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Sociodemographic factors associated with the utilisation of specialist palliative care in individuals with end-stage kidney disease: protocol for a scoping review

Por: Jameson · E. · Brown · P. P. · Bruni · A. · Wassef · M. · Chang · R. · Milne · K. · Berry · J. · Bonares · M.
Introduction

Individuals with end-stage kidney disease (ESKD), whether receiving dialysis or conservative care, experience high symptom burden and limited life expectancy, indicating substantial palliative care needs. Integrating palliative care into kidney care is vital for comprehensive ESKD management, but access remains uneven across sociodemographic groups. Identifying and addressing these disparities is key to ensuring equitable care and improving patient outcomes. This study aims to explore sociodemographic factors associated with specialist palliative care utilisation among people with ESKD.

Methods and analysis

This study protocol outlines a scoping review of peer-reviewed and grey literature using an established methodological framework by the Joanna Briggs Institute (JBI), and reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Relevant literature will be identified through a multi-database (Ovid MEDLINE, Embase, CINAHL, PsycINFO) and grey literature search strategy designed alongside a health sciences librarian. To be included, articles must involve individuals with ESKD and report on how sociodemographic factors influence access to and utilisation of specialist palliative care services. Results of the search will be screened independently by two reviewers and data from included studies will be extracted independently and in duplicate. A narrative and thematic analysis will be conducted to identify key themes related to sociodemographic influences on specialist palliative care access and utilisation among individuals with ESKD, with particular attention to differences between kidney care modalities (dialysis vs conservative care) and the extent to which intersectionality of sociodemographic factors has been examined.

Ethics and dissemination

Ethics approval is not required for this scoping review. Findings will be submitted for publication in a peer-reviewed journal. Results will identify patient-related factors influencing access to specialist palliative care in ESKD and remaining gaps in the literature, informing future research and policy to support equitable care.

Cardiovascular Prevention and Rehabilitation for Ischaemic Non‐Obstructive Coronary Artery Disease: Implementation Considerations From a Survey of UK Health Professionals

ABSTRACT

Aims

Investigate if UK healthcare professionals have the resources and knowledge to provide cardiovascular prevention and rehabilitation to people with ischaemic non-obstructive coronary artery disease (INOCA), and explore what type of care healthcare professionals believe patients should receive.

Design

Electronic cross-sectional survey of UK healthcare professionals, circulated between 7 January and 7 March 2022.

Methods

Quantitative data were analysed descriptively. Qualitative data were analysed inductively.

Results

Healthcare professionals lacked knowledge and capacity to care for this patient group. Healthcare professionals recommended patients receive two unsupervised sessions per week, for 8 weeks, at home and in person. Recommend include physical activity advice/exercise training, health behaviour support, psychological support, smoking cessation, dietetics/nutritional support, weight management, counselling and medication titration.

Conclusion

In the UK, healthcare professionals lack resources and knowledge to provide cardiovascular presentation and rehabilitation to people with INOCA. Recommended care reflected care currently available to other patient groups.

Implications for the Profession

There is a need to create and evaluate educational material for healthcare professionals.

Impact

Before people with INOCA are offered cardiovascular prevention and rehabilitation it was necessary to determine if healthcare professionals had sufficient clinical knowledge and resources to provide care. We conclude that additional training and resources are required to enable health professionals to deliver care to people with INOCA.

Researchers should create and evaluate educational material for cardiovascular prevention and rehabilitation programmes. Programmes also require additional resources to deliver care to this group.

Reporting Method

Reporting adheres to the Cherries guidelines.

Patient or Public Contribution

A patient (SB) was consulted on study design, data collection, and interpretation, and manuscript preparation.

Virtual Nursing in Residential Aged Care: What Is Known? A Rapid Review

ABSTRACT

Aims

To review current evidence on the implementation and impact of virtual nursing care in long-term aged care.

Design

An integrative rapid literature review.

Data Sources

Medline, CINAHL, Web of Science, Embase, Ageline and Scopus.

Review Methods

The review included studies involving virtual care interventions provided by nurses (or by a multidisciplinary team including nurses) to older people in residential aged care that reported health outcomes or stakeholder experiences. Consistent with PRISMA guidelines, databases were systematically searched in July and August 2024, focusing on literature published since 2014. Studies were screened in Covidence by three team members, with conflicts resolved by additional reviewers. Studies not involving nurses or not set in aged care were excluded.

Results

The search identified 13 studies, which included quantitative, qualitative and mixed-method approaches, conducted in both Australian and international settings, as well as in rural and metropolitan locations. Nurses were often involved as part of an existing virtual care programme, typically located in a hospital setting. The training and credentials of nurses delivering VN varied in terms of specialisation and advanced practice. The model of care in general was ad hoc, though in some cases there were regular, scheduled VN consultations. The time requirements for onsite staff and nurses were not well articulated in any of the studies, and information on the funding models used was also lacking.

Conclusion

There is some evidence that VN interventions in aged care may improve communication, enhance person-centred care and reduce emergency department presentations and hospitalisations.

Impact, Patient or Public Contribution

Rigorous, ongoing evaluation of VN interventions is required to ensure their appropriate application in residential aged care.

Agreement testing of AMSTAR-PF, a tool for quality appraisal of systematic reviews of prognostic factor studies

Por: Henry · M. L. · OConnell · N. E. · Riley · R. D. · Moons · K. G. M. · Shea · B. J. · Hooft · L. · Wallwork · S. B. · Damen · J. A. A. G. · Skoetz · N. · Appiah · R. P. · Berryman · C. · Crouch · S. M. · Ferencz · G. A. · Grant · A. R. · Henry · K. M. · Herman · A. M. · Karran · E. L. · K
Objectives

To test the agreement and usability of a novel quality appraisal tool: A MeaSurement Tool to Assess systematic Reviews of Prognostic Factor studies (AMSTAR-PF).

Design

Observational study.

Participants

14 appraisers of varied experience levels and backgrounds, including undergraduate, master’s and PhD students, postgraduate researchers, research fellows and clinicians.

Study procedure

Eight systematic reviews were rated by all reviewers using AMSTAR-PF.

Outcome measures

Planned measures included intrapair and inter-pair agreement using Cohen’s and Fleiss’ kappa, time of use and time to reach consensus. Interrater agreement was an added measure, and Gwet’s agreement coefficient was calculated and presented due to its greater stability across agreement levels. The percentage of intrapair agreements identical or one category apart was also presented.

Results

Interrater agreement averaged 0.59 (range 0.21–0.90), inter-pair agreement 0.61 (range 0.24–0.91) and intrapair agreement 0.75 (range 0.45–0.95) across the domains, with agreement for the overall rating 0.46 (95% CI 0.30 to 0.62) for interrater agreement, 0.46 (95% CI 0.17 to 0.74) for inter-pair agreement and 0.68 (range of averages 0.22–1.00) for intrapair agreement. The majority (60.7%) of intrapair ratings were identical, with 94.6% of final ratings either identical or only one category different for the overall appraisal. The time taken to appraise a study with AMSTAR-PF improved with use and averaged around 34 min after the first two appraisals.

Conclusions

Despite some variance in agreement for different domains and between different appraisers, the testing results suggest that AMSTAR-PF has clear utility for appraising the quality of systematic reviews of prognostic factor studies.

Trends in incident acute rheumatic fever or rheumatic heart disease in Indigenous youth in Western Australia: a retrospective cohort study

Por: MacDonald · B. · Sodhi-Berry · N. · Stacey · I. · Robinson · M. · Carapetis · J. · Bowen · A. C. · Budgeon · C. · Nedkoff · L. · Katzenellenbogen · J. M.
Objective

To determine age-specific and age-standardised incidence trends of acute rheumatic fever (ARF) or rheumatic heart disease (RHD) among Indigenous Western Australians aged less than 35 years of age.

Design

A population-based retrospective cohort study with linked data analysis.

Setting

Western Australian hospital admissions (1996–2022) and RHD notifications to the state-based register (2011–2015).

Participants

Patients, both Indigenous and non-Indigenous aged

Results

Of 1746 incident ARF/RHD cases, 1526 (87%) were Indigenous peoples, with the highest rates observed in patients aged 5–14 years, with an annual estimated increase of 4.3% (95% CI 3.2% to 5.2%). The 0–4 years age group experienced an annual increase in incidence rates of 4.8% (95% CI 1.4% to 8.2%). Overall, Indigenous patients experienced an annual increase of 1.9% (95% CI 1.3% to 2.6%) from 1996 to 2022. However, most cases (n=894) were identified after multiple significant policy developments (2011–2022) with an annual increase of 5.7% (95% CI 3.7% to 7.5%) for this period.

Conclusion

Increasing trends of incident ARF/RHD were observed in Indigenous patients aged under 15 years, with the greatest annual increments observed after policy implementation for disease reporting and awareness in the period from 2011 to 2022. Improvement in case ascertainment of ARF/RHD may be contributing towards increasing trends with improved reporting and monitoring of incident cases in very young Indigenous Australians more recently.

Photobiomodulation for postoperative pain relief following conventional periapical surgery: a randomised controlled study protocol

Por: Cirisola · R. W. C. · Moya · L. E. P. · Olazabal · M. V. G. · Wagmann · D. A. A. · Suarez · G. P. · Wince · C. · Bruno · M. L. H. · Salaberry · D. R. · Sobral · A. P. T. · Longo · P. L. · Motta · L. J. · Bussadori · S. K. · Duran · C. C. G. · Fernandes · K. P. S. · Mesquita-Ferrari
Introduction

Photobiomodulation (PBM) has shown promising effects in managing postoperative pain following conventional periapical surgery, although current evidence remains limited. This study aims to assess the effect of PBM on postoperative pain 24 hours after periapical surgery.

Methods and analysis

A randomised, controlled, double-blind trial will include 34 patients undergoing periapical surgery in the maxillary region, randomly assigned to an experimental group (n=17) or control group (n=17). The experimental group will receive PBM (GaAlAs diode laser, 808 nm, 100 mW, 4 J/cm², applied at five vestibular points) and placebo ibuprofen immediately and 24 hours postoperatively. The control group will receive simulated PBM and active ibuprofen. The primary outcome is postoperative pain assessed by the visual analogue scale at 24 hours. Secondary outcomes include pain at the seventh day, paracetamol intake, oedema, ecchymosis, soft tissue status and temperature at 24 hours and 7 days. Radiographic evaluation of healing will be performed at 1 and 3 months. Statistical analysis will be conducted based on data distribution, using repeated measures ANOVA (Analysis of Variance) or non-parametric equivalents for longitudinal outcomes, and appropriate tests for categorical variables. Significance will be set at p

Ethics and dissemination

The study was approved by the Human Research Ethics Committee of Universidad Católica del Uruguay (process no. 220914). Results will be disseminated to participants, healthcare professionals, the public and scientific communities.

Trial registration number

NCT05935306.

Mindfulness-based mHealth intervention for pregnant black and Latina women at high risk of postpartum depression--the Healthy Mama and Baby study: protocol and data overview for a randomised controlled trial in an integrated healthcare delivery system

Por: Kubo · A. · Kurtovich · E. · Aghaee · S. · Rubin · M. V. · Gomez Chavez · L. · Brown · S. D. · Ridout · K. · Bhalala · M. · Williams · A. · Elmer · M. · Ramsey · M. · Suazo · S. · Chess · A. · Quesenberry · C. P. · Avalos · L. A.
Introduction

Postpartum depression (PPD) is a debilitating condition affecting over 20% of postpartum women, with disproportionately higher rates among black and Latina women compared with their white counterparts. Current recommendations for PPD prevention demand significant healthcare system resources, highlighting the need for alternative, evidence-based interventions that minimise strain on these systems. Mindfulness has been shown to effectively reduce depressive symptoms and prevent relapse across various populations. However, no studies to date have evaluated the efficacy of a digitally delivered mindfulness intervention specifically for black and Latina women at increased risk of PPD.

This article presents the protocol for the Healthy Mama and Baby study, a randomised controlled trial (RCT). This trial evaluates whether a mobile-based (mHealth) mindfulness intervention tailored for pregnant women reduces depressive symptoms among pregnant black and Latina women at high risk for PPD.

Methods and analysis

We are conducting a fully remote RCT, recruiting 600 pregnant black and/or Latina women at risk of PPD from Kaiser Permanente Northern California (KPNC), an integrated healthcare delivery system. Participants are enrolled before 30 weeks’ gestation. They are randomised into either an mHealth mindfulness intervention arm, which receives access to a mindfulness app tailored specifically for pregnant and postpartum women, or a time-matched and attention-matched active control arm, which receives access to an online program of calming nature sounds. Both arms are instructed to engage in their assigned program for 5–20 min per day for 6 weeks. Outcome assessments are conducted online at baseline, post intervention and post partum (~7 weeks post partum) using validated questionnaires. Outcomes include depressive symptoms (primary) and anxiety, sleep and perceived stress (secondary).

Ethics and dissemination

All study procedures have been approved by the KPNC Institutional Review Board. The findings will be disseminated widely through peer-reviewed publications and conference presentations.

Trial registration number

NCT05186272.

Acceptability and preferences of people with long-term conditions for delivery of digital healthcare interventions: scoping review protocol

Por: Gerlis · C. · Berry · A. · Thomas · R. · Pacey-halls · S. · Loizou · M. · Swales · C. · Cramp · F.
Background

Digital health interventions (DHIs) are prevalent and have been shown to help some people with long-term conditions (LTCs) to manage their condition. There are myriad options for digital delivery yet limited understanding of what modes of delivery are acceptable to people with LTCs. It is important to understand the acceptability of delivery methods of DHIs to inform future DHI development and promote engagement. This scoping review aims to explore the acceptability of the delivery of DHIs for people with LTCs.

Methods and analysis

This review will follow the Joanna Briggs Institute guidance for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping reviews extension checklist. Databases including MEDLINE, PubMed, CINAHL, AHMED and PsycINFO will be searched for primary studies that provide data on preferences for delivery methods of DHIs by people with LTCs. Narrative analysis is anticipated, and a summary of the findings will be presented in a tabulated format.

Ethics and dissemination

Ethical approval will not be required for this scoping review. The findings will be disseminated via appropriate peer-reviewed journals and conferences and PhD theses.

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