Search Results for: Cardio-oncology: rivista open access

Childhood obesity has become a global public health challenge and as such has attracted worldwide attention due to its negative impact on children’s health. Despite its diverse determinants, there is a paucity of information on cultural beliefs and parental feeding practices related to childhood obesity in Ghana. This study aimed to explore the influence of cultural beliefs and parental feeding practices on obesity among schoolchildren in Ghana.
Background
Childhood obesity is a global public health concern, drawing widespread attention for its negative impact on children’s health. While the determinants are multifaceted, limited information exists on the impact of cultural beliefs and parental feeding practices in the context of childhood obesity in Ghana. The primary objective of this exploratory study was to investigate the influence of cultural beliefs and parental feeding practices on obesity among schoolchildren in Ghana.

Method
Data for the study were collected through an online interview and focus group discussion from a purposively sampled 60 respondents. An audio recording device was used to compile information shared with respondents during the interview and focus group discussion, both held remotely over the internet. Following Braun and Clarke’s procedure for analysing data, audio-recorded information was transcribed verbatim using Microsoft Word. Vital information to address research questions was assigned codes for collation. Similar codes were collated to form subthemes and major themes which aligned with the Attride-Stirling transcription approach of thematic analysis.

Findings
Four themes emerged from data analysis: parental beliefs and perception of weight and feeding practices; evolving dietary practices; the impact of westernisation and socioeconomic status; and lifestyle at home and obesogenic environments. The cultural inclination towards considering obesity as a sign of a ‘well-fed child’ was evident, and traditional feeding practices were found inadequate, necessitating supplementation with modern approaches. Additionally, factors such as digital media, limited playing space and sedentary behaviours facilitated by transportation to school and easy access to electronic devices contributed to obesity among schoolchildren.

Conclusion
While parents actively promoted mixed food diets, this often conflicted with nutritional needs. Parents also inadvertently encouraged sedentary behaviours hindering physical activity and contributing to weight gain among children. The study highlighted the challenges posed by cultural beliefs on body image and modern influences, necessitating a comprehensive understanding to formulate effective interventions to address childhood obesity in the Ghanaian context.

Background
The COVID-19 pandemic had detrimental effects on routine health and social care as countries instituted widespread public health measures to control transmission of SARS-CoV-2. This affected care delivery for many chronic and non-communicable diseases, including oral health and dental diseases with implications in the postpandemic period.

Objectives
This scoping review, conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Review guidelines, aims to synthesise evidence regarding the impact of COVID-19 on access to dental services among children and their implications for future models of care, especially for children from low-income families, to inform policy decision making around subsidised dental services in Australia.

Data sources
PubMed, Web of Science, Embase, Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials.

Eligibility criteria
Primary studies of any design published between 1 January 2020 and 31 July 2024. Included studies described provision of paediatric dental services, considered components of access or utilisation and were published in English. Excluded studies were those that only evaluated maxillofacial services.

Data extraction and synthesis
Data were extracted using a standardised template in MS Excel then analysed to thematically classify findings based on key areas of impact. Quality assessment of studies was not conducted.

Results
54 articles from 17 countries were included. Studies identified reductions in service availability and utilisation, including patient and parent-driven demand. Changes to the configuration of services included greater rates of emergency treatment, reductions in use of aerosol-generating procedures and more use of teledentistry, as well as self-management and prevention approaches. Substantial delays to routine dental care, leading to more dental problems and ongoing need, especially untreated dental caries, were observed with a disproportionate impact on socioeconomically disadvantaged and vulnerable children and families.

Conclusion
The COVID-19 pandemic has had pronounced negative effects on the provision of primary and secondary dental care for children around the world. Access to care was affected by disruptions to service availability and by changes in demand for services related to parental anxiety around the risk of COVID-19 transmission. Delays in receipt of routine dental care and changes to oral health behaviours are likely to lead to an increased need for oral health services, with service adaptations needed to ensure this increased demand can be met.

Introduction
The night-time economy comprises various sectors, including hospitality, transportation and entertainment, which generate substantial revenues and contribute to employment opportunities. Furthermore, the night-time economy provides spaces for leisure activities, cultural expression and social interaction. On-trade alcohol premises (places where consumers can buy and consume alcohol such as bars, pubs, clubs and restaurants) are a significant component of this night-time economy, functioning as focal points for socialising, entertainment and cultural events. However, when on-trade alcohol premises stay open later at night, this can be associated with negative public health impacts including increased alcohol consumption, intoxication, assaults, injuries and burden on public services including ambulance call outs, hospitalisations and increased impacts on criminal justice services. The evidence on the societal impact of policies to ‘later’ trading hours for bars and clubs in the night-time economy is limited. This protocol details the design of an economic evaluation of policy to later trading hours for bars and clubs in the night-time economy alongside the ELEPHANT study (National Institute for Health and Care Research (NIHR) Public Health Research, ref:129885).

Methods and analysis
The research design is an economic evaluation alongside a natural experiment within the ELEPHANT study carried out in Glasgow and Aberdeen. The economic evaluation has been designed to identify, measure and value prospective resource impacts and outcomes to assess the costs and consequences of local policy changes regarding late night trading hours for bars and clubs. A number of economic evaluation frameworks will be employed. A cost-effectiveness analysis (CEA) is appropriate for assessing the effectiveness of complex interventions when the impacts of policy are measured in natural units. Therefore, a CEA will be conducted for the primary consequence, alcohol-related ambulance call-outs, using a health service sector perspective. Since this outcome is essentially a cost, the CEA will also be reported as a cost-analysis. A cost-consequence analysis will also be performed for the primary and secondary consequences including all ambulance call-outs and reported crimes to evaluate the full economic impacts of later trading hours for bars and clubs in the night-time economy. The analysis will be conducted from a wider societal perspective, including health sector, criminal justice system, business and third sector perspectives and will be in line with the recent National Institute for Health and Care Excellence guidance and recommendations.

Ethics and dissemination
The economic evaluation of the ELEPHANT study will be conducted using secondary data. Thus, no ethical approval is required for this economic evaluation. However, ethical approval for the ELEPHANT study has been granted from the University of Stirling’s General Research Ethics Committee, and prior consent has also been obtained from the participants, if involved. The results of this study will be disseminated through peer-reviewed publications in journals and national and international conferences.

We sincerely thank the 581 peer reviewers who completed manuscript reviews for JAMA Oncology in 2024.

Introduction
Child maltreatment (CM) is a major public health issue with lifelong consequences on mental health, quality of life, educational and economic prospects of children who experienced CM. Early identification of maltreated children is important to prevent further CM and ensure that children’s basic needs are met, as well as to address and avoid further consequences. However, above and beyond early identification, it is crucial to avoid the occurrence of CM. This may include the reduction of risk factors at the family and community level as well as creating supportive environments for growing up safely. Therefore, we need to understand the prevention of CM conceptually and view it not only from a medical perspective, but also from a population health perspective. The aim of this scoping review is to identify and describe theories, models or frameworks on the prevention of CM from a broad population health perspective, considering primary, secondary and tertiary prevention strategies.

Methods and analysis
A broad search in four databases (PubMed (NIH NLM), PsycInfo (Ovid), CINAHL Plus (EBSCOhost) and Web of Science (Clarivate)) will be conducted from 2009 to current. Additionally, the grey literature on websites from key public health organisations will be considered. Results will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews: Checklist and Explanation (2018). The review will include articles describing a theory, model or framework on prevention strategies for CM. Studies focussing on single interventions that do not describe prevention strategies conceptually, will be excluded. General characteristics of the frameworks, theories and models and information on types of prevention strategies they describe will be extracted. Findings will be presented in a structured table format as well as narratively.

Ethics and dissemination
As we will not collect any personal, confidential or sensitive data, ethical approval is not required. We will publish our results in a scientific journal, present them at conferences and use them for further knowledge translation activities. The scoping review is registered with the Open Science framework: https://osf.io/49g7z/.

Circulation, Ahead of Print. The “open vein hypothesis” postulates that early thrombus clearance and restoration of venous blood flow may prevent postthrombotic syndrome after proximal deep vein thrombosis. Since its proposal several decades ago, new insights from basic and clinical studies have motivated a re-evaluation and refinement of this hypothesis. According to data from these studies, susceptibility to postthrombotic syndrome occurs as a result of differences in genetic composition, thrombophilic conditions, predilection to inflammation and fibrosis, endogenous fibrinolytic capability, timing of s ymptom presentation and treatment initiation, and efficacy of antithrombotic therapy. Although initial restoration of an open vein appears to be beneficial for selected patient groups, freedom from postthrombotic syndrome is more likely in the setting of long-term venous patency, reduced recurrent thrombotic episodes, and reduced perithrombotic (eg, vein wall and valve) inflammation. These underlying biological mechanisms need further elucidation, with a long-term goal of personalizing treatment by mapping the individuals’ clinical presentation with their underlying risk factors and assessing time-dependent biological processes that occur as a clinical venous thrombosis resolves. This scientific statement (1) highlights historical fundamentals of the open vein hypothesis and then showcases new research insights into the pathophysiological factors driving postthrombotic syndrome; (2) discusses advantages and disadvantages of imaging modalities for deep vein thrombosis used in clinical practice, including the potential to depict thrombus chronicity and status of vein wall injury; (3) proposes measures to develop integrated multidisciplinary care for deep vein thrombosis focused on the reduction of postthrombotic syndrome; and (4) identifies priority areas and questions for further research.

To the Editor Dr Grover’s Viewpoint emphasizes the importance of incorporating health policy education into medical curricula. As a medical student, I concur that it is essential for trainees to understand how health policy intersects with clinical practice given the implications for patient outcomes, access to care, and resource allocation. Furthermore, without an understanding of how practical policy action can remedy inequities, advocacy alone is insufficient.

Introduction
A traumatic childbirth can have severe negative effects on the mental health of the mother and can negatively impact the child and partner. Eye movement desensitisation and reprocessing (EMDR) is a psychological intervention used to treat symptoms of trauma. The National Institute for Health and Care Excellence guidelines for antenatal and postnatal mental health recommend that trauma-focused cognitive behavioural therapy or EMDR should be offered to women who suffer from post-traumatic stress disorder resulting from a traumatic birth. However, the use of EMDR for birth trauma has not been clearly outlined in the literature.

Objectives
The aim of this scoping review is to explore the extent of the currently available research and to identify knowledge gaps in the use of EMDR for treating birth trauma.

Methods and analysis
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines will be followed to provide a comprehensive scoping review of the use of EMDR for birth trauma. Several databases will be searched, such as PsychInfo, Pubmed, the Cochrane Library, Embase, Scopus and CINAHL, from the date the database was developed, until approximately August 2026. The grey literature sources will also be searched, and searches will be limited to include studies written in the English language. Two researchers will independently screen and extract data from both quantitative and qualitative studies, which meet the inclusion criteria. Data will be analysed in a descriptive and thematic manner. Data extraction may include study characteristics, data collection procedures, outcomes and results. Findings will be presented in tabular and narrative formats.

Ethics and dissemination
Ethical Approval is not necessary for this review, as only secondary data will be used. It is expected that the review will be disseminated at psychological conferences and in relevant journal articles.

Trial registration number
This scoping review protocol has been registered on Open Science Framework. The registration DOI is: https://doi.org/10.17605/OSF.IO/UJZ52.

Introduction
A traumatic childbirth can have severe negative effects on the mental health of the mother and can negatively impact the child and partner. Eye movement desensitisation and reprocessing (EMDR) is a psychological intervention used to treat symptoms of trauma. The National Institute for Health and Care Excellence guidelines for antenatal and postnatal mental health recommend that trauma-focused cognitive behavioural therapy or EMDR should be offered to women who suffer from post-traumatic stress disorder resulting from a traumatic birth. However, the use of EMDR for birth trauma has not been clearly outlined in the literature.

Objectives
The aim of this scoping review is to explore the extent of the currently available research and to identify knowledge gaps in the use of EMDR for treating birth trauma.

Methods and analysis
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines will be followed to provide a comprehensive scoping review of the use of EMDR for birth trauma. Several databases will be searched, such as PsychInfo, Pubmed, the Cochrane Library, Embase, Scopus and CINAHL, from the date the database was developed, until approximately August 2026. The grey literature sources will also be searched, and searches will be limited to include studies written in the English language. Two researchers will independently screen and extract data from both quantitative and qualitative studies, which meet the inclusion criteria. Data will be analysed in a descriptive and thematic manner. Data extraction may include study characteristics, data collection procedures, outcomes and results. Findings will be presented in tabular and narrative formats.

Ethics and dissemination
Ethical Approval is not necessary for this review, as only secondary data will be used. It is expected that the review will be disseminated at psychological conferences and in relevant journal articles.

Trial registration number
This scoping review protocol has been registered on Open Science Framework. The registration DOI is: https://doi.org/10.17605/OSF.IO/UJZ52.

Aim
This study aims to identify factors that influence the role of community pharmacy teams in preventing prescription and over-the-counter (OTC) opioid misuse.

Design
Qualitative design using interviews; thematic analysis was used to generate themes mapped to the Capability, Opportunity and Motivation Behaviour (COM-B) model.

Setting
Community pharmacies in North East England.

Participants
28 community pharmacy staff including 16 pharmacists, 1 pharmacy assistant, 10 dispensers and 1 pharmacy technician.

Results
Factors related to the capability component include communication skills, ability to identify service users who misuse OTC opioids, and education and training. Factors in the opportunity component include staff and funding, tools for identification and referral of service users at risk of opioid misuse, and relationship with other healthcare professionals. For the motivation component, attitude towards role, attitude of pharmacist or pharmacy manager, perception about commissioners and commissioned services, and attitude towards service users were identified.

Conclusion
This study identified factors that could influence community pharmacists’ roles in opioid misuse. A critical factor influencing community pharmacy teams preventing opioid misuse is access to a single system to record the use of both OTC and prescription opioids. This would enable teams to identify service users misusing or at risk of misusing opioids, while supporting staff education and training and regulatory compliance. Future research should focus on developing interventions using these identified factors to enhance community pharmacists’ roles in opioid misuse prevention.

Aim
This study aims to identify factors that influence the role of community pharmacy teams in preventing prescription and over-the-counter (OTC) opioid misuse.

Design
Qualitative design using interviews; thematic analysis was used to generate themes mapped to the Capability, Opportunity and Motivation Behaviour (COM-B) model.

Setting
Community pharmacies in North East England.

Participants
28 community pharmacy staff including 16 pharmacists, 1 pharmacy assistant, 10 dispensers and 1 pharmacy technician.

Results
Factors related to the capability component include communication skills, ability to identify service users who misuse OTC opioids, and education and training. Factors in the opportunity component include staff and funding, tools for identification and referral of service users at risk of opioid misuse, and relationship with other healthcare professionals. For the motivation component, attitude towards role, attitude of pharmacist or pharmacy manager, perception about commissioners and commissioned services, and attitude towards service users were identified.

Conclusion
This study identified factors that could influence community pharmacists’ roles in opioid misuse. A critical factor influencing community pharmacy teams preventing opioid misuse is access to a single system to record the use of both OTC and prescription opioids. This would enable teams to identify service users misusing or at risk of misusing opioids, while supporting staff education and training and regulatory compliance. Future research should focus on developing interventions using these identified factors to enhance community pharmacists’ roles in opioid misuse prevention.

Introduction
Healthcare systems face the challenge of managing limited resources while addressing the growing demand for care and the need for equitable access. Traditional cost-effectiveness analyses focus on maximising health benefits but often fail to account for how these benefits are distributed across various populations, potentially increasing health inequities. As a result, there is increasing interest in distributional cost-effectiveness analysis (DCEA), which incorporates equity considerations by explicitly assessing how health outcomes and costs are shared among diverse populations. This scoping review explores the practical application of DCEA methodology in evaluating programs and interventions. We seek to learn more about the barriers to DCEA’s application, highlighting its practical challenges, limited use globally and the steps necessary to integrate equity more effectively into implementing and adopting programs and interventions into healthcare policy and resource allocation.

Methods and analysis
To evaluate the use of DCEA in the literature, a scoping review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Scoping Review Extension guidelines. Systematic searches will be performed across scientific databases (MEDLINE, SCOPUS, BASE, APA Psych and JSTOR), grey literature sources (Google Custom Search Engine), and handsearching to identify eligible articles published from January 2015 to March 2025. No limits will be placed on language. Reviewers will independently chart data from eligible studies using standardised data abstraction. The collected information will be synthesised both quantitatively and narratively.

Ethics and dissemination
Formal ethical approval is not necessary as this study will not collect primary data. The findings will be shared with professional networks, published in conference proceedings and submitted for peer-reviewed publication.

Introduction
Healthcare systems face the challenge of managing limited resources while addressing the growing demand for care and the need for equitable access. Traditional cost-effectiveness analyses focus on maximising health benefits but often fail to account for how these benefits are distributed across various populations, potentially increasing health inequities. As a result, there is increasing interest in distributional cost-effectiveness analysis (DCEA), which incorporates equity considerations by explicitly assessing how health outcomes and costs are shared among diverse populations. This scoping review explores the practical application of DCEA methodology in evaluating programs and interventions. We seek to learn more about the barriers to DCEA’s application, highlighting its practical challenges, limited use globally and the steps necessary to integrate equity more effectively into implementing and adopting programs and interventions into healthcare policy and resource allocation.

Methods and analysis
To evaluate the use of DCEA in the literature, a scoping review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Scoping Review Extension guidelines. Systematic searches will be performed across scientific databases (MEDLINE, SCOPUS, BASE, APA Psych and JSTOR), grey literature sources (Google Custom Search Engine), and handsearching to identify eligible articles published from January 2015 to March 2025. No limits will be placed on language. Reviewers will independently chart data from eligible studies using standardised data abstraction. The collected information will be synthesised both quantitatively and narratively.

Ethics and dissemination
Formal ethical approval is not necessary as this study will not collect primary data. The findings will be shared with professional networks, published in conference proceedings and submitted for peer-reviewed publication.

Objectives
(1) Determine geographical access to community pharmacy in England, (2) explore the relationship between community pharmacy access and urbanity and multiple deprivation and (3) understand any changes in access over time.

Design
An area-level spatial analysis study exploring the relationship between spatial access to and availability of community pharmacies over the past 10 years from 2014 to 2023, deprivation and urbanicity, using Geographic Information System and descriptive statistics on a Middle layer Super Output Area level.

Primary outcome measure
Availability per 10 000 people of a community pharmacy in their local area.

Results
For geographical access, in 2014, 91.3% of people lived within a 20-minute walk to a community pharmacy and, in 2023, this number increased to 91.7%. There was a positive relationship between geographical community pharmacy access and urbanity and geographical community pharmacy access and deprivation. For availability, the median number of community pharmacies per 10 000 people in 2014 was 1.60, while in 2023, the number reduced to 1.51 community pharmacies per 10 000 people. The most deprived areas were more likely to lose a pharmacy, compared with the least deprived areas (OR 1.65 (1.38, 1.98)).

Conclusions
There is high access to community pharmacies in England with access to a community pharmacy greatest in the most deprived areas, showing that the ‘positive pharmacy care law’ remains. However, the ‘positive pharmacy care law’ is eroding as the availability of community pharmacies has reduced over time—particularly in deprived areas, with more people reliant on each community pharmacy.

Rubino e Guglielmetti nella classifica delle personalità più influenti pubblicata dalla rivista

Objective
To evaluate the role of using outputs from patient-facing online triage tools in clinical decision-making in primary care.

Design
Systematic review.

Data sources
Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus were searched for literature published between 1 January 2002 and 31 December 2022 and updated for literature published up to end of November 2024.

Eligibility criteria for selecting studies
Studies of any design are included where the study investigates how primary care clinicians make clinical decisions in response to patient concerns reported using online triage tools.

Data extraction and synthesis
Data were extracted, and quality assessment was conducted using the Mixed Methods Appraisal Tool. Narrative synthesis was used to analyse the findings.

Results
14 studies were included, which were conducted in the UK (n=9), Sweden (n=3) and Spain (n=2). There were no studies that examined clinical decision-making as an outcome. Outcomes relating to the impact on clinical decision-making were grouped into three categories: patient clinical outcomes (n=9), primary care practitioner experience (n=11) and healthcare system outcomes (n=14). Studies reported faster clinical decisions made in response to patient concerns. Other studies reported clinicians offering unnecessary urgent appointments as patients learnt to ‘game’ the system. Clinicians felt confident managing patient requests as they can access additional information (such as a photo attachment). Moreover, clinicians’ time was freed up from appointments with limited clinical value. Contrarily, online triage was perceived as an additional step in the workflow.

Conclusion
Clinicians should be aware that their decision-making processes are likely to differ when using online triage tools. Developers can use the findings to improve the usability of the tools to aid clinical decision-making. Future research should focus on patient-facing online triage tools in general practice and the process of clinical decision-making.

PROSPERO registration number
CRD42022373944.