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Objective: The ENT Scotland society (formerly known as the Scottish Otolaryngological Society) has two meetings a year and accepts oral presentations from trainees. This study aimed to identify publication rates from these meetings. Methods: Abstracts of the presentations are published in The Journal of Laryngology and Otology. A structured search on PubMed and Google Scholar was undertaken to identify which presentations from the 2005 to 2014 meetings have been published. Results: Of the 145 abstracts found, 60.7 per cent were presenting clinical research and 44.1 per cent were related to the head and neck subspecialty. Seventy-three abstracts (50.3 per cent) were associated with publication as a peer-reviewed article; otology papers were more likely to be published than those focusing on other subspecialties (64.3 per cent, p = 0.036). No correlation was found between publication and other factors. Conclusion: Presentations at the ENT Scotland meetings undergo unbiased peer review and are as likely to be published as those of other conferences. [ABSTRACT FROM AUTHOR]

Background: In the past few years there has been a growing interest in the employment of verbal productions as digital biomarkers, namely objective, quantifiable behavioural data that can be collected and measured by means of digital devices, allowing for a low‐cost pathology detection, classification and monitoring. Numerous research papers have been published on the automatic detection of subtle verbal alteration, starting from written texts, raw speech recordings and transcripts, and such linguistic analysis has been singled out as a cost‐effective method for diagnosing dementia and other medical conditions common among elderly patients (e.g., cognitive dysfunctions associated with metabolic disorders, dysarthria). Aims: To provide a critical appraisal and synthesis of evidence concerning the application of natural language processing (NLP) techniques for clinical purposes in the geriatric population. In particular, we discuss the state of the art on studying language in healthy and pathological ageing, focusing on the latest research efforts to build non‐intrusive language‐based tools for the early identification of cognitive frailty due to dementia. We also discuss some challenges and open problems raised by this approach. Methods & Procedures: We performed a scoping review to examine emerging evidence about this novel domain. Potentially relevant studies published up to November 2021 were identified from the databases of MEDLINE, Cochrane and Web of Science. We also browsed the proceedings of leading international conferences (e.g., ACL, COLING, Interspeech, LREC) from 2017 to 2021, and checked the reference lists of relevant studies and reviews. Main Contribution: The paper provides an introductory, but complete, overview of the application of NLP techniques for studying language disruption due to dementia. We also suggest that this technique can be fruitfully applied to other medical conditions (e.g., cognitive dysfunctions associated with dysarthria, cerebrovascular disease and mood disorders). Conclusions & Implications: Despite several critical points need to be addressed by the scientific community, a growing body of empirical evidence shows that NLP techniques can represent a promising tool for studying language changes in pathological aging, with a high potential to lead a significant shift in clinical practice. WHAT THIS PAPER ADDS: What is already known on this subject: Speech and languages abilities change due to non‐pathological neurocognitive ageing and neurodegenerative processes. These subtle verbal modifications can be measured through NLP techniques and used as biomarkers for screening/diagnostic purposes in the geriatric population (i.e., digital linguistic biomarkers—DLBs). What this paper adds to existing knowledge: The review shows that DLBs can represent a promising clinical tool, with a high potential to spark a major shift to dementia assessment in the elderly. Some challenges and open problems are also discussed. What are the potential or actual clinical implications of this work?: This methodological review represents a starting point for clinicians approaching the DLB research field for studying language in healthy and pathological ageing. It summarizes the state of the art and future research directions of this novel approach. [ABSTRACT FROM AUTHOR]

Purpose: The European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) congress is an important venue, and the research presented can be a critical source of information used to impact clinical decisions and health policies. The purpose of this study was to evaluate the level of evidence of clinical free papers presented at the ESSKA congress from 2008 to 2016. Moreover, this study evaluated whether there were any changes in the distribution of level of evidence over time.Methods: Two reviewers screened the free papers presented at the ESSKA biannual congresses 2008-2016 for clinical evidence. Clinical papers included observational studies and trials involving direct interaction between an investigator and human subjects. Biomechanical studies, technique demonstrations, cadaveric studies, and panel discussions were excluded. The reviewers independently graded their level of evidence from level I (e.g. high-quality randomized trials) to level IV (e.g. case series and reports) using the classification system published by the American Academy of Orthopaedic Surgeons.Results: Of 1036 free papers that were identified, 729 met the inclusion criteria and were evaluated. Overall, 18% of studies were level I, 24% level II, 25% level III, and 33% level IV evidence. There was a significant improvement in level of evidence over time (p < 0.0001), with the proportion of level I studies increasing most dramatically (9% in 2008, 20% in 2012, 24% in 2016). Free papers studying the knee had higher levels of evidence than those evaluating other joints (p = 0.002).Conclusion: The level of evidence of clinical free papers presented at the ESSKA congress between 2008 and 2016 is high relative to other orthopaedic meetings. Moreover, there has been a significant improvement in the level of evidence over time.Level Of Evidence: Systematic review, Level IV. [ABSTRACT FROM AUTHOR]

Over the last decade, Educational Data Mining (EDM) and Learning Analytics (LA) have evolved enormously as interrelated research areas and disciplines. Many researchers interested in these areas may wonder why there are two different communities, whether they are the same concept or not, and the differences between them, which is key information for designing their research and publication strategies. To address this, we conducted a systematic review of academic papers about the differences between LA and EDM following the Preferred Reporting Method for Systematic Reviews (PRISMA) guidelines. We selected 10 research works and identified 11 differences. Our conclusions are that, although both use the same data and share similar goals and interests, EDM and LA are different research communities with different origins and focuses, with their respective conferences and journals. However, there is active collaboration between the two communities and their members often tend to publish in both fields' conferences and journals. Additionally, none of the differences are apparently large enough to conclude that LA and EDM follow different paths for improving the teaching-learning process, but rather the opposite. Following a common future line, it seems that the two "sister" communities are working together with the same perspective, along with some "cousin" communities such as AIED (Artificial Intelligence in Education), L@S (Learning at Scale), Learning Science (LS), etc. in the same area that could be called Educational Data Science (EDS). We propose using the term EDS to integrate both LA and EDM with all these related communities. [Display omitted] • Educational Data Mining (EDM) and Learning Analytics (LA) are interrelated and sometimes interchanged terms. • Five original differences between EDM and LA have been identified. • Other six new differences have emerged since these initial five differences. • The term Educational Data Science (EDS) is proposed to integrate EDM and LA. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper is to outline the updated methodological approach for conducting a JBI mixed methods systematic review with a focus on data synthesis, specifically, methods related to how data are combined and the overall integration of the quantitative and qualitative evidence. Introduction: Mixed methods systematic reviews provide a more complete basis for complex decision-making than that currently offered by single method reviews, thereby maximizing their usefulness to clinical and policy decision-makers. Although mixed methods systematic reviews are gaining traction, guidance regarding the methodology of combining quantitative and qualitative data is limited. In 2014, the JBI Mixed Methods Review Methodology Group developed guidance formixedmethods systematic reviews; however, since the introduction of this guidance, there have been significant developments in mixed methods synthesis. As such, the methodology group recognized the need to revise the guidance to align it with the current state of knowledge on evidence synthesis methodology. Methods: Between 2015 and 2019, the JBI Mixed Methods Review Methodology Group undertook an extensive review of the literature, held annual face-to-face meetings (which were supplemented by teleconferences and regular email correspondence), sought advice from experts in the field, and presented at scientific conferences. This process led to the development of guidance in the form of a chapter in the JBI Manual for Evidence Synthesis, the official guidance for conducting JBI systematic reviews. In 2019, the guidance was ratified by the JBI International Scientific Committee. Results: The updated JBI methodological guidance for conducting a mixed methods systematic review recommends that reviewers take a convergent approach to synthesis and integration whereby the specific method utilized is dependent on the nature/type of questions that are posed in the systematic review. The JBI guidance is primarily based on Hong et al. and Sandelowski's typology on mixed methods systematic reviews. If the review question can be addressed by both quantitative and qualitative research designs, the convergent integrated approach should be followed, which involves data transformation and allows reviewers to combine quantitative and qualitative data. If the focus of the review is on different aspects or dimensions of a particular phenomenon of interest, the convergent segregated approach is undertaken, which involves independent synthesis of quantitative and qualitative data leading to the generation of quantitative and qualitative evidence, which are then integrated together. Conclusions: The updated guidance on JBI mixed methods systematic reviews provides foundational work to a rapidly evolving methodology and aligns with other seminal work undertaken in the field of mixed methods synthesis. Limitations to the current guidance are acknowledged, and a series of methodological projects identified by the JBI Mixed Methods Review Methodology Group to further refine the methodology are proposed. Mixed methods reviews offer an innovative framework for generating unique insights related to the complexities associated with health care quality and safety. [ABSTRACT FROM AUTHOR]

Background Today's nurse managers are challenged to effectively lead culturally diverse nursing teams and to improve care in multicultural nursing work environments. Cultural competence has been described as a central tool to improve supportive work environments in organizations, to successfully lead a culturally diverse workforce and to plan and provide culturally congruent care to patients. Aim To identify nurse manager's interventions that improve culturally competent nursing work environments. Methods It was conducted an integrative literature review according to recommendations of Whittemore & Knafl. Indexed papers were searched in EBSCO's databases, including CINAHL and MEDLINE, and ScienceDirect. It was included qualitative, quantitative and mixed- -method design studies, literature reviews and text and opinion articles, published between 2012 and 2022, identifying nurse leader or manager's interventions that improve culturally competent work environments in all settings where nursing care is provided. Data were collected using a data extraction tool. Results A total of eleven papers were included identifying nurse managers' interventions related to patients care and interventions targeting nurses' relationships improvement, at the organizational, unit and nurse levels. Literature advocates that nurse managers must identify barriers, know the nurses' levels of cultural competence and use this information to plan and organise nursing care in their units, and to develop recruitment and retention strategies to facilitate adequate staffing, in number and competence, to provide quality of care to people from different cultural backgrounds. Leadership skills are also needed to value cultural diversity, to attend the needs of healthcare workers and challenge the cultural and professional boundaries. Dialogue and collaboration should be encouraged in multicultural teams in order to decrease discrimination and improve union between people. Conclusions and implications for knowledge development Cultural diversity in the nursing work environments tends to be the rule rather than the exception, which deserves the research attention. This integrative review allowed to comprehensively access the state-of-the-art on the nurse manager's role in improving culturally competent nursing work environments, understand its implications for nurses and patients care, and inform the practice. Nurse managers should participate in policy development at the organisational level, should improve the coordination and organization of nursing care and resources in their units, and should devote for training and development of nurses for improved levels of cultural competence, leading to mutual understanding and respect, and to the delivery of culturally congruent nursing care. Nurse managers need to engage in the process of becoming culturally competent to better understand patients' needs and to lead effectively their culturally diverse teams. It is recommended to conduct studies that explore the effectiveness of the identified interventions. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of use of the core outcome domains published by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) in burning mouth syndrome (BMS) randomized controlled trials (RCTs). Methods: This systematic review, conducted as part of the World Workshop on Oral Medicine VII (WWOM VII), was performed by searching the literature for studies published in PubMed, Web of Science, PsycINFO, Cochrane Database/Cochrane Central, and Google Scholar from January 1994 (when the first BMS definition came out) through October 2017. Results: A total of 36 RCTs (n = 2,175 study participants) were included and analyzed. The overall reporting of the IMMPACT core and supplemental outcome domains was low even after the publication of the IMMPACT consensus papers in 2003 and 2005 (mean before IMMPACT consensus publication = 2.6 out of 6; mean after IMMPACT publication = 3.8 out of 6). Use of validated assessment tools recommended by the IMMPACT consensus was scarce (1.9 out of 6). None of the RCTs reviewed cited the IMMPACT consensus papers. Conclusions: The underreporting of IMMPACT outcome domains in BMS RCTs is significant. Raising awareness regarding the existence of standardized outcome domains in chronic pain research is essential to ensure more accurate, comparable, and consistent interpretation of RCT findings that can be clinically translatable. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). Introduction: Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. Methods: Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. Results: The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues,such as whena scoping reviewis (or is not) appropriate, and howto extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. Conclusions: The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned. [ABSTRACT FROM AUTHOR]

Introduction: The management of chronic diseases and multimorbidity is an important part of primary healthcare. Current disease management programs focus primarily on a single disease, while multimorbidity and social problems often co-occur. Person-centered integrated care delivered by interprofessional collaborative teamwork tailors care to the needs of the individual patient and empowers the patient to become an active participant in his own care. However, it is uncertain how healthcare professionals can be optimally equipped to deliver care and participate as team members in this contemporary approach. Objective: In this review, we explored what competencies primary healthcare professionals need to deliver high-quality person-centered integrated care, and how these competencies can be acquired. Methods: We performed a scoping review guided by the methodological framework proposed by Arksey and O'Malley. Guidelines and chronic disease management programs were searched in the Trip medical database with the following terms including their linguistic variations; a) primary care, b) integrated care, c) chronic illness, d) multimorbidity, e) shared decision making and f) competencies. Next, using the same keywords, we searched for peer-reviewed articles in the following scientific literature databases: Cinahl, Embase, PubMed, Medline, and Web of Science. Grey literature was hand-searched through websites of relevant national and international journals, scanning reference lists and through Google and Google Scholar. All titles and abstracts of both the guidelines and peer-reviewed articles were reviewed against inclusion and exclusion criteria and screened independently by two researchers. Then full text publications were retrieved and synthesized when they met the inclusion criteria. Results: The screening resulted in 17 guidelines and 89 articles to be obtained in full text. After reading full text papers, a total of 4 guidelines and 21 articles met the inclusion criteria and were included in the data synthesis. Next to several subthemes four main themes were identified; interprofessional communication, interprofessional collaborative teamwork, leadership and patient-centred communication. However, all included papers lacked a description of competencies' core concepts, such as knowledge, skills and attitudes necessary for the personcentered integrated care approach or how competencies can be acquired in addition to academic or bachelor professional training. Conclusion: This review provides an integrative view on professionals' competencies necessary for person-centered integrated care within the practice of primary care, though details on competencies' core concepts are lacking. More research is needed, on competencies and educational programs to ensure healthcare professionals in primary care are better equipped to deliver person-centred integrated care for chronic ill patients. [ABSTRACT FROM AUTHOR]

Study Design: Systematic review.Objective: We systematically reviewed the level of clinical evidence presented at Cervical Spine Research Society annual meetings from 2008 through 2017.Summary Of Background Data: The Cervical Spine Research Society is dedicated to advancing knowledge of the cervical spine to promote evidence-based care. Research presented at these meetings impacts clinical practice.Methods: A total of 774 paper abstracts presented at Cervical Spine Research Society (CSRS) annual meetings were independently assessed by two reviewers. Reviewers designated a clinical level of evidence (LOE) to each included abstract from level I to level IV based on criteria set forth by the Oxford Centre for Evidence-Based Medicine. Reviewer agreement was assessed using Cohens Kappa coefficient (k) and disagreements were discussed until a consensus was reached. Wilcoxon rank sum test was used to assess for differences in LOE grades. Chi-squared testing was used to assess nonrandom changes in level of evidence and in excluded studies.Results: A total of 583 abstracts were included. Over the last 10 CSRS meetings, 5.15% of presentations were level I, 27.8% level II, 27.4% level III, and 39.6% level IV. The average LOE from 2008 to 2017 was 3.02 (median = 3). Additionally, 49.7% were therapeutic studies, 37.6% prognostic studies, and 12.7% diagnostic studies. When comparing the first 5 years (2008-2012) to the last 5 years (2013-2017), we observed a significant increase in Level II (P = 0.007) evidence and a corresponding decrease in level IV evidence (P < 0.001). The average LOE improved from 3.14 (2008-2012) to 2.91 (2013-2017); there was a significant improvement in LOE between the two periods (P = 0.001).Conclusion: Emphasis on evidence-based medicine within cervical spine research has positively influenced the clinical level of evidence disseminated at CSRS annual meetings between 2008 and 2017. Continued focus on higher quality Level I studies is warranted.Level Of Evidence: 4. [ABSTRACT FROM AUTHOR]

Background Wearable technology is a fast developing area. Often, the focus of research is on accuracy, while the practicalities of using the device may be overlooked, despite the fact that this greatly influences utility. This scoping review therefore explored the design and usability preferences of people for wearable technology for health monitoring. Methods A scoping review was conducted of literature evaluating user preferences for the design of wearable technology systems, for people aged >50 years, with good health, or chronic diseases. Results A search of relevant databases yielded 628 potential studies (after duplicates removed). Following title/abstract and then full text screening, 17 papers were included. The most commonly reported theme related to design and user interface (13 studies). Users wanted a small, unobtrusive and light device which doesn't snag on clothing or affect activities of daily living, but yet has a readable and easy-to-use interface, which may prove challenging for designers! Users were most happy to wear a device on the wrist and/or hip region, being considered the least obtrusive / most discrete. Users were open to the technology aspects of the device, but wanted specific training, or clear and readable instructions. Less commonly reported parameters included issues with privacy and ownership of data (two studies); cost (two studies); reliability and accuracy (three studies), including being accurate overnight and in the shower, etc.; and clinical usefulness, i.e. the data being effectively linked with other healthcare data. Where considered, participants didn't want to wear a device by night (two studies). Safety of wearable devices was not a theme in any study. Conclusion Overall, user needs seem to be rarely considered in the design of wearable technology for health monitoring. However, the limited studies do highlight important user concerns, which should be considered by the technology designers and prescribers. [ABSTRACT FROM AUTHOR]

Background Family carers provide thousands of hours of unpaid work every year, a third of whom are men, however this group are generally under-represented in research. Comparative studies have shown that male carers experience their caring role differently to female counterparts. Social concepts related to masculinity can help to explain help-seeking behaviours of male carers, as well as their attitudes to accessing outside support. Compared to women carers, men have lower rates of uptake of formal support services. This aim of this review, therefore, was to examine accounts of male carers' experiences and perceptions of receiving formal support. Methods The study followed a meta-ethnography process starting with a systematic literature search of five electronic databases. The methodological quality of the included studies was evaluated using the McMaster checklist. Using NVivo 12 software, primary qualitative data was analysed and key themes were identified. Results were synthesised using Noblit and Hare's (1988) process of meta-ethnography, retaining direct quotes from the studies. Results Eighteen studies were included in the final paper. Three main themes were identified: 1) asserting control over the caring role 2) desire to excel in caring role and 3) coping without formal support. Conclusion For the most part, male carers expressed a desire to be competent in their caring role. Perceived loss of control within the caring relationship was a key factor when men had low trust and dissatisfaction with services. Support services that were collaborative, education-based and gender-sensitive were favoured by the men. To engage more male carers, service providers should acknowledge men's experience and capabilities as well as their wish to stay involved in decision-making around care for their family member. For men over the age of 85 male family carers outnumber females in Ireland (CSO 2016). It is important to understand male carers' experience to develop more inclusive supports and consequently increase service uptake. [ABSTRACT FROM AUTHOR]

Background: According to the National Crime Records Bureau (2014), TBI is increasingly being recognized as a public health problem of immense proportions with the substantial burden of disability and death occurring in low and middle income countries (LMICs). Many people with traumatic brain injury (TBI) experience various degrees of motor function impairment which can have a significant impact on participation in all areas of occupation. There is scarcity of Evidence Based Occupational therapy (OT)-specific motor intervention. Before developing any intervention, it's necessary to know current literature available to support recovery of our patients. Objective: To describe recent trends in OT specific motor interventions for adults with TBI. Study Design: A scoping review was conducted for this study. Methods: Arksey and O'Malley's six-stage framework for scoping reviews guided our study. A search was conducted in various databases including Cochrane Database of Systematic Reviews, and National Institute for Health and Care Excellence (NICE) & the Cumulative Index to Nursing and Allied Health Literature--CINAHL for papers published between 2015 and 2021. The search strategy was developed based on concepts and keywords used in the Population, Intervention, Comparison, Outcomes and Study design (PICOS) framework. Numerical and thematic analyses were employed. Results: Of the 35 articles identified in the review process, 9 papers were included in the scoping review. On performing analyses, six major themes were identified which were as follows: (1) Intervention based on activities, (2) Intervention based on exercise, (3) Use of resiliency model, advanced therapy and multicomponent intervention, (4) Outcome measure for functional status, (5) Multidisciplinary team, (6) Use of adjunct therapies Conclusion: This study has demonstrated limited evidence for OT specific motor interventions and outcome measures to show change in functional status. While there are articles on intervention for traumatic brain injury, there are still some challenges. [ABSTRACT FROM AUTHOR]

Introduction: Longer lifespans and living with multiple chronic conditions are driving necessary change in healthcare systems. There is an increasing shift towards team-based integrated care, that is accessible, continuous, and of high quality. Health professional roles are changing rapidly; traditional educational approaches no longer suffice. The World Health Organization and the Institute of Medicine acknowledge that preparation of the healthcare workforce has not kept pace with these changes. Interprofessional education (IPE) and professional development training that includes partnering with patients, providers, and communities are identified as key solutions. However, understanding how IPE supports workforce development for integrated care remains unclear. Aims Objectives Theory or Methods: We followed the Arksey and O'Malley method for conducting scoping reviews. The CINAHL, MEDLINE, ProQuest Nursing and Allied Health, and Scholars Portal databases were searched using key search terms (interprofessional education, interdisciplinary education, integrated care, integrated health care delivery). Articles included were peer-reviewed, from all sectors, published in English, from the year 2000 to 2020 and comprised post-licensure health care workers. Study selection and data extraction were conducted by two independent reviewers using a standardized data extraction form. Data were collated, summarized, and key themes were identified. Highlights or Results or Key Findings: A total of 32 papers were included in the review consisting of primary research studies (16), reviews (10), and reports/position papers (6). Integrated care was described as having multiple definitions, various models, key principles, and competencies. Key Themes: The role of IPE in training health care professionals to work in integrated care was elucidated through qualitative thematic analysis. Four key themes were identified: 1) laying the foundation, 2) providing a building block, 3) acting as a catalyst, and 4) generating practice change. Conclusions: IPE has a critical role in training health and social care providers to work in various models of integrated care and increasingly complex healthcare systems. However, IPE is only one part of a larger program of training that is necessary. Extending IPE beyond traditional roles and settings is crucial. Implications for applicability/transferability sustainability and limitations: IPE should begin in academic programs and continue as workplace learning that is context specific. Evidence and theory-based multi-component interventions are required to reinforce learning in the practice setting. A formal evaluation of the quality of the evidence was not conducted and only papers written in English were included. [ABSTRACT FROM AUTHOR]

Purpose: To determine the publication rates of free papers and posters presented at the All India Ophthalmic Conference (AIOC) 2010 in peer-reviewed journals up to December 2015 and compare this with publication rates from AIOC2000 published previously.Methods: A thorough literature search was conducted using PubMed, Google Scholar, and the general Google search engine by two independent investigators. The title of the paper, keywords and author names were used to "match" the AIOC free-paper with the published paper. In addition, the "purpose," "methods," and "outcome measures" between the two were studied to determine the "match."Results: A total of 58 out of 394 free-papers (14.7%) from AIOC2010 were published till December 2015 compared to 16.5% from AIOC2000. Out of these, 52 (90%) were published in PubMed indexed journals. Maximum publications were seen in pediatric ophthalmology (50%) followed by glaucoma (24.4%) and cornea (23.8%). Fifteen out of 272 posters (5.5%) were published; orbit/oculoplastics had the highest poster publications (13%). Excluding papers in nonindexed journals and those by authors with international affiliations, the publication rate was approximately 12%.Conclusion: The publication rate of free papers from AIOC2010 has marginally reduced compared to AIOC2000. Various causes for this such as lack of adequate training, motivation, and lack of incentives for research in the Indian scenario have been explored, and measures to improve this paradigm have been discussed. It will be prudent to repeat this exercise every decade to compare publication rates between periodic AIOC, stimulate young minds for quality research and educate policy makers toward the need for developing dedicated research departments across the country. [ABSTRACT FROM AUTHOR]

Background Longer lifespans and living with multiple chronic conditions are driving necessary change in healthcare systems. There is an increasing shift towards team-based integrated care, to provide person-centred care that is accessible, continuous, and of high quality. Health professional roles are changing rapidly; traditional educational approaches no longer suffice. New models of care require new models of learning - from a focus on workforce planning for professionals to workforce planning for patients and populations. The World Health Organization and the Institute of Medicine acknowledge that preparation of the healthcare workforce has not kept pace with these changes. Interprofessional education (IPE) and professional development training that includes partnering with patients, providers, and communities are identified as key solutions. However, understanding how IPE supports workforce development for integrated care remains unclear. This scoping review aimed to answer the question: What is the role of IPE in training healthcare professionals to work in integrated care? The focus of this review was on post-licensure health care professionals (HCPs) in the current workforce versus preparation of students in academic settings. Theory/Methods We followed the Arksey and O'Malley method for conducting scoping reviews. The CINAHL, MEDLINE, ProQuest Nursing and Allied Health, and Scholars Portal databases were searched using key search terms (interprofessional education, interdisciplinary education, integrated care, integrated health care delivery). Articles included were peer-reviewed, from all sectors, published in English, from the year 2000 to 2020 and comprised post-licensure health care workers. Study selection and data extraction were conducted by two independent reviewers using a standardized data extraction form. Data were collated, summarized, and key themes were identified. Results A total of 32 papers were included in the review consisting of primary research studies (16), reviews (10), and reports/position papers (6). Integrated care was described as having multiple definitions, various models, key principles, and competencies. Key Themes The role of IPE in training health care professionals to work in integrated care was elucidated through qualitative thematic analysis. Four key themes were identified: 1) laying the foundation, 2) providing a building block, 3) acting as a catalyst, and 4) generating practice change. Discussion The findings have implications for education and practice. IPE should begin in academic programs and continue as workplace learning that is flexible and context specific. Multi-component interventions based on theory and evidence should be used to reinforce learning in the practice setting. Conclusions IPE has a unique and important role in training health and social care providers to work in various models of integrated care. However, IPE is only one part of a larger program of training that is necessary. Lessons Learned IPE is a critical component in training current health and social care providers to work in increasingly complex health care systems. Extending IPE beyond traditional roles and settings is crucial. Limitations A formal evaluation of the quality of the evidence was not conducted and only papers written in English were included. Future Research More rigorous research designs that clearly link IPE in integrated care to provider and patient outcomes are required. [ABSTRACT FROM AUTHOR]

Objective: The World Workshop on Oral Medicine VII chose the oral microbiome as a focus area. Part 1 presents the methodological state of the science for oral microbiome studies. Part 2 was guided by the question: What is currently known about the microbiome associated with oral squamous cell carcinoma and potentially malignant disorders of the oral mucosa? Materials and Methods: A scoping review methodology was followed to identify and analyse relevant studies on the composition and potential functions of the oral microbiota using high‐throughput sequencing techniques. The authors performed searches in PubMed and EMBASE. After removal of duplicates, a total of 239 potentially studies were identified. Results: Twenty‐three studies on oral squamous cell carcinoma, two on oral leukoplakia and four on oral lichen planus were included with substantial differences in diagnostic criteria, sample type, region sequenced and sequencing method utilised. The majority of studies focused on bacterial identification and recorded statistically significant differences in the oral microbiota associated with health and disease. However, even when comparing studies of similar methodology, the microbial differences between health and disease varied considerably. No consensus on the composition of the microbiomes associated with these conditions on genus and species level could be obtained. Six studies on oral squamous cell carcinoma had included in silico predicted microbial functions (genes and/or pathways) and found some similarities between the studies. Conclusions: Attempts to reveal the microbiome associated with oral mucosal diseases are still in its infancy, and the studies demonstrate significant clinical and methodological heterogeneity across disease categories. The immense richness and diversity of the microbiota clearly illustrate that there is a need for additional methodologically comparable studies utilising deep sequencing approaches in significant cohorts of subjects together with functional analyses. Our hope is that following the recipe as outlined in our preceding companion paper, that is Part 1, will enhance achieving this in the future and elucidate the role of the oral microbiome in oral squamous cell carcinoma and potentially malignant disorders of the oral mucosa. [ABSTRACT FROM AUTHOR]

While the scope of the term physical employment standards is wide, the principal focus of this paper is on standards related to physiological evaluation of readiness for work. Common applications of such employment standards for work are in public safety and emergency response occupations (e.g., police, firefighting, military), and there is an ever-present need to maximize the scientific quality of this research. Historically, most of these occupations are male-dominated, which leads to potential sex bias during physical demands analysis and determining performance thresholds. It is often assumed that older workers advance to positions with lower physical demand. However, this is not always true, which raises concerns about the long-term maintenance of physiological readiness. Traditionally, little attention has been paid to the inevitable margin of uncertainty that exists around cut-scores. Establishing confidence intervals around the cut-score can reduce for this uncertainty. It may also be necessary to consider the effects of practise and biological variability on test scores. Most tests of readiness for work are conducted under near perfect conditions, while many emergency responses take place under far more demanding and unpredictable conditions. The potential impact of protective clothing, respiratory protection, load carriage, environmental conditions, nutrition, fatigue, sensory deprivation, and stress should also be considered when evaluating readiness for work. In this paper, we seek to establish uniformity in terminology in this field, identify key areas of concern, provide recommendations to improve both scientific and professional practice, and identify priorities for future research. [ABSTRACT FROM AUTHOR]

Background: Hospitals operate under constant pressure to contain costs and improve the quality of care (Q). The potential association between hospital financial performance (FP) and Q can have two directions: (1) providers with better FP might have a greater capacity to maintain and/or improve Q; (2) a better Q might lead to better FP, i.e. increased revenues, and/or lower costs. The general objective of this study was to identify and map the available evidence on the association between hospital FP and Q. Methods: A scoping review based on the methodological framework outlined by Arksey and O’Malley was conducted. Five databases were used: (1) Medline via PubMed; (2) Embase; (3) Web of Science; (4) Scopus; and (5) EconLit. Search strategy combined multiple terms from three topics: (1) hospital,(2) FP and (3) Q. There was no limit for publication years, but only studies in English were included. Results: After screening 8,015 records and 129 full text papers, 54 empirical studies were included. They are mostly observational studies, applying diverse regression models, published between 1992 and 2019. FP is most often measured by profitability indicators while Q measures are much more diverse. In the majority of studies, FP measures are used as dependent variables, thus the impact of Q on FP is assessed. The comparability of the studies’ results is limited, yet a general overview shows that in the majority of papers, a positive association between hospital FP and Q is identified (positive in 24 studies and positive or mixed in 10). The studies’ authors emphasize numerous limitations related to both, the data used and the methods applied including the ability to identify associations yet not causality. Conclusions: There seems to be a growing interest in exploring the association between FP and Q. Our review provides a broad overview of the existing literature and helps to identify areas for further investigations. [ABSTRACT FROM AUTHOR]

Background: Contact tracing (CT) is a pillar of infection control during outbreaks and its implementation has been great ally in the context of the COVID-19 pandemic that pressured national health systems. Digital CT (DCT) aids manual CT by logging proximity contacts and timely notifying contacts of positive cases, contributing to greater epidemic. We aim to systematically review and critically appraise the available evidence on adoption, effectiveness, acceptance and barriers to access of available CT apps. Methods: We conducted a systematic literature review by means of Pubmed, Embase, Cochrane and Web of Science and applying the PRISMA guidelines. We classified studies according to selected characteristics (eg, original data, mathematical models, policy papers, overview of the experience with national CT apps) in order to better outline our results. Results: Our queries yielded 1201 articles, of which 790 remained after duplicates’ removal. After applying a priori selected inclusion criteria, 428 (54.17%) were eliminated after screening by title and abstract. 362 records were included in our study: of them 33.7% were original studies, 54.1% were opinion papers not reporting quantitative data, 14.91% were mathematical models, 6% were systematic reviews on DCT-related topics. Among original studies, 11.47% described national experiences and 25.40% discussed adoption dynamics. Conclusions: DCT adoption still faces several cultural, normative and technical barriers, ranging from adoption mandates to privacy issues, to device compatibility. Overall, scant evidence is available on the impact of DCT in controlling infection spread and wide heterogeneity persists within studies in term of design and assessed outcomes Future research is needed based on shared evaluation frameworks. Key messages: Digital contact tracing apps are a powerful but underestimated tool to counter epidemiological emergencies. Future epidemiological challenges will require a shared implementation and evaluation protocol for digital contact tracing apps. [ABSTRACT FROM AUTHOR]

Background: Many studies around the world have been carried out to establish the association between deprivation and health outcomes. Both separate deprivation indicators (income, education) and indices that include several ones are used. Deprivation indices have been actively used in public health since the mid-80s of the last century. Nowadays, there is no clear classification of deprivation indices. Methods: In order to create a taxonomy of deprivation indices, scientific publications related to the development and application of indices have been combined, analyzed, and systematized. The search was carried out in two bibliographic databases (PubMed and Google Sholar). After conducting a full-text review and searching and adding relevant papers from the bibliography, and adding papers that were already known to the authors, 61 documents were included in the study. These documents referred to 61 original deprivation indices. Original index is defined as ‘‘an index that includes a combination of deprivation indicators that is unique and not repeated in other indices’’. Results: Four key characteristics of the indices included in the classification were determined: type of deprivation, spatial scale, data source and weighting method. To create the taxonomy, an integrative approach was used that allows you to add new classes and subclasses when new information appears. In accordance with the type of deprivation 72% (44 \ 61) socio-economic, 7% (4 \ 61) material deprivation, 5% (3 \ 61) environmental deprivation and 16% (10 \ 61) multidimensional indices were identified. Conclusions: The terms and definitions introduced during the review are aimed at ensuring uniformity in the taxonomy and finding a common language among researchers and specialists who develop and use indices. We also hope that the data from the study will stimulate the use of a competent approach and will help in resolving conflicts or inconsistencies that arise during the construction and use of indices. [ABSTRACT FROM AUTHOR]

Introduction: LBP is a leading cause of disability and exerts a considerable burden on healthcare systems. Management is frequently inconsistent with clinical guidelines, which advocate a demedicalised approach in primary care settings for most patients, with easy access to specialised care when necessary. Integrated care pathways have potential to enhance care quality and costeffectiveness through bridging the evidence-practice gap and optimising resource use. Care integration across the primary-secondary care continuum aims to address care fragmentation, reduce duplication, improve clinical outcomes and enhance cost-effectiveness. This review aimed to synthesise the evidence for integrated care pathways for LBP from primary to specialised care. Methods: This review was reported in accordance with Preferred Reporting Information for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Electronic database searches (CINAHL, MEDLINE, Cochrane Library, EMBASE) were conducted (2006 onwards) with further manual and citation searching. Search results were exported to Covidence (systematic review software). Two independent reviewers conducted eligibility assessment and data extraction, as well as quality appraisal using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies or the Critical Appraisal Skills Programme (CASP) qualitative studies checklist. A narrative synthesis of findings is presented. Results: From 18,443 identified studies, 28 papers met inclusion criteria. LBP pathways were reported from high-income countries, primarily to address over-burdened secondary care services with long wait-times for consultant appointments. Pathways almost universally re-organised care using non-consultant interface services to manage the primary-secondary care boundary by triaging patients for surgical opinion or conservative management. Interface services aim to optimise use of the multidisciplinary workforce to ensure judicious use of surgical clinics. Accordingly, evaluation of healthcare resource use and patient flow predominated, with reports of enhanced service efficiency through decreased wait-times and appropriate use of consultant appointments. Interface services were evenly represented across community and hospital settings. Using a model that conceptualises care integration on a five-level continuum, the included pathways demonstrated the two most basic levels of integration, 'full segregation' or 'linkage'. Low quality study designs, heterogenous outcomes and insufficient comparative data precluded definitive conclusions regarding clinical and cost-effectiveness of pathways. Conclusions: Interface services, delivered by non-consultant multidisciplinary team members, to ensure appropriate referrals to specialised care dominated the LBP integrated care pathway literature with enhanced efficiency of care delivery reported. Pathways demonstrated the most basic levels of care integration, 'full segregation' and 'linkage', across traditional healthcare boundaries. Implications: Further exploration of the potential of care pathways as a model for the delivery of integrated, cost-effective, person-centred, guideline-concordant care which improves clinical outcomes for patients with LBP is required, with patient involvement in integrated care pathway development. [ABSTRACT FROM AUTHOR]

Introduction: As in many other countries, the challenges in the health status of the population and in the healthcare system persist in the Netherlands, despite longstanding reforms and integration efforts. This raises questions about the long-term sustainability of the system. As more and more studies describe the implementation of whole system transformation initiatives, approaches such as Population Health Management (PHM) gain traction. This study aims to contribute to the growing area of research by exploring the knowledge in recent literature about these kind of initiatives worldwide, focussing on the different levels of integrated care. Methods: A scoping review was performed using the six-stage methodological framework from Arksey and O'Malley. The electronic databases Embase, PubMed and Academic Search Premier were searched for papers published between January 2016 and January 2021. Structuring of the data was done from a realist analysis perspective, identifying context, mechanism and outcome (CMO) items describing what works for whom under what circumstances. Secondly, these items were then allocated to the levels of the Rainbow model of integrated care to identify the level to which the transformation item pertains. Finally, six topic clusters were formed, which constitute key elements of PHM. This resulted in a matrix of items corresponding to the levels of integrated care, the CMO structure and the six elements of PHM. Results: The literature search generated 531 articles, of which 11 were included. Structuring the data showed that most reported items were normative and functional items on the organizational level about 'accountable regional organization'. Also containing a high number of functional items are 'cross domain business model' and 'emergent implementation strategy', both on system and organizational levels. In contrast to that, items on the clinical level and normative items were overall underreported. The PHM elements 'co-designing workforce and community', 'integrated data infrastructure' and 'population health data analysis' contained overall the lowest number of items. Items that were mentioned by four or more articles were: Data availability, IT infrastructure, additional funding or monetary resources, and financial incentives aligned with system goals. Conclusions: This scoping review demonstrated that recent literature mainly reports on context, mechanisms and outcomes on system and organizational level of integrated care when it comes to PHM initiatives. And while the need for data availability and IT infrastructure are frequently specified, there is limited consideration for the normative side of integration in this regard. Implications for applicability/transferability, sustainability, and limitations: One of the limitations of this study is that many initiatives are not published in scientific literature, and therefore there may be items that are missing in the overview. However, the resultant matrix gives a first comprehensive overview of what needs to be done on what level to achieve what outcome. It also shows the lack of involvement of and attention to providers and patients within these initiatives. [ABSTRACT FROM AUTHOR]

This paper summarizes a debate on whether meta-analyses and systematic reviews are decisive in formulating guidelines for dietary fat. Held during the 12th congress of the International Society for the Study of Fatty Acids and Lipids in Stellenbosch, South Africa, September 7, 2016, the debate was hosted by the International Union of Nutritional Sciences and the International Expert Movement to Improve Dietary Fat Quality (IEM, www.theiem.org). Clemens von Schacky, Ludwig Maximilians-University, Munich, Germany, supported the statement, describing the types of weaknesses in individual studies and clinical trials. With examples of how to overcome such limitations, he concluded that nutritional guidelines on fat need a proper scientific basis in which randomized controlled trials (RCTs) with clinical end-points and their meta-analyses are essential and decisive. In contention, Ingeborg Brouwer, Vrije Universiteit, Amsterdam, declared that recommendations on dietary fat intake should always be based on the totality of the evidence, including physiologic and biochemical knowledge and associations from observational epidemiology. RCTs and meta-analyses have their shortcomings, but well-conducted systematic reviews and meta-analyses support a transparent process for developing dietary fat guidelines. Participants agreed that evidence-based decision-making for dietary guidance should consider all the best available evidence using a transparent, systematic review. [ABSTRACT FROM AUTHOR]

Study Question: Does publication bias or non-publication exist in fertility trials presented as conference abstracts?Summary Answer: This study did not detect any publication bias; however, it did identify a high level of non-publication, with only 49% of abstracts reaching full-text publication four or more years after abstract presentation.What Is Known Already: Systematic reviews of randomized controlled trials (RCTs) are the foundation of evidence based medicine. Non-publication or publication deficit refer to the failure to publish trial results. A publication bias exists when there is any tendency on the parts of the investigators or editors to fail to publish study results on the basis or strength of the study findings. Both present a serious problem for researchers, clinicians and policymakers alike, and ultimately impact on patient care.Study Design, Size, Duration: A retrospective cohort study identified 337 fertility RCTs presented as conference abstracts between 2007 and 2010, as captured by an electronic search of the Cochrane Gynaecology and Fertility Database. After excluding ineligible trials and duplicates, 224 abstracts remained.Participants/materials, Setting, Methods: A search for the full-text papers of each abstract was undertaken in Pubmed, MEDLINE, Embase, CINAHL and Google in May 2015 using a probabilistic approach. Trial authors were contacted to query the publication status of abstracts when no full-text was identified. The association between individual variables and the probability of publication, and time to publication, was assessed using logistic regression and Cox regression, respectively.Main Results and the Role Of Chance: Of the 224 included abstracts, only 110 (49%; 95% CI: 42.6, 55.6) were found to be published as full-text articles. Publication bias was not identified in this cohort; studies with positive results had a similar probability of reaching full-text publication 52/113 (46%; 95% CI: 37.0, 55.3) as studies with non-positive (negative or null) results 58/111 (52%; 95% CI: 17.8, 33.9) (adjusted odds ratio (AOR): 1.02; 95% CI: 0.53, 1.97). Similarly, the time from abstract presentation to full-text publication was similar in studies with positive and non-positive results. Oral presentations were more likely to be published, and to be published sooner, than poster presentations (poster presentation AOR: 0.31; 95% CI: 0.15, 0.61 and adjusted hazard ratio (AHR): 0.57; 95% CI: 0.38, 0.86). Studies that were not registered were less likely to be published and to have delayed publication, than studies which were registered either prospectively or retrospectively (AOR: 0.14; 95% CI: 0.04, 0.44 and AHR: 0.43; 95% CI: 0.25, 0.72). Abstracts which were presented a longer time ago also had a higher probability of reaching full-text publication (P  = 0.01).Limitations, Reasons For Caution: Commencing with a cohort of RCTs from ethics committee registers may provide a better picture of the extent of non-publication and publication bias, as not all trials reach the stage of abstract presentation. It is also possible that the search did not identify all published trials, as some may have been published after the follow-up period.Wider Implications Of the Findings: This study did not identify any publication bias. However, only half of the abstracts in this cohort have been published as full-text articles, four or more years after their presentation at a conference. This is similar to publication rates reported previously for fertility trials, and is despite increasing awareness of the importance of publishing trial results, and subsequent requirements for all RCTs to be registered prior to trial initiation. A better understanding of the reasons for non-publication should assist in facilitating the prompt full-text publication of RCTs in the future.Study Funding/competing Interest(s): Funding provided from the University of Auckland. All authors declare they have no conflicts of interest in relation to this article.Trial Registration Number: Not applicable. [ABSTRACT FROM AUTHOR]

The 6th ITI Consensus Conference was held in Amsterdam on 17–19 April 2018. In preparation for the conference, 21 systematic reviews were written. They were divided into five main topics in dental implantology—surgery, prosthodontics, patient‐reported outcomes, complications/risk and digital technologies. Based on these review papers, the working groups prepared consensus statements, clinical guidelines and recommendations for future research. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of COVID-19 has created global transmission. While effective at reducing the spread, public health measures implemented may impact individuals differently leaving them susceptible to the detrimental effects on their health and wellbeing. Therefore this review aims to synthesise the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID-19 pandemic. Methods: A three-step search strategy was used to find both published and unpublished papers. The databases searched included: MEDLINE, CINAHL, EMBASE, and Google Scholar. Following the search, all identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed independently by two reviewers, with meta-synthesis conducted in accordance with JBI methodology. Results: Fifteen papers were included. Three synthesized conclusions were established a) Vulnerable populations groups, particularly those from a racial minority and those with low incomes, are more susceptible and have been disproportionately affected by COVID-19 including mortality; b) Gender inequalities and family violence have been exacerbated by COVID-19, leading to diminished wellbeing among women; and c) COVID-19 is exacerbating existing social determinants of health through loss of employment/income, disparities in social class leading to lack of access to healthcare, housing instability, homelessness and difficulties in social distancing. Conclusions: Vulnerable population groups have been disproportionately impacted by COVID-19, including health outcomes such as hospitalisations and mortality. The COVID-19 pandemic has highlighted the need for action on health inequalities and the social determinants of health. Reflection on social and health policies implemented are necessary to ensure that the COVID19 pandemic does not exacerbate health inequalities into the future. [ABSTRACT FROM AUTHOR]

Introduction Internationally, the Triple Aim agenda (improved health of populations, improved patient experience, and reduced per capita health care expenditures) is gaining momentum in reforming healthcare systems. Towards implementing accountable care, policymakers, insurances, and managers need information about population health status to allocate resources, set priorities, plan interventions, and measure outcomes. To this extent, consolidated tools from public health research are attracting renewed interest. This paper aims to analyze the Burden of Diseases (BoD) tool and how it could be deployed to pursue the Triple Aim agenda, nationally or regionally. The Global BoD (GBoD) was introduced in the 1990s and then developed by the World Health Organization (WHO) and the Institute for Health Metrics and Evaluation (IHME), relying on aggregated data, population samples, and surveys. Nevertheless, to achieve more accurate and calibrated estimates, several countries have started to develop the BoD with different methodologies, which could influence the results and the tool's deployment within accountable care. Methods An Arksey and O'Malley approach was used in this scoping review. Electronic database MEDLINE and search engine Google were searched from January 2010 to February 2021. National BoD reports were included, and data and methodologies were extracted. The scoping review addressed three main goals: 1) benchmarking international and national or local development of the BoD; 2) analyzing and comparing the methods and data sources; 3) comparing the deployment strategies and the tool's scope. Results The IHME and WHO approaches are the most consolidated hitherto. National experiences are increasing, while local applications are still limited to pilot research. Calculation methods vary based on age-weighting, discount rates, the number of included diseases and risk factors, reported advantages and disadvantages, data sources, and data computations. The deployment strategies are very fragmented and still at an embryonic stage compared to the debate on accountable care. Discussion Whereas the utilization of a nation-based BoD is promising, experiences are still limited. The national implementation could be more reliable and calibrated on targeted populations to guide health interventions and measure population health outcomes. Multiple factors hamper the tool's development, such as costs, human and time resources, less meticulous methodology, and health analytics availability and robustness at the country level. Also, population health strategies and outcomes measurement are not yet institutionalized within accountable care. The tool deployment is fragmented across multiple entities and governance patterns. National and private insurance players are the most active, pioneering new strategies. Conclusions The BoD is an efficient way to assess the impact of diseases and risk factors in populations' life and quality of life. GBoD remains an essential benchmark for researchers and public health institutions worldwide. Lessons Learned National tools development is increasing and could be deployed for evaluating and planning healthcare interventions at the national or sub-national level. Limitations This study does not use systematic review criteria, and access to tools methodologies and deployment strategies is limited through published sources. Suggestions for future research Assessment of the development, methods, and deployment of a national-based BoD compared to the accountable care aims and agenda. [ABSTRACT FROM AUTHOR]

Introduction Internationally, the pursuit of the Triple Aim is leading the reform of healthcare systems. To implement accountable care, a target population and its health assessment must first be identified. This assessment should address resource allocation, program planning, healthcare delivery, and measure outcomes to achieve value-based care. Health Needs Assessment (HNA) tools are around since the '90s, but gained policymakers' attention as the accountable care movement spreads. HNA systematically reviews a population's health issues by defining their unmet needs. This paper reviews HNA tools used internationally and their implementation to assess population health compared to accountable care requirements. The analysis of HNA tools considers both demand and supply and examines them through comprehensive international tools. Methods An Arksey-O'Malley approach was used in this scoping review. Electronic database MEDLINE and search engine Google were searched combined with snowballing strategies. HNA reports were included, and methodologies were extracted. The scoping review addressed four: 1) reviewing frameworks, domains, and subdomains deployed in HNA tools to assess needs, demand, and supply; 2) how the tools achieved population-health assessment vs. an aggregated measure of quality, access, and health services utilization?; 3) how tools were deployed in program planning and priority setting of interventions to improve population health?; 4) Who is accountable for measuring and improving population health? Results Results were organized in comparative tables benchmarking domains and subdomains of HNA for both demand and supply. Few tools assessed both demand and supply; however they relied on utilization data while using targeted surveys for an actual needs assessment. Supply tools result more developed with high accuracy in data collection to assess access, readiness, coverage, and targeted sub-populations. The institutional deployment of HNA tools focuses on program planning of health policies and interventions, while supply tools are exploited for benchmarking the productivity and availability of services. National tools are more accurate and calibrated on the local epidemiology and health services organization. Discussions The use of HNA to pursue accountable care remains limited. Tools retrieved measuring population health for accountable care were excluded from the review because they represent performance framework and not HNA. The use of HNA for implementing accountable care is expanding, exploiting health analytics and routine analysis, foremost applying utilization data. The development of comprehensive whole-population HNA tools to inform health policymaking and interventions is hampered by the time and resources required, especially for needs assessment and data available for routine analysis. Lessons Learned With accountable care, population HNA is a requirement. What matters is how to perform it on whole-population to inform the policymaking and health interventions. Multiple tools can be applied and combined to analyze the dimensions of supply, demand, and needs within the scope of ACOs. Nevertheless, a key challenge for a comprehensive assessment is the coordination and governance of data sharing from multiple stakeholders to collect community-level data. Collaboration among players is required for deploying HNA and sharing the accountability for measuring and monitoring. Limitations The review included only published tools in English, which may undermine the collection of relevant experiences. [ABSTRACT FROM AUTHOR]

At present, for adults with chronic hepatitis B virus (HBV) infection, two new analogues, entecavir (ETV) and tenofovir, are recommended as the first-line therapy by the EASL (European Association for the Study of the Liver), AASLD (American Association for the Study of Liver Diseases), and APASL (Asian Pacific Association for the Study of the Liver) guidelines. The use of pegylated interferon-α (PEG IFN-α) is recommended as the first-line therapy instead of standard IFN-α according to the above 3 guidelines. In this paper, the aim was to assess: (1) the long-term efficacy and safety as well as the resistance to ETV and tenofovir disoproxil fumarate (TDF); (2) the efficacy of PEG IFN-α; (3) the role of combination therapy with IFN plus two analogues, such as lamivudine and ETV; (4) the efficacy and safety of two analogues with cirrhosis, and (5) suppression of hepatocellular carcinoma (HCC) by ETV and IFN treatment. The results are as follows: (1) both ETV and TDF showed long-term efficacy and safety; (2) PEG IFN-α resulted in a greater decline in HBV DNA levels and a higher rate of HBeAg seroconversion; (3) combination therapy with IFN plus two analogues did not elevate the rate of sustained responses; (4) both ETV and TDF showed efficacy and safety with cirrhosis (ETV especially displayed efficacy and safety with decompensated cirrhosis), and (5) suppression of HCC was observed by ETV and IFN. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction: Lesions of the upper digestive tract due to ingestion of caustic agents still represent a major medical and surgical emergency worldwide. The work-up of these patients is poorly defined and no clear therapeutic guidelines are available. Purpose of the study: The aim of this study was to provide an evidence-based international consensus on primary and secondary prevention, diagnosis, staging, and treatment of this life-threatening and potentially disabling condition. Methods: An extensive literature search was performed by an international panel of experts under the auspices of the World Society of Emergency Surgery (WSES). The level of evidence of the screened publications was graded using the Oxford 2011 criteria. The level of evidence of the literature and the main topics regarding foregut caustic injuries were discussed during a dedicated meeting in Milan, Italy (April 2015), and during the 3rd Annual Congress of the World Society of Emergency Surgery in Jerusalem, Israel (July 2015). Results: One-hundred-forty-seven full papers which addressed the relevant clinical questions of the research were admitted to the consensus conference. There was an unanimous consensus on the fact that the current literature on foregut caustic injuries lacks homogeneous classification systems and prospective methodology. Moreover, the non-standardized definition of technical and clinical success precludes any accurate comparison of therapeutic modalities. Key recommendations and algorithms based on expert opinions, retrospective studies and literature reviews were proposed and approved during the final consensus conference. The clinical practice guidelines resulting from the consensus conference were approved by the WSES council. Conclusions: The recommendations emerging from this consensus conference, although based on a low level of evidence, have important clinical implications. A world registry of foregut caustic injuries could be useful to collect a homogeneous data-base for prospective clinical studies that may help improving the current clinical practice guidelines. [ABSTRACT FROM AUTHOR]

Background: Mixed Reality is becoming more widespread in the training of nursing students because it allows students to face situations that are difficult to manage or that rarely occur in their practice, but for which they must be prepared. Our objective is to evaluate whether mixed reality improves nursing students’ learning outcomes and satisfaction compared to simulation. Material and methods: This systematic review was performed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) The generic keywords used were ‘‘(nurses OR nurse OR nursing) AND mixed reality AND simulation’’. The literature search was carried out in the PubMed and CINAHL databases between 2011 and 2021. After the review, 4 references were selected. Based on the study title and abstract, two independent authors selected potential. Whenever a study meets the inclusion criteria, the authors access the full text. To assess potential bias, all studies included in the review were evaluated with the Newcastle-Ottawa Quality Assessment Scale Results: The search produced 54 papers but after reviewing only 4 were selected. Two studies were pretest post-test with a control group, while the other 2 were post-test only with no control group. Mixed reality was used in several settings (Maternal Health, Mental Health, CPR, and hospital ward) to increase the realism of simulations, increase confidence, reduce anxiety and stress of students in clinical situations. The results of the studies are contradictory, with poor quality studies showing positive effects, while studies with better quality and design showed poorer results. Conclusions: Mixed reality is a very recent technique in nursing education. It is necessary to carry out well-designed studies of adequate size to evaluate in which contexts it is effective. [ABSTRACT FROM AUTHOR]

Background In 2019, WHO classified vaccine hesitancy as one of the top 10 threats to global health. Vaccination is an area of excellence in nursing that has gained a new focus and has become a challenge in the provision of care and in the management field. Vaccine hesitation raises questions about mandatory vaccination, individual versus collective freedom that are highlighted in the current context due to the emergence of new vaccines. In this paper, we want to analyze and update knowledge about vaccines hesitancy from an ethical and bioethical perspective. Methods A combination of literature reviews on vaccine refusal/hesitancy, ethics and COVID-19 vaccine confidence, accessed on SciELO and PubMed databases and analysis of documents from General Directorate of Health and Ordem dos Enfermeiros (National Nurses Association). Results Vaccination programs aim is a collective protection. The desirable effects at individual level do not have the same ethical value at collective level, leading to cost-benefit imbalances. Moral conflicts between the individual and the collective, cost-benefit imbalances and the insufficiency of bioethics principles, lead us to the use of other moral values and principles, such as responsibility, solidarity and social justice, as a tool for ethical reflection problems related to COVID-19 vaccines. Conclusions There are no perfect solutions to ethical dilemmas and some optimal solutions could depend the context. In a pandemic situation, one of the most relevant ethical issues is the herd immunity since it leaves public health at risk. Equity and the principle of justice in vaccination campaign are shown daily in the nursing profession. [ABSTRACT FROM AUTHOR]

Background Physical activity (PA) has multiple important benefits for older adults, but many do not undertake the recommended amount. This systematic review examined the quantitative literature detailing barriers and motivators to PA in older adults: a concurrent qualitative review is underway. Previous reviews investigated younger age groups or specific diseases. Method We included adults ≥70 years, observational studies and baseline data for randomised controlled trials (RCTs); we excluded studies of specific disease groups, care home residents, and rates of cognitive impairment above population norms. We searched Medline, Embase, CINAHL and PsycINFO on 25th February 2020. We assessed risk-of-bias using ROBANS. We undertook a narrative review; meta-analysis was not possible. The protocol was registered on PROSPERO (CRD42021160503). Results We identified 35 papers (24 cross-sectional studies, eight prospective cohort studies, two studies of baseline data from RCTs and one mixed method study); n = 26,264 subjects, median age 77.7 years (range 70–101) and median percentage female 62.1% (range 0–100). Quality assessment identified low risk-of-bias overall, except two studies were identified as having a high risk-of-bias for one section (confounding variables). The most cited barriers were physical health (N = 14 studies), environmental factors (N = 12), fear of falls (N = 7) and lack of interest (N = 4). Other barriers identified were lack of company (N = 1) and urine leakage (in women) (N = 1). Key motivating factors included social aspects of PA (N = 8), intrinsic/psychological (e.g. self-determination, future orientation) (N = 8), health (e.g. doctor's advice) (N = 7) and environmental (e.g. nearby green space) (N = 4). Discussion This review identified key barriers and motivators to PA in older adults. There is a lack of evidence for the oldest old. These findings should be used to create trials of suitable interventions which enable older adults to take up and maintain recommended levels of PA. The wide range of factors we identified indicates an individualised approach may be best. [ABSTRACT FROM AUTHOR]

Background Early supported discharge (ESD) facilitates people with a stroke to be discharged from the hospital environment earlier than conventional care to continue their rehabilitation within the home with a multi-disciplinary team. Known benefits of ESD from Randomised Controlled Trials conducted include reducing the length of a hospital stay, long term dependency, and cost savings. There is limited qualitative evidence available on ESD. This systematic review and qualitative synthesis explored the experiences of those involved in ESD including people with stroke, family members, caregivers as well as healthcare professionals. Method A literature search was completed in 11 databases which generated 3,425 articles. Qualitative or mixed Method studies that included qualitative data on the experiences of people with stroke, family members, caregivers and healthcare professionals of an ESD service were included. The Critical Appraisal Skills Programme checklist was used to appraise the methodological quality of the papers. The findings were synthesised using the three step process for thematic synthesis. Results A total of fourteen studies were included with the methodological quality of the studies deemed good overall. Four key themes emerged: 1) ESD is experienced by people with stroke as a goal-focused and supportive process leading to positive outcomes, 2) ESD eases the transition from the hospital to the home environment but the transition from ESD to social and community services is often problematic, 3) Organisational, logistical and inter-professional factors are critical to the success of ESD and 4) The home environment enhances rehabilitation. Conclusion The findings of this qualitative evidence synthesis highlight the importance of the home environment in the rehabilitation process post stroke. Key practice implications point to the need for increased attention to periods where care transitions occur from ESD to community services. [ABSTRACT FROM AUTHOR]

Introduction Anticoagulation of elderly patients with Atrial Fibrillation (AF) and falls remains a domain of contention amongst clinicians. There is limited evidence to guide long-term anticoagulation decision in such patients. We performed a systematic-review and meta-analysis to guide anticoagulation decision. Methods We conducted a prospectively registered systematic-review and meta-analysis (PROSPERO: CRD42021228661). Studies investigating patients >65 years of age anticoagulated for AF at risk of falls were included. Outcomes included were stroke/systemic embolism (SSE), CNS bleeds, major non-CNS bleeds, and mortality. CENTRAL, MEDLINE, PsycINFO, CINAHL, DARE, Web of science and Scopus were searched. Two authors performed paper inclusion/exclusion, data extraction, risk of bias and GRADE assessment. Data was pooled quantitatively using random-effects models and expressed as Odds Ratio (OR) and 95% Confidence Intervals (95%CI). Results Nine studies were included and five were combined quantitatively. Studies had low to moderate risk of bias. Anticoagulated fallers were at higher risk of SSE (OR = 1.73, 95%CI:1.21–2.47, p = 0.003), CNS bleeds (OR = 1.67, 95%CI:1.25–2.23, p < 0.001), major bleeds (OR = 1.87, 95%CI:1.66–2.11, p < 0.001) and mortality (OR = 1.96, 95%CI:1.71–2.25, p < 0.001) compared to anticoagulated non-fallers. Anticoagulated fallers were at higher risk of major bleeds compared to fallers not on anticoagulation (OR = 1.69, 95%CI:1.03–2.77, p = 0.04). However, there was no statistically significant difference in SSE, CNS bleeds or mortality. In fallers, Direct Oral Anticoagulants (DOACs) have lower risk of CNS bleeds (OR = 0.19, 95%CI:0.09–0.041, p < 0.001) and major bleeds (OR = 0.78, 95%CI:0.60–1.01, p = 0.06) compared to warfarin. There was no statistically significant difference in SSE or mortality between the anticoagulants. Conclusion: (s) Falling on anticoagulation is associated with increased risk of complications. However, only risk of major non-CNS bleeds increases when anticoagulating fallers. In fallers, DOACs appear safer than warfarin for bleeding complications. There remains paucity of evidence about anticoagulation in fallers (GRADE certainty = very low—moderate). Further evidence is needed to help clinicians and patients regarding anticoagulation. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable.This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods: Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results: Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions: Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status. [ABSTRACT FROM AUTHOR]

Objectives: Cogan's syndrome is a rare disease of the inner ear and the eyeball. In several cases it may result in deafness, which may be treated with cochlear implantation. The aim of the study is to evaluate the effect of cochlear implantation in patients with Cogan syndrome based on the audiometric findings. Material: A literature research was held in English using key phrases: „Cogan's syndrome" or „Cogan syndrome" and „implantation" in scientific databases PubMed and Medline. Methods: The basic inclusion criterion was the description of hearing- and speech test results in patients with Cogan's syndrome before the implantation and after the implantation. Time criteria weren't used due to expected small number of the achievable articles. Results: In all papers a significant improvement of free-field hearing results was observed in patients after the implantation, no matter of the cochlear implant model. A gradual improvement in hearing abilities was noted along with the time from cochlear implantation. Regarding the speech audiometry, the results varied from 40% to 100% of speech intelligibility, with most of the patients achieving more than 80%. Conclusions: Cochlear implantation in patients Cogan's syndrome and concomitant deafness of results in significant improvement of hearing abilities. However, the literature is quite small and future studies are needed to conduct reliable metanalyses and draw firm conclusions. [ABSTRACT FROM AUTHOR]

Aim: Publication rate of congress abstracts has gained attention in the recent literature. Our aim was to assess publication rate and the reasons behind publication of abstracts presented at North American Spine Society (NASS) 2009-2012 annual scientific meetings. Methods: We evaluated the abstracts presented at the NASS 2009-2012 annual scientific meetings. We searched abstract titles and author names through the PubMed/MEDLINE and Google Scholar. Author specialty, origin of the abstract, journal name, time to publication (years) and content change were looked for. Results: The publication rate of the abstracts presented at NASS 2009-2012 was 48%. The 2011 congress was the most successful one at reaching publication compared to other three years. Oral presentation abstracts were more likely to be published than poster abstracts, except the year 2011. Orthopedic surgery was the leading specialty in the number of presented abstracts (70%), while neurosurgery was the most successful specialty in seeing publication of the presented abstracts (58%). Conclusion: The publication rate of presented abstracts of NASS has increased compared to the previous years. Further research is needed to understand the reasons for some presented abstracts that could not have been published in scientific journals. [ABSTRACT FROM AUTHOR]

Background: More than 50% of non-smoking women and children are exposed to second-hand smoke (SHS) in Middle Eastern countries. This review aims to synthesize the evidence on experiences and views of parents, children, and professionals towards SHS exposure prevention in Middle Eastern countries. Methods: We included qualitative studies exploring experiences and views on prevention of SHS exposure among women and children in all settings in Middle Eastern countries. A systematic review was undertaken according to the Joanna Briggs Institute (JBI) guidelines for qualitative systematic reviews. Nine databases were searched from inception to January 2021. Meta-aggregation was used to synthesize the findings. Results: Out of 5229 records identified, two qualitative studies reported in three publications met the eligibility criteria and were included. Using the JBI checklist for qualitative research, the critical appraisal scores of all papers were high. One study was conducted in Turkey and the other one in Israel, and study participants were parents of children. A total of 49 findings were extracted and aggregated into 8 categories, based on the similarity of meaning. Parents were aware that SHS is harmful, although the hazards of SHS exposure were not commonly discussed during pregnancy. However, there were conflicting views on ways of SHS exposure and approaches to minimise it. Parents implemented rules to decrease SHS exposure among children. While some parents were uncertain about the effectiveness of protective measures. Most common perceived barriers to reducing SHS exposure were beliefs about traditional values and personal psychological factors. Conclusions: Parents in Middle Eastern countries knew that children's SHS exposure is harmful, though knowledge was not comprehensive and did not translate into actions to protect children. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures. Key messages: Parents' risk-awareness of SHS exposure is inadequate. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures in Middle Eastern countries. [ABSTRACT FROM AUTHOR]

Background: Evidence available on the determinants of vegetable intake in young populations is inconsistent. No review has particularly focused on this topic in disadvantaged adolescents. This systematic review aimed to investigate the determinants of vegetable intake in disadvantaged adolescents reported in qualitative studies. Methods: Five electronic databases were searched until October 2020 using combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Studies published in peer-reviewed journals were included if they used qualitative methods (e.g., interviews, focus groups, etc.), targeted disadvantaged individuals aged 12-18 years, investigated determinants, motivators and barriers to vegetable intake, and were conducted in urban settings of high-income countries. Two reviewers independently and systematically summarized the papers, assessed their quality and synthesized the findings across studies. Results: Sixteen studies meeting the inclusion criteria were included. The synthesis of findings identified the following determinants for vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, selfefficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment; parental influence; encouragement/support outside the household; friends' influence; school nutrition education; teachers' support; school food environment; local produce; community nutrition knowledge; and availability and accessibility of vegetables in local stores, restaurants and fastfood outlets. Conclusions: Multiple determinants of vegetable intake were identified which complement those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in disadvantaged adolescents. Key messages: Vegetable intake is influenced by multiple factors in disadvantaged adolescents. Main determinants are vegetable attributes, personal factors, friends, family, school and community environment. [ABSTRACT FROM AUTHOR]

Primary care is a growing medical field willing to become a more integrated and technological asset. Although big changes already happened and more investments have been made, a limited amount of literature describes processes and technologies there applied or to be used. This paper aims to evaluate the efficacy and usability of different types of algorithms in primary care to improve drug safety by speeding up processes and achieving greater accuracy opening the path to providing better healthcare overall. The PICO model was adopted, three electronic databases (PubMed, Cochrane, Web of Science) were searched using appropriate keywords. Selected studies were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment of Controlled Intervention Studies. Data were analysed using descriptive statistic, comparison of drug usage between algorithms or artificial intelligence application and usual care was performed using a X² test(α= 0.05). Out of 2207,19 studies were included,37% of them regarding error prevention,21% drug interactions,21% drug monitoring,16% drug prescription,5% drug administration. Results showed an easier and safer medication use in 74% of studies, a loss of safeness and accuracy in 16%; 10% of total studies did not come up with a valid esteem of results either for inadequate availability of the AI machine or because of the heterogeneity of the results in different settings. The evaluation of errors prevention, 40% of total studies, showed the most statistically significant results with 88% of positive outcomes from AI application. The results support that this technological approach to drugs management could contribute to the safety of treatment and to increase patients’ and general practitioners’ satisfaction. The application of AI or algorithms is significantly associated with a reduction of drug use errors (p < 0.05). Future studies should work toward establishing a gold standard to measure AI performances. Key messages: · Artificial Intelligence and Algorithms in primary care have the potentiality to disrupt patient care with a safer and faster medication management. · A comparison between Artificial Intelligence or algorithms and standard clinical practice may help finding the medication fields where a technological support could lead to better results. [ABSTRACT FROM AUTHOR]

Background: Healthcare decision-makers need comprehensive evidence to mitigate surges in the demand for human resources for health (HRH) during infectious disease outbreaks, in terms of both short- and longer-term impacts. This study aimed to assess the state of the evidence to address HRH surge capacity during COVID-19 and other outbreaks of global significance in the 21st century. Methods: We systematically searched eight bibliographic databases to extract primary research articles published between 01/2000- 06/2020, capturing temporal changes in HRH requirements and responses surrounding viral respiratory infection pandemics. A systems approach was used, considering providers in hospitals, out-of-hospital systems, emergency medical services, and public health. We narratively synthesized the evidence following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) standard. Results: Of the 1,155 retrieved records, 16 studies met our inclusion criteria; of these, 5 focused on COVID-19, 3 on H1N1, and 8 on a hypothetical pandemic. Different training, mobilization, and redeployment options to address pandemic-time health system capacity were assessed. Few governance scenarios drew on observational HRH data allowing for comparability across contexts. Notable evidence gaps included occupational and psychosocial factors affecting healthcare workers’ absenteeism and risk of burnout, gendered considerations of HRH capacity, evaluations in low- and lower-middle income countries, and policy-actionable assessments to inform post-pandemic recovery and sustainability of services for noncommunicable disease management. Conclusions: This research emphasized the critical need for timely, internationally comparable, and equity-informative HRH data and research to enhance preparedness, response, and recovery policies for this and future pandemics. Full paper is available at: https://doi.org/10.1002/hpm.3137 Key messages: The COVID-19 pandemic has highlighted the critical need for enhanced health workforce data and research, including better tracking of demographics, exposures, infections and deaths of health workers. Although women comprise 70% of the health workforce in many countries, gender-blindness persists in the global literature on health workforce research and governance in public health emergencies./bodyt [ABSTRACT FROM AUTHOR]

Background: Migrants in Europe are at risk of under-immunisation and may also have lower COVID-19 vaccination intent and uptake. There is an urgent need to better understand the drivers of uptake in these groups to inform the development of migrantsensitive interventions for COVID-19 vaccination and routine vaccination beyond the pandemic. Methods: We did a systematic review (PROSPERO: CRD42020219214) following PRISMA guidelines to explore factors influencing vaccine uptake in migrants in the EU/EEA and identify determinants of under-immunisation. We also held 3 participatory workshops with multinational migrant community leaders (n = 23) in London, to explore solutions and approaches to strengthen COVID-19 vaccine roll-out. Results: We included 66 papers reporting data on 262,761 migrants in the review. Numerous access-related factors (e.g. government policy, communication barriers) influenced uptake. Vaccine hesitancy was attributed to lack of information, concerns [ABSTRACT FROM AUTHOR]

PURPOSE: A systematic review of experimental design studies published from 2000 to 2020 was conducted in order to identify if Obsessive-Compulsive Disorder (OCD) symptoms are reduced by participation in physical activity modalities. METHODS: Six Databases were searched: Medline, Cinhal, Psychinfo, SportsDiscus, Pubmed, and Science Direct. The following Search Terms (or Combination) related were employed: Exercise AND OCD; Exercise AND Obsessive Compulsive Disorder; Physical Activity AND Obsessive Compulsive Disorder; Physical Activity AND OCD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was implemented in order to examine and to report published studies. The inclusion criteria are: Participants include adults 18-years or older, clinically diagnosed with OCD; Independent Variable: Physical activity or an exercise regimen; Designs: Randomized Controlled Trial (RCT) or Repeated Measure Design (RMD); Only papers written in English were included. The Effect Size (d) is reported for evaluating continuous outcome, to ascertain the mathematical difference between baseline and post-treatment assessment or follow-up result was evaluated to determine the change in secondary outcomes. Study quality was evaluated using the Downs and Black Risk of Bias Checklist. RESULTS: Overall, 6 experimental design studies were identified; 3 out of 6 were RMD, and 3 out of 6 were RCT. The results of most of the reviewed studies show that exercise Intervention with Cognitive Behavioral Therapy (CBT) achieved greater reduction of OCD symptoms at post-intervention, while also maintaining the reduction of OCD symptoms during multiple follow- ups ranging from 3-weeks to 1-year. The greatest effects of longer-term reduction in OCD symptoms were found at 12-weeks post-treatment with a combination of Exercise Modalities and CBT. CONCLUSIONS: A combination of Exercise Modality and CBT offer potential reduction of distressing signs and symptoms for OCD sufferers. [ABSTRACT FROM AUTHOR]

Introduction Big data is defined as the amount of data that once organized and analysed, can make a value, make decisions, make predictions and discover patterns in order to reduce costs, avoid risks and optimize services. Machine Learning (ML) is a field of artificial intelligence and is characterized as a method of machine learning, which uses algorithms that learn from data analysis, allowing computers to find patterns, draw conclusions and make predictions. These tools can be used in different areas of human knowledge, particularly in the health sector which are generated daily a huge amount of information, allowing the creation of algorithms that learn and gain understanding to assist in various clinical practices. Objectives The purpose of this paper is to analyse the benefits of Big Data and Machine Learning in providing overall health care. Methodology We conducted a review of the scientific literature published in the electronic databases PubMed/MEDLINE and Google Scholar, according to specific criteria, using keywords: Big Data", "Machine Learning". Results In the field of oncology (skin cancer, breast, lung, leukaemia) ML and Big Data have contributed to early diagnosis of different pathologies and their evolution, as well as optimizing therapies. In ophthalmology (diabetic retinopathy and congenital cataract) has shown high efficacy in rapid diagnosis and appropriate treatment crucial to prevent the progress of the disease. The tested algorithms achieved very favourable results in cases of Parkinson's and cardiovascular diseases. In the pharmaceutical industry these computer and digital tools have contributed to the optimization of clinical trials, genome sequencing of tumours to then identify and develop specific drugs to fight it. Conclusion Advances of MIL and Big data are notorious and development opportunities are immense and can come to revolutionize tasks such as diagnosis, treatment and health care in general. [ABSTRACT FROM AUTHOR]

Background/Aims: Physiotherapy consultations in an orthopaedic setting often require visualisation and a 'hands on' approach. There has been an increasing number of research studies exploring the effectiveness and acceptability of telephone and videoconferencing consultations within orthopaedics. Much of the drive behind this change has been to improve access to care and to link the clinic to the home environment. The introduction of communication technology consultations requires a shift in patient workload, which may impact on patient experience of accessing healthcare and managing their condition. The purpose of this research is to systematically review qualitative papers reporting communication technology consultations (phone and videoconference) in orthopaedics. Attention will be focused towards the effect of communication technology on the workload of being a patient. Methods: The protocol for the systematic review was registered and is available to view on the PROSPERO database (CRD42018100896). MEDLINE, AMED, CINAHL, PsychINFO, SCOPUS databases were independently searched, using the search strategy, by two researchers to identify qualitative papers reporting communication technology use in an orthopaedics setting. Data from Introduction, Results and Discussion sections were extracted and an attribution of statements formulated. All statements were thematically analysed into families of themes surrounding patient workload. Results: The search identified 1542 papers that were included for review and eight full texts met the inclusion criteria and were included for analysis. Two studies reported telephone consultations and six reported real time videoconferencing consultations. Six families of themes were identified: (1) skills; (2) clinical interactions; (3) environment; (4) processes; (5) impact on patient; (6) preferences. Conclusions: Literature on the use of communication technologies in healthcare, such as videoconferencing and telephone consultations, is growing in orthopaedics. Qualitative papers highlight the benefits and challenges of communication technology consultations. This review synthesises the change in the workload that patient's face when using these technologies. These altered demands of communication technology consultations affect the patient's experience of accessing healthcare. Consideration of these factors and tailored individualised support for patients may enhance the patient experience and increase suitability of communication technology consultations for orthopaedic patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION Ankle-foot orthoses (AFOs) are commonly prescribed to treat a range of lower-limb deficits by providing ankle support during walking. Current prescription standards provide general guidelines for choosing between AFO types but are limited in terms of guiding specific design parameter choices. AFO design parameters; e.g., trimlines, thickness, and material type, affect the AFO’s torsional stiffness (Major, 2004). In order to prescribe the best designs for their patients, clinicians need to know if and how stiffness affects patient outcomes. Therefore, the purpose of this literature review was to determine the impact of AFO torsional stiffness on walking performance. METHOD A literature search was conducted during February 2018 using three databases (Pubmed, Engineering Village, and Web of Science), PRISMA guidelines (Moher, 2009), and the following search terms: (ankle-foot orthosis OR AFO OR ankle foot orthosis) AND (stiffness OR resistance OR compliance OR rigidity OR flexibility OR energy storage OR energy return) AND (gait OR walking OR outcomes OR performance). Potentially relevant articles were screened against the following exclusion criteria: (1) no experimental subject data was presented; (2) the study did not include an AFO/AFO-like device; (3) no comparisons were drawn across stiffness conditions or only one stiffness was tested for each subject; (4) the intervention applied powered assistance and not passive resistance at the ankle; (5) AFO stiffness varied (was not constant) within a single stiffness condition; and (6) the study did not include a walking activity. The remaining articles were further analyzed, and their quality was assessed by three independent reviewers using a 10-point modified PEDro scale (Tyson, 2013). Each was scored by reviewer consensus. RESULTS After applying the exclusion criteria, 26 of 287 potential articles were included. A majority of the studies had low to moderate quality scores (i.e., below 7/10); the highest rating received was 8/10. Only one study ensured subjects were blinded to the test conditions, only three included sufficient participant eligibility criteria, and 11 papers failed to perform between-group statistical analyses. The included papers tested a variety of stiffnesses (0.02 to 8.17 Nm/ deg), covered several populations (healthy, post-stroke, cerebral palsy, Charcot-Marie-Tooth, and lower-limb salvage and trauma), and reported a variety of outcome measures. Nineteen of 26 studies measured stiffness experimentally. Measurement methods differed between studies. Ankle kinematics parameters were the most frequently reported and consistently affected measures. Greater stiffnesses generally resulted in decreased peak ankle plantar flexion, dorsiflexion, and range of motion, as well as increased initial contact ankle angle. At the knee, increased stiffness caused reduced peak knee extension during stance, increased peak knee flexion during stance, and increased knee flexion at initial contact. There was low evidence for the effect of stiffness on hip or pelvis kinematics. Stiffness did not affect hip kinetics, and there was low evidence for its effects on ankle and knee kinetics, muscle activity, metabolics, ground reaction force pattern, and gait spatiotemporal parameters. There were no generalizable trends for the impact of stiffness on user preference. DISCUSSION Drawing comparisons between the studies proved difficult due to differences in stiffness reporting and measurement, and the low number of participants for each subject population. Others have also highlighted the lack of established standards for reporting AFO design variables (Malas, 2011) and patient deficits (Chisholm, 2012). Nonetheless, stiffness consistently affected distal joint kinematics. CONCLUSION AFO torsional stiffness is a key factor influencing ankle movement. Clear reporting standards for AFO design parameters, as well as additional higher quality research is needed with larger sample sizes and different clinical populations to ascertain the true effect of stiffness on gait. [ABSTRACT FROM AUTHOR]

Introduction: Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT; www.the4AT.com) is a short (<2 min) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. Methods: We searched the following electronic databases through Ovid: MEDLINE, Embase, and PsycINFO. Additional databases were searched: CINAHL (EBSCOhost), clinicaltrials.gov and Cochrane Central Register of Controlled Trials from 2011 (4AT publication) until 21 December 2019. Inclusion criteria: older adults (≥65) across any setting of care except critical care; validation study of the 4AT against a delirium reference standard (standard diagnostic criteria or validated tool). Two reviewers independently screened abstracts and papers and performed the data extraction. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model. Results: 17 studies (n = 3,701 observations) were included. Various settings including acute medicine, surgery, stroke wards and the emergency department were represented. The overall prevalence of delirium was 24.2% (95% CI 17.8–32.1%; range 10.5–61.9%). The pooled sensitivity was 0.88 (95% CI 0.80–0.93) and the pooled specificity was 0.88 (95% CI 0.82–0.92). The methodological quality of studies was mostly good. Conclusions: The 4AT is now supported by a substantial evidence base comparable to other well-studied tools such as the Confusion Assessment Method (CAM). The strong pooled sensitivity and specificity findings for the 4AT in this meta-analysis along with its brevity and lack of need for specific training provide support for its use as an effective assessment tool for delirium. [ABSTRACT FROM AUTHOR]

Background and Objectives: The socioeconomic burden of dementia is very high and on the rise. Currently there is no cure for dementia; therefore, it is key to identify the modifiable risk factors for this condition.The association between adiposity and dementia is not yet convincingly established. This systematic review aimed to critically appraise the quality and to synthesise the findings of recently published longitudinal studies examining the association between adiposity and the development of dementia. Methods: A comprehensive literature search on longitudinal studies published between 2013 and 2018 was conducted across MEDLINE, EMBASE, PsycINFO and SCOPUS. The quality of selected papers was assessed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies (NOS) and PRISMA-IPD checklist. The results of the included studies were qualitatively synthesised. Results: Of the 1,370 citations identified and reviewed, 10 completely met the inclusion criteria.Of the 10 included studies, 9 were high quality cohort studies, scoring an average of 8.4 out of 9 for NOS. One study was an individual patient data meta-analysis study (IPD). The IPD had high scientific rigour and largely adhered to the PRISMA-IPD checklist. In total, the 9 cohort studies included more than 2 million subjects, with 3 cohorts recruiting exclusively men. The IPD contained data from 39 cohorts and 1.3 million participants. 4 studies were conducted in highly selective cohorts. Apart from European male populations, the other populations were markedly under-represented. All studies used body mass index (BMI) as a proxy for adiposity. None of the included studies did a sample size calculation. Only half of the included studies were able to produce significant results, suggesting insufficient sample size and lack of power. The included studies reached contradictory results, with half of the studies favouring a protective effect of adiposity. Conclusions: In view of the results and quality of the studies, this review found that there was insufficient evidence to establish the association between adiposity and dementia. Current evidence suggests an association between mid-life obesity and dementia development in late-life. Longer studies were more likely to conclude that adiposity was detrimental to health.The inconsistent conclusions could be the result of reverse causality. To conclusively establish the link between adiposity and dementia, more research with robust methodology is warranted. [ABSTRACT FROM AUTHOR]