From agenda to action: JBI Evidence Synthesis and the United Nations Sustainable Development Goals.

OBJECTIVE: This pilot study sought to map the alignment of publications in JBI Evidence Synthesis to the United Nations Sustainable Development Goal (SDG) 3 (global health and well-being) and to understand JBI authors' awareness of and engagement with the goals. This will contribute to a larger-scale analysis to assist the JBI Collaboration in engaging with and working toward achieving the SDGs. INTRODUCTION: In 2015, the United Nations agreed on 17 SDGs as the central framework for sustainable development worldwide. However, in the wake of the global pandemic, the 2030 SDG agenda is in jeopardy due to multiple cascading and intersecting crises. The Global Commission on Evidence has urged the evidence community to consider how it might more meaningfully contribute to the evidence architecture. As we pass the midway point to the SDG 2030 target date, it is timely to reflect on the contribution of those in the evidence synthesis community to achieving these important global objectives. METHODS: A 2-phase study was conducted utilizing desktop audit methods. SDG 3 targets were mapped across systematic and scoping reviews published in JBI Evidence Synthesis using established key terms, followed by a brief author survey and thematic analysis. RESULTS: The results of this pilot study indicate that 28.5% of syntheses published in JBI Evidence Synthesis address 11 of the 13 targets of SDG 3. SDGs are not currently a priority consideration for most JBI Evidence Synthesis authors, but there is a desire to learn more and integrate the goals into their prioritization processes. CONCLUSIONS: While this was only a small pilot study, it is indicative of a need to reset and recommit to mutual global agendas to transform the evidence ecosystem, and to maximize the limited resources available in order to truly have a global impact on health outcomes.

Parental perceptions of chickenpox and the varicella vaccine: A qualitative systematic review.

BACKGROUND: In countries where varicella vaccination is not on the routine childhood immunisation schedule, such as those in the United Kingdom (UK), chickenpox is an almost universal disease of childhood. Chickenpox can cause serious complications, particularly in infants, pregnant women, and the immunocompromised. In November 2023 the varicella vaccine was recommended for inclusion in the UK routine childhood immunisation schedule. Successful rollout of the vaccine may be hindered by parental concerns about vaccine safety and efficacy, and perceptions of chickenpox as a mild illness. OBJECTIVE: To examine parental perceptions of chickenpox and varicella vaccination, which may be crucial to effective vaccination campaigns. DESIGN: Qualitative systematic review and thematic analysis. METHODS: Six electronic databases were systematically searched for studies published between 2016 and 2023: CINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, and Web of Science. The included studies were appraised against the Critical Appraisal Skills Program checklist for qualitative studies. Thematic analysis was used to analyse qualitative data, through the development of themes. RESULTS: 22 articles were included in this review, and five themes identified: perceptions that chickenpox is a mild illness, that parents have concerns about varicella vaccine efficacy and safety, a notion of natural immunity as superior, social determinants of health influence vaccine decision making, and vaccination is overwhelming perceived as a parental decision. CONCLUSIONS: Whilst some parents displayed an acceptance and willingness to vaccinate against chickenpox, many expressed concerns, and perceived chickenpox as a routine unworrying childhood illness. Analysis demonstrated a knowledge gap in understanding UK parental opinions regarding chickenpox and varicella vaccination, highlighting the need for research in this area, particularly given ongoing reconsideration for inclusion in the UK vaccination schedule. REGISTRATION: The review was registered on PROSPERO, registration ID CRD42021236120.

Dementia care behind prison walls: A descriptive study understanding nurse's knowledge and educational needs.

AIM/OBJECTIVE: To establish correctional nurses' dementia knowledge base and identify their educational needs related to caring for prisoners with dementia. BACKGROUND: The aging prison population is growing, posing a heightened risk of dementia among older inmates. This study examined the knowledge and perceived educational needs of nurses caring for prisoners with dementia. DESIGN: A descriptive study which was qualitative in nature was undertaken. METHODS: Data was collected using an online survey which included Demographics, the Dementia Knowledge Assessment Tool 2 and open-ended questions. Descriptive statistics such as percentages and frequency were used to analyse the quantitative data and a qualitative analysis was undertaken to identify common themes and extract meaningful insight from the open-ended questions. RESULTS: Nurses showed a general understanding of dementia and its environmental impact but lacked knowledge of late-stage changes. Eight main themes relating more broadly to the environmental and staffing challenges faced by nurses are presented. CONCLUSION: Although participants appeared to have a reasonable dementia knowledge base the study highlights the need for specific dementia education and support focussed on the correctional setting and collaborative partnerships with dementia experts in the community.

Epidemiology of hospitalisations due to chickenpox and quality of life lost in community and hospital settings: protocol for a prospective cohort study across two countries.

INTRODUCTION: While still a ubiquitous disease of childhood, chickenpox has been effectively controlled in many countries through the use of vaccination. Previous health economic assessment of the use of these vaccines in the UK were based on limited quality of life data and only routinely collected epidemiological outcomes. METHODS AND ANALYSIS: This two armed study will carry prospective surveillance of hospital admissions and recruit from community settings to measure the acute quality of life loss caused by paediatric chickenpox both in the UK and in Portugal. The quality of life effects on children and their primary and secondary caregivers will be assessed using the EuroQol EQ-5D with the Child Health Utility instrument (CHU-9) in addition for children. Results will be used to derive quality-adjusted life year loss estimates for cases of simple varicella and the secondary complications. ETHICS AND DISSEMINATION: We have received National Health Service ethical approval (REC ref: 18/ES/0040) for the inpatient arm, university ethical approval (University of Bristol ref: 60721) for the community arm and 10 sites currently are recruiting in the UK and 14 in Portugal. Informed consent is obtained from the parent(s). Results will be disseminated in peer-reviewed publications. TRIAL REGISTRATION NUMBER: ISRCTN15017985.

Investigating different typologies for the synthesis of evidence: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify evidence synthesis types and previously proposed classification systems, typologies, or taxonomies that have guided evidence synthesis. INTRODUCTION: Evidence synthesis is a constantly evolving field. There is now a plethora of evidence synthesis approaches used across many different disciplines. Historically, there have been numerous attempts to organize the types and methods of evidence synthesis in the form of classification systems, typologies, or taxonomies. This scoping review will seek to identify all the available classification systems, typologies, or taxonomies; how they were developed; their characteristics; and the types of evidence syntheses included within them. INCLUSION CRITERIA: This scoping review will include discussion papers, commentaries, books, editorials, manuals, handbooks, and guidance from major organizations that describe multiple approaches to evidence synthesis in any discipline. METHODS: The Evidence Synthesis Taxonomy Initiative will support this scoping review. The search strategy will aim to locate both published and unpublished documents utilizing a three-step search strategy. An exploratory search of MEDLINE has identified keywords and MeSH terms. A second search of MEDLINE, Embase, CINAHL with Full Text, ERIC, Scopus, Compendex, and JSTOR will be conducted. The websites of relevant evidence synthesis organizations will be searched. Identified documents will be independently screened, selected, and extracted by two researchers, and the data will be presented in tables and summarized descriptively. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT: Open Science Framework https://osf.io/qwc27.

Turning the flywheel: mobilizing the JBI model of evidence-based healthcare.

ABSTRACT: Since its emergence in the 1990s, evidence-based healthcare (EBHC) has made great strides in locating, synthesizing, summarizing, and disseminating evidence, but sustainable mechanisms for getting trustworthy evidence into policy and practice continues to be less well understood. We propose that there is an EBHC 'Flywheel' that begins and ends with culture and the development of adaptive but disciplined approaches that generate new 'norms' in relation to EBHC. In mechanics, a flywheel is a device that uses momentum to create rotational energy. The concept of a 'flywheel effect' has been adopted in management fields to demonstrate how change in organizations or practices rarely happen in one fell swoop; rather, sustainable change requires energy and persistent effort.This energy might be exemplified by leadership to get the wheel moving, but it needs to be guided, channelled, harnessed and supported throughout the rest of the organization. To achieve sustainable momentum, it is necessary to communicate with transparency the EBHC principles, practices, and perspectives that are considered of broad organizational value to generate cohesion and understanding about practice expectations. With a common vision, cooperation and collective identity in place, true multidisciplinary collaboration underpinned by EBHC is possible. The final component in the EBHC flywheel, capacity, is self-generating (i.e. you do not need 'more time' or 'more resource' for EBHC as EBHC is embedded in the fabric and fibre of the organization). This shifts the notion of EBHC initiatives from being 'in addition to' or being singular one-off initiatives or projects to being part of the lifeblood of how the organization functions. EBHC is, ultimately, a human-to-human endeavour. It relates to individuals connecting and committing to a common purpose. The 'four C's' that underpin the JBI Model (culture, communication, collaboration, and capacity) are the organizational navigational instruments and roadmaps required to provide the human focus/lens that is needed.

Use of Electrocardiogram Monitoring in Adult Patients Taking High-Risk QT Interval Prolonging Medicines in Clinical Practice: Systematic Review and Meta-analysis.

INTRODUCTION: Electrocardiogram (ECG) monitoring is an important tool to detect and mitigate the risk of potentially fatal drug-induced QT prolongation and remains fundamental in supporting the quality use of high-risk QT interval prolonging medicines. OBJECTIVE: The aim of this systematic review was to determine the prevalence of baseline and/or follow-up ECG use in adult patients taking high-risk QT interval prolonging medicines in clinical practice. METHODS: CINAHL, Cochrane Library, Embase, PubMed, EThOS, OpenGrey and Proquest were searched for studies in adults that reported ECG use at baseline and/or at follow-up in relation to the initiation of a high-risk QT interval prolonging medicine in any clinical setting; either hospital or non-hospital. Two reviewers independently assessed the methodological quality of included studies. Proportional meta-analysis was conducted with all studies reporting baseline ECG use, before medicine initiation, and follow-up ECG use, within 30 days of medicine initiation. RESULTS: There was variability in baseline ECG use according to the practice setting. The prevalence of baseline ECG use for high-risk QT interval prolonging medicines was moderate to high in the hospital setting at 75.1% (95% CI 64.3-84.5); however, the prevalence of baseline ECG use was low in the non-hospital setting at 33.7% (95% CI 25.8-42.2). The prevalence of follow-up ECG use was low to moderate in the hospital setting at 39.2% (95% CI 28.2-50.8) and could not be determined for the non-hospital setting. CONCLUSIONS: The use of ECG monitoring for high-risk QT interval prolonging medicines is strongly influenced by the clinical practice setting. Baseline ECG use occurs more in the hospital setting in comparison to the non-hospital setting. There is lower use of follow-up ECG in comparison to baseline ECG.

JBI series paper 1: Introducing JBI and the JBI Model of EHBC.

Joanna Briggs Institute (JBI) is an international research organization and collaborative network hosted in the Faculty of Health and Medical Sciences at the University Of Adelaide, South Australia. Now in its 25th year of activity, JBI is concerned with improving health outcomes in communities globally by promoting and supporting the use of the best available evidence to inform decision making in health policy and practice. The JBI Model of Evidence Based Healthcare, developed in the early 2000s, represents an articulation of the evidence ecosystem and the pragmatic approach required to navigate the complexity of health systems globally to improve health outcomes. The programs of JBI are aligned with the JBI Model and are representative of the supportive structures that facilitate the pragmatic realization of each of the elements of evidence based healthcare.

JBI series paper 4: the role of collaborative evidence networks in promoting and supporting evidence-based health care globally: reflections from 25 years across 38 countries.

Evidence-based health care (EBHC) is a worldwide movement with hundreds of organizations and thousands of individuals working to ensure that health care practice, policy, and decision-making are informed by rigorous research evidence, to improve health outcomes. The success of this global agenda, however, depends on individuals and organizations working together within a functioning evidence ecosystem. Collaborative evidence networks are a key mechanism to facilitate the synthesis, transfer, and implementation of evidence into health care policy and practice. Using the network functions approach as a framework for review, this paper explores the strategic functions and form of the JBI Collaboration to illustrate the role of a collaborative evidence network in promoting and supporting EBHC globally. It illustrates how the functions of a collaborative evidence network enable the development, exchange, and dissemination of knowledge, the building of social capital, mobilization of resources, and amplification and advocacy of members work and ideas, which increase the capacity and effectiveness of members in achieving their unified purpose. Effective and sustainable collaborative evidence networks have innovative ways of relating and mobilizing energy for action and combine formal and informal structures and relationships to successfully work together to address complex global health issues and drive the EBHC agenda forward.

JBI series paper 3: The importance of people, process, evidence, and technology in pragmatic, healthcare provider-led evidence implementation.

In this paper, we describe and discuss evidence implementation as a venture in global human collaboration within the framework of "people, process, evidence, and technology" as a roadmap for navigating implementation. At its core implementation is not a technological, or theoretical process, it is a human process. That health professionals central to implementation activities may not have had formal training in implementation, highlights the need for processes and programs that can be integrated within healthcare organization structures. Audit with feedback is an accessible implementation approach that includes the capacity to embed theory, frameworks, and bottom-up change processes to improve the quality of care. In this third paper in the JBI series, we discuss how four overarching principals necessary for sustainability (Culture, Capacity, Communication, and Collaboration) are combined with evidence, technology, and resources for evidence-based practice change. This approach has been successfully used across hundreds of evidence implementation projects around the globe for over 15 years. We present healthcare practitioner-led evidence-based practice improvement as sustainable and achievable in collaborative environments such as the global JBI network as a primary interest of the practicing professions and provide an overview of the JBI approach to evidence implementation.

JBI series paper 2: tailored evidence synthesis approaches are required to answer diverse questions: a pragmatic evidence synthesis toolkit from JBI.

Evidence synthesis is critical in evidence-based healthcare and is a core program of JBI. JBI evidence synthesis is characterised by a pluralistic view of what constitutes evidence and is underpinned by a pragmatic ethos to facilitate the use of evidence to inform practice and policy. This second paper in this series provides a descriptive overview of the JBI evidence synthesis toolkit with reference to resources for 11 different types of reviews. Unique methodologies such as qualitative syntheses, mixed methods reviews, and scoping reviews are highlighted. Key features include standardised and collaborative processes for development of methodologies and a broad range of tailored resources to facilitate the conduct of a JBI evidence synthesis, including appraisal and data extraction tools, software to support the conduct of a systematic review and an intensive systematic review training program. JBI is one of the leading international protagonists for evidence synthesis, providing those who want to answer health-related questions with a toolkit of resources to synthesize the evidence.

Speech Outcomes Following Orticochea Pharyngoplasty in Patients With History of Cleft Palate and Noncleft Velopharyngeal Dysfunction.

OBJECTIVE: To report speech outcomes following Orticochea pharyngoplasty in 43 patients with cleft palate and noncleft velopharyngeal dysfunction. DESIGN: A retrospective surgical audit of patients undergoing Orticochea pharyngoplasty between 2004 and 2012, with speech as a primary outcome measure. SETTING: Patients known to a regional UK cleft center. METHODS: Forty-three patients underwent Orticochea pharyngoplasty by a single surgeon in a UK regional cleft center. Twenty-one patients had undergone a prior procedure for velopharyngeal dysfunction. Pre- and postoperative speech samples were assessed blindly using the Cleft Audit Protocol for Speech-Augmented by a specialist cleft speech and language therapist, external to the team. Speech samples were rated on the following parameters: hypernasality, hyponasality, audible nasal emission, nasal, turbulence, and passive cleft speech characteristics. Statistical differences in pre- and postoperative speech scores were tested using the Wilcoxon matched-pairs signed-ranks test. Inter- and intrareliability scores were calculated using weighted Cohen κ. RESULTS: Whole group: A statistically significant difference in pre- and postoperative scores for hypernasality (P < .001), hyponasality (P < .05), nasal emission (P < .01), and passive cleft speech characteristics (P < .01) were reported. Patients with cleft diagnoses: A statistically significant difference in scores for hypernasality (P < .001), nasal emission (P < .01), and passive cleft speech characteristics (P < .01) were reported for this group of patients. Patients with noncleft diagnoses: The only parameter to demonstrate a statistically significant difference was hypernasality (P < .01) in this group. CONCLUSIONS: Orticochea pharyngoplasty is a successful surgical procedure in treating velopharyngeal dysfunction in both the cleft and noncleft populations.

Correctional nurse education and training to care for and support prisoners with dementia: a systematic review of text and opinion.

OBJECTIVE: The objective of this review was to synthesize the best available evidence on the training required for correctional nurses to care for and support prisoners with dementia. INTRODUCTION: Nurses caring for people in aged care facilities receive training related to aging and dementia; however, this has not carried across to training for the increasing aging population within correctional settings. Most research related to dementia care is focused on the aged and acute care sectors, and there is an absence of research in the correctional setting. Therefore, this systematic review was based on expert opinion and synthesizes information related to correctional nurse training for the support and care of prisoners with dementia. INCLUSION CRITERIA: Articles focusing on correctional nurses, regardless of gender, who were responsible for the health care of adult prisoners were considered for this review. The primary phenomenon of interest was the training needs and requirements for correctional nurses to support prisoners with dementia. The secondary phenomenon of interest was how the delivery of the training could be facilitated. The context of this review was the adult correctional setting. The sources of information considered for this review included text and narratives describing expert opinion, expert opinion-based guidelines, expert consensus, published discussion papers, unpublished dissertations, reports accessed from professional organization websites, and government policy documents. METHODS: A three-step search strategy was employed to look for both published and unpublished articles as recommended by JBI. The search was conducted for English-only articles, and from database inception to November 2020. All included articles were assessed by two independent reviewers for methodological quality. The data were extracted and pooled. Categories were developed and assigned based on similarity of meaning, and a set of synthesized conclusions was developed after subjecting the categories to meta-synthesis. RESULTS: Sixteen papers met the inclusion criteria and underwent critical appraisal and data extraction. Five synthesized findings were generated from 103 findings, which were aggregated into 15 categories. As expected, the rating was very low due to the nature of the included papers (ie, non-research), and the mix of unequivocal, credible, and unsupported findings. CONCLUSIONS: The review highlighted gaps in correctional nurse training related to caring for prisoners with dementia. Training for correctional nurses should incorporate information on general aging, alterations in aging, and dementia screening and management. Other findings included the need for policy and procedures related to training nurses to become dementia experts, and the development of partnerships with experts in the community to adapt training to the correctional setting.

Use of ECG monitoring for adult patients taking high-risk QT interval-prolonging drugs in clinical practice: a systematic review protocol.

OBJECTIVE: The objective of this review is to determine the rates of electrocardiogram use in adult patients taking high-risk QT interval-prolonging drugs in clinical settings. This review will determine the extent of ECG monitoring being used to mitigate the risk of drug-induced QT prolongation. INTRODUCTION: High-risk QT interval-prolonging drugs pose a well-established risk of cardiac arrhythmia, including torsades de pointes, among other serious long QT syndromes, which can be fatal. Detection and mitigation of QT prolongation involves use of electrocardiogram monitoring. This systematic review will present evidence for uptake of electrocardiogram monitoring in clinical practice to support the quality use of high-risk QT interval-prolonging drugs. INCLUSION CRITERIA: Quantitative studies, published from 2004 that determine the rate of electrocardiogram monitoring before and during use of high-risk QT interval-prolonging drugs in adults 18 years or older, either in community or hospital settings, will be eligible for inclusion. METHODS: CINAHL, Cochrane Library, Embase, and PubMed will be searched to identify published studies. EThOS, OpenGrey, and ProQuest Dissertations and Theses will be searched to identify unpublished studies. Conference abstracts will be excluded. There will be no restriction on country or language. Two reviewers will independently screen and select studies, assess methodological quality, and extract data. The JBI approach to systematic reviews of prevalence and incidence will be followed. Meta-analysis will be performed, if possible, and the Grading of Recommendations Assessment Development and Evaluation (GRADE) Summary of Findings presented.