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The Lancet. Planetary Health Apr 2024Climate change and mental health outcomes are two of the most pressing global crises. Despite the increasing global mental health burden, climate-related mental health... (Review)
Review
BACKGROUND
Climate change and mental health outcomes are two of the most pressing global crises. Despite the increasing global mental health burden, climate-related mental health outcomes research is nascent and isolated, with substantial gaps across regions and disciplines. Connecting Climate Minds is a global initiative connecting researchers, experts, and people with lived experience of adverse mental health outcomes to identify regional research needs and create a community to support improved climate-related mental health outcomes.
METHODS
We focused on North America and Europe as part of the global Connecting Climate Minds effort, using semi-structured interviews, focus groups, regional dialogues (ie, discussions between experts in climate health, planetary health, human health, and mental health and with lived experience to discuss the climate threats most affecting their communities, their effects on mental health, and opportunities for action), and a literature review to identify crucial research gaps in climate change and mental health. We collected insights into priorities when addressing mental health outcomes related to climate change in Europe and North America; requirements for effective research, policy, and practice; and encouraging collaboration from a diverse community that included experts, researchers, practitioners from multiple disciplines, indigenous groups, and youth representatives. We used a qualitative framework analysis to identify consensus priorities.
FINDINGS
Several themes emerged regarding research gaps. First, research into the effects of climate change on mental health is needed (eg, how pre-existing mental health outcomes are affected by climate disaster events, risk factors and protective factors, the effects of climate action or inaction on mental health, and economic costs). Second, investigating connections between climate-related mental health outcomes and Indigenous and other cultural practices (eg, the effects of climate change on Indigenous peoples and practices, cultural variations in mental health responses, and the effectiveness of integrating Indigenous and cultural knowledge into mental health interventions). Third, mixed-methods research is needed to explore the relationships between climate change, global and national economies, and governance and their associations with mental health outcomes. Fourth, evaluating social and cultural connectedness in mental health outcomes and climate change, community-level interventions, and the effectiveness of climate-education programmes that incorporate mental health considerations are research priorities. Finally, understanding how emerging technology can be used to understand climate-related mental health outcomes and use of technology to collect, analyse, and respond to population health data (with ethical considerations).
INTERPRETATION
Connecting Climate Minds aims to psychologically equip people in Europe and North America to navigate the challenges of a changing climate. Climate-related mental health experts in should collaborate and encourage research and action that are proactive, community-led, and accessible.
FUNDING
Imperial College London, the Wellcome Trust, and the Planetary Health Alliance via Harvard University.
Topics: Adolescent; Humans; Evidence Gaps; Mental Health; North America; Outcome Assessment, Health Care; Europe
PubMed: 38632917
DOI: 10.1016/S2542-5196(24)00086-X -
The Journal of Hand Surgery, European... May 2024The aim of the present study was to reach international consensus on the minimum set of outcomes to measure and report in adult traumatic brachial plexus injury care and...
UNLABELLED
The aim of the present study was to reach international consensus on the minimum set of outcomes to measure and report in adult traumatic brachial plexus injury care and research. This would facilitate comparison of outcomes from different centres and meta-analysis in research. A list of outcomes was developed from a systematic review ( = 54) and patient interviews ( = 12). The outcomes were rated in a three-round online Delphi survey completed by international surgeons, patients and therapists. Two online consensus meetings with patients and clinicians ratified the final core outcome set. A total of 72 people (20 surgeons, 21 patients, 31 therapists) from 19 countries completed all survey rounds. Thirty-eight people from nine countries attended separate patient ( = 13) and clinician consensus ( = 25) meetings. Outcomes were included if recommended by more than 85% of contributors. Pain, voluntary movement and carrying out a daily routine are the core outcome domains that should be assessed and reported when treating and researching adults with a traumatic brachial plexus injury.
LEVEL OF EVIDENCE
V.
Topics: Humans; Delphi Technique; Brachial Plexus; Adult; Brachial Plexus Neuropathies; Outcome Assessment, Health Care; Consensus; Female; Male
PubMed: 37987677
DOI: 10.1177/17531934231212973 -
Journal of Cancer Education : the... Oct 2023The Project ECHO model of telementoring has been used for the past 10 years to expand access to specialized cancer care. This scoping review identifies evidence for the... (Review)
Review
The Project ECHO model of telementoring has been used for the past 10 years to expand access to specialized cancer care. This scoping review identifies evidence for the model's ability to improve provider outcomes, synthesizing findings from existing studies within Moore et al.'s (2009) framework for continuing medical education outcomes. We search two large research databases and a collection maintained by Project ECHO staff for articles that focus on cancer ECHO programs, involve primary data collection, and were published between December 1, 2016, and November 30, 2021. We identified 25 articles for inclusion in our scoping review. Most articles reported results for outcomes related to program participation: attendance, satisfaction, and learning. Yet, just under half reported changes in provider practices. Results demonstrate widespread participation and improved learning resulting from ECHO programs focused on cancer care. There is also evidence of improved practices related to HCV vaccination and palliative care. We highlight examples of best practices as well as opportunities to improve provider outcome evaluations for cancer ECHO programs.
Topics: Humans; Outcome Assessment, Health Care; Education, Medical, Continuing; Data Collection; Neoplasms
PubMed: 37002507
DOI: 10.1007/s13187-023-02292-x -
Journal of the American Geriatrics... Oct 2023Frailty has emerged as an important prognostic marker of increased mortality after cardiac surgery, but its association with quality of life (QoL) and patient-centered... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Frailty has emerged as an important prognostic marker of increased mortality after cardiac surgery, but its association with quality of life (QoL) and patient-centered outcomes is not fully understood. We sought to evaluate the association between frailty and such outcomes in older patients undergoing cardiac surgery.
METHODS
This systematic review included studies evaluating the effect of preoperative frailty on QoL outcomes after cardiac surgery amongst patients 65 years and older. The primary outcome was patient's perceived change in QoL following cardiac surgery. Secondary outcomes included residing in a long-term care facility for 1 year, readmission in the year following the intervention, and discharge destination. Screening, inclusion, data extraction, and quality assessment were performed independently by two reviewers. Meta-analyses based on the random-effects model were conducted. The evidential quality of findings was assessed with the GRADE profiler.
RESULTS
After the identification of 3105 studies, 10 observational studies were included (1580 patients) in the analysis. Two studies reported on the change in QoL following cardiac surgery, which was higher for patients with frailty than for patients without. Preoperative frailty was associated with both hospital readmission (pooled odds ratio [OR] 1.48 [0.80-2.74], low GRADE level) as well as non-home discharge (pooled OR 3.02 [1.57-5.82], moderate GRADE level).
CONCLUSION
While evidence in this field is limited by heterogeneity of frailty assessment and non-randomized data, we demonstrated that baseline frailty may possibly be associated with improved QoL, but with increased readmission as well as discharge to a non-home destination following cardiac surgery. These patient-centered outcomes are important factors when considering interventional options for older patients.
STUDY REGISTRATION
OSF registries (https://osf.io/vm2p8).
Topics: Humans; Aged; Frailty; Quality of Life; Cardiac Surgical Procedures; Patient Readmission; Outcome Assessment, Health Care
PubMed: 37289174
DOI: 10.1111/jgs.18454 -
Psychological Medicine May 2024Extensive research has focused on the potential benefits of education on various mental and physical health outcomes. However, whether the associations reflect a causal...
BACKGROUND
Extensive research has focused on the potential benefits of education on various mental and physical health outcomes. However, whether the associations reflect a causal effect is harder to establish.
METHODS
To examine associations between educational duration and specific aspects of well-being, anxiety and mood disorders, and cardiovascular health in a sample of European Ancestry UK Biobank participants born in England and Wales, we apply four different causal inference methods (a natural policy experiment leveraging the minimum school-leaving age, a sibling-control design, Mendelian randomization [MR], and within-family MR), and assess if the methods converge on the same conclusion.
RESULTS
A comparison of results across the four methods reveals that associations between educational duration and these outcomes appears predominantly to be the result of confounding or bias rather than a true causal effect of education on well-being and health outcomes. Although we do consistently find no associations between educational duration and happiness, family satisfaction, work satisfaction, meaning in life, anxiety, and bipolar disorder, we do not find consistent significant associations across all methods for the other phenotypes (health satisfaction, depression, financial satisfaction, friendship satisfaction, neuroticism, and cardiovascular outcomes).
CONCLUSIONS
We discuss inconsistencies in results across methods considering their respective limitations and biases, and additionally discuss the generalizability of our findings in light of the sample and phenotype limitations. Overall, this study strengthens the idea that triangulation across different methods is necessary to enhance our understanding of the causal consequences of educational duration.
Topics: Humans; Causality; Educational Status; Phenotype; Research Design; Outcome Assessment, Health Care; Mendelian Randomization Analysis; Genome-Wide Association Study
PubMed: 37964430
DOI: 10.1017/S003329172300329X -
BJOG : An International Journal of... Nov 2023
Improving maternal, neonatal and child health outcomes in low-resource settings: Translating research evidence to practice - report from The Third International Conference on Maternal, Newborn and Child Health.
Topics: Infant, Newborn; Child; Humans; Female; Child Health; Infant Mortality; Community Health Services; Outcome Assessment, Health Care; Maternal Health
PubMed: 37530445
DOI: 10.1111/1471-0528.17609 -
Nursing & Health Sciences Dec 2023The aim of this systematic review was to examine the association of nursing workload on patient outcomes in intensive care units. The primary outcome measure was patient... (Review)
Review
The aim of this systematic review was to examine the association of nursing workload on patient outcomes in intensive care units. The primary outcome measure was patient mortality, with adverse events (AE), the secondary outcome measures. Electronic search of databases including MEDLINE, CINAHL, Cochrane, EMCARE, Scopus, and Web of Science were performed. Studies were excluded if they were in non-ICU settings, pediatric, neonatal populations, or if the abstract/full text was unavailable. Risk of bias was assessed by the ROBINS-I tool. After screening 4129 articles, 32 studies were identified as meeting inclusion criteria. The majority of included studies were assessed as having a moderate risk of bias. The nursing activities score (NAS) was the most frequently used tool to assess nursing workload. Our systematic review identified that higher nursing workload was associated with patient-focused outcomes, including increased mortality and AE in the intensive care setting. The varied approaches of measuring and reporting nursing workload make it difficult to translate the findings of the impact of nursing workload on patient outcomes in intensive care settings.
Topics: Infant, Newborn; Humans; Child; Workload; Critical Care; Nursing Care; Intensive Care Units; Outcome Assessment, Health Care
PubMed: 37784243
DOI: 10.1111/nhs.13052 -
LGBT Health Sep 2023Violence affects every community but is particularly prevalent among sexual and gender minority (SGM) people. Although research on violence within SGM populations is...
Violence affects every community but is particularly prevalent among sexual and gender minority (SGM) people. Although research on violence within SGM populations is increasing, knowledge gaps remain that limit development of evidence-based policy, prevention, and intervention efforts to reduce the violence disparities the SGM community faces. In 2021, the National Institutes of Health (NIH) hosted a multiphase scientific workshop to identify and prioritize key research needs to further our understanding of violence affecting SGM communities and its health outcomes. In this perspective, we summarize the research needs identified. NIH supports this special issue as an outcome of the scientific workshop.
Topics: Humans; Sexual and Gender Minorities; Sexual Behavior; Gender Identity; Violence; Outcome Assessment, Health Care
PubMed: 37754920
DOI: 10.1089/lgbt.2023.0240 -
International Dental Journal Feb 2024
Topics: Humans; Sports; Dentistry; Outcome Assessment, Health Care; Oral Health
PubMed: 37673729
DOI: 10.1016/j.identj.2023.07.014 -
The Bone & Joint Journal Mar 2024Children with spinal dysraphism can develop various musculoskeletal deformities, necessitating a range of orthopaedic interventions, causing significant morbidity, and...
AIMS
Children with spinal dysraphism can develop various musculoskeletal deformities, necessitating a range of orthopaedic interventions, causing significant morbidity, and making considerable demands on resources. This systematic review aimed to identify what outcome measures have been reported in the literature for children with spinal dysraphism who undergo orthopaedic interventions involving the lower limbs.
METHODS
A PROSPERO-registered systematic literature review was performed following PRISMA guidelines. All relevant studies published until January 2023 were identified. Individual outcomes and outcome measurement tools were extracted verbatim. The measurement tools were assessed for reliability and validity, and all outcomes were grouped according to the Outcome Measures Recommended for use in Randomized Clinical Trials (OMERACT) filters.
RESULTS
From 91 eligible studies, 27 individual outcomes were identified, including those related to clinical assessment (n = 12), mobility (n = 4), adverse events (n = 6), investigations (n = 4), and miscellaneous (n = 1). Ten outcome measurement tools were identified, of which Hoffer's Functional Ambulation Scale was the most commonly used. Several studies used unvalidated measurement tools originally developed for other conditions, and 26 studies developed new measurement tools. On the OMERACT filter, most outcomes reported pathophysiology and/or the impact on life. There were only six patient- or parent-reported outcomes, and none assessed the quality of life.
CONCLUSION
The outcomes that were reported were heterogenous, lack validation and failed to incorporate patient or family perceptions. Until outcomes can be reported unequivocally, research in this area will remain limited. Our findings should guide the development of a core outcome set, which will allow consistency in the reporting of outcomes for this condition.
Topics: Child; Humans; Orthopedics; Quality of Life; Reproducibility of Results; Outcome Assessment, Health Care; Spinal Dysraphism
PubMed: 38423096
DOI: 10.1302/0301-620X.106B3.BJJ-2023-0916.R1