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Undisclosed financial conflicts of interest among physician-authors in leading US psychiatry journals: a cross-sectional study

Por: Gesel · F. · Baraldi · J. · Goldhirsh · J. · Piper · B. J.
Objective

To assess the prevalence and magnitude of undisclosed financial conflicts of interest (COIs) among physician-authors in high-impact US-based psychiatry journals.

Design

Cross-sectional study comparing the author self-reported disclosures to the journal(s) with payments mandatorily reported in the Open Payments database.

Methods

We examined original research articles published between 1 January 2020 and 31 December 2022 in two prominent US-based psychiatry journals: the American Journal of Psychiatry (AJP) and Journal of the American Medical Association Psychiatry (JAMA-PSY). Of 2872 publications screened, 74 articles authored by 27 eligible US-based physician-authors met the inclusion criteria.

Outcome measures

Total payments received by authors within the 3 years prior to publication and the proportion of undisclosed payments. Additional analyses assessed payment types (research vs general), author demographics and study characteristics associated with undisclosed COIs.

Results

US$4.54 million was paid to authors in the two journals, of which US$645 135 (14.2%) were undisclosed. AJP authors received US$205 943 (7.5% of total payments) in undisclosed payments, while JAMA-PSY authors received US$439 192 (24.8%). Research payments constituted 82.3% of all undisclosed payments. Total undisclosed payments among the top 10 highest-earning authors accounted for 84.8% (AJP) and 99.6% (JAMA-PSY) of all undisclosed payments to journals. Nearly all undisclosed payments, 96.2%, were made to authors conducting randomised controlled trials.

Conclusions

Substantial undisclosed financial COIs were identified among the top 10 earners in high-impact psychiatry journals. These findings highlight potential risks to research transparency and integrity. Further research is needed to evaluate the effectiveness of disclosure policies and develop mechanisms to mitigate COIs in psychiatric research.

Community participatory approaches in infectious disease dynamic transmission modelling: a scoping review protocol

Por: Tahmo · N. B. · Idemili · C. · Noah · A. · Odhiambo · B. · Kyalo · C. · Ligare · F. · Wanjiku · J. · Kong · J. D. · Chan · A. K. · Baral · S. · Walimbwa · J. · Lazarus · L. · Puchalski Ritchie · L. M. · Mishra · S.
Introduction

Community participatory modelling merges participatory research approaches with mathematical modelling. Participatory approaches are grounded in the engagement of people with lived experience (eg, who are affected by the health condition under study) throughout the research process. Mathematical modelling of infectious disease (ID) dynamic transmissions is increasingly used as a tool for public health decision-making, generating predictions, inferring mechanisms and estimating the impact of potential interventions—all of which guide policies, strategies and resource allocation as part of the preparation and response to ID epidemics. However, little is known about the engagement of people with lived experience and affected communities in the ID modelling process. We will map the literature to explore participatory approaches undertaken in ID modelling (practical aspects of formalising participatory modelling), levels of participation and the potential influence from the perspective of communities engaged.

Methods and analysis

The scoping review will follow the Joanna Briggs Institute Manual for Evidence Synthesis. The search strategy includes three electronic bibliographic databases (MEDLINE, Scopus and Embase), no language restrictions and sources published from 2000 to present. We will implement the search with and without the participatory keyword, as we recognise that some studies do not explicitly term community engagement as participatory modelling. After deduplication, two authors will independently screen the titles, abstracts and full texts, with discrepancies resolved with a third team member. We will extract the relevant information from the main text, parameter tables, supplemental files, bibliography, acknowledgment and author affiliation sections. The data extraction will follow a deductive content analysis where we draw from community-based participatory research approaches and established mathematical modelling steps. We will also extract data to assess whether there was equitable engagement of knowledge users by checking for indicators of three equitable engagement domains as outlined by the Ward framework (equity within partnership (eg, whether knowledge user influenced modelling decisions or remuneration), capacity to engage in future partnerships and shift in power/influence (eg, coauthorship). We will supplement our narrative analyses with summaries in tabular format and using appropriate data visualisations.

Ethics and dissemination

No ethics approval will be required for this scoping review because we will map evidence from publicly available literature sources. We will develop multilingual abstracts or one-page lay summaries of the findings (English, French and Swahili), a policy brief and will coauthor an open-access journal article. A summary of the findings will be shared via knowledge user-led presentations at the Maisha HIV and AIDS Conference and with other community-based organisations at the quarterly peer-to-peer support meetings.

Registration

The protocol has been registered in Open Science Framework, DOI: https://doi.org/10.17605/OSF.IO/XQ2WP (December 2024).

Factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 in primary healthcare settings in Nepal: a cross-sectional study

Por: Timalsena · D. · Nakarmi · C. S. · Mali · S. · Dhakal · A. · Bharati · A. · Bishwokarma · A. · Adhikari · A. · Poudel · B. · Rai · B. K. · Baral · P. P. · Bhattarai · S. · Dixit · L. · Pokharel · Y. · Rhodes · E. · Xu · D. R. · Spiegelman · D. · Shrestha · A.
Objective

To assess factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 at primary healthcare (PHC) facilities in Nepal after healthcare workers received training.

Design

Cross-sectional study.

Setting

PHC facilities across various provinces in Nepal.

Participants

A total of 180 healthcare workers trained in PEN, recruited from a random selection of 105 basic healthcare facilities.

Main outcome measures

The adoption of PEN Protocol 1 components: blood pressure measurement, blood glucose screening, 10-year cardiovascular disease (CVD) risk assessment using WHO/International Society of Hypertension risk charts and body mass index (BMI) assessment. Factors associated with protocol adoption were assessed using generalised estimating equations for ORs.

Results

Among participants, 100% reported measuring blood pressure, while 56% measured blood sugar, 28% assessed CVD risk and 27% assessed BMI. The adoption of the CVD risk prediction chart was positively associated with the availability of amlodipine (adjusted OR (aOR) 3.00; 95% CI 1.09 to 8.27). The adoption of BMI assessment was positively associated with access to a stadiometer (aOR 3.23; 95% CI 1.26 to 8.30) and a glucometer (aOR 3.07; 95% CI 1.12 to 8.40), and negatively associated with lack of motivation/inertia of previous practice (aOR 0.60; 95% CI 0.42 to 0.87) and environmental factors such as lack of time and resources (aOR 0.57; 95% CI 0.37 to 0.89). Blood glucose level measurements were positively associated with being at a PHC centre (aOR 7.34; 95% CI 2.79 to 19.3) and the availability of metformin (OR 2.40; 95% CI 1.08 to 5.29).

Conclusion

Adoption of PEN Protocol 1 varied by component and was influenced by resource availability, provider motivation and system barriers. Addressing these factors is key to optimising implementation in low-resource settings.

Family Communication to Enhance Adolescent Depression Recovery—Intervention Development Protocol

ABSTRACT

Aim

To develop a structured intervention aimed at enhancing family communication to reduce relapse in adolescents with depression.

Design

This study follows a multi-stage process guided by the Intervention Mapping procedure with the Medical Research Council framework, assessing the layers of complexity. Its design comprises four interrelated stages to construct a family communication intervention, culminating in a pilot randomised controlled trial.

Methods

The program has four stages: (1) Identifying family interaction gaps through literature review and expert input; (2) Investigating communication needs of depressed adolescents and their families via a mixed methods study to develop a model intervention; (3) Refining the intervention with focus groups and expert e-Delphi; and (4) Finalising the intervention based on pilot randomised controlled trial outcomes. The research will be conducted in Greater Accra, Ghana.

Results

The process will result in a family communication intervention tailored to the needs of adolescents with depression and their families. It will be pilot tested, and the results will inform a nationwide efficacy trial.

Conclusion

This research integrates qualitative and quantitative data to inform the development of an evidence-based family communication intervention. The program will carefully examine data integration and contextual challenges encountered during its implementation.

Implications for the Profession and/or Patient Care

The intervention has the potential to enhance family communication, thus playing a crucial role in adolescent depression recovery by reducing relapse rates. Healthcare professionals will benefit from a structured, evidence-based communication tool that can be used in clinical settings.

Impact

The study focuses on improving communication between families of adolescents with depression, aiming to develop a family communication package for clinical and community use. This intervention may enhance recovery outcomes and reduce relapse risk for adolescents.

Reporting Method

This study adhered to the GUIDED guideline for reporting intervention development studies.

Patient or Public Contribution

No Patient or Public Contribution.

Consensus on addressing HIV-related stigma and achieving the societal enabler targets using an adapted Delphi process

Por: Molesworth · K. · Nkosi · S. · Camacho · S. · Caswell · G. · Salem · S. · Baral · S. · Kamarulzaman · A. · Sprague · L. · Stackpool-Moore · L.
Objectives

To seek consensus among global experts on concepts, measures and approaches to guide national and global action to address HIV-related stigma and formulate a call to action. This outlines priorities to unite actors in more effectively responding to and resourcing efforts to address HIV-related stigma.

Design

An adapted Delphi consensus-building process using two rounds of online questionnaires.

Setting

Online questionnaires sent to a global expert panel.

Participants

50 global experts on HIV-related stigma and discrimination representing sectors including civil society, people living with HIV and key populations, research and academia, clinical practice, law, non-profit organisations, the United Nations, and policy and donor organisations.

Results

The panel reached consensus on 55 points relating to the 12 broad themes extracted from the evidence base. These comprised the importance of addressing HIV-related stigma at scale; HIV-related stigma terms and definitions; Frameworks; Programming and approaches; Community leadership in HIV-related stigma-reduction implementation; Intersectional stigma and discrimination; Stigma and discrimination measures and assessment scales; Monitoring and evaluation; Stakeholder and community participation in monitoring and evaluation; Knowledge gaps and research needs; Funding and Commitment calls. From these, a consensus statement and call to action were formulated on priorities for strong political and financial commitments by all countries to reduce and mitigate HIV-related stigma and achieve global HIV targets adopted in 2021.

Conclusions

This study illustrated that global experts across sectors consider that action is needed to support the three critical enablers of the HIV response—society, systems and services—to ensure that HIV services are non-discriminatory and person-centred. The importance of attention and action to reduce stigma is critical in the current geopolitical and funding crisis affecting HIV and global health.

Evaluating Leadership and Teamwork Competency Acquisition Through Clinical Simulation: Development of the Clinical Simulation Learning Leadership and Teamwork Scale

ABSTRACT

Advanced simulation is a methodology that allows the development of technical skills and transversal skills such as teamwork and leadership. There are tools to measure the development of technical competencies and student satisfaction with the methodology, but not to measure the development and use of transversal competencies in the clinical practice setting.

Aim of the Study

To develop and validate a scale to measure the impact of clinical simulation on the development and application of teamwork and leadership competencies.

Design

A multicentre study was carried out in two Spanish universities in which the Clinical Simulation Learning Teamwork and Leadership Scale was developed and validated.

Methods

The study was carried out in several phases: development of the questionnaire using a Delphi method, pilot test and validation of the construct with a sample of 207 nursing students. Reporting of this research adheres to STROBE guidelines.

Results

Content validity was checked according to Aiken's V for the three attributes of the questionnaire. Reliability or internal consistency was assessed with Cronbach's α and the sensitivity analysis showed no significant variation when any item was eliminated. On the other hand, McDonald's Omega statistic was used. Intraobserver reliability was taken from a sample of 47 students, in which it was observed that the intraclass correlation was positive.

Conclusions

The Clinical Simulation Learning teamwork and leadership scale is a valid instrument for measuring the development of transversal competencies.

Implications for the Profession and/or Patient Care

This scale will provide information to evaluate the weight of the clinical simulation in the students' knowledge.

Impact

It is a tool for evaluating transversal skills that is proven valid and will improve the training of students.

Reporting Method

The instructions of the STROBE checklist have been followed.

Patient or Public Contribution

The students have participated in the knowledge transfer self-assessment.

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