedures based on a systematic protocol. GastroHUN includes 8,834 images from 387 patients and 4,729 labeled video sequences, all annotated by four experts. The dataset covers 22 anatomical landmarks in the stomach and includes an additional category for unqualified images, making it a valuable resource for AI model development. By providing a robust public dataset and baseline deep learning models for image and sequence classification, GastroHUN serves as a benchmark for future research and aids in the development of more effective algorithms.

Evaluating Online and Offline Health Information With the Patient Education Materials Assessment Tool: Protocol for a Systematic Review.

The Patient Education Materials Assessment Tool (PEMAT) is a reliable and validated instrument for assessing the understandability and actionability of patient education materials. It has been applied across diverse cultural and linguistic contexts, enabling cross-field and cross-national material quality comparisons. Accumulated evidence from studies using the PEMAT over the past decade underscores its potential impact on patient and public action. This systematic review aims to investigate how the quality of patient education materials has been assessed using the PEMAT. This review protocol follows PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), APA PsycInfo, and Web of Science Core Collection will be searched systematically for articles published since September 2014. Two independent reviewers will conduct the search to yield a list of relevant studies based on the inclusion and exclusion criteria. Rayyan QCRI software will be used for screening and data extraction. The results will be included in the full systematic review, which is expected to start in September 2024 and be completed to be submitted for publication by early 2025. The findings are expected to identify the quality of materials evaluated by the PEMAT and the areas under evaluation. This review can also highlight gaps that exist in research and practice for improving the understandability and actionability of the materials, offering deeper insights into how existing materials can facilitate patient and public action. PRR1-10.2196/63489.

Research protocol for a systematic review and meta-analysis of the effects of music on anxiety and physiological outcomes in patients undergoing bronchoscopy.

Bronchoscopy is a routine clinical examination that can cause discomfort and anxiety in patients. This paper presents a protocol for a systematic review and meta-analysis aiming to assess the effect of music on anxiety and physiological outcomes in patients undergoing bronchoscopy. The protocol adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines and has been registered in PROSPERO (CRD42024567398). Our documentary research strategy will involve four databases: PubMed, Google Scholar, Scopus, and the Cochrane Library. In addition, manual searches will be conducted through related articles and references. We will include randomized controlled trials that evaluate the effect of music on patients undergoing bronchoscopy. The primary outcome will be the anxiety level and the secondary outcome will include physiological outcomes. Study selection, data extraction, and quality assessment will be carried out independently by two reviewers. Any discrepancies will be resolved through consultation with a third reviewer. The quality and the risk of bias in the studies will be evaluated using The Joanna Briggs Institute critical appraisal tool. The results of this systematic review will be synthesized to provide an overview on the effectiveness of music on anxiety and physiological parameters in patients during bronchoscopy. If the results are considered acceptable and sufficiently homogeneous, a meta-analysis will be performed to synthesize the findings. The systematic review produced from this protocol will provide evidence on the effectiveness of music for patients undergoing bronchoscopy and will contribute to strengthening the existing body of knowledge on non-pharmacological interventions for anxiety management during medical procedures.

The Effects of Social Feedback Through the "Like" Feature on Brain Activity: A Systematic Review.

Problematic social media (SM) use is a growing concern, particularly among adolescents who are drawn to these platforms for social interactions important to their age group. SM dependence is characterized by excessive, uncontrolled usage that impairs personal, social, and professional aspects. Despite the ongoing debate over recognizing SM addiction as a distinct diagnostic category, the impact of social feedback, particularly through the "like" button, on brain activity remains under scrutiny. This systematic review aims to study the neural correlates of online social feedback, focusing on the effects of the "like" feedback on brain activity using fMRI and EEG. The review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA). The review included 11 studies with 504 participants, identifying key brain structures such as the amygdala, ventromedial prefrontal cortex (vmPFC), and ventral striatum involved in reward processing. Positive feedback ("likes") activates areas like the nucleus accumbens (NACC), vmPFC, and amygdala, with NACC correlating with increased SM use intensity. Negative feedback activates the ventrolateral prefrontal cortex (vlPFC) and left medial prefrontal cortex (mPFC). Behavioral data indicates that positive feedback influences subsequent social interactions. The review highlights disparities in the literature regarding the neural response to social feedback, emphasizing the need for further research to clarify the roles of sex, personality traits, and the person giving feedback. Overall, understanding the neurobiological underpinnings of SM engagement is essential for developing effective interventions to prevent or address the negative effects of excessive SM use.

Systematic review meta-analysis protocol preparation and registration – A narrative review

Systematic reviews and meta-analyses (SRMAs) help in decision making, especially on conflicting publication findings and quality. SRMA identifies the source of heterogeneity, reduces subjectivity and identifies and fills gaps in existing knowledge. However, conducting an SRMA requires a well-written protocol, which acts as a clear roadmap for the researcher and defines objectives, methods and expected outcomes. Predefined research questions and methods minimise bias, thus increasing the reliability of the results. The protocol ensures that the study team stays consistent in data collection, synthesis and interpretation. The SRMA protocol includes rationale, hypothesis, aims and methodology. A detailed protocol improves the overall quality of the research. All SRMA protocols must be registered and made available publicly. Protocol registration ensures transparency in the research process, which avoids the wastage of resources and prevents duplication. A well-planned protocol facilitates faster peer review and enhances the chances for publication. This narrative review primarily focuses on SRMA protocol preparation and its registration.

Adherence to tuberculosis (TB) treatment in high compared to low TB burden countries: study protocol for a systematic review and meta-analysis with a qualitative meta-synthesis of themes

IntroductionNon-adherence to tuberculosis (TB) treatment poses a significant challenge to effective TB management globally and is a major contributor to the emergence of multidrug-resistant TB. Although adherence to TB treatment...

Burden of diabetic ketoacidosis and its predictors among diabetic patients in Ethiopia: Systematic review and meta-analysis.

Multiple studies across Ethiopia have investigated the occurrence of DKA, showing significant variations and conflicting findings. This systematic review and meta-analysis seek to consolidate the overall prevalence of diabetic ketoacidosis and its associated factors in the Ethiopian context. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. Data was collected from PubMed/MEDLINE, Science direct, Google Scholar, and gray literature sources. Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software version 4.3.2. The overall pooled prevalence of diabetic ketoacidosis and its components was estimated using a random effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger's regression test. Subgroup analysis were carried out to minimize random variations in the estimates from the primary studies. The pooled estimated prevalence of diabetic ketoacidosis among diabetic patients in Ethiopia was 46% (95% CI; 36, 57; I2 = 100%, P≤0.001). Medication discontinuations (AOR = 1.30, 95 CI 1.20, 1.64), presence of comorbidity (AOR = 1.53, 95 CI 1.10, 2.20) and presence of infection (AOR = 1.62, 95 CI 1.31, 1.98) had an association with diabetic ketoacidosis among diabetic patients. Medication discontinuations, comorbidity, and infection are individual contributors to diabetic ketoacidosis in diabetic patients. Implementing initiatives to enhance medication adherence and establish comprehensive diabetes management programs covering glycemic control, comorbidities, and infection management can effectively address these factors.

Trauma web-based psychoeducational programme: systematic cultural adaptation and protocol for a feasibility-acceptability study

ABSTRACT Background: Trauma exposure in Indonesia is high despite the fact that there is limited accessibility to mental healthcare. Pulihkan Luka (PL) is a web-based trauma psychoeducation intervention that aims to provide a practical solution to overcome barriers to accessing mental healthcare. Objectives: This article aimed to (1) describe the cultural adaptation process of PL for Indonesian students and (2) describe the design of the pilot randomised controlled trial (RCT) that examines the feasibility and acceptability of PL. Methods: First, we describe the cultural adaptation process of PL following the 5-phase Formative Method for Adapting Psychotherapy (FMAP) approach: (1) knowledge generation, (2) information integration, (3) review and revision, (4) mini-testing, and (5) finalisation. Focus Group Discussion (FGD) was conducted to gather the views of 15 stakeholders on psychoeducation material and trauma-related mental health problems. Based on the outcomes, we decided to utilise the informal Indonesian language, incorporate practical worksheets and infographics, which include illustrations that reflect Indonesia’s cultural diversity, and provide guidance on seeking help that aligns with the mental health system in Indonesia. Second, we describe the design of a pilot RCT. Undergraduate students (N = 130) will be randomised to (1) four to seven sessions of PL + Enhanced Usual Care (PL + EUC; n = 65) or (2) Enhanced Usual Care only (EUC only; n = 65). Assessments will be conducted at baseline, post-intervention, and three and six-month follow-up. Additionally, 20 participants will be invited for an FGD to explore their experiences with the intervention. Quantitative data will be analysed using linear mixed-effect models, and qualitative data will be analysed using thematic analysis. Discussion: Cultural adaptation is crucial for optimally developing and assessing the feasibility and acceptability of a web-based trauma psychoeducation intervention in Indonesia. The outcomes of the RCT will inform the feasibility and acceptability of web-based trauma psychoeducation in the Indonesian undergraduate student population.

Impacto de los Mega-incendios Forestales sobre la Salud Mental de Voluntarios de Bomberos de Purén (Chile): Un Estudio Exploratorio

Objective: to understand the implications of mega-forest fires on the mental health of Purén Firefighters (Chile). Method: from a qualitative perspective, an exploratory, transversal and non-experimental design was adopted. An intentional non-probabilistic sampling was used, made up of 15 volunteers (86.7% men and 13.3% women), who have 11 years of average service. Semi-structured interviews were used to collect data. Subsequently, the stories were interpreted through content analysis. Results: the participants showed a medium risk perception. Furthermore, there are no systematic protocols and strategies to protect mental health in the face of disasters. The importance of strengthening the training and protection processes of mental health in Firefighters is discussed, to effectively confront disasters that occur in the future.

Traditional laxatives in preventing opioid-induced constipation in adult patients with cancer: a systematic review and meta-analysis protocol

IntroductionOpioid-induced constipation (OIC) affects up to 90% of patients with cancer receiving long-term opioid-related analgesic therapy, resulting in various potential complications, compromised pain management and decreased quality of life. Laxatives...

Medical Marijuana Documentation Practices in Patient Electronic Health Records: Retrospective Observational Study Using Smart Data Elements and a Review of Medical Records.

Medical marijuana (MMJ) is available in Pennsylvania, and participation in the state-regulated program requires patient registration and receiving certification by an approved physician. Currently, no integration of MMJ certification data with health records exists in Pennsylvania that would allow clinicians to rapidly identify patients using MMJ, as exists with other scheduled drugs. This absence of a formal data sharing structure necessitates tools aiding in consistent documentation practices to enable comprehensive patient care. Customized smart data elements (SDEs) were made available to clinicians at an integrated health system, Geisinger, following MMJ legalization in Pennsylvania. The purpose of this project was to examine and contextualize the use of MMJ SDEs in the Geisinger population. We accomplished this goal by developing a systematic protocol for review of medical records and creating a tool that resulted in consistent human data extraction. We developed a protocol for reviewing medical records for extracting MMJ-related information. The protocol was developed between August and December of 2022 and focused on a patient group that received one of several MMJ SDEs between January 25, 2019, and May 26, 2022. Characteristics were first identified on a pilot sample (n=5), which were then iteratively reviewed to optimize for consistency. Following the pilot, 2 reviewers were assigned 200 randomly selected patients' medical records, with a third reviewer examining a subsample (n=30) to determine reliability. We then summarized the clinician- and patient-level features from 156 medical records with a table-format SDE that best captured MMJ information. We found the review protocol for medical records was feasible for those with minimal medical background to complete, with high interrater reliability (κ=0.966; P<.001; odds ratio 0.97, 95% CI 0.954-0.978). MMJ certification was largely documented by nurses and medical assistants (n=138, 88.5%) and typically within primary care settings (n=107, 68.6%). The SDE has 6 preset field prompts with heterogeneous documentation completion rates, including certifying conditions (n=146, 93.6%), product (n=145, 92.9%), authorized dispensary (n=137, 87.8%), active ingredient (n=130, 83.3%), certifying provider (n=96, 61.5%), and dosage (n=48, 30.8%). We found preset fields were overall well-recorded (mean 76.6%, SD 23.7% across all fields). Primary diagnostic codes recorded at documentation encounters varied, with the most frequent being routine examinations and testing (n=34, 21.8%), musculoskeletal or nervous conditions, and signs and symptoms not classified elsewhere (n=21, 13.5%). This method of reviewing medical records yields high-quality data extraction that can serve as a model for other health record inquiries. Our evaluation showed relatively high completeness of SDE fields, primarily by clinical staff responsible for rooming patients, with an overview of conditions under which MMJ is documented. Improving the adoption and fidelity of SDE data collection may present a valuable data source for future research on patient MMJ use, treatment efficacy, and outcomes.

Task-aware image quality estimators for face detection

Understanding the quality of face images plays a critical role in enhancing the efficiency of end-to-end face analytics systems, which perform tasks such as face detection, alignment, and recognition in a sequential manner. Recently, the development of face quality estimators (QEs) specifically for face recognition has received significant attention. However, in end-to-end face analytics systems, the performance of the face detector directly affects the face recognizer. Thus, assessing the suitability of an image for face detection before passing it on to face recognition can improve the resource utilization in such systems. In this research, we first introduce the detectability (DET) score of an image, a novel quality metric that links image quality to face detection performance. We use this DET score to design two novel QEs for face detection: supervised face detection quality estimator (SFDQE) and unsupervised face detection quality estimator (UFDQE). We also propose the mAP vs. reject protocol (mvR), a systematic evaluation protocol for assessing QEs in the context of face detection. In our experiments, we illustrate the effectiveness of SFDQE and UFDQE in determining the suitability of an image for face detection. Furthermore, we show the ability of our QEs to generalize; each is a powerful tool for image quality estimation in general object detection scenarios.

Epidemiology of Latent Tuberculosis in Moroccan Healthcare Workers: Prevalence Patterns and Predisposing Factors.

Among occupational hazards in healthcare settings, latent tuberculosis infection (LTBI) ranks as a major concern, particularly threatening healthcare workers (HCWs) in nations grappling with intermediate to high tuberculosis (TB) rates. Our study was conducted in Morocco, a country characterized by widespread Bacillus Calmette-Guérin (BCG) vaccination and a moderate TB burden of 93 cases per 100,000 inhabitants in 2022. We examined both the prevalence of LTBI among Moroccan HCWs and its various risk factors. A cross-sectional study was conducted from August 2022 to October 2024 in two Moroccan hospitals. One hundred forty-seven HCWs were recruited and screened for LTBI using the QuantiFERON-TB Gold In-Tube (QFT-GIT) test. Data on demographics, occupational characteristics, and potential risk factors were collected through standardized questionnaires. Statistical analysis included univariate and multivariate logistic regression to identify factors associated with LTBI. The overall prevalence of LTBI was 32.65% (48/147). Multivariate analysis identified several independent risk factors: male gender (OR: 2.84; 95% CI: 1.54-5.22; p<0.001), age above 50 years (OR: 4.58; 95% CI: 1.50-13.90; p=0.007), smoking status (OR: 4.07; 95% CI: 1.63-10.14; p=0.003), and family history of TB (OR: 4.71; 95% CI: 1.33-16.65; p=0.016). Notably, neither specific work areas nor job categories were identified as significant risk factors in the final multivariate model. The observed LTBI prevalence among HCWs in Morocco demonstrates concordance with epidemiological data from comparable intermediate-burden nations. The elucidation of predisposing factors, with particular emphasis on non-occupational determinants, underscores the imperative for implementing systematic surveillance protocols and World Health Organization (WHO)-sanctioned infection prevention measures within healthcare facilities. These epidemiological findings provide an empirical foundation for the formulation and optimization of TB control strategies specifically tailored to the occupational health needs of Morocco's healthcare workforce.

Barriers and facilitators in nurse prescribing practices: a protocol for qualitative meta-synthesis from nurses’ perspectives

IntroductionWith the development of the medical system and the diversification of patient needs, nurse practitioners (NPs) play an increasingly important role in medical practice, assuming more responsibilities and powers, including...

Patient awareness of long-term cardiovascular and metabolic disease risks after hypertensive disorders of pregnancy in Japan.

Given the increasing recognition of the importance of postpartum follow-up care for women with a history of hypertensive disorders of pregnancy (HDP) to mitigate their future risk of cardiovascular and metabolic diseases, here we aimed to evaluate the current status of postpartum follow-up care in Japan and explore the challenges to its implementation. A web-based survey was conducted using a smartphone application among postpartum women between March and May 2024 to assess their knowledge of HDP-related future risk and postpartum follow-up care. A total of 880 valid responses were obtained, 73 (8.3%) of which were from women with a history of HDP. Of them, 56.2% were aware of the heightened risk of cardiovascular disease and even fewer knew about the risks of metabolic syndrome (37.0%) and the preventive use of low-dose aspirin (12.3%); in fact, 31.5% reported receiving no information about their risk or preventive measures from healthcare providers. Furthermore, 43.8% did not consult specialists or attend regular checkups after their 1-month checkup. Among women with a history of HDP, those who received information and guidance were more likely to implement behavioral changes than those who did not. Patient awareness level of HDP-related risk was low and the information provided by their healthcare professionals was insufficient, indicating that postpartum follow-up care in Japan is not satisfactory. This study highlights the need for improved educational strategies and systematic follow-up protocols to ensure that women are adequately informed and supported in managing their long-term health risks.

Effect of therapeutic exercises on the progression of adolescent idiopathic scoliosis: a protocol of a systematic review

IntroductionAdolescent idiopathic scoliosis (AIS) affects an estimated 200 million adolescents globally and curvatures exceeding 30° at skeletal maturity are associated with increased health risks in adulthood. The International Society for...

Determinants of higher education graduates’ employability: a scoping review

PurposeGraduates’ employability has been recognised as a complex and multidimensional phenomenon in the theoretical literature. However, some critics have emerged around the lack of relation between structural, contextual and individual dimensions that have been acknowledged as relevant for the understanding of graduates’ employability. This study aims to map empirical research, grounded on a scoping and integrative review of the research published to date on the determinants of graduates’ employability and offer a wider perspective of the knowledge produced across different disciplinary fields, and theoretical and methodological approaches.Design/methodology/approachFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol for Scoping Reviews, a systematic and extensive search of the literature was carried out and 74 studies focusing on the determinants of graduates’ employability were selected through inclusion and exclusion criteria. Then, data were extracted, analysed and interpreted with quantitative and qualitative techniques.FindingsThe results evidence that multiple factors mainly related to higher education attributes, educational arrangement, personal and interpersonal attributes, and socioeconomic conditions predict the odds of obtaining a job after graduation. This review also demonstrates some fragmentation of knowledge produced in this field and identifies a lack of an integrative approach, calling for more multidisciplinary research that might favour a more comprehensive knowledge of graduates’ employability.Originality/valueBy considering the different factors together, from individual and contextual levels, the present review offers an original and clearer overall picture of what is currently known and what is still unresearched about the determinants of graduates’ employability.