Patient-report and caregiver-report measures of rehabilitation service use following acquired brain injury: a systematic review

Objective
To review patient-report/caregiver-report measures of rehabilitation service use following acquired brain injury (ABI).

Data sources
Medline, APA PsycINFO, Embase and CINAHL were searched on November 2021 and November 2022. Authors were contacted if measures were not included in manuscripts/appendices.

Study selection
Included articles were empirical research or a research protocol, available in English and described measures of patient report/caregiver report of rehabilitation service use post-ABI via quantitative or qualitative methods. Two reviewers independently screened 5290 records using DistillerSR. Discrepancies were resolved by team adjudication.

Data extraction
Data extraction was piloted with high levels of agreement (k=.94). Data were extracted by a single member with team meetings to seek guidance as needed. Data included administration characteristics (reporter, mode of administration, recall period), psychometric evidence and dimensions assessed (types of services, setting, frequency, duration, intensity, qualitative aspects).

Data synthesis
One hundred and fifty-two measures were identified from 85 quantitative, 56 qualitative and 3 psychometric studies. Psychometric properties were reported for four measures, all of which focused on satisfaction. Most measures inquired about the type of rehabilitation services used, with more than half assessing functional (eg, physical therapy) and behavioural health rehabilitation services, but fewer than half assessing community and academic reintegration (eg, special education, vocational rehabilitation) or cognitive (eg, neuropsychology) services. Fewer than half assessed qualitative aspects (eg, satisfaction). Recall periods ranged from 1 month to ‘since the ABI event’ or focused on current use. Of measures that could be accessed (n=71), many included a limited checklist of types of services used. Very few measures assessed setting, frequency, intensity or duration.

Conclusions
Despite widespread interest, the vast majority of measures have not been validated and are limited in scope. Use of gold-standard psychometric methods to develop and validate a comprehensive patient-report/caregiver-report measure of rehabilitation service use would have wide-ranging implications for improving rehabilitation research in ABI.

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Percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures: an umbrella review protocol of systematic reviews and meta-analyses

Introduction
Several systematic reviews and meta-analyses have confirmed that percutaneous vertebroplasty and percutaneous kyphoplasty showed safety and beneficial efficacy in patients with osteoporotic vertebral compression fractures. Whereas, there is wide variation among results, which are not conducive to the evaluation and use of clinicians. This study will investigate the efficacy and safety of percutaneous vertebroplasty and percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures, aiming to provide a more reliable evidence base for clinical practice in treating osteoporotic vertebral compression fractures.

Methods and analysis
We will retrieve the relevant articles using the five databases(PubMed, Scopus, EMBASE, Cochrane Library and Web of Science) from inception to March 2023 for systematic review and meta-analysis comparing the overall safety and efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty in patients with osteoporotic vertebral compression fractures. Three reviewers will screen citation titles, abstracts and evaluate the full text of each relevant citation based on prespecified eligibility criteria. Any discrepancies in decisions between reviewers will be resolved through discussion. We will assess the methodological quality of the included studies according to A MeaSurement Tool to Assess systematic Reviews 2 checklist.

Ethics and dissemination
This umbrella review will inform clinical and policy decisions regarding the benefits and harms of percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures. Neither primary data nor individual patient information will be collected, thus ethics approval is not required. Findings will be reported through a peer-reviewed publication, conference presentations and the popular press.

PROSPERO registration number
CRD42021268141.

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Towards integrated mental health services in low-income and middle-income countries: organisation of primary healthcare providers – a scoping review protocol

Introduction
Mental health conditions constitute a significant percentage of the global burden of disease. A shortfall of mental health specialists and a lack of integration of services in primary care in low-income and middle-income countries (LMICs) contribute towards a mental health treatment gap in excess of 70%. Organising and equipping non-specialist healthcare workers is, therefore, an important strategy for improving access to mental health services in LMICs. This scoping review aims to map literature that addresses the organisation of and support provided to health teams in primary care settings within the context of integrated mental healthcare and as it relates to detection, treatment and referral of mental health conditions. The review will be guided by the ‘Innovative Care for Chronic Conditions’ framework.

Methods and analysis
This review protocol will employ the methodological framework first developed by Arksey and O’Malley and later advanced by others and will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews guidelines. This process will entail identifying the research questions, locating relevant literature, choosing eligible reports and studies, extracting the data and summarising the results in English-language studies and reports from 2008 to 2023 will be sourced from PubMed, CINAHL, Cochrane Library, PsycARTICLES, Scopus, Web of Science, Academic Search Complete and the WHO website. A two-stage screening of titles and abstracts, followed by full-text literature will be done in duplicate with blinded authors. Data extraction will be based on predefined fields.

Ethics and dissemination
All literature accessed for this scoping review is in the public domain and thus, no approval from an ethics review board is required. The findings of the scoping review report will inform future mental health research in LMIC and will be disseminated to relevant stakeholders and published in a peer-reviewed journal.

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German primary care data collection projects: a scoping review

Background
The widespread use of electronic health records (EHRs) has led to a growing number of large routine primary care data collection projects globally, making these records a valuable resource for health services and epidemiological and clinical research. This scoping review aims to comprehensively assess and compare strengths and limitations of all German primary care data collection projects and relevant research publications that extract data directly from practice management systems (PMS).

Methods
A literature search was conducted in the electronic databases in May 2021 and in June 2022. The search string included terms related to general practice, routine data, and Germany. The retrieved studies were classified as applied studies and methodological studies, and categorised by type of research, subject area, sample of publications, disease category, or main medication analysed.

Results
A total of 962 references were identified, with 241 studies included from six German projects in which databases are populated by EHRs from PMS. The projects exhibited significant heterogeneity in terms of size, data collection methods, and variables collected. The majority of the applied studies (n = 205, 85%) originated from one database with a primary focus on pharmacoepidemiological topics (n = 127, 52%) including prescription patterns (n = 68, 28%) and studies about treatment outcomes, compliance, and treatment effectiveness (n = 34, 14%). Epidemiological studies (n = 77, 32%) mainly focused on incidence and prevalence studies (n = 41, 17%) and risk and comorbidity analysis studies (n = 31, 12%). Only 10% (n = 23) of studies were in the field of health services research, such as hospitalisation.

Conclusion
The development and durability of primary care data collection projects in Germany is hindered by insufficient public funding, technical issues of data extraction, and strict data protection regulations. There is a need for further research and collaboration to improve the usability of EHRs for health services and research.

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Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis

Objectives
Occupational moral injury and post-traumatic embitterment disorder (PTED) describe the psychological distress caused by exposure to injustice at work. This meta-analysis aims to determine the prevalence of occupational moral injury and PTED and establish whether prevalence estimates differ depending on occupation.

Design
A systematic review and meta-analysis.

Data sources
Google Scholar, PubMed, APA PsycINFO, Web of Science Core Collection, Scopus, ScienceDirect and Sage Journals Online were searched in June 2020 and updated in November 2022.

Eligibility criteria for selecting studies
Observational studies that measured prevalence or average scores of moral injury, or PTED in any occupational group and any geographical location.

Data extraction and synthesis
Two independent reviewers screened and coded eligible studies. Study design, participant demographics, sampling method, location, measurement tool and prevalence or average scores were extracted. Risk of bias was assessed using the Quality Assessment Checklist for Prevalence Studies tool. Meta-analysis was conducted using random effects models. Results that could not be combined were summarised qualitatively in a narrative synthesis using the Guidance for Systematic Reviews.

Results
In total, 88 studies across armed forces and veterans, healthcare, first responders, educators, journalists, child protection service employees, the unemployed, public-sector employees and mixed occupations were included. Studies included in each separate meta-analysis based on the measure used ranged from 2 to 30. The pooled prevalence of clinically relevant moral injury in healthcare professionals was 45%, and exposure to any potentially morally injurious event (PMIE) across occupations was 67%. Exposure to transgressions by others and betrayal was significantly lower in the armed forces than civilian occupations. Pooled prevalence of PTED across occupations was 26%.

Conclusion
Exposure to PMIEs, moral injury symptoms and PTED are prevalent at work and exposure to transgressions by others and betrayal are more likely in civilian occupations than the armed forces.

PROSPERO registration number
CRD42020191766.

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Nursing students Health Literacy skills: a scoping review protocol for driving research

Introduction
The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research.

Methods and analysis
This scoping review will be conducted following Arksey and O’Malley’s framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit.

Ethics and dissemination
This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals.

Registration details
The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7).

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Clinical and organisational quality indicators for the optimal management of acute ischaemic stroke in the era of thrombectomy: a scoping review and expert consensus study

Objective
The purpose of this study is to identify clinical and organisational quality indicators conducive to the optimal interdisciplinary management of acute-phase ischaemic stroke.

Method
A scoping review based on the six-step methodological framework of Arksey and O’Malley (2005) was conducted including a Delphi process with an experts committee.

Data sources
MEDLINE, CINAHL, Academic search complete, Cochrane Library databases, in addition to Google Scholar and Google were searched through January 2015 to February 2023.

Eligibility criteria
French and English references, dealing with clinical and organisational indicators for the management and optimal care of adults with acute ischaemic stroke.

Data extraction and synthesis
After duplicate removal, all publications were checked for title and abstract. The full text of articles meeting the inclusion criteria was reviewed. Two independent reviewers performed 10% of the study selection and data extraction. Data collected underwent descriptive statistics.

Results
Of the 4343 references identified, 31 were included in the scoping review. About 360 indicators were identified and preliminary screened by two stroke experts. Fifty-four indicators were evaluated for validity, relevance and feasibility by a committee of experts including a partner patient using a Delphi method. A total of 34 indicators were selected and classified based on dimensions of care performance such as accessibility of services, quality of care and resource optimisation. Safety accounted for about one-third of the indicators, while there were few indicators for sustainability, equity of access and responsiveness.

Conclusion
This scoping review shows there are many clinical and organisational indicators in the literature that are relevant, valid and feasible for improving the quality of care in the acute phase of ischaemic stroke. Future research is essential to highlight clinical and organisational practices in the acute phase.

Registration details
https://osf.io/qc4mk/

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Inhaled nitric oxide therapy for preterm infants after 7 days of age: a scoping review protocol

Introduction
Inhaled nitric oxide (iNO) use is recommended for persistent pulmonary hypertension of the newborn in term and late preterm infants. Recently, iNO therapy to prevent bronchopulmonary dysplasia (BPD) or rescue for hypoxic respiratory failure and pulmonary hypertension secondary to BPD has increasingly been used in preterm infants after 7 days of postnatal age (in the postacute phase), despite its off-label use. However, the initiation criteria of iNO therapy for preterm infants in the postacute phase are varied. The aim of this scoping review is to identify the clinical and/or echo findings at the initiation of iNO therapy in preterm infants in the postacute phase.

Methods and analysis
We will search PubMed, Embase and the Japanese database ‘Ichushi.’ The following studies will be included in the review: randomised controlled trials, prospective/retrospective cohort studies, case–control studies and case series on iNO therapy for preterm infants in the postacute phase; studies published between January 2003 and August 2023; studies conducted in developed countries and studies written in English or Japanese. We will independently screen, extract and chart data using the population–concept–context framework following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We will summarise the characteristics and findings of the included studies.

Ethics and dissemination
Obtaining an institutional review board approval is not required because of the nature of this review. A final report of review findings will be published and disseminated through a peer-reviewed journal and presentation at relevant conferences.

Trial registration number
UMIN000051498.

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Survival of Childhood Cancer and Subsequent Clinical Care

To the Editor We read with interest the Review that detailed common subsequent health complications in childhood cancer survivors. The authors accurately highlighted basal cell carcinoma as an important secondary neoplasm in recipients of radiation therapy; however, childhood cancer survivors are also at risk of melanoma and squamous cell carcinoma, which, unlike basal cell carcinoma, can become invasive and metastasize. Chemotherapy alone and primary diagnoses of leukemia or lymphoma have been associated with increased risk of melanoma. Prolonged immunosuppression and chronic exposure to photosensitizing drugs such as voriconazole have been associated with increased risk of squamous cell carcinoma. Hematopoietic stem cell transplant presents unique risk factors for secondary cutaneous neoplasms, such as total body irradiation and chronic cutaneous graft vs host disease (GVHD).

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Survival of Childhood Cancer and Subsequent Clinical Care—Reply

In Reply Dr Boull and colleagues raise important points in their Letter. Our recent Review noted the absence of randomized clinical trials testing the efficacy of the Children’s Oncology Group Long-Term Follow-Up Guidelines (COG LTFU Guidelines) in mitigating the risk of adverse treatment-related outcomes. The lack of randomized clinical trials is not limited to skin cancer but applies to all recommendations within the COG LTFU Guidelines. Given the relatively small absolute numbers of childhood cancer survivors who experience specific adverse outcomes, and the long latency of complications, the plausibility of obtaining such randomized trial data is low. This is the rationale for establishing the modality and intensity of screening recommendations within the COG LTFU Guidelines on expert consensus, although the populations at risk for these recommendations are based on the associations between therapeutic exposures and adverse late outcomes and are evidence based. Thus, we believe that the skin cancer screening recommendations outlined in the COG LTFU Guidelines, which Boull and colleagues have nicely summarized, should be performed as recommended due to the substantial risk that childhood cancer survivors have of developing subsequent skin cancers. But we again qualify that there are no randomized clinical trials that provide level 1 evidence regarding the efficacy of these recommendations.

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Triadic communication with teenagers and young adults with cancer: a systematic literature review – 'make me feel like Im not the third person

Objectives
Clinical communication needs of teenagers and young adults with cancer (TYACs) are increasingly recognised to differ significantly from younger children and older adults. We sought to understand who is present with TYACs, TYACs’ experiences of triadic communication and its impact. We generated three research questions to focus this review: (1) Who is present with TYACs in healthcare consultations/communication?, (2) What are TYACs’ experiences of communication with the supporter present? and (3) What is the impact of a TYAC’s supporter being present in the communication?

Design
Systematic review with narrative synthesis.

Data sources
The search was conducted across six databases: Medline, CINAHL, Embase, PsycINFO, Web of Science and AMED for all publications up to December 2023.

Eligibility criteria for selecting studies
Included papers were empirical research published after 2005; participants had malignant disease, diagnosed aged 13–24 years (for over 50% of participants); the research addressed any area of clinical communication.

Data extraction and synthesis
Three independent reviewers undertook full-text screening. A review-specific data extraction form was used to record participant characteristics and methods from each included paper and results relevant to the three review questions.

Results
A total of 8480 studies were identified in the search, of which 36 fulfilled the inclusion criteria. We found that mothers were the most common supporter present in clinical communication encounters. TYACs’ experiences of triadic communication are paradoxical in nature—the supporter can help or hinder the involvement of the young person in care-related communication. Overall, young people are not included in clinical communication and decisions at their preferred level.

Conclusion
Triadic communication in TYACs’ care is common, complex and dynamic. Due to the degree of challenge and nuances raised, healthcare professionals need further training on effective triadic communication.

PROSPERO registration number
CRD42022374528.

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Association between prepregnancy body mass index or gestational weight gain and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis

Objective
The association between prepregnancy body mass index (BMI) or gestational weight gain (GWG) and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus (GDM) is unknown. This study aims to evaluate such association by synthesising the evidence.

Design
Systematic review and meta-analysis.

Data sources
PubMed, Web of Science, Scopus, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, Wangfang, and China Science and Technology Journal Database searched from inception to 11 August 2023.

Eligibility criteria
Prospective cohort studies, retrospective cohort studies and case–control studies estimating the relationship of abnormal prepregnancy BMI (including underweight, overweight or obesity) or inappropriate GWG (including excess GWG or insufficient GWG) with adverse pregnancy outcomes of interest were included. Outcomes included macrosomia, caesarean section, preterm birth, gestational hypertension, large for gestational age (LGA) and small for gestational age (SGA).

Data extraction and synthesis
Two reviewers independently selected studies, extracted the data and assessed the risk of bias. OR estimate and its 95% CI were pooled using Stata software fixed-effect model. Subgroup analysis, meta-regression and sensitivity analysis were performed to ensure credibility of the results.

Results
Twenty-three studies (eighteen retrospective cohort studies, three prospective cohort studies and two case control studies) involving 57 013 Chinese women with GDM were identified. Meta-analysis results showed that compared with GDM women with normal weight, GDM women with underweight were at a higher risk of SGA (OR=1.79 (1.54 to 2.07), five studies involving 31 967 women); women with overweight had higher risks of macrosomia (OR=1.65 (1.49 to 1.82), eleven studies involving 41 683 women), caesarean section (OR=1.48 (1.38 to 1.59), ten studies involving 34 935 women), preterm birth (OR=1.27 (1.13 to 1.43), eight studies involving 38 295 women) and LGA (OR=1.73 (1.54 to 1.95), seven studies involving 31 342 women) and women with obesity had higher risks of macrosomia (OR=2.37 (2.04 to 2.76), eleven studies involving 41 683 women), caesarean section (OR=2.07 (1.84 to 2.32), nine studies involving 34 829 women), preterm birth (OR=1.31 (1.09 to 1.57), eight studies involving 38 295 women) and LGA (OR=2.63 (2.15 to 3.21), six studies involving 31 236 women). Regard to GWG, compared with Chinese GDM women with sufficient GWG, GDM women with excessive GWG had higher risks of macrosomia (OR=1.74 (1.58 to 1.92), twelve studies involving 40 966 women), caesarean section (OR=1.44 (1.36 to 1.53), nine studies involving 36 205 women) and LGA (OR=2.12 (1.96 to 2.29), twelve studies involving 42 342 women); women with insufficient GWG conversely had higher risks of preterm birth (OR=1.59 (1.45 to 1.74), nine studies involving 37 461 women) and SGA (OR=1.38 (1.27 to 1.51), ten studies involving 41 080 women).

Conclusions
For Chinese women with GDM, abnormal prepregnancy BMI or inappropriate GWG were related to higher risks of many adverse pregnancy outcomes. Therefore, medical staff should pay more attention to the weight management of GDM women during pregnancy.

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Life-course socioeconomic status and obesity: a scoping review protocol

Objective
We aim to explore the literature that studies the links between life-course socioeconomic status and weight status and characterize the life-course approach used.

Introduction
Obesogenic environments are increasing rapidly in deprived environments, and cross-sectional studies have shown limitations in explaining the links between these environments and obesity. The life-course approach has been proposed recently to better understand the links between socioeconomic status and weight status.

Inclusion criteria
Studies that identify life-course socioeconomic status and longitudinal built environment indicators and associate them with body weight indicators between January 2000 and January 2023.

Methods
Studies in French or English were searched in Medline (PubMed), Web of Science and GeoBase (Embase) according to the strategies formulated for each database. The selected studies were exported to Covidence for evaluation according to the inclusion/exclusion criteria.

Results
The main results retained are the association between longitudinal socioeconomic indicators and weight measures; longitudinal built environment indicators and the measures of weight.

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Weight stigma and allostatic load in adults: protocol for a scoping review

Introduction
Weight-related stigma (WS) has been associated with adverse psychosocial and physical health effects. Despite the relationship between WS and allostatic load, there are no integrative reviews of this association. This scoping review aims to provide a comprehensive overview of the relationship between allostatic load biomarkers associated with WS by identifying gaps in this topic and proposing recommendations for future research.

Methods and analysis
This protocol was guided by the methodological framework of Arksey and O’Malley and the Joanna Briggs Institute (JBI). The research questions were based on the population–concept–context framework. Studies in adults diagnosed as overweight or obese, exposed to WS and assessing the association between WS and biomarkers of allostatic load will be included. A search will be conducted in Medline (Ovid), PsycINFO (Ovid), Scopus (Elsevier), Cochrane Library (Wiley) and Google Scholar. The search strategy will be conducted in three stages, based on the JBI recommendation with the MESH terms “Social Stigma,” “Weight Prejudice,” “Biomarkers,” “Allostasis,” “Adults” and related terms. Data extraction will be done with a template adapted from JBI. The search strategy and selection process results will be presented in a flow chart and summarised in the text. The main results will be presented in a descriptive synthesis.

Ethics and dissemination
Ethics review and approval are not required. The results will be disseminated through peer-reviewed publications, conferences, congresses or symposia.

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