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Medication administration errors are high-risk patient safety issues that could potentially cause harm to patients, thereby delaying recovery and increasing length of hospital stay with additional healthcare costs. Nurses are pivotal to the medication administration process and are considered to be in the position to recognize and prevent these errors. However, the effectiveness of interventions implemented by nurses to reduce medication administration errors in acute hospital settings is less reported.
To identify and quantify the effectiveness of interventions by nurses in reducing medication administration errors in adults' inpatient acute hospital.
A systematic review and meta-analysis was conducted up to 03/24. Six databases were searched. Study methodology quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal tools, and data extraction was conducted. Meta-analysis was performed to combine effect sizes from the studies, and synthesis without meta-analysis was adopted for studies that were not included in the meta-analysis to aggregate and re-examine results from studies.
Searches identified 878 articles with 26 studies meeting the inclusion criteria. Five types of interventions were identified: (1) educational program, (2) workflow smart technologies, (3) protocolised improvement strategy, (4) low resource ward-based interventions, and (5) electronic medication management. The overall results from 14 studies included in meta-analysis showed interventions implemented by nurses are effective in reducing medication administration errors (Z = 2.15 (p = 0.03); odds ratio = 95% CI 0.70 [0.51, 0.97], I 2 = 94%). Sub-group analysis showed workflow smart technologies to be the most effective intervention compared to usual care. Findings demonstrate that nurse-led interventions can significantly reduce medication administration errors compared to usual care. The effectiveness of individual interventions varied, suggesting a bundle approach may be more beneficial. This provides valuable insights for clinical practice, emphasizing the importance of tailored, evidence-based approaches to improving medication safety.
PRISMA guided the review and JBI critical appraisal tools were used for quality appraisal of included studies.
To examine the personal characteristics, promoting factors and organisational barriers to the professional realisation of diabetes nurse practitioners in Israel.
A descriptive study using quantitative and qualitative data.
The participants self-completed an electronic questionnaire, which included questions on demographic and professional characteristics and a self-realisation questionnaire constructed by the authors. Researcher-led focus groups were conducted, guided by a semi-structured guide. The discussions were recorded, transcribed and analysed by qualitative methods.
Forty-one diabetes nurse practitioners (median age 50 years, 98% females) participated in the study. On average, the participants reported a relatively high self-realisation of their professional role, especially those who have been working in this role for many years. While some of them work independently and are supported by their organisation, their managers and other healthcare team members, specifically physicians, many feel that there are barriers to the full implementation of the role and achieving professional realisation. These include multitasking challenges and insufficient remuneration. Self-realisation was viewed by the participants as an opportunity to provide excellent care to patients as well as being professional beyond caring for patients. They wanted to expand their knowledge as well as guide and teach. Furthermore, they also associated self-realisation with the autonomy to carry out procedures and make decisions independently of physicians. Internal motivation was perceived as an important factor for personal self-realisation, which stems from personal creativity, aspiration for excellence, a subjective sense of freedom, self-guidance, desire for self-development and aspiration for personal growth at the highest levels.
Recognition and fostering of diabetes nurse practitioners' role contribute to nurses' self-realisation and professional growth.
Personal and organisational factors should be aligned to support diabetes nurse practitioners in delivering high-quality care to patients with diabetes.
COREQ (COnsolidated criteria for REporting Qualitative research).
No patient or public contribution.
Interprofessional socialisation can contribute to collaborative patient care. Although there is research regarding interprofessional socialisation of healthcare students and frontline staff, there is limited literature regarding healthcare educators in practice settings. Our aim was to examine interprofessional socialisation of healthcare educators in the practice setting following an interprofessional simulation facilitator training programme.
Explanatory sequential mixed methods study.
Quantitative provincial simulation programme evaluation data from 2022 and 2023 (n = 87) were analysed and used to inform qualitative interviews (n = 17). Qualitative and quantitative data were integrated following independent analysis.
There was a statistically significant increase in attitudes toward interprofessional socialisation following the simulation facilitator training programme. Qualitative findings revealed themes regarding interprofessional socialisation: (a) benefits gained through interprofessional socialisation, (b) interprofessional, uniprofessional or both, (c) facilitators to interprofessional socialisation, (d) barriers to interprofessional socialisation and (e) opportunities to strengthen interprofessional socialisation.
Despite positive views of interprofessional socialisation, socialisation behaviours may not be consistent in a variety of contexts. Interprofessional education may increase interprofessional socialisation among educators.
It is important to provide interprofessional socialisation opportunities for educators to promote more interprofessional education initiatives.
The findings of this study provided insights into how to foster interprofessional socialisation in existing structures and how new pathways might be built to connect educators.
This study is reported in congruence with the Journal Article Reporting Standards—Mixed Methods, Quantitative, and Qualitative Standards provided on the Equator Network.
Members of the provincial simulation team were consulted regarding study design and data collection to optimise participation.
This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.
Scoping review.
JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.
The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.
A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.
This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.
By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.
The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.
No patient or public contribution.
Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1
This study was an investigation of the key factors influencing nurse retention and attrition focusing on the perspectives of current and former nurses within the context of the ongoing nursing shortage exacerbated by the COVID-19 pandemic.
This descriptive, cross-sectional study was designed to explore the complex dynamics of nurse retention and attrition in a rural and northern academic hospital in northwestern Ontario.
An online survey was administered to current and former nurses to compare the perspectives of those with no intention of leaving the organisation, those contemplating departure within the next year, and those who had reduced their work hours in the past 5 years.
Of the 288 respondents, 47% indicated no intention to leave and 17% reported having already left the organisation. The primary reasons for attrition included excessive workload demands, challenges maintaining a healthy work-life balance and dissatisfaction with management practices and organisational support. Respondents recommended improving leadership effectiveness, increasing staffing levels and implementing retention-focused initiatives to enhance job satisfaction and reduce turnover.
This study underscored the urgent need for strategic interventions tailored to retain nursing staff, particularly in rural and northern communities already facing significant recruitment and retention challenges. By addressing workload pressures, enhancing work-life balance, strengthening leadership and offering retention initiatives, health care organisations can improve job satisfaction and reduce attrition. System-level changes are essential to creating a sustainable and supportive environment for nursing professionals.
The findings highlight the critical need for immediate action to address the nursing crisis in rural and northern health care settings. They emphasise the importance of systemic interventions aimed at improving staffing levels, leadership practices and overall work conditions to safeguard the future of nursing in these underserved regions.
No patient or public contribution.
This research will contribute to the extant literature on the retention and attrition levels of nursing by offering a unique perspective from a rural and northern academ. The findings may help to guide hospital administrators to develop targeted strategies to enhance nurse retention rates within their organisations. By prioritising nurse satisfaction, these efforts will foster positive nurse–patient interactions and improve overall care outcomes.
This study is reported according to STROBE guidelines.
To explore healthcare professionals', patients', and family members' experiences of managing regular medications across the perioperative pathway in a specialist cancer hospital in Melbourne.
An exploratory qualitative study using a descriptive-interpretive approach.
Interviews were conducted with 11 patients and seven family members, and focus groups with 10 anaesthetists, seven surgeons, four nurses, and 10 pharmacists (N = 49) between October 2024 and April 2025. Transcripts were analysed using Braun and Clarke's reflexive thematic approach and mapped into the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 human factors framework.
Three interrelated themes were constructed: (1) Work system elements shaping perioperative medication management, encompassing medication and surgical contexts, documentation gaps, reliable medication information, communication infrastructures, roles and responsibilities, and perioperative area resources; (2) Processes influencing medication management practice, characterised by continuity of care at transition points and flagging processes, interdisciplinary collaboration and role interpretation in medication management, patient involvement, family member involvement, and healthcare professional perspectives; and (3) Outcomes of medication management, including patient and organisational outcomes, such as workflow inefficiencies, procedure cancellations, and unplanned readmissions.
Findings indicated that addressing the complexity of perioperative medication safety demands coordinated contributions across multiple professional disciplines. Strengthening interdisciplinary collaboration, clarifying shared responsibilities, embedding structured reconciliation processes at transitions of care, standardizing communication protocols, and involving patients and families are all critical strategies.
This study highlights the need for interdisciplinary coordination and clear role definitions, with nurses as the key contributor, to support collaborative medication decisions in perioperative cancer care.
This study explored challenges in managing regular medications during cancer surgery, offering insights to guide safer practices for perioperative teams, patients, and families in cancer care settings.
COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.
None.
To examine the decision-making processes underlying missed nursing care.
A qualitative study using Critical Incident Debriefing interviews.
Fifteen nurses from inpatient wards in a general hospital participated in semi-structured interviews following their morning shifts. Interviews focused on care prioritisation incidents leading to missed nursing care. Data were analysed using thematic analysis.
Analysis revealed a central theme of emotions as crucial determinants in care prioritisation decisions. Two subthemes emerged: emotions as drivers of care prioritisation decisions and emotions as responses to these decisions. Positive emotions motivated nurses to prioritise care for specific patients, while negative emotions sometimes led to care delays. Successful care completion generated professional satisfaction, while care omissions produced complex emotional responses, including guilt, frustration and helplessness.
The dual emotional processes identified in this study—emotions functioning as both drivers and responses in care decisions—challenge purely structural explanations of missed nursing care. This perspective reframes nurses as emotionally engaged decision-makers who actively navigate care priorities rather than passively react to contextual constraints, offering a more comprehensive framework for understanding the complexity of clinical judgement in real-world settings.
This study positions emotions as legitimate components of clinical decision-making rather than cognitive biases. For nursing practice, this necessitates integrating emotional awareness into professional development. For patient care, recognising emotional underpinnings may promote equitable care distribution through interventions that engage with the emotional realities of nursing work.
This study addressed limited understanding of decision-making in missed nursing care, particularly emotions' role. Findings reveal how emotions influence nurses' prioritisation decisions and wellbeing, with implications for nurses, educators and administrators seeking interventions addressing structural and emotional dimensions.
This study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines (Appendix S1).
No patient or public contribution.
The study aims to investigate patients' perceptions of recurrence risk associated with atrial fibrillation, with the goal of establishing a theoretical foundation for developing future measurement scale and intervention strategies.
A qualitative interview study.
Seventeen patients diagnosed with atrial fibrillation at a Grade-A tertiary hospital participated in semi-structured, in-depth interviews conducted between October and December 2024. Participants were selected via purposive sampling. The data were analysed employing thematic analysis in accordance with Colaizzi's method. The study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist.
The perceptions of recurrence risk among patients with atrial fibrillation can be summarised into five themes: (1) perceived likelihood of recurrence, (2) perceived severity of recurrence, (3) perceived triggers of recurrence, (4) emotional reaction to recurrence, and (5) efficacy perception of managing recurrence risk.
Perceptions of recurrence risk among patients with atrial fibrillation are diverse and often underestimated due to limited knowledge and subjective symptom interpretation, affecting health behaviours. Understanding patients' subjective appraisals, emotions, and perceived efficacy is essential. Validated assessment tools and tailored risk communication may enhance self-management and support targeted interventions.
This study provides critical insights into how atrial fibrillation patients perceive their risk of recurrence. It also provides a theoretical foundation for creating validated assessment tools and tailoring individualised health education and intervention programmes.
Patients were involved in the study design, data collection, and interpretation of findings. Their contributions included providing feedback on the initial interview guide to ensure relevance and clarity, participating in in-depth interviews to share their lived experiences with atrial fibrillation recurrence, and offering reflections on key themes emerging from the data.
by Megan Wiggins, Marie Varughese, Ellen Rafferty, Sasha van Katwyk, Christopher McCabe, Jeff Round, Erin Kirwin
BackgroundDuring public health crises such as the COVID-19 pandemic, decision-makers relied on infectious disease models to evaluate policy options. Often, there is a high degree of uncertainty in the evidence base underpinning these models. When there is increased uncertainty, the risk of selecting a policy option that does not align with the intended policy objective also increases; we term this decision risk. Even when models adequately capture uncertainty, the tools used to communicate their outcomes, underlying uncertainty, and associated decision risk have often been insufficient. Our aim is to support infectious disease modellers and decision-makers in interpreting and communicating decision risk when evaluating multiple policy options.
MethodsWe developed the Decision Uncertainty Toolkit by adapting methods from health economics and infectious disease modelling to improve the interpretation and communication of uncertainty. Specifically, we developed a quantitative measure of decision risk as well as a suite of risk visualizations. We refined the toolkit contents based on feedback from early dissemination through conferences and workshops.
ResultsThe Decision Uncertainty Toolkit: (i) adapts and extends existing health economics methods for characterization, estimation, and communication of uncertainty to infectious disease modelling, (ii) introduces a novel risk measure that quantitatively captures the downside risk of policy alternatives, (iii) provides visual outputs for dissemination and communication of uncertainty and decision risk, and (iv) includes instructions on how to use the toolkit, standard text descriptions and examples for each component. The use of the toolkit is demonstrated through a hypothetical example.
ConclusionThe Decision Uncertainty Toolkit improves existing methods for communicating infectious disease model results by providing additional information regarding uncertainty and decision risk associated with policy alternatives. This empowers decision-makers to consider and evaluate decision risk more effectively when making policy decisions. Improved understanding of decision risk can improve outcomes in future public health crises.
by Siobhán O’Connor, Sandra M. Malone, Joseph Firnhaber, Sinéad O’Keeffe, John McNamara, Anna Donnla O’Hagan
While mental health literacy is an important component to successful help-seeking, rural populations often face gaps in both knowledge and service provision. Informed by the Theory of Planned Behaviour and Self-Efficacy Theory, we designed the ‘Skills for Resilience’ as a brief, once-off, community-based educational intervention to increase Irish farmers’ mental health literacy and help-seeking intentions. We adopted a quasi-experimental between (group: intervention and control) and within-group design (time: baseline [T1], immediately post-intervention [T2], and ≥ 1 month post-intervention [T3]). A total of 72 participants (intervention n = 37; control n = 35) were recruited from knowledge-sharing discussion groups. Although recruitment was also open to women, all discussion groups consisted of men. A trained facilitator delivered a discussion lasting between 30 and 90 minutes. Five intervention participants also participated in a qualitative interview after T3. Our results identified intervention participants’ mental health literacy increased significantly at T2 and T3 compared to T1, but did not increase between T2 and T3. Mental health literacy was also significantly greater in the intervention group compared to the control group at T2 and T3. Help-seeking intentions and self-efficacy in seeking mental healthcare also increased significantly at T2 compared to T1, but did not increase between T1 and T3 or T2 and T3. There were no significant changes in outcome measures for the control group at any time point. Through reflexive thematic analysis we identified that the intervention also addressed stigma against mental health (Theme 1) and provided important resources for participants and their community’s present and future coping (Theme 2). At T3, 100% of participants enjoyed the discussion and would recommend the intervention to other farmers. This intervention provides a successful example of integrating the Theory of Planned Behaviour and Self-Efficacy Theory to improve mental health literacy in farmers using a brief, educational intervention.by Andrea C. Aplasca, Peter B. Johantgen, Christopher Madden, Kilmer Soares, Randall E. Junge, Vanessa L. Hale, Mark Flint
Amphibian skin is integral to promoting normal physiological processes in the body and promotes both innate and adaptive immunity against pathogens. The amphibian skin microbiota is comprised of a complex assemblage of microbes and is shaped by internal host characteristics and external influences. Skin disease is a significant source of morbidity and mortality in amphibians, and increasing research has shown that the amphibian skin microbiota is an important component in host health. The Eastern hellbender (Cryptobranchus alleganiensis alleganiensis) is a giant salamander declining in many parts of its range, and captive-rearing programs are important to hellbender recovery efforts. Survival rates of juvenile hellbenders in captive-rearing programs are highly variable, and mortality rates are overall poorly understood. Deceased juvenile hellbenders often present with low body condition and skin abnormalities. To investigate potential links between the skin microbiota and body condition, we collected skin swab samples from 116 juvenile hellbenders and water samples from two holding tanks in a captive-rearing program. We used 16s rRNA gene sequencing to characterize the skin and water microbiota and observed significant differences in the skin microbiota by weight class and tank. The skin microbiota of hellbenders that were housed in tanks in close proximity were generally more similar than those housed physically distant. A single taxa, Parcubacteria, was differentially abundant by weight class only and observed in higher abundance in low weight hellbenders. These results suggest a specific association between this taxa and Low weight hellbenders. Additional research is needed to investigate how husbandry factors and potential pathogenic organisms, such as Parcubacteria, impact the skin microbiota of hellbenders and ultimately morbidity and mortality in the species.by Claudia Castro, Jacquelyn Badillo, Melissa Tumen-Velasquez, Adam M. Guss, Thomas S. Collins, Frank Harmon, Devin Coleman-Derr
Recent wildfires near vineyards in the Pacific United States have caused devastating financial losses due to smoke taint in wine. When wine grapes (Vitis vinifera) are exposed to wildfire smoke, their berries absorb volatile phenols derived from the lignin of burning plant material. Volatile phenols are released during the winemaking process giving the finished wine an unpleasant, smokey, and ashy taste known as smoke taint. Bacteria are capable of undergoing a wide variety of metabolic processes and therefore present great potential for bioremediation applications in many industries. In this study, we identify two strains of the same species that colonize the grape phyllosphere and are able to degrade guaiacol, a main volatile phenol responsible for smoke taint in wine. We identify the suite of genes that enable guaiacol degradation in Gordonia alkanivorans via RNAseq of cells growing on guaiacol as a sole carbon source. Additionally, we knockout guaA, a cytochrome P450 gene involved in the conversion of guaiacol to catechol; ΔguaA cells cannot catabolize guaiacol in vitro, providing evidence that GuaA is necessary for this process. Furthermore, we analyze the microbiome of berries and leaves exposed to smoke in the vineyard to investigate the impact of smoke on the grape microbial community. We found smoke has a significant but small effect on the microbial community, leading to an enrichment of several genera belonging to the Bacilli class. Collectively, this research shows that studying microbes and their enzymes has the potential to identify novel tools for alleviating smoke taint.by Rahil Mahmoudi, Maral Nabaee, Akram Kooshki, Saba Shourideh Yazdi, Mahboubeh Neamatshahi, Elaheh Foroumandi
BackgroundWith the high prevalence of diabetes worldwide and the known benefits of functional foods in controlling diabetes, this study aimed to explore the connection between prebiotic food intake and biochemical indices in diabetic patients.
MethodsThis cross-sectional study was conducted on 504 participants with type 2 diabetes who were part of the Sabzevar Persian Cohort study that was initiated in February 2018. A 148-items food frequency questionnaire was utilized to assess the daily amount of prebiotic food consumption. Blood serum samples were collected from participants to measure fasting blood sugar levels, lipid profile, and kidney function indicators. Additionally, anthropometric measurements were taken following standard protocols. Statistical analyses were performed using SPSS version 20, with correlation tests adjusted for confounders, and significance set at p Results
This study involved 44.9% male and 55.1% female participants, with an average age of 54.81 ± 7.65 years. A significant correlation was observed between soybean consumption and serum low density lipoprotein (LDL) status (R = −0.110, P = 0.014). Moreover, a higher intake of banana was linked to lower blood urea nitrogen (BUN) levels (R = −0.109, P = 0.015). Furthermore, the consumption of honey exhibited a negative association with both systolic blood pressure (BP) (R = −0.106, P = 0.018) and diastolic BP (R = −0.132, P = 0.003). Green peas intake was also inversely associated with DBP (R = −0.092, P = 0.039).
ConclusionThis study found a positive correlation between the regular intake of prebiotic foods and improved management of BUN, LDL, and BP in individuals with type 2 diabetes. However, further mechanistic studies are necessary to better understand the potential causal effects of prebiotic foods on metabolic health in this population.
by Catarina Simões, Diana S. Vasconcelos, Raquel Xavier, Xavier Santos, Catarina Rato, D. James Harris
Fire has long been recognized as an important ecological and evolutionary force in plant communities, but its influence on vertebrate community ecology, particularly regarding predator-prey interactions, remains understudied. This study reveals the impact of wildfires on the diet of Podarcis lusitanicus, a lizard species inhabiting a fire-prone region in the Iberian Peninsula. In order to explore diet variability associated with different local burn histories, we evaluated P. lusitanicus diet across three types of sites in Northern Portugal: those had not burned since 2016, those burned in 2016, and those more recently burned in 2022. Podarcis lusitanicus is a generalist arthropod predator with dietary flexibility. Given the turnover of arthropod species after fire, it is expected to find variations in diet caused by different fire histories, especially between unburned and recently burned sites. From DNA metabarcoding of faecal samples, our study revealed that while prey richness remained unaffected by wildfire regime, significant shifts occurred in diet composition between more recently burned and unburned areas. Specifically, we found that differences in diet composition between these two fire regimes were due to the presence of Tapinoma ants and jumping spiders (Salticus scenicus). These prey were present in the diets of lizards occupying unburned areas, while these were absent in areas burned in 2022. Interestingly, diets in unburned areas and areas burned in 2016 showed no significant differences, highlighting the lizards’ ecological flexibility and the habitat’s resilience over time. The ant species T. topitotum was found in dominance in both burned areas, suggesting that this species may be fire tolerant. In addition, families such as Cicadellidae and Noctuidae were found to be more associated with more recently burned areas. The use of DNA metabarcoding in this study was essential to provide a more detailed and accurate view of predator-prey interactions in ecosystems susceptible to fire, and therefore a better understanding of changes in prey consumption in this fire-adapted ecosystem.There are substantial barriers to initiate advance care planning (ACP) for persons with chronic-progressive disease in primary care settings. Some challenges may be disease-specific, such as communicating in case of cognitive impairment. This study assessed and compared the initiation of ACP in primary care with persons with dementia, Parkinson’s disease, cancer, organ failure and stroke.
Longitudinal study linking data from a database of Dutch general practices’ electronic health records with national administrative databases managed by Statistics Netherlands.
Data from general practice records of 199 034 community-dwelling persons with chronic-progressive disease diagnosed between 2008 and 2016.
Incidence rate ratio (IRR) of recorded ACP planning conversations per 1000 person-years in persons with a diagnosis of dementia, Parkinson’s disease, organ failure, cancer or stroke, compared with persons without the particular diagnosis. Poisson regression and competing risk analysis were performed, adjusted for age, gender, migration background, living situation, frailty index and income, also for disease subsamples.
In adjusted analyses, the rate of first ACP conversation for persons with organ failure was the lowest (IRR 0.70 (95% CI 0.68 to 0.73)). Persons with cancer had the highest rate (IRR 1.75 (95% CI 1.68 to 1.83)). Within the subsample of persons with organ failure, the subsample of persons with dementia and the subsample of stroke, a comorbid diagnosis of cancer increased the probability of ACP. Further, for those with organ failure or cancer, comorbid dementia decreased the probability of ACP.
Considering the complexity of initiating ACP for persons with organ failure or dementia, general practitioners should prioritise offering it to them and their family caregivers. Policy initiatives should stimulate the implementation of ACP for people with chronic-progressive disease.
People in rural areas of Australia experience poorer health in almost every indicator compared with urban populations; however, rural communities have lower access to primary health, allied health and specialist healthcare. Timely access to care is compounded by persistent and widespread health workforce issues, including attracting and retaining staff.
Australian University Departments of Rural Health (UDRH) have been established to address the needs of rural populations with the goal of improving recruitment and retention of health professionals across rural and remote Australia. The work-integrated learning team within The University of Melbourne works with nursing and allied health university students on clinical placement to provide exposure to working in rural health, with a remit to build the capacity of the existing and future workforce. The service-learning model aims to provide reciprocal benefits to stakeholders through purposefully co-designed placements that respond to rural health needs by providing services to underserved communities and ensuring university students are exposed to real world, diverse practice settings.
The overarching aim of this project is to determine the impact of the SL programme for key stakeholders, predominately end users and those stakeholders involved in the delivery of the SL model. The key stakeholders are host site staff, allied health university students, allied health supervisors and the end users of the programme. End users are those individuals that have received allied health services through the programme, such as clients, residents and children.
This study will adopt a convergent mixed methods methodology underpinned by a RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance)/PRISM (Practical, Robust Implementation Sustainability Model) approach. Data collection will include document review, existing programme data review and primary data collection. This will involve conducting surveys and interviews with allied health university students, host organisations and allied health supervisors, and interviews with adult recipients of the service-learning programme. Art-based consultation will be conducted with school-aged children recipients of the service-learning programme. Analysis will be underpinned by the RE-AIM/PRISM framework to inform programme learnings and impact for key stakeholders.
This study has been approved by the University of Melbourne Human Research Ethics Committee (Project ID: 30409).
Findings will be published in a stakeholder project report and peer-review journals in the fields of rural health, implementation science and work integrated learning.
The effect of prophylactic clipping for colorectal cold snare polypectomy (CSP) on delayed bleeding (DB) in patients with antithrombotic drugs remains unverified. The aim of the PERCOLD study is to demonstrate the non-inferiority of DB rates in cases without prophylactic clips compared with cases with prophylactic clips in patients taking antithrombotic drugs for colorectal CSP through randomised controlled trial (RCT).
This study is a multicentre prospective parallel-group RCT phase 3 trial that is being conducted at 14 institutions in Japan at the time of writing this manuscript. After providing consent, patients will undergo screening and assessment for study enrolment eligibility. Patients taking antithrombotic drugs (aged 20 years or older at the time of consent and who have agreed to participate in this study) will be selected if they have a preoperative suspected adenoma (including sessile serrated lesion) with an endoscopic diameter of
The trial protocol has been approved by the Chiba University Certified Clinical Research Reviewer Board (CRB3180015), which serves as the central ethics committee, and registered with Japan Registry of Clinical Trials. The current protocol V.1.7, dated 4 October 2024. Written informed consent for participation in the study will be obtained from all participating patients. All participating institutions have formally agreed to conduct the study in accordance with this central approval, and local site permissions were obtained as required by each institution. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conferences.
Japan Registry of Clinical Trials (jRCT1032230086).
Neonatal haemochromatosis, considered to be a gestational alloimmune liver disease (NH-GALD), is a rare but serious disease that results in fulminant hepatic failure. The recurrence rate of NH-GALD in a subsequent infant of a mother with an affected infant is 70%–90%. Recently, antenatal maternal high-dose intravenous immunoglobulin (IVIG) therapy has been reported as being effective for preventing recurrence of NH-GALD in a subsequent infant. However, no clinical trial has been conducted to date.
This is a multicentre open-label, single-arm study of antenatal maternal high-dose IVIG therapy in pregnant women with a history of documented NH in a previous offspring. The objective of this study is to evaluate the efficacy and safety of antenatal maternal high-dose IVIG therapy in preventing or reducing the severity of alloimmune injury to the fetal liver.
The clinical trial is being performed in accordance with the Declaration of Helsinki. The trial protocol was approved by the Clinical Research Review Board at four hospitals. Before enrolment, written informed consent would be obtained from eligible pregnant women. The results are expected to be published in a scientific journal.
28 October 2024, V.8.0.
jRCT1091220353.
Care pathways are crucial for patients with mental health disorders and should be designed to support integrated rehabilitation while reducing the burden of these disorders. The contemporary shift toward an outpatient follow-up model of care presents an opportunity to improve mental health care beyond the stagnation in advancements in pharmacological treatments. Various pharmacist-led interventions exist and can serve as levers to address ongoing challenges in mental health care pathways: they could help manage difficult transitions, ensure continuity between inpatient and outpatient care, and reduce high rehospitalisation rates. However, the contexts in which these solutions benefit patients and improve care outcomes remain unclear. Thus, the primary objective of this study will be to identify how pharmaceutical solutions contribute to improving mental health care pathways, what works, for whom and in what context. The secondary objective will be to identify the key outcomes currently used to evaluate the impact of pharmaceutical solutions on care pathways.
A systematic realist review will be conducted, following 5 iterative steps to synthesise heterogeneous evidence: (1) Scope definition with a general review of the literature and experts’ discussions, (2) Initial programme theory development based on the preliminary searches, (3) Systematic review for evidence, to refine and test initial programme theory across PubMed, Embase and Web Of Science, (4) Data extraction, including context-mechanism-outcome configurations, and evidence appraisal and (5) Data analysis, synthesis and refined programme theory construction with the realist logic. This process will involve consensus among expert researchers, incorporating insights from individuals with lived experience.
The final programme theory modelling will result in a new framework for pharmaceutical solutions applied in diverse mental health contexts. The findings of this systematic realist review could serve as a guide for implementing pharmaceutical solutions across healthcare settings, ensuring that interventions are evidence-based, contextually relevant and grounded in real-world needs.
As this realist review will collect previously published data and will not involve human or animal participants, no ethical approval is required. Since this manuscript is a review protocol, no datasets were generated or analysed. All data extraction forms will be made available as part of the publication of the realist review.
Systematic review registration PROSPERO 2025 CRD420251011954.
Dates of the study: September 2025 to September 2026.
FreshRSS 