HRB open research最新文献_第10页

Profiling the characteristics of people after stroke in Ireland discharged home with and without Early Supported Discharge: Analysis of a nationally representative cohort study 分析爱尔兰中风后出院回家者的特征，包括早期支持出院和非早期支持出院：一项具有全国代表性的队列研究分析

HRB open research

Pub Date : 2023-12-01 DOI: 10.12688/hrbopenres.13808.1

Elaine O Connor, Eamon Dolan, F. Horgan, Margaret O’Connor, Joan McCormack, Olga Brych, Katie Robinson, Rose Galvin

Background Early Supported Discharge (ESD) after stroke has demonstrated cost savings, reducing hospital length of stay (LOS) and long-term dependency. ESD discharges people after stroke from hospital earlier than conventional care with rehabilitation continuing at home. The Irish National Stroke Strategy 2022–2027 aims for ESD to be available to 92% of the stroke inpatient population. This study aims to profile the clinical characteristics and rehabilitation needs of those referred to ESD on discharge versus those discharged home without it in Ireland. Methods This study represents secondary analysis of an anonymised nationally representative prospective cohort study; the Irish National Audit of Stroke (INAS). Data were retrieved for 2018–2020 inclusive. A subset of 20 variables were used to profile the clinical characteristics and rehabilitation needs of those referred to ESD on discharge versus those discharged home without it. Data were analysed descriptively. Results In 2018, 139 people were discharged home with ESD, representing 3.8% of all people after stroke discharged home. This increased to 207 (4.9%) in 2019 and to 325 (6.6%) in 2020. More men were discharged home with and without ESD. Those aged 65–79 years represented the largest proportion of those discharged home with and without ESD. For those discharged with ESD, the mean LOS reduced each year from 17 days (SD=20) in 2018, 16 days (SD=16) in 2019 to 13 days (SD=13) in 2020. Those with a modified Rankin Scale score of 1, 2 at discharge represented the highest proportion of those returning home with ESD (59.3%) and without ESD (40.8%). Of those returning home with ESD, 10.8% were seen by a psychologist. Conclusions There is a need for significant scale-up of ESD to meet National Stroke Strategy targets. Consensus on ESD eligibility criteria nationally needs to be established and access to psychology services for people after stroke needs expansion.

背景:卒中后早期支持出院(ESD)已证明可节省费用，减少住院时间(LOS)和长期依赖性。与传统护理相比，ESD可使中风患者提早出院，并在家中继续康复。爱尔兰国家中风战略2022-2027的目标是为92%的中风住院患者提供ESD。本研究旨在分析那些在爱尔兰出院时接受ESD治疗的患者的临床特征和康复需求，以及那些没有接受ESD治疗的患者。方法:本研究对一项具有全国代表性的匿名前瞻性队列研究进行了二次分析;爱尔兰中风国家审计(INAS)。检索的数据为2018-2020年(含2020年)。一个包含20个变量的子集被用来描述那些在出院时被称为ESD的人的临床特征和康复需求，而那些出院时没有这样做的人。对数据进行描述性分析。结果2018年有139人因ESD出院，占卒中后出院总人数的3.8%。2019年这一数字增至207人(4.9%)，2020年增至325人(6.6%)。有或没有ESD的男性出院回家。在有或没有接受“可持续发展服务”的出院人士中，65至79岁人士所占比例最大。以ESD出院的患者为例，平均生存时间逐年减少，2018年为17天(SD=20)， 2019年为16天(SD=16)， 2020年为13天(SD=13)。出院时改良Rankin量表得分为1、2分的患者中，有ESD(59.3%)和无ESD(40.8%)的比例最高。在患有ESD的患者中，10.8%的人接受了心理医生的治疗。结论:为实现国家卒中战略目标，有必要大力推广ESD。需要在全国范围内就ESD的资格标准达成共识，需要扩大中风后患者获得心理服务的机会。

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引用次数: 0

General practice focussed strategies to increase participation in lung cancer screening – a systematic review protocol 提高肺癌筛查参与率的全科医生策略--系统性审查方案

HRB open research

Pub Date : 2023-12-01 DOI: 10.12688/hrbopenres.13767.1

Priya Patel, Benjamin Jacob, Barbara Clyne, Alice Le Bonniec, Samantha L. Quaife, Stephen H. Bradley, Patrick Redmond

Background Lung cancer is the leading cause of cancer-related mortality worldwide. Despite this, the uptake of lung cancer screening (LCS) using low-dose CT is substantially low in comparison to established cancer screening programmes. Additionally, those at higher risk of the disease are the least likely to participate in screening, including current smokers and those experiencing socioeconomic deprivation. General practice (which may be referred to as primary care or family medicine depending on location) plays a vital role in screening through the identification of eligible individuals, overcoming participation barriers, and facilitating shared decision-making. Given the low rates of participation, it is important to understand which, if any, strategies from general practice could improve the effectiveness of a national programme. Objectives To assess and quantify the effects of strategies implemented in general practice to increase participation in LCS. Method A systematic review and meta-analysis, where possible, will be conducted following PRISMA reporting guidelines. Searches of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform will be conducted. All randomised trials, non-randomised studies, and quantitative descriptive studies that report recruitment strategies based in general practice and LCS outcomes will be eligible. Screening and data extraction will be conducted independently by two reviewers. The risk of bias and overall certainty of findings will be assessed using the MMAT and GRADE tools, respectively. The Template for Intervention Description and Replication (TIDieR) checklist will be used for data extraction and the Behavioural Change Techniques (BCT) Taxonomy for data analysis of the components of interventions. Conclusion This review will provide data on the most effective general practice-based recruitment strategies aimed at improving LCS participation. Understanding the most effective and equitable strategies is important in the development of successful LCS and ensuring individuals at the greatest risk can participate.

肺癌是世界范围内癌症相关死亡的主要原因。尽管如此，与已建立的癌症筛查计划相比，使用低剂量CT进行肺癌筛查(LCS)的接受程度仍低得多。此外，那些患病风险较高的人最不可能参与筛查，包括目前的吸烟者和那些经历社会经济剥夺的人。全科医生(视地点而定，可称为初级保健或家庭医学)通过确定合格个人、克服参与障碍和促进共同决策，在筛查方面发挥着至关重要的作用。鉴于参与率低，重要的是要了解，如果有的话，来自一般做法的哪些战略可以提高国家方案的效力。目的评估和量化在全科实践中实施的策略的效果，以增加LCS的参与。方法在可能的情况下，按照PRISMA报告指南进行系统评价和荟萃分析。检索PubMed、Embase、CINAHL、Cochrane图书馆、Web of Science、ClinicalTrials.gov和WHO国际临床试验注册平台。所有报告基于一般实践和LCS结果的招募策略的随机试验、非随机研究和定量描述性研究都将符合条件。筛选和数据提取将由两名审稿人独立进行。偏倚风险和结果的总体确定性将分别使用MMAT和GRADE工具进行评估。干预措施描述和复制模板(TIDieR)清单将用于数据提取，行为改变技术(BCT)分类法将用于干预措施组成部分的数据分析。本综述将提供旨在提高LCS参与的最有效的基于一般实践的招聘策略的数据。了解最有效和公平的策略对于成功发展LCS和确保风险最大的个人能够参与至关重要。

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引用次数: 0

Contextual factors and intentional rounding in acute hospitals: understanding what works, for whom, in what settings: a realist synthesis protocol 急症医院的环境因素和有意查房：了解在什么情况下对什么人有效：现实主义综合方案

HRB open research

Pub Date : 2023-12-01 DOI: 10.12688/hrbopenres.13792.1

Aileen Hetherton, F. Horgan, Jan Sorensen, Siobhan E. Mc Carthy

Background This study aims to understand and explain the influence of contextual factors on the implementation of Intentional Rounding in acute hospitals using the realist synthesis methodology. Falls of hospital admitted patients are one of the most frequent concerns for patient safety in the acute hospital environment. The reasons why people fall are complex. International guidelines recommend a multifactorial assessment and effective prevention and management of identified risk factors in order to reduce the number of falls. One approach for delivering this is by Intentional Rounding (IR). IR is an umbrella term, understood as a structured process whereby nurses or care staff carry out regular checks with individual patients using a standardised protocol to address such issues as positioning, pain, personal needs and placement of possessions. Methods This study will use realist synthesis to understand what works, for whom, in what circumstances and in what settings. Realist synthesis is a theory driven interpretive approach to evidence synthesis. It is the intention of the researchers to analyse IR as an intervention, which aims to enhance patient care and safety in hospital settings. The synthesis forms part of a larger implementation study examining interventions that reduce the number of falls that occur in hospitals. Search terms will include intentional rounding, purposeful rounding, comfort rounding and hourly rounding and will encompass search terms beyond IR and falls rates in order not to limit the synthesis. This synthesis will conform to the RAMESES (realist and meta-narrative evidence synthesis group) publication and reporting quality standards for a realist synthesis. Conclusions The findings will inform the next phase of an implementation study on IR in acute hospital settings, namely selection of an IR approach and evidence informed barriers and enablers to its implementation. The results will be disseminated in a peer-reviewed journal and through presentations.

本研究旨在运用现实主义综合方法，了解和解释情境因素对急症医院实施故意围舍的影响。住院患者的跌倒是急性医院环境中最常见的患者安全问题之一。人们跌倒的原因很复杂。国际准则建议对已确定的危险因素进行多因素评估并有效预防和管理，以减少跌倒次数。实现这一点的一种方法是有意舍入(IR)。IR是一个总称，被理解为一个结构化的过程，护士或护理人员使用标准化协议对个别患者进行定期检查，以解决诸如体位，疼痛，个人需求和物品放置等问题。方法本研究将运用现实主义综合来理解什么是有效的，对谁有效，在什么情况下有效，在什么环境下有效。现实主义综合是一种理论驱动的证据综合解释方法。研究人员的目的是分析IR作为一种干预措施，其目的是加强医院环境中的患者护理和安全。该综合报告是一项更大的实施研究的一部分，该研究审查了减少医院发生的跌倒次数的干预措施。搜索词将包括有意的四舍五入，有目的的四舍五入，舒适的四舍五入和每小时四舍五入，并将包括超出IR和下降率的搜索词，以便不限制合成。该综合将符合RAMESES(现实主义和元叙事证据综合组)现实主义综合的出版和报告质量标准。研究结果将为急性医院环境中IR实施研究的下一阶段提供信息，即IR方法的选择和证据告知其实施的障碍和推动因素。研究结果将在同行评议的期刊上发表，并通过演讲的形式发表。

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引用次数: 0

Protocol for a systematic review and systems-based exploration of interventions to reduce medicines wastage 对减少药品浪费的干预措施进行系统性审查和系统性探索的议定书

HRB open research

Pub Date : 2023-12-01 DOI: 10.12688/hrbopenres.13800.1

Áine Harris, Ryan Jayesinghe, Lorna Bonnici West, Derek Stewart, T. Grimes, Patrick Redmond

Introduction A reduction in medicines wastage is an important objective in promoting appropriate use of finite resources. The objective of this systematic review is to both assess the effectiveness of interventions to reduce medicines wastage, and apply a systems based exploration of the factors affecting implementation of interventions. Methods A systematic review will be conducted following PRISMA reporting guidelines. Searches will be performed in Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, PubMed, Science Citation Index, PsycInfo, Scopus, the Cochrane Library, grey literature, and trials registries. Data extraction and critical appraisal will be completed independently by two reviewers. If studies are sufficiently homogenous in terms of design and comparators, we will conduct a meta-analysis. Where this is not possible, we will provide a narrative synthesis of results grouping studies with similar interventions together. The barriers and enablers of the described interventions will then be analysed using the Systems Engineering Initiative in Patient Safety (SEIPS 101) model. Conclusions This review will describe the effectiveness of interventions to reduce medicines wastage and issues associated with their implementation in order to inform policy development and intervention implementation in the future. This will have the potential to reduce both the economic and environmental burden of medicines wastage on the health service. PROSPERO registration CRD42022335848 (12/06/2022)

减少药品浪费是促进合理利用有限资源的一个重要目标。本系统综述的目的是评估减少药物浪费的干预措施的有效性，并对影响干预措施实施的因素进行基于系统的探索。方法按照PRISMA报告指南进行系统评价。检索将在护理和联合健康文献累积索引(CINAHL)、Embase、Medline、PubMed、科学引文索引、PsycInfo、Scopus、Cochrane图书馆、灰色文献和试验注册中进行。数据提取和关键评估将由两名审稿人独立完成。如果研究在设计和比较物方面具有足够的同质性，我们将进行荟萃分析。如果这是不可能的，我们将提供一个叙述性的综合结果，将具有类似干预措施的研究分组在一起。然后将使用患者安全系统工程计划(SEIPS 101)模型分析上述干预措施的障碍和促成因素。本综述将描述减少药物浪费的干预措施的有效性及其实施相关问题，以便为未来的政策制定和干预措施实施提供信息。这将有可能减轻医药浪费给卫生服务造成的经济和环境负担。普洛斯彼罗注册编号42022335848 (12/06/2022)

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引用次数: 0

mHealth clinical decision-making tools for maternal and perinatal health care in Sub-Saharan Africa: A systematic review protocol 用于撒哈拉以南非洲孕产妇和围产期保健的移动保健临床决策工具：系统性审查协议

HRB open research

Pub Date : 2023-11-27 DOI: 10.12688/hrbopenres.13799.1

Gaudensia A. Olomi, L. Cansdale, Simon Woodworth, Rachel Manongi, Pendo Mlay, Karen Yeates, Nicola West, Jane E. Hirst, Christopher Redman, M. Mahande, B. Mmbaga, A. Khashan

Background Mobile health (mHealth) tools are increasingly being used in Sub-Saharan Africa (SSA) to improve the quality of health services. mHealth clinical decision-making tools have several established roles in maternal and perinatal healthcare including health surveillance, data collection and access to guidelines. The adoption of mHealth clinical decision-making tools in low-resource environments like SSA, as well as the lessons learnt from using them, have not yet been determined. As new mHealth technologies are quickly being evaluated and deployed in resource-poor settings, it is crucial to thoroughly analyse what has been accomplished in order to inform implementers and policy makers on the effectiveness of technology in evidence-based practice. Objective This study aims to synthesize the available evidence 1) on the use of mHealth clinical decision-making tools for maternal and perinatal care in SSA, and 2) whether these tools lead to improvements in the quality of maternal and perinatal care in SSA. Methods A systematic review of the literature will be performed to identify publications describing the use mHealth tools for maternal and perinatal clinical decision-making in SSA. PubMed, CINAHL, EMBASE, Global Health and Web of Science will be searched for relevant articles following a predetermined search strategy with no date restrictions. A limited grey literature search will also be carried out. Two independent reviewers will screen the articles. Pre-determined data items will be extracted, and data synthesis carried out using a descriptive approach. Appraisal will be done using the Appraisal of Guidelines Research and Evaluation Health Systems (AGREE-HS) instrument. Conclusions This systematic review protocol for identifying and appraising mHealth clinical decision-making tools in maternal and perinatal care may help to establish best practice for developing and scaling up, thus help to improve care in SSA. Registration PROSPERO (CRD42023452760; 19 August 2023).:

移动医疗临床决策工具在孕产妇和围产期保健中发挥着多种既定的作用，包括健康监测、数据收集和获取指南。在 SSA 等低资源环境中采用移动医疗临床决策工具的情况以及从使用这些工具中汲取的经验教训尚未确定。随着新的移动医疗技术在资源匮乏的环境中迅速得到评估和部署，彻底分析已取得的成果至关重要，以便让实施者和决策者了解技术在循证实践中的有效性。本研究旨在综合现有证据：1）在撒哈拉以南非洲地区使用移动医疗临床决策工具进行孕产妇和围产期保健的情况；2）这些工具是否提高了撒哈拉以南非洲地区孕产妇和围产期保健的质量。方法将对文献进行系统性综述，以确定描述在 SSA 地区使用移动医疗工具进行孕产妇和围产期临床决策的出版物。将按照预先确定的检索策略在 PubMed、CINAHL、EMBASE、Global Health 和 Web of Science 上检索相关文章，没有日期限制。此外，还将进行有限的灰色文献检索。两名独立审稿人将对文章进行筛选。将提取预先确定的数据项，并采用描述性方法进行数据综合。评估将使用卫生系统指南研究与评估（AGREE-HS）工具进行。结论该系统综述方案用于确定和评估孕产妇和围产期保健中的移动医疗临床决策工具，有助于确立开发和推广的最佳实践，从而帮助改善撒哈拉以南非洲地区的保健服务。注册 PROSPERO（CRD42023452760；2023 年 8 月 19 日）：

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引用次数: 0

Which outcome measurement instruments are used to measure core infant feeding outcomes in children up to 1 year of age? A scoping review protocol 哪些结果测量工具可用于测量1岁以内婴儿喂养的核心结果？范围界定审查协议

HRB open research

Pub Date : 2023-11-27 DOI: 10.12688/hrbopenres.13797.1

K. Matvienko-Sikar, Linda Adair, Lucinda K Bell, C. Birken, Vicki Brown, Darren Dahly, A. Doherty, Rebecca K Golley, Patricia Leahy-Warren, Marian McBride, Elizabeth McCarthy, Andrew W Murphy, Sarah Redsell, C. B. Terwee

Background How, what, and when infants are fed plays a role in the aetiology of childhood obesity. Heterogeneity in how infant feeding outcomes are measured in trials of interventions to prevent childhood obesity limits evidence syntheses and understanding of intervention effectiveness. An infant feeding core outcome set (COS) was previously developed to standardised outcome measurement and reporting. The COS represents what to measure; determining how best to measure these outcomes is the next essential step to improve intervention evaluations. The aim of this scoping review is therefore to identify what outcome measurement instruments have been used in trials, and how they have been used, to measure the core infant feeding outcomes. Methods A scoping review will be conducted. MEDLINE, EMBASE, CINAHL, PsychINFO, the Cochrane Central Register of Controlled Trials, OpenGrey and GreyNet will be searched from inception. Papers are eligible for inclusion if they report trials involving primary data collection that measure and report at least one core infant feeding outcome in infants ≤one year of age. Following searching and screening, eligible studies will be categorised into the following four overarching categories for data extraction, synthesis and write-up: caregiver-related outcomes; diet-related outcomes; feeding environment outcomes; child weight outcomes. Data will be narratively described and presented in tabular format, with findings presented in four separate review papers delineated by the four overarching categories. Discussion This scoping review forms part of the Standardised measurement for Childhood Obesity Prevention (SCOPE) study (www.eiascope.com). Evidence from this scoping review on what measurement instruments are used, and how they are used, represents an essential first step in developing recommendations and guidance about how best to measure core infant feeding outcomes for childhood obesity prevention. This can improve evidence syntheses and understanding of what infant feeding interventions are most effective for childhood obesity prevention.

背景婴儿的喂养方式、内容和时间在儿童肥胖症的病因中起着重要作用。在对预防儿童肥胖的干预措施进行试验时，对婴儿喂养结果的测量方法存在差异，这限制了对证据的综合分析和对干预效果的理解。以前曾开发过一套婴儿喂养核心结果集（COS），以实现结果测量和报告的标准化。COS 代表了要测量的内容；确定如何最好地测量这些结果是改进干预评估的下一个关键步骤。因此，本范围综述旨在确定试验中使用了哪些结果测量工具，以及如何使用这些工具来测量婴儿喂养的核心结果。方法将进行范围界定综述。从一开始就将检索 MEDLINE、EMBASE、CINAHL、PsychINFO、Cochrane 对照试验中央登记册、OpenGrey 和 GreyNet。如果论文报告的试验涉及原始数据收集，并测量和报告了至少一项一岁以下婴儿喂养的核心结果，则符合纳入条件。经过搜索和筛选后，符合条件的研究将分为以下四大类进行数据提取、综合和撰写：护理人员相关结果；饮食相关结果；喂养环境结果；儿童体重结果。将对数据进行叙述性描述，并以表格形式呈现，研究结果将按照四个总体类别分别撰写成四篇综述论文。讨论本范围界定综述是儿童肥胖症预防标准化测量（SCOPE）研究的一部分 (www.eiascope.com)。本范围界定综述提供了有关使用哪些测量工具以及如何使用这些工具的证据，这是就如何最好地测量预防儿童肥胖的核心婴儿喂养结果提出建议和指导的重要第一步。这可以提高证据的综合水平，并加深对哪些婴儿喂养干预措施对预防儿童肥胖最有效的理解。

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引用次数: 0

Age of first self-harm act in childhood and adolescence: A scoping review protocol. 儿童和青少年首次自我伤害行为的年龄：范围界定审查协议。

HRB open research

Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13764.2

Daisy Wiggin, Elaine McMahon, Fiona McNicholas, Eve Griffin

Background: Self-harm in youth is associated with adverse outcomes for many. The age of first self-harm is not often reported in the literature and there is considerable heterogeneity in how it is reported and in the methods used to estimate it. The objective of this study will be to examine the age of first self-harm act in childhood and adolescence and to identify the research methods used to assess this.

Methods: This scoping review will follow JBI guidance. Five electronic databases, Medline, PsycInfo, CINAHL Plus, Embase, and Web of Science will be searched from inception. Grey literature will be searched via Google Scholar. Studies reporting the age of first act of self-harm in young people aged 17 years and younger are of interest. Any study design and methodology will be eligible for inclusion. Included studies may use any self-harm definition, any measures used to assess self-harm and the age of the first act. The focus can be in any context, including health services presenting or community samples. Title and abstract screening and full text screening will be carried out by two reviewers independently. The data extraction tool will be piloted by two reviewers independently, included studies will undergo data extraction by one reviewer and this will be checked by a second, independent reviewer.

Results: The resulting data will be presented using descriptive statistics, in tabular format, and accompanied with a narrative presentation of results. The results of this study will be distributed by publication in an academic journal.

背景：青少年自残与许多人的不良后果有关。首次自我伤害的年龄在文献中并不常见，而且在报告方式和估算方法上也存在相当大的差异。本研究的目的是探讨儿童和青少年首次自我伤害行为的年龄，并确定用于评估这一年龄的研究方法：本次范围界定审查将遵循 JBI 指南。将从一开始就检索 Medline、PsycInfo、CINAHL Plus、Embase 和 Web of Science 这五个电子数据库。灰色文献将通过谷歌学术进行搜索。报告 17 岁及以下青少年首次自我伤害行为年龄的研究将受到关注。任何研究设计和方法均可纳入。纳入的研究可以使用任何自我伤害定义、任何用于评估自我伤害的方法以及首次行为的年龄。研究重点可以是在任何情况下，包括医疗服务机构或社区样本。标题和摘要筛选以及全文筛选将由两名审稿人独立完成。数据提取工具将由两名审稿人独立试用，纳入的研究将由一名审稿人进行数据提取，并由第二名独立审稿人进行检查：研究结果：研究结果数据将以表格形式进行描述性统计，并附有结果说明。研究结果将在学术期刊上发表。

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引用次数: 0

Examining Quality, Use and Impact of Psychotropic (Use) in older adults with intellectual disabilities (EQUIP): study protocol 研究智障老年人精神药物（使用）的质量、使用情况和影响（EQUIP）：研究方案

HRB open research

Pub Date : 2023-11-21 DOI: 10.12688/hrbopenres.13645.2

Ashleigh Gorman, Marina Odalović, P. McCallion, Eilish M Burke, Malcolm MacLachlan, M. McCarron, M. Henman, Maeve Moran, J. O’Connell, Mike Walsh, Rohit Shankar, M. O'Dwyer

Widespread, and sometimes inappropriate use of psychotropics in adults with intellectual disability has been an international concern. These medicines have been used to treat mental health conditions, but also, controversially, some types of behaviours not necessarily associated with the diagnosis or in the absence of a relevant diagnosis. Results from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) study of older adults with intellectual disability in Ireland revealed that 60% were taking psychotropics in 2010. In the intervening decade changes in regulations, policy, and increased decongregation of people with intellectual disability have taken place likely influencing the use of psychotropics. The HSE National Clinical Programme for People with Disability (NCPDD) established in the 2020 has medicines optimisation as a key priority. Existing multi-wave data from the IDS-TILDA study and the HSE national prescribing database offers an opportunity to better understand psychotropic use and prescribing patterns. This is a novel collaboration on lived experience, research, practice and policy. The aim of this research is to examine the quality and trends of psychotropic use of older adults with intellectual disability over a ten-year period in Ireland to evaluate the effects of and to inform both practice and policy to optimise medicines use and health outcomes. Health and medication data from ten years (four waves) of the IDS-TILDA study and corresponding medicines data from the HSE-PCRS prescribing database are available. Descriptive and longitudinal analysis will examine association between long-term psychotropic use, changes in trends of use, and the impact of decongregation on medicines use. This research will inform the development of national guidance on medicines optimisation for older people with intellectual disability and has the potential to change prescribing practices and improve health and wellbeing for older people with intellectual disability.

精神药物在智障成人中的广泛使用，有时甚至是不当使用，一直是国际社会关注的问题。这些药物不仅被用于治疗精神疾病，而且还被用于治疗某些不一定与诊断相关或没有相关诊断的行为，这一点颇受争议。爱尔兰老龄化纵向研究（IDS-TILDA）智障补充研究对爱尔兰智障老年人的研究结果显示，2010 年有 60% 的智障老年人在服用精神药物。在这十年间，法规、政策发生了变化，智障人士的非集中化程度也有所提高，这些都可能对精神药物的使用产生影响。HSE 于 2020 年制定的 "国家残疾人临床计划"（NCPDD）将药物优化作为重点优先事项。来自 IDS-TILDA 研究和 HSE 国家处方数据库的现有多波数据为更好地了解精神药物的使用和处方模式提供了机会。这是一项关于生活经验、研究、实践和政策的新颖合作。这项研究的目的是对爱尔兰智障老年人在十年内使用精神药物的质量和趋势进行检查，以评估使用精神药物的影响，并为实践和政策提供信息，从而优化药物使用和健康结果。IDS-TILDA研究提供了十年（四波）的健康和用药数据，HSE-PCRS处方数据库提供了相应的用药数据。描述性分析和纵向分析将研究长期使用精神药物、使用趋势的变化之间的关联，以及解除隔离对药物使用的影响。这项研究将为制定国家智障老年人药物优化指南提供信息，并有可能改变处方做法，改善智障老年人的健康和福祉。

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引用次数: 0

Definitions of serious injury in long-term residential care: a systematic review protocol 长期寄宿护理中的严重伤害定义：系统性审查协议

HRB open research

Pub Date : 2023-11-20 DOI: 10.12688/hrbopenres.13705.1

David Morrissey, Elizabeth A. O'Donnell, L. Behan, Martin McMahon, L. Keyes

Background Evidence indicates that the reporting of serious injury in long-term residential care has increased substantially over the past decade. However, what constitutes a serious injury in residential care is poorly and inconsistently defined. This may result in incidences being unnecessarily reported as a serious injury. It is therefore, crucial to develop a consistent definition of serious injury to reduce reporting burden and to facilitate comparison between different residential care settings and across jurisdictions. This protocol describes the methods for a systematic review of existing definitions from the literature to inform the development of a consistent definition of serious injury in long-term residential care. Methods A wide range of published peer-reviewed and grey literature will be sought for this review, including guidance and policy documents. Searches will be conducted of databases including MEDLINE, CINAHL, SocINDEX, Academic Search Ultimate, and Westlaw International. Grey literature database searches will include Trip and Social Care Online. Country specific searches of government and health and social care websites will be conducted. Quality appraisal will be facilitated using the Quality Assessment for Diverse Studies (QuADS) tool and Tyndall’s checklist. The level of confidence in the findings will be assessed using the GRADE CERQual approach. A customised data extraction form will be used to extract data to reduce the risk of bias. Conceptual content analysis of data will facilitate identification of definitions of serious injury and their frequency within texts. Conclusion The findings will inform the development of a consistent definition of serious injury in long-term residential care that will reduce reporting burden, facilitate the accuracy of data collected and allow for comparison across jurisdictions. A more universal and consistent definition will enable regulators, policy makers, service providers and researchers to develop policy and practical interventions to prevent the occurrence of serious injury in long-term residential care.

背景有证据表明，在过去十年中，关于长期寄宿护理中严重伤害的报告大幅增加。然而，对于什么是寄宿护理中的严重伤害却没有明确的定义，而且定义也不一致。这可能会导致不必要地将事故报告为严重伤害。因此，制定统一的严重伤害定义至关重要，这样可以减轻报告负担，并便于在不同的寄宿护理环境和不同的司法管辖区之间进行比较。本协议介绍了对文献中现有定义进行系统性回顾的方法，以便为制定长期寄宿护理中严重伤害的统一定义提供参考。方法本综述将广泛收集已发表的同行评审文献和灰色文献，包括指导和政策文件。检索数据库包括 MEDLINE、CINAHL、SocINDEX、Academic Search Ultimate 和 Westlaw International。灰色文献数据库搜索将包括 Trip and Social Care Online。还将针对具体国家搜索政府、卫生和社会保健网站。将使用多元化研究质量评估（QuADS）工具和廷德尔核对表进行质量评估。研究结果的可信度将采用 GRADE CERQual 方法进行评估。将使用定制的数据提取表来提取数据，以降低偏倚风险。数据的概念内容分析将有助于确定严重伤害的定义及其在文本中的出现频率。结论研究结果将为制定长期寄宿护理中严重伤害的统一定义提供信息，从而减轻报告负担，提高所收集数据的准确性，并可进行跨辖区比较。一个更加普遍和一致的定义将使监管者、政策制定者、服务提供者和研究人员能够制定政策和实际干预措施，以防止在长期寄宿护理中发生严重伤害。

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引用次数: 0

Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial. 一项试验(quality - swat)中定性方法学研究的方案开发:karma - deep -2试验。

HRB open research

Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13721.2

John McCaffrey, Andrew Hunter

Background: Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes.

Methods: A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10).

Ethics and dissemination: Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication.

Host trial registration: ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].

背景:尽管临床试验的设计和实施在方法学上有所改进，但有关精神卫生保健的试验仍然存在方法学上的局限性。在karma - deep -2宿主试验中，将进行一项定性研究(quality - swat)，以探索和理解精神卫生保健随机试验中的两个方法学问题:(1)参与精神卫生随机试验的主要障碍和推动因素是什么;(2)随机试验如何成为常规精神卫生保健的一部分。这些问题将根据优先研究主题，从患者-参与者和临床医生/研究人员-参与者的角度进行检查。方法:采用描述性定性研究设计。数据将通过一对一的半结构化访谈收集，由微软团队进行。访谈数据将使用布劳恩和克拉克的主题分析方法进行分析。将对三个参与者组(N = 30)进行一对一访谈:1)主持试验的患者-参与者(N = 10);2)可能符合条件的宿主试验患者-拒绝纳入宿主试验的参与者(n = 10);3)与宿主试验相关的临床医生/研究人员参与者(n = 10)。伦理和传播:爱尔兰圣帕特里克精神卫生服务研究伦理委员会(参考:第09/20号议定书)批准了伦理批准。研究完成后，将编写一份报告并提交给卫生研究委员会(HRB)。研究结果将与主办试验团队和研究参与者共享，并提交发表。主试验注册:ClinicalTrials.gov (NCT04939649);草案(2019-003109-92)。官方标题:氯胺酮作为重度抑郁症的辅助治疗-一项随机对照试验:[KARMA-Dep(2)]。

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引用次数: 0