-
The Lancet. Digital Health Oct 2023Data sharing is central to the rapid translation of research into advances in clinical medicine and public health practice. In the context of COVID-19, there has been a... (Review)
Review
Data sharing is central to the rapid translation of research into advances in clinical medicine and public health practice. In the context of COVID-19, there has been a rush to share data marked by an explosion of population-specific and discipline-specific resources for collecting, curating, and disseminating participant-level data. We conducted a scoping review and cross-sectional survey to identify and describe COVID-19-related platforms and registries that harmonise and share participant-level clinical, omics (eg, genomic and metabolomic data), imaging data, and metadata. We assess how these initiatives map to the best practices for the ethical and equitable management of data and the findable, accessible, interoperable, and reusable (FAIR) principles for data resources. We review gaps and redundancies in COVID-19 data-sharing efforts and provide recommendations to build on existing synergies that align with frameworks for effective and equitable data reuse. We identified 44 COVID-19-related registries and 20 platforms from the scoping review. Data-sharing resources were concentrated in high-income countries and siloed by comorbidity, body system, and data type. Resources for harmonising and sharing clinical data were less likely to implement FAIR principles than those sharing omics or imaging data. Our findings are that more data sharing does not equate to better data sharing, and the semantic and technical interoperability of platforms and registries harmonising and sharing COVID-19-related participant-level data needs to improve to facilitate the global collaboration required to address the COVID-19 crisis.
Topics: Humans; COVID-19; Cross-Sectional Studies; Information Dissemination; Registries; Metadata
PubMed: 37775189
DOI: 10.1016/S2589-7500(23)00129-2 -
Microbiology Spectrum Aug 2023The global dissemination of methicillin-resistant Staphylococcus aureus (MRSA) is associated with the emergence and establishment of clones in specific geographic areas....
The global dissemination of methicillin-resistant Staphylococcus aureus (MRSA) is associated with the emergence and establishment of clones in specific geographic areas. The Chilean-Cordobes clone (ChC) (ST5-SCCI) has been the predominant MRSA clone in Chile since its first description in 1998, despite the report of other emerging MRSA clones in recent years. Here, we characterize the evolutionary history of MRSA from 2000 to 2016 in a Chilean tertiary health care center using phylogenomic analyses. We sequenced 469 MRSA isolates collected between 2000 and 2016. We evaluated the temporal trends of the circulating clones and performed a phylogenomic reconstruction to characterize the clonal dynamics. We found a significant increase in the diversity and richness of sequence types (STs; Spearman = 0.8748, < 0.0001) with a Shannon diversity index increasing from 0.221 in the year 2000 to 1.33 in 2016, and an effective diversity (Hill number; q = 2) increasing from 1.12 to 2.71. The temporal trend analysis revealed that in the period 2000 to 2003 most of the isolates (94.2%; = 98) belonged to the ChC clone. However, since then, the frequency of the ChC clone has decreased over time, accounting for 52% of the collection in the 2013 to 2016 period. This decline was accompanied by the rise of two emerging MRSA lineages, ST105-SCCII and ST72-SCCVI. In conclusion, the ChC clone remains the most frequent MRSA lineage, but this lineage is gradually being replaced by several emerging clones, the most important of which is clone ST105-SCCII. To the best of our knowledge, this is the largest study of MRSA clonal dynamics performed in South America. Methicillin-resistant Staphylococcus aureus (MRSA) is a major public health pathogen that disseminates through the emergence of successful dominant clones in specific geographic regions. Knowledge of the dissemination and molecular epidemiology of MRSA in Latin America is scarce and is largely based on small studies or more limited typing techniques that lack the resolution to represent an accurate description of the genomic landscape. We used whole-genome sequencing to study 469 MRSA isolates collected between 2000 and 2016 in Chile providing the largest and most detailed study of clonal dynamics of MRSA in South America to date. We found a significant increase in the diversity of MRSA clones circulating over the 17-year study period. Additionally, we describe the emergence of two novel clones (ST105-SCCII and ST72-SCCVI), which have been gradually increasing in frequency over time. Our results drastically improve our understanding of the dissemination and update our knowledge about MRSA in Latin America.
Topics: Humans; Methicillin-Resistant Staphylococcus aureus; Staphylococcal Infections; Chile; Phylogeny; Tertiary Care Centers; Anti-Bacterial Agents
PubMed: 37338398
DOI: 10.1128/spectrum.05351-22 -
Antimicrobial Stewardship & Healthcare... 2023Early in the pandemic, pre-print servers sped rapid evidence sharing. A collaborative of major medical journals supported their use to ensure equitable access to...
Early in the pandemic, pre-print servers sped rapid evidence sharing. A collaborative of major medical journals supported their use to ensure equitable access to scientific advancements. In the intervening three years, we have made major advancements in the prevention and treatment of COVID-19 and learned about the benefits and limitations of pre-prints as a mechanism for sharing and disseminating scientific knowledge. Pre-prints increase attention, citations, and ultimately impact policy, often before findings are verified. Evidence suggests that pre-prints have more spin relative to peer-reviewed publications. Clinical trial findings posted on pre-print servers do not change substantially following peer-review, but other study types (e.g., modeling and observational studies) often undergo substantial revision or are never published. Nuanced policies about sharing results are needed to balance rapid implementation of true and important advancements with accuracy. Policies recommending immediate posting of COVID-19-related research should be re-evaluated, and standards for evaluation and sharing of unverified studies should be developed. These may include specifications about what information is included in pre-prints and requirements for certain data quality standards (e.g., automated review of images and tables); requirements for code release and sharing; and limiting early postings to methods, results, and limitations sections. Academic publishing needs to innovate and improve, but assessments of evidence quality remains a critical part of the scientific discovery and dissemination process.
PubMed: 37663450
DOI: 10.1017/ash.2023.410 -
Frontiers in Public Health 2024Food security (FS) is a powerful social determinant of health (SDOH) and is crucial for human and planetary health. The objectives of this article are to (i) provide... (Review)
Review
Food security (FS) is a powerful social determinant of health (SDOH) and is crucial for human and planetary health. The objectives of this article are to (i) provide clarity on the definitions of FS and nutrition security; (ii) provide a framework that clearly explains the links between the two constructs; (iii) summarize measurement approaches, and (iv) illustrate applications to monitoring and surveillance, policy and program design and evaluation, and research, mainly based on the ongoing rich experience with food insecurity (FI) scales. A clear and concise definition of FI and corresponding frameworks are available. There are different methods for directly or indirectly assessing FI. The best method(s) of choice need to be selected based on the questions asked, resources, and time frames available. Experience-based FI measures disseminated from the United States to the rest of the world in the early 2000s became a game changer for advancing FI research, policy, program evaluation, and governance. The success with experience FI scales is informing the dissemination, adaptation, and validation of water insecurity scales globally. The many lessons learned across countries on how to advance policy and program design and evaluation through improved FS conceptualization and measurement should be systematically shared through networks of researchers and practitioners.
Topics: Humans; United States; Food Supply; Nutritional Status
PubMed: 38550323
DOI: 10.3389/fpubh.2024.1340149 -
JBI Evidence Implementation Sep 2023A gap exists between scientific discovery and implementation and adoption of research findings in healthcare and public health practice. This gap is due to the fact that...
BACKGROUND
A gap exists between scientific discovery and implementation and adoption of research findings in healthcare and public health practice. This gap is due to the fact that research on treatment efficacy and safety in clinical trials ends prematurely with the publication of results, leaving a lack of knowledge of treatment effectiveness in real-world clinical and community settings. Comparative effectiveness research (CER) can facilitate the translation of research findings, reducing the gap between discovery and adoption into practice. Getting CER findings to patients and healthcare providers requires efforts to disseminate and train providers to successfully implement and sustain change in the healthcare setting. Advanced practice registered nurses (APRNs) are instrumental in the implementation of evidence-based research in primary care settings and an important group to target for the dissemination of research findings. There are numerous implementation training programs, but none focus specifically on APRNs.
OBJECTIVE
The objective of this article is to describe the infrastructure established to develop a 3-day implementation training program for APRNs and an implementation support system.
METHOD
A description of the processes and strategies is provided, including stakeholder engagement through focus groups and the formation of a multistakeholder program planning advisory team, which includes APRNs, organization leaders, and patients. The program also includes curriculum development and program planning as well as the development of an implementation toolkit.
RESULTS
Stakeholders were instrumental in shaping the implementation training program, including the content of the curriculum and the program agenda. In addition, the unique perspective of each stakeholder group contributed to the selection of the CER findings disseminated through the intensive training program.
CONCLUSION
It is important that strategies to address the lack of implementation training opportunities for APRNs be discussed and disseminated within the healthcare community. This article discusses the plan to address implementation training for APRNs through the development of an implementation curriculum and toolkit for APRNs.
Topics: Humans; Advanced Practice Nursing; Implementation Science; Delivery of Health Care; Curriculum; Nurses
PubMed: 37102428
DOI: 10.1097/XEB.0000000000000376 -
Diseases (Basel, Switzerland) Apr 2024Globally, sepsis and pneumonia account for significant mortality and morbidity. A complex interplay of immune-molecular pathways underlies both sepsis and pneumonia,... (Review)
Review
Globally, sepsis and pneumonia account for significant mortality and morbidity. A complex interplay of immune-molecular pathways underlies both sepsis and pneumonia, resulting in similar and overlapping disease characteristics. Sepsis could result from unmanaged pneumonia. Similarly, sepsis patients have pneumonia as a common complication in the intensive care unit. A significant percentage of pneumonia is misdiagnosed as septic shock. Therefore, our knowledge of the clinical relationship between pneumonia and sepsis is imperative to the proper management of these syndromes. Regarding pathogenesis and etiology, pneumococcus is one of the leading pathogens implicated in both pneumonia and sepsis syndromes. Growing evidence suggests that pneumococcal pneumonia can potentially disseminate and consequently induce systemic inflammation and severe sepsis. Streptococcus pneumoniae could potentially exploit the function of dendritic cells (DCs) to facilitate bacterial dissemination. This highlights the importance of pathogen-immune cell crosstalk in the pathophysiology of sepsis and pneumonia. The role of DCs in pneumococcal infections and sepsis is not well understood. Therefore, studying the immunologic crosstalk between pneumococcus and host immune mediators is crucial to elucidating the pathophysiology of pneumonia-induced lung injury and sepsis. This knowledge would help mitigate clinical diagnosis and management challenges.
PubMed: 38667530
DOI: 10.3390/diseases12040072 -
Indian Journal of Dermatology 2024We retrospectively analyzed the clinical data of 1 case of disseminate and recurrent infundibular folliculitis (DRIF) in our hospital and 31 cases of DRIF reported in...
We retrospectively analyzed the clinical data of 1 case of disseminate and recurrent infundibular folliculitis (DRIF) in our hospital and 31 cases of DRIF reported in previous domestic and international studies. There were 32 cases, including 22 males and 10 females, with a mean age of onset of 24.72 ± 13.68 years. Skin lesions were more likely to occur on the trunk and proximal extremities and may involve the face, neck, and genitals. Typical histopathology revealed mild thickening and spongy edema of the spinous layer, different degrees of pigmentation increase in the basal layer, and mild to moderate spongy edema and inflammatory cell infiltration (predominantly lymphocytes and neutrophils) in the infundibulum and around the hair follicle. DRIF is a chronic disease more prevalent in young men of African descent and individuals with Fitzpatrick skin types 4-6. This disease is diagnosed based on clinical features and histopathology and is preferentially treated with retinoids.
PubMed: 38572033
DOI: 10.4103/ijd.ijd_695_23 -
Medical Humanities Dec 2023Arthur Conan Doyle's medical and writing careers intertwined and his work has a history of being read in the light of his medical expertise. He wrote at a time when the...
Arthur Conan Doyle's medical and writing careers intertwined and his work has a history of being read in the light of his medical expertise. He wrote at a time when the professionalisation and specialisation of medicine had resulted in an increasing distance between the profession and the public, yet general practitioners relied financially on maintaining good relationships with their patients and popular medical journalism proliferated. A variety of contrasting voices often disseminated narratives of medical science. These conflicting developments raised questions of authority and expertise in relation to the construction of medicine in the popular imagination: how is knowledge constructed? Who should disseminate it? How and by whom is authority conferred? How can the general population judge experts in medical science? These are questions explored more widely in Conan Doyle's writing as he examines the relationship between expertise and authority. In the early 1890s, Conan Doyle wrote for the popular, mass-market periodical His contributions to it address these questions of authority and expertise for a lay audience. First establishing the medical context of doctor/patient relationships in which these questions arose, this article undertakes a close reading of these mostly rarely studied single-issue stories and articles as a means of ascertaining how Conan Doyle and his illustrators identified the relationship between competing narratives, expertise and authority. It argues that rather than maintaining a distance between public and professional, Conan Doyle's illustrated work demonstrates to his readers that there are ways to successfully navigate the appearance of authority and recognise expertise as they confront entangled representations of advances in medical science.
Topics: Male; Humans; Literature, Modern; Medicine; Medicine in Literature; Knowledge; Physician-Patient Relations
PubMed: 37142410
DOI: 10.1136/medhum-2022-012491 -
Clinical Nurse Specialist CNSCommunication of practice changes to frontline nurses across an organization can be difficult. Frequent daily communication to all nursing staff can be ineffective and...
PURPOSE/OBJECTIVES
Communication of practice changes to frontline nurses across an organization can be difficult. Frequent daily communication to all nursing staff can be ineffective and lead to email fatigue and information overload. The purpose of this article is to further describe the communication intervention developed to disseminate practice changes and the critical modifications made over time to ensure its continued success and sustainability.
DESCRIPTION OF THE PROJECT/PROGRAM
In 2019, this team from a multisite institution developed a monthly email correspondence, called the Evidence-Based Practice Update, sent to local leaders to disseminate important policy and practice updates and reminders to more than 3400 nurses. This strategy was initially successful in reaching the nurses yet lacked a method to ensure accountability that each nurse has read the content. A quick response code was added to track monthly readership, and clinical nurse specialists were leveraged to ensure practice changes reached, reviewed, and understood by nurses across the institution.
OUTCOME
Metrics were tracked for quick response code scans and demonstrated an increase in readership over time. By combining various alerts into the single correspondence, fewer daily notifications to staff were sent. The EBP Update email dissemination structure involving local leaders was well received.
CONCLUSION
This article describes how a standardized communication strategy coupled with thoughtful leadership engagement improved uptake of important practice information by nurses across a vast institution.
Topics: Humans; Communication; Nurse Clinicians; Evidence-Based Nursing; Electronic Mail; Nursing Evaluation Research; Information Dissemination; Leadership
PubMed: 38889058
DOI: 10.1097/NUR.0000000000000832 -
BMJ Open Aug 2023Dementia-related stigma reduces the quality of life of people living with dementia and their care partners. However, there is a dearth of literature synthesising...
INTRODUCTION
Dementia-related stigma reduces the quality of life of people living with dementia and their care partners. However, there is a dearth of literature synthesising knowledge on stigma of dementia during the COVID-19 pandemic. This scoping review protocol outlines a methodology that will be used to understand the impact of stigma on people living with dementia during the pandemic. Addressing dementia-related stigma is critical to promoting timely dementia diagnoses and enhancing the quality of life for people living with dementia and their care partners.
METHODS AND ANALYSIS
This review will follow the Arksey and O'Malley methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The review will focus on English-language, peer-reviewed literature published between 13 January 2020 and 30 June 2023. Stigma will be broadly defined according to pre-established components (stereotypes, prejudice and discrimination). We will search six databases including CINAHL, EMBASE, Google Scholar, Medline, PsycINFO and Web of Science. We will also hand-search the reference lists of relevant articles to identify additional manuscripts. Two reviewers will develop the data extraction table, as well as independently conduct the data screening. Any disagreements will be resolved through open discussion between the two researchers, and if necessary, by consulting the full team to achieve consensus. Data synthesis will be conducted using an inductive thematic analysis approach.
ETHICS AND DISSEMINATION
This review will be the first to explore the impact of dementia-related stigma during the COVID-19 pandemic. An advisory panel including a person living with dementia and a care partner will be consulted to inform our review's findings and support the data dissemination process. The results of this scoping review will be shared and disseminated through publication in a peer-reviewed journal, presentations at academic conferences, a community workshop and webinars with various stakeholders.
Topics: Humans; COVID-19; Dementia; Pandemics; Quality of Life; Review Literature as Topic; Social Stigma
PubMed: 37643852
DOI: 10.1136/bmjopen-2023-076300