HRB open research最新文献

Student carers in higher education institutions (HEIs) is an emerging policy issue in many countries. Researchers have sought to synthesise the literature on student carers in HEIs. Runacres et al. (2024) conducted a scoping review, which included 14 studies, and Knopf et al. (2022) conducted a systematic review of university students who are caring for an older adult, which included six studies. These reviews identified some key themes discussed in the literature. However, there are further areas of discussion that have yet to be explored in the evidence to date. This observation is in the context of a growing body of international literature published on the topic and the greater visibility of family carers post-pandemic. One key area yet to be examined is the policy and practice responses to student carers in HEIs in different countries. The scope of this review will be broader than previous reviews with a specific focus on policy and practice responses regarding this population. This scoping review will: examine definitional issues concerning student carers in HEIs; summarise studies from different countries that provide estimates of the number of student carers in HEIs; identify theoretical perspectives and concepts underpinning research on this topic; and assess the available evidence on the value and outcomes of supports. The 5-stage methodological framework developed by Arksey and O'Malley (2005) will be used to guide this scoping review, as described in detail in this protocol. The findings of the scoping review will be used to inform the enhancement of supports for student carers in HEIs. A range of vehicles will be used to disseminate the findings, including conference presentations, publication in an international peer-reviewed journal, and preparation of a policy brief to disseminate the findings of this scoping review to policymakers and other relevant stakeholders.

Objective: To review and summarise interprofessional breastfeeding curricula-educational initiatives involving multiple health professions-that have been proposed for undergraduate or pre-registration health students. This review will help guide the development of future Interprofessional Education (IPE) curricula for undergraduate health students, specifically in the area of breastfeeding care.

Introduction: Breastfeeding care and support from healthcare professionals are vital for breastfeeding success. To ensure mothers receive high-quality, consistent care, healthcare professionals must receive comprehensive, evidence-based breastfeeding education. However, there is limited understanding of how breastfeeding curricula are delivered across different disciplines in undergraduate health programs, particularly in the context of IPE.

Inclusion criteria: Primary research designs, including quantitative, qualitative and mixed-method studies and evidence syntheses of primary research including systematic and scoping reviews that meet the inclusion criteria will be considered. Position papers and policy documents will also be considered for inclusion in this scoping review.

Methods: Medline (Ovid), CINAHL (EBSCO), ERIC (EBSCO), Social Sciences, and Cochrane Databases of Systematic Reviews will be searched with English language and date restrictions (2005-current). Titles and abstracts and full-text articles will be independently screened by two reviewers. The reference lists of the included studies will be searched. A grey literature search will be undertaken on Google scholar, BASE and National Institute for Health and Care Excellence (NICE) website in October 2024. Studies will be screened in Covidence by two independent reviewers. All reviewers will agree on the included studies. Data will be extracted and presented graphically using figures and tables. Narrative summary text will accompany the tables and figures.

Background: Individuals with first-episode psychosis (FEP) face an increased risk of physical comorbidities, notably cardiovascular diseases, metabolic disorders, respiratory disorders, and certain types of cancer. Previous reviews report pooled physical health prevalence from chronic psychosis and FEP groups. By contrast, this review will focus on antipsychotic-naïve FEP cohorts and incorporate data from observational longitudinal studies and antipsychotic intervention studies to understand the progression of physical health comorbidities from the onset to later stages of psychosis. This review aims to examine the short-, medium-, and long-term period prevalence of these comorbidities in FEP and variations related to demographic factors.

Methods: Using the PRISMA and MOOSE guidelines, Medline, Embase, PsycINFO, and CINAHL+, as well as Clinical Trials gov.uk, OpenGrey, WHO International Clinical Trials Registry Platform, Current Controlled Trials, United States National Institute of Health Trials Registry, and the Irish Health Repository, will be searched from inception. Longitudinal studies and antipsychotic intervention studies monitoring health outcomes in antipsychotic naïve FEP individuals will be eligible for inclusion. Two reviewers will independently screen titles, abstracts, and full-text articles. Risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist. A meta-analysis of the short-, medium-, and long-term prevalence of cardiovascular, metabolic, cancer, and respiratory outcomes and a narrative synthesis will be conducted. Where feasible, a meta-regression on the impact of demographic variables will be conducted. Potential limitations include the risk of diagnostic heterogeneity across studies and possible underreporting of certain comorbidities.

Conclusions: This systematic review will clarify the progression of physical health comorbidities in FEP, informing early intervention strategies and policies. Subsequent findings will be submitted to a leading journal, supplemented by a recovery education module and a lay summary for wider dissemination.

Registration: The study was registered in PROSPERO, the International Prospective Register of Systematic Reviews ( CRD42023431072; 17/06/2023).

Background: Correct staging and risk stratification is essential in ensuring prostate cancer patients are offered the most appropriate treatment. Interest has been growing in the use of radiotracers targeting prostate specific membrane antigen (PSMA), including the use of ¹⁸F-PSMA PET-CT, as part of the primary staging or restaging of prostate cancer. Preliminary scoping identified a number of relevant systematic reviews and meta-analyses; however, individually, these each appear to look at only part of the picture. An overview of reviews aims to systematically identify, appraise and synthesise multiple systematic reviews, related to a relevant research question or questions. We present a protocol for an overview of reviews, which aims to collate existing evidence syntheses exploring the diagnostic accuracy of ¹⁸F-PSMA in staging and restaging of prostate cancer. It also aims to highlight evidence gaps in prostate cancer staging or restaging.

Methods: This protocol is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for systematic review protocols (PRISMA-P). The search strategy will be designed in consultation with a librarian. Searches will be performed in Medline (EBSCO), Embase (Ovid), Google Scholar and the Cochrane Database for Systematic Reviews, supplemented by a targeted grey literature search, forward citation searching and searching reference lists of included reviews. No language or date restrictions will be applied to the eligibility criteria or the search strategy. Title & abstract and full text screening will be performed independently by two reviewers. Data will be extracted by one reviewer and checked in full by a second reviewer. Quality appraisal will be performed using the Risk of Bias in Systematic Reviews (ROBIS) tool independently by two reviewers, and results will be narratively synthesised.

Conclusions: This overview of reviews may be of interest to healthcare professionals, academics and health policy decision-makers.

Registration: OSF (September 7, 2023).

Background: Physical activity is essential for youth physical and mental health, yet just 15% of adolescent girls versus 22% of adolescent boys worldwide meet the World Health Organization guideline of at least an average of 60 minutes of moderate-to-vigorous physical activity per day. As activity patterns established in adolescence often persist into adulthood, there is a looming risk of adverse health outcomes due to insufficient physical activity. A persistent challenge faced by physical activity providers, however, is recruiting adolescent girls into their programmes. This systematic review will quantitatively synthesise existing knowledge surrounding the recruitment of adolescent girls into physical activity interventions and aims to provide evidence-based recommendations for optimal recruitment practices.

Methods: Five electronic databases will be searched to identify randomised controlled trials of physical activity interventions for adolescent girls worldwide. Hand-searches of reference lists of included randomised controlled trials, relevant systematic reviews, and author publications will also be conducted. Data will be extracted regarding study, participant, and intervention characteristics, pre-determined recruitment goals, recruitment strategies employed, and the number of participants screened, eligible, approached, randomised, and retained. Outcomes will include whether pre-determined recruitment goals were met, recruitment rate, and any adapted or extended recruitment measures required mid-study. Descriptive statistics, including the median recruitment rate for all included studies, will be calculated and stratified by subgroups such as the type or setting of physical activity. Recruitment strategies will be categorised, and the percentage of studies using each category, along with their associated recruitment rates, will be documented. If sufficient studies are found, multi-variable regression will be employed to determine if the use of a specific recruitment strategy increases enrolment.

Discussion: Application of the findings of this review by physical activity programme providers may enhance their recruitment processes, potentially increasing teenage girls' physical activity enrolment worldwide.

Systematic review registration: PROSPERO CRD#42023475858.

Background: Breastfeeding rates in Ireland are among the lowest in the world. Lactation consultancy provides mothers with support and information on how to cope with any challenges they encounter. There is emerging evidence that COVID-19 restrictions impacted access to and the quality of breastfeeding support.The aim of this study was to explore breastfeeding mothers' and lactation consultants' experiences of breastfeeding support throughout the COVID-19 restrictions in Ireland. It also aimed to explore what adaptations had to be made to the delivery of lactation consultancy and how these changes impacted mothers' experiences of breastfeeding support.

Methods: A qualitative research design was chosen. Semi-structured interviews were conducted with eight participants, three breastfeeding mothers and five lactation consultants. Interviews were conducted online via Zoom, audio-recorded and transcribed. The data were analysed using thematic analysis.

Results: Five key themes were identified: 'Lack of Support', 'Adapting to COVID-19 Restrictions', Emotional Response to COVID-19 and Restrictions', Vaccination against SARS-CoV-2 as a Barrier to and Facilitator of Support' and Inconsistency of Lactation Support Across Ireland'. Both lactation consultants and mothers identified similar issues however, slight variations within lactation consultants' perceptions of mothers' and mothers' attitudes towards online services were seen. An notable finding was the lack of support in hospitals pre-COVID-19.

Conclusions: Both mothers' and lactation consultants' experiences of lactation consultancy were impacted by the COVID-19 restrictions. Although exacerbated by COVID-19, the lack of support in hospitals existed before COVID-19. Provision of better breastfeeding support is required.Increased availability of lactation consultants and the implementation of breastfeeding rooms within hospitals is required in addition to debrief counselling sessions for lactation consultants. Further research is required to understand the unavailability of lactation consultants in hospital settings and to identify how to manage breastfeeding support in future emergency situations.

Background: Patient safety is a key issue for health systems and a growing global public health challenge. Administrative healthcare data provide a coded summary of a patient and their encounter with the healthcare system. These aggregated datasets are often used to inform research and decisions relating to health service planning and therefore it is vital that they are accurate and reliable. Given the reported inaccuracy of these datasets for detecting and recording adverse events, there have been calls for validation studies to explore their reliability and investigate further their potential to inform research and health policy. Researchers have since carried out validation studies on the rates of adverse events in administrative data through chart reviews therefore, it seems appropriate to identify and chart the evidence and results of these studies within a scoping review.

Methods: The scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. A search of databases such as PubMed, CINAHL, ScienceDirect and Scopus will be conducted in addition to a search of the reference lists of sourced publications and a search for grey literature. Following this, Covidence will be used to screen the sourced publications and subsequently extract data from the included sources. A numerical summary of the literature will be presented in addition to a charting based on the qualitative content analysis of the studies included.

Conclusions: This protocol provides the structure for the conduct of a review to identify and chart the evidence on validation studies on rates of adverse events in administrative healthcare data. This review will aim to identify research gaps, chart the evidence of and highlight any flaws within administrative datasets to improve extraction and coding practices and enable researchers and policy makers to use these data to their full potential.

Objective: This scoping review aims to synthesise the extent and type of evidence on behaviour change interventions which address antibiotic treatment seeking behaviour for respiratory tract infections in primary care and/or community care settings.

Introduction: Antimicrobial Resistance is recognised as a global health and economic threat by the World Health Organization and World Bank. Multiple factors, including patient and public demand, may contribute to unnecessary prescribing practices, which can lead to an overuse of antibiotics, and affect AMR. Current policy initiatives acknowledge the need to prepare for the future by managing public expectations regarding antibiotics, especially for influenza-like illness and other respiratory tract infections. These initiatives emphasise the importance of designing and evaluating effective interventions that generate actionable knowledge for policy and practices related to the appropriate use of antibiotics. Behaviour change interventions, in this context, can aim to modify patients' attitudes, beliefs, and behaviours regarding antibiotics.

Inclusion criteria: Identified studies will describe behaviour change interventions aimed at potential patients and/or carers within the primary care and/or community care setting that address antibiotic treatment seeking behaviour for respiratory tract infections.

Methods: This scoping review will search the literature in Medline, Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, EThOS, and Google Scholar to explore behaviour change interventions used to reduce expectations of antibiotics for respiratory tract infections in primary care. This review will follow the Joanna Briggs Institute guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

Background: People who are homeless are more likely to experience poor mental health and addiction as well as suffering from non-communicable diseases. There is evidence of frailty and accelerated physical ageing among people experiencing homelessness. Appropriate physical rehabilitation and nutritional supplementation strategies can stabilise or reverse frailty and general physical decline, but it is not known how this type of intervention would work in practice in this population.

Aim: To evaluate the feasibility and pre-post intervention impact of a low threshold physical rehabilitation intervention with protein supplementation to target physical functioning and frailty in people with problematic substance use who are experiencing homelessness.

Methods: The intervention will consist of a 12-week low threshold rehabilitation programme with protein supplementation. Participants will be service users of the Ballyfermot Advance Project, a day services centre for people with addiction issues and experiencing homelessness. Primary outcomes will be feasibility including numbers recruited, retention of participants and adherence to the exercise intervention and protein supplement. Any adverse events will be recorded. Secondary outcomes will be strength and muscular mass, physical performance and lower extremity physical function, pain, frailty and nutritional status.

Discussion: An immediate impact may be simply a distraction from difficult circumstances and potentially an improvement of physical health of participants, which can be a conduit for the emergence of other positive behaviours and recovery. Longer term, this study will generate preliminary data on which to inform the design of a definitive randomised controlled trial of physical rehabilitation and protein supplementation, if indicated.

Ethics and dissemination: Ethical approval was granted by the Faculty of Health Sciences Research Ethics Committee in TCD. Study findings will be disseminated through publication into an international peer-reviewed journal and presented at national and international conferences.

Background: HIV pre-exposure prophylaxis (PrEP) is a medication that prevents the acquisition of HIV, most commonly taken in the form of a pill. PrEP is an efficacious tool for HIV prevention, including among gay, bisexual, and other men who have sex with men (gbMSM). PrEP is often provided through formal PrEP programmes. Research on these programmes may employ discourses shaped by heteronormativity and homophobia. Given that expert language influences how HIV prevention is understood and delivered, problematic discourses in research likely extend into PrEP implementation. This study will use critical discourse analysis (CDA) to explore research on PrEP programme implementation for gbMSM. Within this literature, we will identify interpretive repertoires used to discuss gbMSM; the subject positions afforded to gbMSM; and the implications of these interpretive repertoires and subject positions for gbMSM engaging with HIV PrEP programmes.

Methods: Systematic search methods identified relevant articles through timebound searching (2012-2023) in ProQuest ASSIA, EBSCOhost PsycInfo, OVID Medline, OVID Embase, and EBSCOhost CINAHL, with forward and backward citation searching of included studies. Grey literature will be identified through ProQuest and Google Scholar. Screening will be conducted by two independent reviewers, who will conduct random partial double screening for titles and abstracts and for all full text articles. Data will be analysed and synthesised using CDA informed by critical realism (CR). CDA focuses on relationships between language and power, including how language enables inequality. The analytic process will explore the background of included studies, identify themes, and analyse external and internal relations in included studies.

Conclusions: Highlighting issues with discourses in PrEP implementation may enhance reflective engagement with assumptions underlying this research, preventing further stigmatisation of gbMSM's sexual and protective practices. As PrEP programmes become more common, diverse and inclusive perspectives in PrEP programme research may inform interventions that enhance their acceptability and implementation.