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Prospective cohort study of genomic newborn screening: BabyScreen+ pilot study protocol

Por: Lunke · S. · Bouffler · S. E. · Downie · L. · Caruana · J. · Amor · D. J. · Archibald · A. · Bombard · Y. · Christodoulou · J. · Clausen · M. · De Fazio · P. · Greaves · R. F. · Hollizeck · S. · Kanga-Parabia · A. · Lang · N. · Lynch · F. · Peters · R. · Sadedin · S. · Tutty · E. · Eggers
Introduction

Newborn bloodspot screening (NBS) is a highly successful public health programme that uses biochemical and other assays to screen for severe but treatable childhood-onset conditions. Introducing genomic sequencing into NBS programmes increases the range of detectable conditions but raises practical and ethical issues. Evidence from prospectively ascertained cohorts is required to guide policy and future implementation. This study aims to develop, implement and evaluate a genomic NBS (gNBS) pilot programme.

Methods and analysis

The BabyScreen+ study will pilot gNBS in three phases. In the preimplementation phase, study materials, including education resources, decision support and data collection tools, will be designed. Focus groups and key informant interviews will also be undertaken to inform delivery of the study and future gNBS programmes. During the implementation phase, we will prospectively recruit birth parents in Victoria, Australia, to screen 1000 newborns for over 600 severe, treatable, childhood-onset conditions. Clinically accredited whole genome sequencing will be performed following standard NBS using the same sample. High chance results will be returned by genetic healthcare professionals, with follow-on genetic and other confirmatory testing and referral to specialist services as required. The postimplementation phase will evaluate the feasibility of gNBS as the primary aim, and assess ethical, implementation, psychosocial and health economic factors to inform future service delivery.

Ethics and dissemination

This project received ethics approval from the Royal Children’s Hospital Melbourne Research Ethics Committee: HREC/91500/RCHM-2023, HREC/90929/RCHM-2022 and HREC/91392/RCHM-2022. Findings will be disseminated to policy-makers, and through peer-reviewed journals and conferences.

Dogs’ social susceptibility is differentially affected by various dog–Human interactions. A study on family dogs, former shelter dogs and therapy dogs

by Anna Kis, Katinka Tóth, Lívia Langner, József Topál

When pre-treated with social stimuli prior to testing, dogs are more susceptible to human influence in a food preference task. This means, after a positive social interaction they are more willing to choose the smaller amount of food indicated by the human, as opposed to their baseline preference for the bigger amount. In the current study we investigate if and how various forms of social interaction modulate choices in the same social susceptibility task, testing dogs with varying early life history (pet dogs, therapy dogs, former shelter dogs). In line with previous studies, dogs in general were found to be susceptible to human influence as reflected in the reduced number of “bigger” choices in the human influence, compared to baseline, trials. This was true not only for pet dogs with a normal life history, but also for dogs adopted from a shelter. Therapy dogs, however, did not uniformly change their preference for the bigger quantity of food in the human influence trials; they only did so if prior to testing they had been pre-treated with social stimuli by their owner (but not by a stranger). Pet dogs were also more influenced after pre-treatment with social stimuli by their owner compared to ignoring and separation; however after pre-treatment by a stranger their behaviour did not differ from ignoring and separation. Former shelter dogs on the other hand were equally influenced regardless of pre-treatment by owner versus stranger. In summary these results show that dogs’ social susceptibility is modulated by both interactions immediately preceding the test as well as by long term social experiences.

Health risks of exposure to air pollution in areas where coal-fired power plants are located: protocol for a scoping review

Por: Mahlangeni · N. · Kapwata · T. · Laban · T. · Wright · C. Y.
Introduction

Coal-fired power plants are major sources of air pollution which impact human health. Coal combustion byproducts released into the air include particulate matter, nitrogen oxides and sulphur dioxide. Exposure to fine particulate matter is associated with increased risk of mortality. This scoping review will examine and summarise the current literature on the health risks of exposure to air pollution in areas in which coal-fired power plants exist.

Methods and analysis

This scoping review will be conducted according to the Joanna Briggs Institute methodological framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Five electronic databases (PubMed, ScienceDirect, Scopus, Web of Science and Google Scholar) will be searched for relevant articles. Studies will be included up until 31 January 2024. There will be no restriction on geographical area. The searches will be limited to studies published in English. Title, abstract, full-text screening and data extraction of relevant articles will be done by two independent reviewers. Discrepancies will be resolved by group discussion. The findings will be presented in tables with a narrative summary. This review will consider epidemiological studies and grey literature that report on the health risks of exposure to air pollution in areas where coal-fired power plants exist.

Ethics and dissemination

All data will be collected from published and grey literature. Ethics approval is therefore not required. We will submit our findings for publication in a peer-reviewed journal.

Reaching consensus on the definition of person‐centred handover practices in emergency departments: A modified online Delphi

Abstract

Aim

To reach consensus on the definition and attributes of ‘person-centred handover practices’ in emergency departments.

Background

Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments.

Design

A three-round online Delphi survey.

Methods

Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted.

Results

Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated.

Conclusion

Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners.

Implications for the profession and/or patient care

Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments.

Reporting method

The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist.

Impact (Addressing)

Improve handover practices and patient care. Improve person-centred care in emergency departments.

Patient or public contribution

Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.

Effect of two different surgical modalities for pelvic organ prolapse on postoperative wound infection in patients: A meta‐analysis

Abstract

Sacrospinous ligament fixation (SSLF) is widely applied to the treatment of female pelvis organ prolapsed. Contradictory findings have already been reported in the comparison of sacrocolpopexy (SC) with SSLF. The objective of this study is to evaluate the efficacy of SC versus SSLF in treating pelvis organ prolapsed after operation. We conducted a meta-analysis of both operative approaches, including PubMed, Embase, and Cochrane Library. In this research, 822 articles were chosen from three databases, 201 were copied, and 10 were included. Among them, 7248 cases were operated on the prolapsed pelvis. It was found that SSLF surgery could significantly decrease the rate of postoperative wound infection after operation (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.42–0.82; p = 0.001). No statistical significance was found among the SSLF and the SC surgery for the post-operation haemorrhage of the patient (OR, 0.81; 95% CI, 0.23–2.83; p = 0.75). No statistical significance was found among the SSLF and the SC surgery for the postoperative period of the patient's operation (mean difference, −15.46; 95% CI, −52.87 to 21.94; p = 0.42). Applying SSLF surgery to treat pelvic prolapse in women may benefit from a reduction in the number of post-operative wound infections. However, SSLF had no statistical significance with respect to the amount of haemorrhage after operation or operation time.

Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study

Abstract

Aim

To construct a nursing assessment framework for patients in anaesthesia recovery period.

Design

A three-round modified Delphi method was employed to capture the consensus of 22 panellists.

Methods

The initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini-clinical evaluation exercise (mini-CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post-anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework.

Results

This study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History-taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern.

Conclusion

The nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts’ opinions.

Implications for the profession and patient care

The assessment framework constructed in this study could be used for the process evaluation of post-anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills.

Reporting method

The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations.

Patient or public contribution

No patient or public contribution.

Silhouette showcards confirm altered obesity-associated body image perception in international cohort study of African-origin populations

Por: Choo-Kang · C. · Reese · T. O. · Micklesfield · L. K. · Bovet · P. · Bedu-Addo · K. · Forrester · T. · Gilbert · J. A. · Goedecke · J. H. · Plange-Rhule · J. · Lambert · E. V. · Layden · B. T. · Rae · D. E. · Viswanathan · B. · Luke · A. · Dugas · L.
Objectives

Given the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual’s body image can inform obesity prevention and management. This study’s objective was to examine the use of silhouette showcards to measure body size perception compared with measured body mass index, and assess body size dissatisfaction, in three different African-origin populations spanning the epidemiological transition. An ancillary objective was to investigate associations between body size perception and dissatisfaction with diabetes and hypertension.

Setting

Research visits were completed in local research clinics in respective countries.

Participants

Seven hundred and fifty-one African-origin participants from the USA and the Republic of Seychelles (both high-income countries), and Ghana (low/middle-income country).

Primary and secondary outcome measures

Silhouette showcards were used to measure perceived body size and body size dissatisfaction. Objectively measured body size was measured using a scale and stadiometer. Diabetes was defined as fasting blood glucose ≥126 mg/dL and hypertension was defined as ≥130 mm Hg/80 mm Hg.

Results

Most women and men from the USA and Seychelles had ‘Perceived minus Actual weight status Discrepancy’ scores less than 0, meaning they underestimated their actual body size. Similarly, most overweight or obese men and women also underestimated their body size, while normal weight men and women were accurately able to estimate their body size. Finally, participants with diabetes were able to accurately estimate their body size and similarly desired a smaller body size.

Conclusions

This study highlights that overweight and obese women and men from countries spanning the epidemiological transition were unable to accurately perceive their actual body size. Understanding people’s perception of their body size is critical to implementing successful obesity prevention programmes across the epidemiological transition.

Hepatitis E virus infections among patients with acute febrile jaundice in two regions of Cameroon: First molecular characterization of hepatitis E virus genotype 4

by Abdou Fatawou Modiyinji, Lange Tchamba Amorgathe Tankeu, Chavely Gwladys Monamele, Moise Henri Yifomnjou Moumbeket, Paul Alain Tagnouokam Ngoupo, Huguette Tchetgna Simo, Abanda Njei Ngu, Kazanji Mirdad, Richard Njouom

Background

Febrile jaundice is a common indicator of certain infectious diseases, including hepatitis E. In Cameroon, the yellow fever virus is the only pathogen that is monitored in patients who present with this symptom. However, more than 90% of the samples received as part of this surveillance are negative for yellow fever. This study aimed to describe the prevalence and hepatitis E virus (HEV) genotype among yellow fever-negative patients in the Far North and West regions of Cameroon.

Methods

In a cross-sectional study, yellow fever surveillance-negative samples collected between January 2021 and January 2023 were retrospectively analyzed. Anti-HEV IgM and IgG antibodies were tested using commercially available ELISA kits. Anti-HEV IgM and/or IgG positive samples were tested for HEV RNA by real-time RT-PCR, followed by nested RT-PCR, sequencing and phylogenetic analysis.

Results

Overall, 121 of the 543 samples (22.3%, 95% CI: 19.0% - 26.0%) were positive for at least one anti-HEV marker. Amongst these, 8.1% (44/543) were positive for anti-HEV IgM, 5.9% (32/543) for anti-HEV IgG, and 8.3% (45/544) for both markers. A total of 15.2% (12/79) samples were positive for HEV RNA real-time RT-PCR and 8 samples were positive for HEV RNA by nested RT-PCR. Phylogenetic analysis showed that the retrieved sequences clustered within HEV genotypes/subtypes 1/1e, 3/3f and 4/4b.

Conclusion

Our results showed that HEV is one of the causes of acute febrile jaundice in patients enrolled in the yellow fever surveillance program in two regions of Cameroon. We described the circulation of three HEV genotypes, including two zoonotic genotypes. Further studies will be important to elucidate the transmission routes of these zoonotic HEV genotypes to humans in Cameroon.

VersKiK qualitative study design: actual follow-up needs of paediatric cancer survivors, their informal caregivers and follow-up stakeholder perceptions in Germany

Por: Aleshchenko · E. · Swart · E. · Voigt · M. · Langer · T. · Calaminus · G. · Glogner · J. · Baust · K.
Introduction

This article presents the study design of the qualitative part of the VersKiK study (Long-term care, care needs and wellbeing of individuals after cancer in childhood or adolescence: study protocol of a large scale multi-methods non-interventional study) aiming to explore actual follow-up needs of childhood and adolescence cancer survivors and their informal caregivers, gaps in current follow-up care provision and trajectories of cancer survivors’ transition from paediatric to adult healthcare.

Methods and analysis

We will conduct up to 30 interviews with survivors of childhood and adolescence cancer and their informal caregivers with up to 20 participant observations of follow-up appointments. The results of these will be discussed in up to four focus groups with healthcare professionals and representatives of self-help groups. The study design aims to evaluate follow-up care after childhood cancer considering perspectives from survivors, their informal caregivers as well as healthcare providers. The combination of different data sources will allow us to get an in-depth understanding of the current state of follow-up care after paediatric cancer in Germany and to suggest recommendations for care improvement.

Ethics and dissemination

The VersKiK study was approved by the Ethics Committee Otto von Guericke University on 2 July 2021 (103/21), by the Ethics Committee of Johannes Gutenberg University Mainz on 16 June 2021 (2021-16035), by the Ethics Committee University of Lübeck on 10 November 2021 (21-451), by the Ethics Committee University of Hospital Bonn on 28 February 2022 (05/22). For each part of the qualitative study, a separate written informed consent is prepared and approved accordingly by the ethics committees named above.

Trial registration number

Registered at German Clinical Trial Register, ID: DRKS00026092.

Empowering Ontarios long-term care residents to shape the place they call home: a codesign protocol

Por: Lee · C. · Tripp · D. · McVie · M. · Fineczko · J. · Ramsden · G. · Hothi · S. · Langston · J. · Gilhuly · J. · Collingwood · B. · McAiney · C. · McGilton · K. S. · Bethell · J.
Background

Canada’s long-term care (LTC) homes were founded on an institutional model that viewed residents as passive recipients of care. Many homes continue to follow this model leaving residents removed from operational decision-making within their homes. However, involving residents in the design of their LTC home’s environment, programmes and operations can improve the residents’ quality of life and other outcomes. This codesign project creates a toolkit/resource for LTC homes to facilitate meaningful resident engagement in their home’s organisational design and governance.

Method

This three-part project consists of a scoping review, qualitative interviews, toolkit/resource development and prototyping. In part 1, we conduct a scoping review to synthesise existing knowledge on approaches to engaging LTC home residents in organisational design and governance of their LTC homes, as well as explore barriers, challenges and facilitators of engagement, considerations for diversity and cognitive change, and approaches to evaluation. In part 2, we will have interviews and focus groups with residents, team members (staff) and administrators to assess community capacity to implement and sustain a programme to engage LTC residents in organisational design and governance of their LTC homes. The third part of our project uses these findings to help codesign toolkit(s)/resource(s) to enable the engagement of LTC residents in the organisational design and governance of their LTC homes.

Ethics and dissemination

The project is conducted in partnership with the Ontario Association of Residents’ Councils. We will leverage their communication to disseminate findings and support the use of the codesigned toolkit(s)/resource(S) with knowledge users. We will also publish the study results in an academic journal and present at conferences, webinars and workshops. These results can influence practices within LTC homes by inspiring an organisational culture where residents help shape the place they call home. The interviews and focus groups, conducted in part 2, have been submitted to the University Health Network Research Ethics Board.

Symptoms and need for individualised support during the first year after primary treatment for breast cancer—A qualitative study

Abstract

Background

The survival rate among patients with breast cancer is high. It is well described that after primary treatment patients may experience symptoms and concerns but the needs and resources during the first year to manage everyday life are not well described.

Aim

To describe experiences of symptom distress, needs and support during the first year after primary treatment for breast cancer from the perspectives of patients and healthcare professionals.

Design

Qualitative descriptive.

Methods

Data collection through individual interviews with patients (n = 17) and a focus group interview with healthcare professionals (n = 7). Data was analysed using thematic analysis and resulted in three themes.

Results

The first theme, ‘Struggling with symptoms and changes in everyday life’ shows how symptoms and concerns interfered with the everyday life of patients and in some situations even impeded them. Patients try to adapt to their new situation by creating new routines and managing symptoms through self-care. The second theme, ‘Adaption in a period of uncertainty’ describes thoughts about cancer recurrence and doubts about continuing with the endocrine therapy if symptoms prolong. In the third theme, ‘Support and need for individualized follow-up care’ healthcare professionals described that they provide support by being available and by giving both verbal and written information. Patients expressed that the information could be too general and voiced a need for more individually tailored support.

Conclusion

During the first year after primary treatment, patients with breast cancer describe how they try to manage by themselves, but express both unmet needs and a wish for extended and more individually tailored support. The healthcare professionals recognised that patients lack a structured plan for the first year and the need for continued support. This stresses a need for development of care models with special consideration towards individualised support after breast cancer treatment.

No Patient or Public Contribution

There was no patient or public involvement in the design or conduct of the study. The interview study was not considered to benefit from involving patients or healthcare professionals when designing the interview guides as they were developed through literature and previous research of patients treated for breast cancer.

Supporting regional pandemic management by enabling self-service reporting—A case report

by Richard Gebler, Martin Lehmann, Maik Löwe, Mirko Gruhl, Markus Wolfien, Miriam Goldammer, Franziska Bathelt, Jens Karschau, Andreas Hasselberg, Veronika Bierbaum, Toni Lange, Katja Polotzek, Hanns-Christoph Held, Michael Albrecht, Jochen Schmitt, Martin Sedlmayr

Background

The COVID-19 pandemic revealed a need for better collaboration among research, care, and management in Germany as well as globally. Initially, there was a high demand for broad data collection across Germany, but as the pandemic evolved, localized data became increasingly necessary. Customized dashboards and tools were rapidly developed to provide timely and accurate information. In Saxony, the DISPENSE project was created to predict short-term hospital bed capacity demands, and while it was successful, continuous adjustments and the initial monolithic system architecture of the application made it difficult to customize and scale.

Methods

To analyze the current state of the DISPENSE tool, we conducted an in-depth analysis of the data processing steps and identified data flows underlying users’ metrics and dashboards. We also conducted a workshop to understand the different views and constraints of specific user groups, and brought together and clustered the information according to content-related service areas to determine functionality-related service groups. Based on this analysis, we developed a concept for the system architecture, modularized the main services by assigning specialized applications and integrated them into the existing system, allowing for self-service reporting and evaluation of the expert groups’ needs.

Results

We analyzed the applications’ dataflow and identified specific user groups. The functionalities of the monolithic application were divided into specific service groups for data processing, data storage, predictions, content visualization, and user management. After composition and implementation, we evaluated the new system architecture against the initial requirements by enabling self-service reporting to the users.

Discussion

By modularizing the monolithic application and creating a more flexible system, the challenges of rapidly changing requirements, growing need for information, and high administrative efforts were addressed.

Conclusion

We demonstrated an improved adaptation towards the needs of various user groups, increased efficiency, and reduced burden on administrators, while also enabling self-service functionalities and specialization of single applications on individual service groups.

Registered nurses' perceptions of healthy lifestyle counselling for immigrants in primary healthcare: A focus group study

Abstract

Background

The use of primary healthcare and health promotion services is low among immigrants compared with native citizens. Immigrants are at risk of developing chronic diseases due to genetics, nutrition and a sedentary lifestyle. Registered nurses play an integral role in teaching, counselling for a healthy lifestyle and care coordination in primary healthcare.

Aim

We aimed to explore the perceptions of registered nurses on healthy lifestyle counselling for preventing type 2 diabetes and other chronic diseases among immigrants in the primary healthcare setting.

Design

We performed a qualitative descriptive study using focus group interviews.

Methods

Data were collected with semi-structured focus group interviews with a total of 23 registered nurses working in primary healthcare. We recruited the participants by using the purposive sampling method in the primary healthcare setting of four municipalities in Finland. Interviews were audio-recorded, transcribed verbatim and analysed with qualitative inductive content analysis.

Results

The participants' perceptions were related to (1) uniform counselling practice for both immigrants and native citizens, (2) challenges in counselling immigrants, (3) understanding cultural factors influencing immigrant counselling, (4) the need to improve immigrant counselling and (5) utilizing insights from practical experience to improve the counselling service.

Conclusions

Developing a culturally sensitive health promotion service is suggested to support the health of immigrants. Moreover, both migrant communities and healthcare professionals should be involved in co-designing and implementing health promotion projects through a community-based participatory approach.

Impact

Our study contributes to healthcare practice and management by underscoring the need for culturally tailored health promotion services for the at-risk group of immigrants in primary healthcare. Cultural competence in nursing education needs to be reinforced. The provided recommendations inform researchers and policymakers about the health disparities and health needs of immigrants.

Public Contribution

Healthcare professionals were consulted in the study design.

Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment

by Jason Lang, Georgia Wylie, Caroline Haig, Christopher Gillberg, Helen Minnis

Background

Children’s health services in many countries are moving from single condition diagnostic silo assessments to considering neurodevelopment in a more holistic sense. There has been increasing recognition of the importance of clinical overlap and co-occurrence of different neurotypes when assessing neurodivergent children. Using a cross-sectional service evaluation design, we investigated the overlap of neurodivergences in a cohort of children referred for autism assessment, focusing on motor, learning, and attention/activity level domains. We aimed to determine what proportion of children in a cohort referred for an autism assessment showed traits of additional neurodivergences, and what proportion were further investigated.

Methods

We evaluated anonymised medical records of children aged between two and 17 years referred for autism assessment. We used validated questionnaires to assess for neurodivergent traits. A weighted scoring system was developed to determine traits in each neurodevelopmental domain and a score above the median was considered to indicate a neurodivergent trait. Evidence of further investigations were recorded. We then examined the relationships between autism traits and traits of additional neurodivergence.

Results

114 participants were included for evaluation. 62.3% (n = 71) had completed questionnaires for analysis. Of these, 71.8% (n = 51) scored greater than the median for at least one additional neurotype, indicating the presence of other neurodivergent traits, and 88.7% (n = 64) attracted a diagnosis of autism. Only 26.3% of children with evidence of additional neurotypes were further investigated beyond their autism assessment.

Conclusions

Our results demonstrate the extensive overlap between additional neurodivergent traits in a population of children referred with suspected autism and show that only a small proportion were further investigated. The use of standardised questionnaires to uncover additional neurodivergences may have utility in improving the holistic nature of neurodevelopmental assessments.

Ambulatory Care Coordination Data Gathering and Use

imageCare coordination is a crucial component of healthcare systems. However, little is known about data needs and uses in ambulatory care coordination practice. Therefore, the purpose of this study was to identify information gathered and used to support care coordination in ambulatory settings. Survey respondents (33) provided their demographics and practice patterns, including use of electronic health records, as well as data gathered and used. Most of the respondents were nurses, and they described varying practice settings and patterns. Although most described at least partial use of electronic health records, two respondents described paper documentation systems. More than 25% of respondents gathered and used most of the 72 data elements, with collection and use often occurring in multiple locations and contexts. This early study demonstrates significant heterogeneity in ambulatory care coordination data usage. Additional research is necessary to identify common data elements to support knowledge development in the context of a learning health system.

Methods and measures to evaluate the impact of participatory model building on public policymakers: a scoping review protocol

Por: Henson · R. M. · Purtle · J. · Headen · I. · Stankov · I. · Langellier · B. A.
Introduction

Public policymakers are increasingly engaged in participatory model building processes, such as group model building. Understanding the impacts of policymaker participation in these processes on policymakers is important given that their decisions often have significant influence on the dynamics of complex systems that affect health. Little is known about the extent to which the impacts of participatory model building on public policymakers have been evaluated or the methods and measures used to evaluate these impacts.

Methods and analysis

A scoping review protocol was developed with the objectives of: (1) scoping studies that have evaluated the impacts of facilitated participatory model building processes on public policymakers who participated in these processes; and (2) describing methods and measures used to evaluate impacts and the main findings of these evaluations. The Joanna Briggs Institute’s Population, Concept, Context framework was used to formulate the article identification process. Seven electronic databases—MEDLINE (Ovid), ProQuest Health and Medical, Scopus, Web of Science, Embase (Ovid), CINAHL Complete and PsycInfo—will be searched. Identified articles will be screened according to inclusion and exclusion criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist for scoping reviews will be used and reported. A data extraction tool will collect information across three domains: study characteristics, methods and measures, and findings. The review will be conducted using Covidence, a systematic review data management platform.

Ethics and dissemination

The scoping review produced will generate an overview of how public policymaker engagement in participatory model building processes has been evaluated. Findings will be disseminated through peer-reviewed publications and to communities of practice that convene policymakers in participatory model building processes. This review will not require ethics approval because it is not human subject research.

Chronotherapy for patients with a depressive episode treated in a public outpatient mental healthcare clinic in Norway: protocol for a randomised controlled trial

Por: Ramfjord · L. S. · Kahn · N. · Langsrud · K. · Halvorsen · J. O. O. · Morken · G. · Saksvik · S. · Engvik · L. S. S. · Lydersen · S. · Kallestad · H.
Introduction

Depression is highly prevalent in outpatients receiving treatment for mental disorders. Treatment as usual (TAU) usually consists of either psychotherapy and/or antidepressant medication and often takes several weeks before clinical effect. Chronotherapy, consisting of sleep deprivation, sleep-wake phase advancement and stabilisation, and light therapy, is a possible addition to TAU that may decrease the time to treatment response. This randomised controlled trial will examine the benefits of adding chronotherapy to TAU compared with TAU alone.

Methods and analysis

The trial will include 76 participants with a depressive episode who initiate outpatient treatment at a secondary mental healthcare outpatient clinic at St. Olavs University Hospital. Participants will be randomly allocated 1:1 to either chronotherapy in addition to TAU or TAU alone. Assessments will be performed at baseline, day 3, day 4, day 7, day 14 and weeks 4, 8, 24 and 52, in addition to longer-term follow ups. The main outcome is difference in levels of depressive symptoms after week 1 using the Inventory of Depressive Symptomatology Self-Report. Secondary outcomes include levels of depressive symptoms at other time points, as well as anxiety, health-related quality of life and sleep assessed through subjective and objective measures.

Ethics and dissemination

The study protocol has been approved by the Regional Committee for Medical Research Ethics Central Norway (ref: 480812) and preregistered at ClinicalTrials.gov (ref: NCT05691647). Results will be published via peer-reviewed publications, presentations at research conferences and presentations for clinicians and other relevant groups. The main outcomes will be provided separately from exploratory analysis.

Trial registration number

NCT05691647.

The octopamine receptor OAα1 influences oogenesis and reproductive performance in <i>Rhodnius prolixus</i>

by Luca Finetti, Ian Orchard, Angela B. Lange

The control of reproductive processes in Rhodnius prolixus involves a variety of neuroactive chemicals. Among these, several studies have suggested that the biogenic amine octopamine (OA), might play an active role in these processes. Here, we investigate the molecular profile of the R. prolixus α adrenergic-like OA receptor 1 (RpOAα1-R) and its role in egg production. Comparative molecular analyses confirm that the RpOAα1-R gene codes for a true OAα1 receptor. The RpOAα1-R transcript is highly expressed in tissues associated with egg production, and after a blood meal, which is the stimulus for full egg production in R. prolixus, the RpOAα1-R transcript is upregulated in the ovaries and spermatheca. After RNAi-mediated RpOAα1-R knockdown, an ovarian phenotype characterized by slow egg development is observed. Furthermore, an altered egg phenotype has been characterized with eggs that are deformed. Interestingly, there is no evidence of disruption in vitellogenin (Vg) synthesis by the fat body or uptake by the oocytes. On the other hand, RpOAα1-R downregulation is correlated with defective choriogenesis in the eggs. These results provide critical information concerning the role of OAα1-R in oogenesis in R. prolixus.

How does subjective social status at school at the age of 15 affect the risk of depressive symptoms at the ages of 18, 21, and 28? A longitudinal study

by Marie Kjærgaard Lange, Vivi Just-Nørregaard, Trine Nøhr Winding

Background

Young people’s mental health is declining. Depression is a public disease which is increasing internationally, and in Denmark an increase is seen especially among young people. Objective social status is known to be associated with mental health and depression, but little is known about the association between adolescent subjective social status at school and depressive symptoms during young adulthood. The aim was to investigate the association between 15-year-old’s subjective social status at school and the development of depressive symptoms at age 18, 21 and 28.

Methods

The study is a longitudinal study using questionnaire data from The West Jutland Cohort Study Denmark. The study population consisted of adolescents who at baseline, at age 15 (2004), had answered questions about their subjective social status in school using the MacArthur scale-youth version. Answers were categorised into low, medium, and high subjective social status. Outcome data about depressive symptoms was collected at age 18 (2007), age 21 (2010) and age 28 (2017) using the CES-DC and CES-D scales, dichotomised into few or many depressive symptoms. The associations between subjective social status at school at age 15 and depressive symptoms at ages 18, 21 and 28 were analysed using multiple logistic regression.

Results

Statistically significant associations were found between low subjective social status at school at age 15 and the odds of many depressive symptoms at all three age points in young adulthood. When adjusting for co-variates the odds ratio for many depressive symptoms at age 18 was OR 3.34 [1.84;6.08], at age 21 OR 3.31 [1.75;6.26] and at age 28 OR 2.12 [1.13;3.97].

Conclusions

The subjective social status of 15-year-olds is associated with depressive symptoms at ages 18, 21 and 28, respectively. It seems that subjective social status at age 15 is of greatest importance for the occurrence of depressive symptoms in the short run, and that the impact attenuates over time.

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