Interventions to Support Mental Health among Those with Health Conditions That Present Risk for Severe Infection from Coronavirus Disease 2019 (COVID-19): A Scoping Review of English and Chinese-Language Literature.

This study aimed to address knowledge gaps related to the prevention and management of mental health responses among those with a condition that presents risk of severe COVID-19 infection. A scoping review that mapped English and Chinese-language studies (2019-2020) located in MEDLINE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Sociological Abstracts, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Airiti Library was undertaken. Search terms related to COVID-19, mental health, and physical health were used and articles that included all three of these factors were extracted (n = 77). With the exception of one hospital-based pilot study, there were no intervention studies targeting mental health in those at risk of severe COVID-19 infection. Promising practices such as integrated care models that appropriately screen for mental health issues, address health determinants, and include use of digital resources were highlighted. Patient navigator programs, group online medical visits, peer support, and social prescribing may also support those with complex needs. Future policies need to address digital health access inequities and the implementation of multi-integrated health and social care. Furthermore, research is needed to comprehensively assess multi-integrated interventions that are resilient to public health crises.

Treatment of tungiasis using a tea tree oil-based gel formulation: protocol for a randomised controlled proof-of-principle trial.

INTRODUCTION: Tungiasis (sand flea disease or jigger infestation) is a neglected tropical disease caused by penetration of female sand fleas, Tunga penetrans, in the skin. The disease inflicts immense pain and suffering on millions of people, particularly children, in Latin America, the Caribbean and sub-Saharan Africa. Currently, there is no standard treatment for tungiasis, and a simple, safe and effective tungiasis treatment option is required. Tea tree oil (TTO) has long been used as a parasiticidal agent against ectoparasites such as headlice, mites and fleas with proven safety and efficacy data. However, current data are insufficient to warrant a recommendation for its use in tungiasis. This trial aims to generate these data by comparing the safety and efficacy of a 5% (v/w) TTO proprietary gel formulation with 0.05% (w/v) potassium permanganate (KMnO4) solution for tungiasis treatment. METHODS AND ANALYSIS: This trial is a randomised controlled trial (RCT) in primary schools (n=8) in South-Western Kenya. The study will include school children (n=88) aged 6-15 years with a confirmed diagnosis of tungiasis. The participants will be randomised in a 1:1 ratio to receive a 3-day two times a day treatment of either 5% TTO gel or 0.05% KMnO4 solution. Two viable embedded sandflea lesions per participant will be targeted and the viability of these lesions will be followed throughout the study using a digital handheld microscope. The primary outcome is the proportion of observed viable embedded sand fleas that have lost viability (non-viable lesions) by day 10 (9 days after first treatment). Secondary outcomes include improvement in acute tungiasis morbidities assessed using a validated severity score for tungiasis, safety assessed through adverse events and product acceptability assessed by interviewing the participants to rate the treatment in terms of effectiveness, side effects, convenience, suitability and overall satisfaction. ETHICS AND DISSEMINATION: The trial protocol has been reviewed and approved by the University of Canberra Human Research Ethics Committee (HREC-2019-2114). The findings of the study will be presented at scientific conferences and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBERS: Australian New Zealand Clinical Trials Registry (ACTRN12619001610123); PACTR202003651095100 and U1111-1243-2294.

Transcutaneous Electrical Stimulation for Neurogenic Bladder Dysfunction Following Spinal Cord Injury: Meta-Analysis of Randomized Controlled Trials.

OBJECTIVES: To assess the efficacy of transcutaneous electrical nerve stimulation (TENS) for neurogenic bladder dysfunction secondary to spinal cord injury (SCI). MATERIALS AND METHODS: A systematic search of MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane libraries up to February 2021 was performed using PRISMA methodology. All randomized controlled trials (RCTs) that studied TENS for neurogenic bladder in a SCI population were included. The primary outcomes of interest were maximum cystometric capacity (MCC) and maximum detrusor pressure (Pdet). Meta-analysis was conducted with RevMan v5.3. RESULTS: Six RCTs involving 353 participants were included. Meta-analysis showed that TENS significantly increased MCC (standardized mean difference 1.11, 95% confidence interval [CI] 0.08-2.14, p = 0.03, I2  = 54%) in acute SCI. No benefits were seen for maximum Pdet. TENS was associated with no major adverse events. CONCLUSIONS: TENS may be an effective, safe intervention for neurogenic bladder dysfunction following SCI. Further studies are essential to confirm these results and more work is required to determine optimal stimulation parameters and duration of the treatment.

Non-invasive neuromodulation for bowel, bladder and sexual restoration following spinal cord injury: A systematic review.

Bowel, bladder and sexual dysfunctions are widespread among people with spinal cord injury (SCI) and significantly impact their health and quality of life. Any non-invasive intervention which offers clinical benefits and safety is an advantage in restoring these functions. Despite the potential of non-invasive neuromodulation to improve the clinical outcomes in people with SCI, its characteristics are poorly defined, and reviews of efficacy are scarce in the literature. This study aimed to perform a systematic literature review of clinical studies investigating the use of non-invasive neuromodulation in restoring bowel, bladder and sexual functions following SCI. Electronic databases were searched, including the PubMed/Medline, EMBASE, Web of Science, Scopus and Cochrane databases, along with the reference lists of retrieved publications. Studies were eligible for inclusion if they adopted a clinical design based on participants with SCI, had main outcomes of restoration of bowel, bladder or sexual function and the intervention investigated was non-invasive neuromodulation. A total of 46 studies (combined sample of 1,801) were included in this systematic review, comprising studies of transcutaneous electrical nerve stimulation, magnetic stimulation and vibratory stimulation. Of the 46 studies, 7 were randomized controlled trials (RCTs), 36 were non-RCTs and 3 were case reports. Most studies (43/46) reported improvements in bowel (5/5), bladder (32/35) and sexual (6/6) dysfunction after SCI. However, the quality of the included studies was variable and associated with a high risk of bias. Thus, well-designed, blinded and sham-controlled RCTs with larger populations are required to establish clinical efficacy of these methods.

Application of xCELLigence RTCA Biosensor Technology for Revealing the Profile and Window of Drug Responsiveness in Real Time.

The xCELLigence technology is a real-time cellular biosensor, which measures the net adhesion of cells to high-density gold electrode arrays printed on custom-designed E-plates. The strength of cellular adhesion is influenced by a myriad of factors that include cell type, cell viability, growth, migration, spreading and proliferation. We therefore hypothesised that xCELLigence biosensor technology would provide a valuable platform for the measurement of drug responses in a multitude of different experimental, clinical or pharmacological contexts. In this manuscript, we demonstrate how xCELLigence technology has been invaluable in the identification of (1) not only if cells respond to a particular drug, but (2) the window of drug responsiveness. The latter aspect is often left to educated guess work in classical end-point assays, whereas biosensor technology reveals the temporal profile of the response in real time, which enables both acute responses and longer term responses to be profiled within the same assay. In our experience, the xCELLigence biosensor technology is suitable for highly targeted drug assessment and also low to medium throughput drug screening, which produces high content temporal data in real time.

Community-based participatory action research: transforming multidisciplinary practice in primary health care

OBJETIVOS: Los sistemas de salud de todo el mundo se encuentran en un proceso de reestructuración y reforma de sus sistemas de prestación de servicios, reorientándose hacia el modelo de atención primaria de salud (APS) que utiliza equipos de consultorios multidisciplinarios (CMD) para brindar un conjunto de servicios coordinados e integrados. En este estudio se exploran los retos de poner en práctica el enfoque de CMD en una comunidad urbana de Canadá. MÉTODOS:Los datos analizados se tomaron de un proyecto de investigación-acción participativa basada en la comunidad (IAPBC) llevado a cabo en 2004. Su objetivo era perfeccionar un CMD colaborativo en un centro de APS que atiende a una comunidad de 11 000 personas, compuesta por una zona residencial y pequeños negocios, en una ciudad canadiense de aproximadamente 300 000 personas. La IAPBC permite abordar de manera planificada y sistemática problemas importantes para la comunidad en cuestión, requiere la participación de la comunidad, se enfoca hacia la solución de los problemas, se dirige a lograr cambios en la sociedad y hace contribuciones duraderas a la comunidad. Se partió de un aspecto de este complejo proyecto de varios años, para transformar la defensa retórica de la reforma de la APS en una práctica real y sustentable. La comunidad estudiada era diversa en cuanto a la edad, las características socioeconómicas y los estilos de vida. Su equipo multidisciplinario atendía aproximadamente a 3 000 pacientes al año, 30 por ciento de los cuales tenían 65 años o más. Gracias a su enfoque multidisciplinario e integrado con respecto a la atención, este centro de APS pasó a formar parte de un selecto grupo dentro del extenso sistema de atención primaria de Canadá. RESULTADOS: El análisis del trabajo de APS puso de manifiesto ideas arraigadas e inconcientes acerca de los límites y las limitaciones de la atención prestada. En el sentido retórico de la APS, el CMD era elogiado por muchos. En la...(AU)