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BMJ Open Jul 2023Quality of life (QoL) greatly influences the outcomes of patients with mental illnesses and there is evidence that there is an association between QoL and the relapse of...
INTRODUCTION
Quality of life (QoL) greatly influences the outcomes of patients with mental illnesses and there is evidence that there is an association between QoL and the relapse of Opioid Use Disorder (OUD). However, no reviews elucidate the relationship between QoL and the relapse of OUD. This document provides a scoping review protocol that aims to systematically chart and synthesise the published, unpublished and grey literature about the relationship between QoL and relapse of OUD.
METHODS AND ANALYSIS
The enhanced six-stage methodological framework for scoping reviews of Arksey and O'Malley will be used. The main research question guiding the review will be: What is the relationship between QoL and relapse of OUD? Peer-reviewed and non-peer-reviewed articles, reports, and policy documents will be eligible to be included in the review with no limits on publication date. PubMed, PsycINFO, Google Scholar, Scopus, OVID and Cochrane Library will be among the databases searched. We shall identify grey literature from Google Scholar, ProQuest database, Grey Source Index, Open Grey and OpenDOAR. The reporting of the review will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Criteria for evidence inclusion and exclusion will be used during literature screening and mapping.
ETHICS AND DISSEMINATION
Patients and the public will not be involved in the interpretations of the findings, therefore, we shall not seek approval from an ethics committee. Results will be disseminated through publication in a peer-reviewed, scientific journal, conference presentations.
Topics: Humans; Quality of Life; Chronic Disease; Opioid-Related Disorders; Peer Review; Recurrence; Research Design; Systematic Reviews as Topic; Review Literature as Topic
PubMed: 37474165
DOI: 10.1136/bmjopen-2022-069778 -
Frontiers in Health Services 2024Evidence-based practice (EBP) involves making clinical decisions based on three sources of information: evidence, clinical experience and patient preferences. Despite... (Review)
Review
BACKGROUND
Evidence-based practice (EBP) involves making clinical decisions based on three sources of information: evidence, clinical experience and patient preferences. Despite popularization of EBP, research has shown that there are many barriers to achieving the goals of the EBP model. The use of artificial intelligence (AI) in healthcare has been proposed as a means to improve clinical decision-making. The aim of this paper was to pinpoint key challenges pertaining to the three pillars of EBP and to investigate the potential of AI in surmounting these challenges and contributing to a more evidence-based healthcare practice. We conducted a selective review of the literature on EBP and the integration of AI in healthcare to achieve this.
CHALLENGES WITH THE THREE COMPONENTS OF EBP
Clinical decision-making in line with the EBP model presents several challenges. The availability and existence of robust evidence sometimes pose limitations due to slow generation and dissemination processes, as well as the scarcity of high-quality evidence. Direct application of evidence is not always viable because studies often involve patient groups distinct from those encountered in routine healthcare. Clinicians need to rely on their clinical experience to interpret the relevance of evidence and contextualize it within the unique needs of their patients. Moreover, clinical decision-making might be influenced by cognitive and implicit biases. Achieving patient involvement and shared decision-making between clinicians and patients remains challenging in routine healthcare practice due to factors such as low levels of health literacy among patients and their reluctance to actively participate, barriers rooted in clinicians' attitudes, scepticism towards patient knowledge and ineffective communication strategies, busy healthcare environments and limited resources.
AI ASSISTANCE FOR THE THREE COMPONENTS OF EBP
AI presents a promising solution to address several challenges inherent in the research process, from conducting studies, generating evidence, synthesizing findings, and disseminating crucial information to clinicians to implementing these findings into routine practice. AI systems have a distinct advantage over human clinicians in processing specific types of data and information. The use of AI has shown great promise in areas such as image analysis. AI presents promising avenues to enhance patient engagement by saving time for clinicians and has the potential to increase patient autonomy although there is a lack of research on this issue.
CONCLUSION
This review underscores AI's potential to augment evidence-based healthcare practices, potentially marking the emergence of EBP 2.0. However, there are also uncertainties regarding how AI will contribute to a more evidence-based healthcare. Hence, empirical research is essential to validate and substantiate various aspects of AI use in healthcare.
PubMed: 38919828
DOI: 10.3389/frhs.2024.1368030 -
Proceedings of the National Academy of... Nov 2023Horizontal transfer of F-like plasmids by bacterial conjugation is responsible for disseminating antibiotic resistance and virulence determinants among pathogenic...
Horizontal transfer of F-like plasmids by bacterial conjugation is responsible for disseminating antibiotic resistance and virulence determinants among pathogenic Enterobacteriaceae species, a growing health concern worldwide. Central to this process is the conjugative F pilus, a long extracellular filamentous polymer that extends from the surface of plasmid donor cells, allowing it to probe the environment and make contact with the recipient cell. It is well established that the F pilus can retract to bring mating pair cells in tight contact before DNA transfer. However, whether DNA transfer can occur through the extended pilus has been a subject of active debate. In this study, we use live-cell microscopy to show that while most transfer events occur between cells in direct contact, the F pilus can indeed serve as a conduit for the DNA during transfer between physically distant cells. Our findings enable us to propose a unique model for conjugation that revises our understanding of the DNA transfer mechanism and the dissemination of drug resistance and virulence genes within complex bacterial communities.
Topics: Escherichia coli; Genes, Bacterial; Plasmids; Fimbriae, Bacterial; DNA, Bacterial; Conjugation, Genetic; DNA; Gene Transfer, Horizontal
PubMed: 37963249
DOI: 10.1073/pnas.2310842120 -
Journal of Interpersonal Violence Aug 2023Sext dissemination (i.e., the online sharing of sexually explicit images) has the potential to result in legal, social, and psychological harms. Recent research has...
Sext dissemination (i.e., the online sharing of sexually explicit images) has the potential to result in legal, social, and psychological harms. Recent research has shown that this behavior can be consensual or non-consensual in nature; yet little is known about how motivations or attitudes may differ between these forms, or with gender. This study is based on a cross-sectional online survey investigating consensual and non-consensual sext dissemination and associated demographic, behavioral, attitudinal, and psychological factors. Participants were 2,126 cisgendered adults aged 18 to 30 years ( = 22.97, = 3.21, 55% women, 45% men), resident in Western, English-speaking nations, particularly Australia. Around 10% of respondents reported disseminating texts, and of these, only 19.8% indicated they had permission for this, with no differences across gender. When sexts were disseminated "to gossip," this was significantly more likely to be non-consensual. There were no significant differences between consensual and non-consensual dissemination in subjective attitudes or norms toward dissemination, nor levels of psychological distress. Women were more likely to non-consensually disseminate sexts that had been received as unwanted or unwelcome. Consensual dissemination was weakly associated with being sexually active and having given consent to having one's own images disseminated. We discuss implications for future research regarding consent, and relationship and sexuality education.
Topics: Male; Adult; Humans; Female; Motivation; Cross-Sectional Studies; Sexual Behavior; Attitude; Informed Consent
PubMed: 37067003
DOI: 10.1177/08862605231163886 -
BMJ Open May 2024Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from...
INTRODUCTION
Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results. No evidence has been synthesised and consolidated on how, why and under what contexts certain staffing models produce different outcomes. We aim to describe how we will (1) conduct a realist review to determine how nurse staffing models produce different client, staff and health system outcomes, in which contexts and through what mechanisms and (2) coproduce recommendations with decision-makers to guide future research and implementation of nurse staffing models.
METHODS AND ANALYSIS
Using an integrated knowledge translation approach with researchers and decision-makers as partners, we are conducting a three-phase realist review. In this protocol, we report on the final two phases of this realist review. We will use itation tracking, tracing ead authors, identifying npublished materials, Google cholar searching, heory tracking, ancestry searching for arly examples, and follow-up of elated projects (CLUSTER) searching, specifically designed for realist searches as the review progresses. We will search empirical evidence to test identified programme theories and engage stakeholders to contextualise findings, finalise programme theories document our search processes as per established realist review methods.
ETHICS AND DISSEMINATION
Ethical approval for this study was provided by the Health Research Ethics Board of the University of Alberta (Study ID Pro00100425). We will disseminate the findings through peer-reviewed publications, national and international conference presentations, regional briefing sessions, webinars and lay summary.
Topics: Humans; Personnel Staffing and Scheduling; Research Design
PubMed: 38719308
DOI: 10.1136/bmjopen-2023-082883 -
BMJ Open Aug 2023Transgender and gender non-binary (TNB) youth living in the USA report elevated levels of substance use compared with their cisgender counterparts, with previous...
BACKGROUND
Transgender and gender non-binary (TNB) youth living in the USA report elevated levels of substance use compared with their cisgender counterparts, with previous literature pointing to minority stressors as some of the factors that could facilitate such elevated levels. Yet, substance use and misuse prevalence and associated modifiable factors among TNB youth are not fully known. The current paper details the protocol for a systematic review aimed at (1) identifying substance use and misuse prevalence among TNB youth (ages <25) and related demographic disparities (based on racial, ethnic and gender identity, and sexual orientation), (2) examining factors associated with substance use and misuse among TNB youth and (3) examining protective factors against substance use and misuse among TNB youth.
METHODS AND ANALYSIS
Systematic searches will be conducted across four databases: PubMed, LGBTQ+ Source, CINAHL and PsycInfo to identify quantitative, qualitative and mixed-methods peer-reviewed research publications. An exhaustive list of keywords and corresponding MeSH (Medical Subject Headings) terms representing the concepts of 'TNB' (the population of interest) and 'substance use and misuse' (outcome) will be employed. Identified records will be initially screened via a review of titles and abstracts. Full text of the remaining records will be reviewed corresponding to the inclusion and exclusion criteria. Extracted data will be synthesised in table and narrative format. A meta-analysis will be considered contingent on the existence of sufficient data. Methodological quality and risk of bias of studies will be assessed.
ETHICS AND DISSEMINATION
This review does not require approval from the Institutional Review Board as it involves no interactions with human subjects. We will disseminate our findings via peer-reviewed manuscripts and academic conference presentations.
PROSPERO REGISTRATION NUMBER
CRD42023394985.
Topics: Female; Adolescent; Humans; Male; United States; Transgender Persons; Prevalence; Gender Identity; Ethics Committees, Research; Minority Groups; Meta-Analysis as Topic; Review Literature as Topic
PubMed: 37640466
DOI: 10.1136/bmjopen-2023-073877 -
Cancer Causes & Control : CCC Sep 2023Partnerships between researchers and community members and organizations can offer multiple benefits for research relevance and dissemination. The goal of this project...
PURPOSE
Partnerships between researchers and community members and organizations can offer multiple benefits for research relevance and dissemination. The goal of this project was to build infrastructure to create bidirectional relationships between University of Wisconsin Carbone Cancer Center (UWCCC) researchers and community educators in the Division of Extension, which connects the knowledge and resources of the university to communities across the state.
METHODS
This project had three aims: (1) create linkages with Extension; (2) establish an in-reach program to educate and train researchers on the science of Community Outreach and Engagement (COE); and (3) identify and facilitate collaborative projects between scientists and communities. Survey and focus group-based needs assessments were completed with both researchers and Extension educators and program activity evaluations were conducted.
RESULTS
Most Extension educators (71%) indicated a strong interest in partnering on COE projects. UWCCC faculty indicated interest in further disseminating their research, but also indicated barriers in connecting with communities. Outreach webinars were created and disseminated to community, a "COE in-reach toolkit" for faculty was created and a series of "speed networking" events were hosted to pair researchers and community. Evaluations indicated the acceptability and usefulness of these activities and supported continuation of collaborative efforts.
CONCLUSION
Continued relationship and skill building, along with a sustainability plan, is critical to support the translation of basic, clinical, and population research to action in the community outreach and engagement context. Further incentives for faculty should be explored for the recruitment of basic scientists into community engagement work.
Topics: Humans; Surveys and Questionnaires; Research Personnel; Neoplasms; Community-Institutional Relations; Program Evaluation
PubMed: 37247136
DOI: 10.1007/s10552-023-01725-8 -
Journal of the American Dental... Dec 2023Dental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and...
BACKGROUND
Dental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and perceptions among providers. The authors assessed pediatric dentists' use of and attitudes toward evidence-based pain management (EBPM) strategies.
METHODS
The authors used a 27-item online survey to assess attitudes about EBPM, pain management and assessment practices, tools for disseminating knowledge about EBPM, and opinions regarding priority areas for improving pain management. Descriptive statistics were used to summarize findings; open-ended items were analyzed thematically.
RESULTS
Participants (N = 625) were pediatric dentists (89.2%) and pediatric dentistry residents (10.8%). Most respondents agreed that pain management is an important aspect of clinical care and thought that improvements in pain management practices are needed. Providers reported spending the most time facilitating pain management during the procedure (compared with before or after), and 73.2% said they feel this is an adequate amount of time. Distraction, tell-show-do techniques, and supportive language were the most used nonpharmacologic pain management strategies, and providers' observational approaches were used most frequently for pain assessment. Top priority areas for improving pain management were reported as developing tools for caregivers and provider resources on nonpharmacologic pain management (ie, continuing education courses).
CONCLUSIONS
Providers reported high use of EBPM strategies, low use of validated pain assessment tools, and a particular interest for professional development opportunities and patient resources focused on nonpharmacologic pain management.
PRACTICAL IMPLICATIONS
Findings from this survey can inform dissemination and implementation of science efforts to improve pain management in pediatric dentistry.
Topics: Adolescent; Humans; Child; Pediatric Dentistry; Pain Management; Attitude of Health Personnel; Surveys and Questionnaires; Dentists
PubMed: 37877929
DOI: 10.1016/j.adaj.2023.09.003 -
Advanced Science (Weinheim,... Nov 2023The global crisis in antimicrobial resistance continues to grow. Estimating the risks of antibiotic resistance transmission across habitats is hindered by the lack of...
The global crisis in antimicrobial resistance continues to grow. Estimating the risks of antibiotic resistance transmission across habitats is hindered by the lack of data on mobility and habitat-specificity. Metagenomic samples of 6092 are analyzed to delineate the unique core resistomes from human feces and seven other habitats. This is found that most resistance genes (≈85%) are transmitted between external habitats and human feces. This suggests that human feces are broadly representative of the global resistome and are potentially a hub for accumulating and disseminating resistance genes. The analysis found that resistance genes with ancient horizontal gene transfer (HGT) events have a higher efficiency of transfer across habitats, suggesting that HGT may be the main driver for forming unique but partly shared resistomes in all habitats. Importantly, the human fecal resistome is historically different and influenced by HGT and age. The most important routes of cross-transmission of resistance are from the atmosphere, buildings, and animals to humans. These habitats should receive more attention for future prevention of antimicrobial resistance. The study will disentangle transmission routes of resistance genes between humans and other habitats in a One Health framework and can identify strategies for controlling the ongoing dissemination and antibiotic resistance.
Topics: Animals; Humans; Genes, Bacterial; Anti-Bacterial Agents; Drug Resistance, Microbial; Metagenome; Feces
PubMed: 37870180
DOI: 10.1002/advs.202303925 -
BMC Psychiatry Jul 2023The importance and value of involvement of people with lived experience of suicide has been recognized in suicide research and prevention. Nonetheless, clear guidance on...
BACKGROUND
The importance and value of involvement of people with lived experience of suicide has been recognized in suicide research and prevention. Nonetheless, clear guidance on research collaboration and co-production is lacking. This study aimed to address this gap by developing a set of guidelines on active involvement of people with lived experience of suicide in suicide studies., i.e., conducting research with or by people with lived experience, rather than to, about or for them.
METHODS
The Delphi method was used to determine statements on best practice for the active involvement of people with lived experience of suicide in suicide research. Statements were compiled through a systematic search of the scientific and grey literature, and reviewing qualitative data from a recent related study conducted by the authors. Two expert panels: people with lived experience of suicide (n = 44) and suicide researchers (n = 29) rated statements over three rounds of an online survey. Statements endorsed by at least 80% of panellists of each panel were included in the guidelines.
RESULTS
Panellists endorsed 96 out of 126 statements in 17 sections covering the full research cycle from deciding on the research question and securing funding, to conducting research and disseminating and implementing outcomes. Overall, there was a substantial level of agreement between the two panels regarding support from research institutions, collaboration and co-production, communication and shared decision making, conducting research, self-care, acknowledgment, and dissemination and implementation. However, panels also disagreed on specific statements regarding representativeness and diversity, managing expectations, time and budgeting, training, and self-disclosure.
CONCLUSIONS
This study identified consensus recommendations on active involvement of people with lived experience of suicide in suicide research, including co-production. Support from research institutions and funders, and training on co-production for researchers and people with lived experience, are needed for successful implementation and uptake of the guidelines.
Topics: Humans; Budgets; Communication; Consensus; Delphi Technique; Suicide; Patient Selection
PubMed: 37434145
DOI: 10.1186/s12888-023-04973-9