Search Results for: Report aggiornato sulla qualità dell’aria in Europa (2015)

Objectives
Pregnant women in low- and middle-income countries (LMICs), including Mali, often face challenges such as limited access to comprehensive health information and services. Mobile health (mHealth) interventions, particularly SMS-based interventions, have shown promise in addressing maternal health challenges. This review aims to provide an overview of existing SMS-based antenatal care (ANC) applications and assess their effectiveness in improving maternal and child health outcomes.

Design
A systematic literature review was conducted based on updated PRISMA 2020 guidelines.

Data sources
PubMed, Scopus, Web of Science, Cochrane Library, Association for Information Systems eLibrary, Direct Science and Google Scholar were searched through 25 March 2024.

Eligibility criteria
Studies that focused on SMS-based interventions designed to improve ANC information and attendance, published in English or French, conducted in LMICs and published between 2014 and 2024 were included. Exclusion criteria eliminated studies that did not report primary outcomes or did not directly involve SMS-based interventions for ANC.

Data extraction and synthesis
Relevant data were systematically extracted, including study characteristics, intervention details, and outcome measures. The risk of bias was assessed using the Cochrane Risk of Bias tool for randomised trials (RoB 2), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) and the Checklist for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI), depending on the study design. A subgroup analysis was performed to explore variations in outcomes by region and study design.

Results
The review identified a range of SMS-based interventions (n=12) that differed in target audience, message frequency (weekly, pregnancy stage-oriented) and content (reminders (91.7% of cases, 11/12), educational (75%) and danger signs (16.7%)). Regional analysis highlighted significant research activity in East Africa but with mixed significance levels. The study design analysis revealed that randomised controlled trials yielded the most significant results, with five of eight studies showing full significance, whereas quasi-experimental studies demonstrated consistent but less frequent effectiveness. Implementation tools varied from SMS gateways to custom applications and third-party platforms, with some interventions combining these approaches. SMS interventions positively impacted ANC attendance, maternal health knowledge and behaviours, with effectiveness varying based on the intervention type, content, frequency and implementation approach.

Conclusion
SMS-based interventions have the potential to enhance ANC in LMICs by providing tailored health information and promoting healthy behaviours. Further research should focus on refining or replicating these interventions and exploring their long-term effects on maternal and child health outcomes, particularly in underrepresented regions.

This study compares knowledge of diagnosis and worry among adults presented with prostate biopsy reports in a patient-centered format, which presents important clinical data in plain language, vs standard report format.

To the Editor We read with interest the SIRAKI02 trial by Dr Pérez-Fernández and colleagues, which was recently published in JAMA. They report a reduction in acute kidney injury (AKI) when using an extracorporeal blood purification (EBP) device during nonemergent cardiac surgery that required cardiopulmonary bypass. The purification column used in this study was proposed to reduce AKI risk via removal of intraoperative inflammatory cytokines and damage-associated molecular patterns, such as free hemoglobin. The reduction of inflammatory cytokines was supported by a reported reduction in circulating tumor necrosis factor α and interleukin 8 in the EBP group compared with the control group.

I risultati di una ricerca Iqvia promossa da Europa Donna Italia

Introduction
Across different populations, listening difficulties have been shown to adversely impact social interactions and work performance, and substantively contribute to poorer quality of life. Following a stroke, people also report listening difficulties in noisy, everyday environments such as cafes and workplaces. Despite the prevalence of these challenges, there is limited understanding of this issue, which means the listening needs of stroke survivors remain under-recognised and unmet. The aim of this scoping review is to map the breadth and depth of the existing literature on stroke survivors’ experiences of listening in noisy environments, encompassing qualitative descriptions and quantitative assessments of listening-in-noise abilities, to identify contributing factors, knowledge gaps and potential intervention strategies.

Methods and analysis
This protocol has been registered with the Open Science Framework (protocol number: 39TCA) and follows the Joanna Briggs Institute guidelines for scoping reviews. The protocol was developed by a multidisciplinary and multiprofessional team, led by a survivor of stroke and informed by additional patient input. A mixed-methods approach will be used to generate independent narrative summaries of qualitative and quantitative studies, followed by an integrated narrative of findings across data types. We will first conduct a comprehensive search using Medline, Embase, PsycInfo, Scopus, Cumulated Index in Nursing and Allied Health Literature and Web of Science databases in February 2025. Eligible studies will include stroke survivors as participants and focus on listening-in-noise experiences or abilities. Qualitative studies must explore personal experiences or perceptions related to listening in noisy environments, and quantitative studies must assess listening-in-noise performance. Studies addressing mediating factors, such as cognition, comorbidities (eg, hearing loss, aphasia), environmental factors and intervention strategies (eg, auditory training, assistive devices) will also be included. Two independent reviewers will assess the studies for eligibility. In cases of disagreement, a third reviewer will independently compare and resolve any discrepancies, ensuring a consensus is reached. This approach aims to minimise bias and enhance the validity of the review findings. The data extraction and synthesis will adhere to established guidelines, ensuring a robust and transparent analysis.

Ethics and dissemination
Ethical approval is not required as this review will analyse the existing literature. The results will be published in an open-access peer-reviewed journal and presented at local and international conferences. This dissemination strategy aims to reach a wide audience, including clinicians, researchers, policymakers and people with lived experience of stroke.

Trial registration number
Open Science Framework (https://osf.io; protocol number: 39TCA).

Objective
To examine recent patterns regarding oral anticoagulant (OAC) use among patients hospitalised with atrial fibrillation (AF) and quantify the impact of insurance coverage for non-vitamin K oral anticoagulants (NOACs) on quality of care and care inequality regarding OAC use among hospitalised patients with AF.

Design
Interrupted time series analysis.

Setting
Hospitals in China.

Participants
A total of 36 393 patients hospitalised with non-valvular AF were involved between 2015 and 2019 across China.

Primary and secondary outcome measures
Outcome was the impact of insurance coverage for NOACs on quality of care regarding OAC prescription using interrupted time series analysis with segmented regression models.

Results
OAC prescription rate during hospitalisation was 52.1% (31.3% for warfarin and 20.8% for NOACs) in patients with high-risk AF and 66.3% (29.8% for warfarin and 36.5% for NOACs) in low-risk patients. Insurance coverage for NOACs was associated with an immediate 10.9% (95% CI 7.6% to 14.3%) increase in NOAC prescription and a 0.33% (95% CI 0.08% to 0.58%) increase in the slope of the secular trend of NOAC prescription among all the patients. Disparities in NOAC prescription among hospitals decreased from 18.9 before the insurance coverage for NOACs to 3.4 after that. Similar results were found in patients with high risk of stroke.

Conclusion
A large gap exists between clinical practice and guideline recommendations regarding OAC prescription among patients hospitalised with AF in China. Insurance coverage may be an effective healthcare strategy to improve quality of care and reduce care disparities regarding OAC prescription among patients with AF.

Trial registration number
NCT02309398.

Background
The introduction of immune checkpoint inhibitors (ICIs) has modified treatment modalities for patients with lung cancer, offering new alternatives for treatment. Despite improved survival benefits, ICIs may cause side effects impacting patients’ quality of life (QoL). We aim to study the changes in global QoL (gQoL) of patients with advanced-stage lung cancer up to 18 months after treatment with ICIs between 2015 and 2021.

Methods and analysis
A longitudinal cohort study was conducted using the Oncological Life Study: Living well as a cancer survivor data-biobank from the University Medical Center Groningen. Participants completed the European Organisation for Research and Treatment of Cancer QoL 30-item questionnaire, at the beginning of their ICI treatment (baseline) and then at 6, 12 and 18 months. Using joint modelling, changes in predicted mean gQoL were studied by treatment regimens from baseline to 18 months, while accounting for the competing risk of death and adjusting for prespecified covariates.

Results
Of the 418 participants with median age of 66 years, 39% were women. Patients receiving first-line immuno-monotherapy with palliative intent had a small improvement in their gQoL within 6 months and no clinically significant change thereafter. Patients receiving first-line immune-chemotherapy with palliative intent had a small improvement in their gQoL within 12 months and no clinically significant change thereafter. Patients with second/further line immunotherapy with palliative intent or first-line chemoradiotherapy followed by durvalumab with curative intent had no clinically significant change in their gQoL over 18 months.

Conclusion
The changes in gQoL over time among patients with advanced-stage lung cancer may vary by treatment regimens based on drug intensity, line and intent of treatment, which will help clinicians and patients understand the potential dynamic of treatments on QoL. It may further influence treatment decisions and patient management strategies, reflecting the practical implications of different treatment regimens.

Objectives
Systems approaches (SAs) seek to understand the dynamics behind system behaviour and formulate effective actions given these dynamics. In public health, SAs often rely on qualitative systems maps visualising factors and their interconnections, frequently developed through group model building. Quantitative system dynamics models (SDMs) can offer additional insights: SDMs can simulate how system behaviour would change if we were to make an adjustment to the system, in what-if scenarios. We explored what (added) value Australian community leaders involved in SAs see in an SDM for understanding a system and its behaviour.

Setting
The Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHOSTOPS), a community-level collaboration between researchers and community leaders in South-Western Victoria, Australia.

Design
We calibrated an existing small and high-level SDM with local data from the WHOSTOPS communities, so that the simulations pertained to their local context. The SDM was developed to simulate potential interventions addressing either social norms regarding body weight or individual weight-related behaviour. We presented the SDM to the community leaders via an interactive interface in an online workshop.

Participants
We calibrated the SDM using WHOSTOPS’ baseline measurement (2015), with an 80% participation rate among eligible children (1792/2516). 11 community leaders participated in the workshop.

Results
The community leaders’ first impression of the SDM was that it could be a valuable additional tool, particularly because of its ability to compare what-if scenarios resembling individual vs systems perspectives, intuitive presentation of simulation results, and use of local data.

Conclusions
Our preliminary exploration showed that the small and high-level SDM, using what-if scenarios reflecting interventions on different system levels, could contribute to the understanding and communication of (community-based) SAs.

Introduction
As educators and health professionals, school nurses are in an optimal position to improve and advocate for adolescent reproductive and sexual health. This report outlines a protocol for a systematic review to synthesize evidence on the effects of school nurse-led education interventions and barriers and facilitators to implementing the interventions to improve students’ knowledge, attitudes and behaviours related to sexual and reproductive health in high-income countries.

Methods and analysis
We will develop a protocol to systematically review school nurse-led education interventions aimed at promoting adolescent sexual and reproductive health. This protocol will be based on the methodology of the Cochrane Handbook for Systematic Reviews of Interventions. The search will be conducted in Ovid-MEDLINE, CINAHL, Cochrane Library, Ovid-Embase, PsycINFO, Koreamed and ScienceON using relevant Medical Subject Headings and text words to identify the literature on different types of studies examining school nurse-led sexual and reproductive health education interventions in April 2024. Two independent reviewers will select relevant studies and extract data using a predefined template. We will assess methodological quality using the risk-of-bias tools appropriate for study designs and will resolve discrepancies through discussion with the review team. Where appropriate, we will conduct meta-analyses to estimate the effectiveness of school nurse-led sexual and reproductive health education interventions. Additionally, a qualitative evidence synthesis will be performed for the qualitative research included in the review. Finally, both a quantitative synthesis and a qualitative synthesis will be combined into a secondary synthesis addressing the facilitators and barriers of sexual and reproductive health educational interventions provided by school nurses to adolescents.

Ethics and dissemination
This review will synthesise publicly available resources and does not require ethical approval. The findings will provide insights into how school nurses can improve students’ sexual and reproductive health. The results will be disseminated through peer-reviewed publications, reports and academic conferences.

PROSPERO registration number
CRD42022347625.

Introduction
Pulmonary complications frequently occur as comorbidities in individuals with transfusion-dependent thalassaemia (TDT). Despite their clinical significance, the existing literature lacks a systematic review and meta-analysis examining the prevalence and risk factors for pulmonary dysfunction in this patient cohort. Therefore, we propose to conduct a systematic review and meta-analysis to report the prevalence and associated risk factors of pulmonary dysfunction in TDT patients.

Methods and analysis
This systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We will search PubMed, EMBASE, the Cochrane Library, Scopus and Web of Science to identify English-language literature from the inception of each database up to 31 May 2024. We will include studies that involve TDT patients and report on the method of pulmonary function assessment, the proportion of pulmonary dysfunction and the analysis of risk factors for pulmonary dysfunction. The study designs included will be cohort, case-control and cross-sectional studies. Exclusions will apply to studies on non-TDT or patients with other diseases, reviews, case reports and animal experiments, as well as duplicated published studies, studies without full-text availability or studies from which raw data cannot be extracted. The screening process, including title, abstract and full texts, will be conducted independently by two reviewers. Data extraction will be performed following standardised protocols. The quality of the included studies will be assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality criteria. The meta-analysis will be conducted using Stata 14.0 and Review Manager (RevMan) 5.4 software, incorporating subgroup analyses, heterogeneity assessments and publication bias evaluations to ensure the robustness and reliability of the findings.

Ethics and dissemination
As the data for this systematic review and meta-analysis are sourced exclusively from previously published literature, there is no requirement for ethical approval. The dissemination of the results will occur through publication in a peer-reviewed scholarly journal and presentations at relevant scientific conferences.

PROSPERO registration number
CRD42024504353.

This study examines temporal trends in US Food and Drug Administration clearance summaries for pulse oximeters that report information about race and ethnicity and/or skin color or tone.

Worldwide, the rate of deaths from drowning decreased by 38% over the past 2 decades, from 6.1 to 3.8 per 100 000 people. The first-ever status report on drowning prevention from the World Health Organization (WHO) estimated that 300 000 people died from drowning in 2021, down from 375 000 in 2000.

To the Editor In their excellent research, Dr Palmqvist and colleagues report high diagnostic accuracy of blood biomarkers in the diagnosis of Alzheimer disease. The authors used the STROBE checklist for observational studies, but this is a prospective diagnostic accuracy study, for which the STARD checklist is more appropriate.

Introduction
Up to one-fifth of breast cancer survivors will develop chronic breast cancer-related lymphoedema (BCRL). To date, complex physical decongestion therapy (CDT) is the gold standard of treatment. However, it is mainly symptomatic and often ineffective in preventing BCRL progression. Lymphovenous anastomosis (LVA) and vascularised lymph node transfer (VLNT) are microsurgical techniques that aim to restore lymphatic drainage. This international randomised trial aims to evaluate advantages of microsurgical interventions plus CDT versus CDT alone for BCRL treatment.

Methods and analysis
The effectiveness of LVA and/or VLNT in combination with CDT, which may be combined with liposuction, versus CDT alone will be evaluated in routine practice across the globe. Patients with BCRL will be randomly allocated to either surgical or conservative therapy. The primary end point of this trial is the patient-reported quality of life (QoL) outcome ‘lymphoedema-specific QoL’, which will be assessed 15 months after randomisation. Secondary end points are further patient-reported outcomes (PROs), arm volume measurements, economic evaluations and imaging at different time points. A long-term follow-up will be conducted up to 10 years after randomisation. A total of 280 patients will be recruited in over 20 sites worldwide.

Ethics and dissemination
This study will be conducted in compliance with the Declaration of Helsinki and the International Council for Harmonisation-Good Clinical Practice (ICH-GCP) E6 guideline. Ethical approval has been obtained by the lead ethics committee ‘Ethikkommission Nordwest- und Zentralschweiz’ (2023-00733, 22 May 2023). Ethical approval from local authorities will be sought for all participating sites. Regardless of outcomes, the findings will be published in a peer-reviewed medical journal. Metadata detailing the dataset’s type, size and content will be made available, along with the full study protocol and case report forms, in public repositories in compliance with the Findability, Accessibility, Interoperability and Reuse principles.

Trial registration number
NCT05890677.

Che attesta l’eccellenza, la garanzia di qualità e la sicurezza

Introduction
Autoimmune pancreatitis (AIP) mainly manifests in two distinct forms with different clinical, serological and prognostic characteristics. Previous studies indicated a higher risk of malignancy in AIP patients compared with the general population. However, a direct comparison of cancer incidence in AIP patients with controls from the general population has not been conducted yet.

Methods and analysis
This is an international, multicentre, retrospective study on patients diagnosed with AIP after 2005. Retrospective data regarding demography, AIP characteristics and cancer incidence will be extracted from the medical files of AIP patients. The primary outcome is the standardised incidence ratio of any first invasive cancer after AIP diagnosis compared with the general population. The expected number of cancers in the general population will be determined using the ‘Cancer Incidence in Five Continents Volume XI’ registry. Secondary outcomes are the prevalence of all cancer diagnoses within 12 months prior to AIP diagnosis and AIP features associated with a cancer diagnosis.

Ethics and dissemination
This study was approved by the ethics committees of the autoimmune pancreatitis, pancreatic and extrapancreatic cancer (AIPPEAR) core group centres (Halle (Saale), Germany; Aalborg, Denmark; Tartu, Estonia; Munich, Germany; Göttingen, Germany; Maribor, Slovenia, with the following reference numbers: 2023–204, 2023–0 29 953, 382 /T-3, 24–0768, 9/7/23, UKC-MB-KME 59/23, respectively). Where required, the study protocol will be reviewed and approved by the ethics committees of participating centres in compliance with local regulations. Data will be stored in an electronic case report form within REDCap. In this context, the AIPPEAR core group will share joint responsibility for the data. All results from this study will be submitted to international, peer-reviewed journals and presented at international conferences.

Trial registration number
NCT06328101.