Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care.

We will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews.

Results will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.

Inflammatory bowel diseases (IBDs) and multiple sclerosis (MS) are inflammatory diseases resulting from an interplay of genetic and environmental factors. This study aims to describe the prevalence of patients diagnosed with both conditions among those receiving hospital care in England, as well as the characteristics and healthcare resource use (HCRU) of such patients.

This study is a retrospective observational cohort study.

The study was conducted through secondary use of the English Hospital Episode Statistics (HES) Database. HES records care delivered by hospitals in England and associated diagnoses.

Patients who had a diagnosis code for either IBD or MS recorded in HES between January 2014 and May 2020 were included. Patients were classified as having each diagnosis individually or as having both diagnoses, in which case they were further categorised based on temporal occurrence.

The primary outcome was the prevalence of patients with a recorded diagnosis of either IBD, MS or both during the study period. Secondary outcome measures included patient demographic and clinical characteristics, as well as HCRU in the 6 months before and after the diagnosis of interest.

From an overall cohort of 352 698 patients, 1016 (0.3%) had both diagnoses. Among those with both, 29.8% (303) had a record of IBD first, 40.5% (411) had MS diagnosed first and 29.7% (302) had the first record of both diagnoses in the same episode. From the overall cohort, 80.9% (285 439) of patients had a single diagnosis of IBD, and 18.8% (66 243) of patients had a single diagnosis of MS.

The population with a dual diagnosis of IBD and MS is larger than previously reported and shows evidence of frequent interactions with secondary care.

Development of clinical skills in areas, such as exercise risk stratification, testing, prescription, monitoring and outcome assessment, is vital for patient safety and clinical effectiveness in clinical exercise physiology (CEP). This study explored how current CEP courses are being taught and assessed and to identify potential best practice recommendations from a variety of stakeholders

Qualitative methods were employed to explore the thoughts of CEPs, academics and current students regarding the teaching and assessment of CEPs in the UK. Research design involved (1) semistructured interviews with students (n=16) and (2) focus groups with academics (n=8) and CEP (n=5) stakeholders. Data obtained were audio recorded using a portable Dictaphone and transcribed verbatim, then thematically analysed manually.

Three themes: (1) in situ learning/real-world practice (working with patients and specialist practitioners); (2) programme design (scaffold learning and integrated modules) and (3) teaching approach (simulated learning and research competency) were generated concerning teaching methods and approaches across CEP postgraduate degrees. The current use of simulated tasks for the delivery of taught content was identified as lacking effectiveness, with clinical placements identified as being the most important source of knowledge and skill attainment due to the real-world exposure to patients and practitioners. Clinical placements and simulated learning were recognised as the two main methods of problem-based learning used to develop student knowledge, skills and competency to practice. Two themes (placement tariffs/assessors in situ and role play/simulation) were identified for the assessment of students.

Clinical placements remain the optimal method for developing the knowledge, skills and competency to practice for student CEPs. However, suitable placements remain limited, and novel approaches such as university-led exercise services require consideration for student competency development. A standardised and accredited training pathway from undergraduate through to postgraduate level should be explored to allow student competency to be developed over a longer period, to enhance knowledge, skills and competency on graduation and registration.

To assess the severity of anaemia and associated factors among drug-resistant tuberculosis (DR-TB) patients treated in DR-TB treatment-initiating centers in Addis Ababa, Ethiopia.

A retrospective cross-sectional study.

This study was conducted in Alert and St. Peters specialised hospitals, Addis Ababa, from 20 September to 15 October 2022.

Data was collected from 331 patients with DR-TB. The data was entered into Epi-Data 4.1, and SPSS version 25 was used for data cleaning and analysis. A multinomial logistic regression model was fitted after the multi-collinearity assumptions, and goodness-of-fit tests were done. The OR with 95% CI was reported for each outcome variable, taking normal haemoglobin level as a reference category. Variables with a P value of 0.05 were considered statistically significant.

Of the 331 patients, 51.4% had baseline anaemia, of which 5.7%, 15.7% and 29.9% had severe, moderate and mild anaemia, respectively.

Patients who were urban residents (AOR: 0.06, 95% CI: 0.012, 0.32), government employees (AOR: 0.33, 95% CI: 0.001, 0.79), private job holders (AOR: 0.02, 95% CI: 0.001, 0.27), undernourished (AOR: 15.72, 95% CI: 2.46, 100.28), patients with HIV (AOR: 7.28, 95% CI: 1.627, 32.628) and farmers and students (AOR: 0.05, 95% CI: 0.004, 0.58) were significantly associated with severe anaemia.

Patients who were male (AOR: 0.31, 95% CI: 0.11, 0.93), single (AOR: 0.19, 95% CI: 0.04, 0.85), daily labourer (AOR: 6.19, 95% CI: 1.27, 30.2), undernourished (AOR: 12.83, 95% CI: 4.88, 33.7) and patients with HIV (AOR: 12.74, 95% CI: 4.67, 34.75) were significantly associated with moderate anaemia. Patients with undernutrition (AOR: 3.92, 95% CI: 2.1, 7.35), HIV (AOR: 2.79, 95% CI: 1.22, 6.39) and primary and secondary education (AOR: 0.36, 95% CI: 0.17, 0.77) were significantly associated with mild anaemia.

In our study, more than 50% of patients with DR-TB had baseline anaemia, of which mild anaemia was the most common typeanaemia. Rural residents were at a higher risk of developing severe anaemia (11.5%), while the overall rate of anaemia (58.8%) was higher among urban residents.

This study aims to synthesise evidence on the pooled level of exit knowledge among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia and to identify the associated factors associated with medication knowledge by conducting a systematic review and meta-analysis of primary articles focused on this area.

This systematic review and meta-analysis study employed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Three electronic databases—MEDLINE, Scopus and Google Scholar—were searched for all English-language articles published from 2010 until 18 December 2024.

The review exclusively included studies that reported original data, were freely accessible in full text and were written in English, as well as those investigating the level of knowledge among outpatients and associated factors, irrespective of study design. Studies lacking abstracts and full texts, reports, qualitative research, and conference summaries were excluded from the analysis.

Data from selected studies were extracted by three independent reviewers using a standardised data extraction format created using Microsoft Excel. Their results were cross-checked by two additional reviewers for consistency.

Of the 521 identified studies, 9 met the inclusion criteria. The overall pooled knowledge level was 45%. Factors associated with knowledge included residence (OR=0.67, 95% CI: 0.27 to 0.71), adequacy of information provided (OR=0.87, 95% CI: 0.24 to 0.90), education level (OR=0.70 CI: 0.39 to 0.89), clarity of instructions (OR=0.80 CI: 0.14 to 0.99) and pharmacist politeness (OR=0.72 CI: 0.46 to 0.77).

The systematic review and meta-analysis showed that pooled patient knowledge regarding their dispensed medications in Ethiopia is about 45%. Key determinant factors of knowledge included education level, quality of pharmacist communication, urban versus rural residence and pharmacist politeness. Recommendations for improvement include enhancing pharmacist training, developing educational materials in local languages, outreach programmes for rural areas and implementing patient-centred care policies.

PROSPERO number: CRD42024560816