JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts.

INTRODUCTION: Racialized population groups have worse health outcomes across the world compared with non-racialized populations. Evidence suggests that collecting race-based data should be done to mitigate racism as a barrier to health equity, and to amplify community voices, promote transparency, accountability, and shared governance of data. However, limited evidence exists on the best ways to collect race-based data in healthcare contexts. This systematic review aims to synthesize opinions and texts on the best practices for collecting race-based data in healthcare contexts. METHODS AND ANALYSES: We will use the Joanna Briggs Institute (JBI) method for synthesizing text and opinions. JBI is a global leader in evidence-based healthcare and provides guidelines for systematic reviews. The search strategy will locate both published and unpublished papers in English in CINAHL, Medline, PsycINFO, Scopus and Web of Science from 1 January 2013 to 1 January 2023, as well as unpublished studies and grey literature of relevant government and research websites using Google and ProQuest Dissertations and Theses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement methodology for systematic reviews of text and opinion will be applied, including screening and appraisal of the evidence by two independent reviewers and data extraction using JBI's Narrative, Opinion, Text, Assessment, Review Instrument. This JBI systematic review of opinion and text will address gaps in knowledge about the best ways to collect race-based data in healthcare. Improvements in race-based data collection, may be related to structural policies that address racism in healthcare. Community participation may also be used to increase knowledge about collecting race-based data. ETHICS AND DISSEMINATION: The systematic review does not involve human subjects. Findings will be disseminated through a peer-reviewed publication in JBI evidence synthesis, conferences and media. PROSPERO REGISTRATION NUMBER: CRD42022368270.

Enhancing nurses' capacity to provide concurrent mental health and substance use disorder care: A quasi-experimental intervention study.

BACKGROUND: Patients experiencing concurrent disorders (i.e., co-occurring mental health and substance use disorders) are prevalent in mental health settings and their health and social outcomes are often poor. This reflects persistent stigma as well as inadequate preparatory training or continuing education for healthcare professionals, including nurses. OBJECTIVE: To explore the impacts of the 1-day 'Enhancing Concurrent Disorder Care Intervention' on nurses' and student nurses' capacity to deliver care, grounded in current evidence, to patients with concurrent disorders in inpatient mental health settings. DESIGN: A Quasi-experimental intervention design was used with pre- and postt-test components, guided by the STROBE checklist for observational studies. SETTINGS: Five acute mental health units across two hospitals in British Columbia, Canada, as well as two schools of nursing representing students completing clinical practicum rotations within these settings. PARTICIPANTS: Seventy-six nurses (Registered Nurses and Registered Psychiatric Nurses) and student nurses practicing in inpatient mental health care. METHODS: This educational intervention was informed by a pilot study, which included content validation from international concurrent disorder experts, and further refined through collaborative processes with lived experience and nurse partners. Intervention impacts were examined using online surveys conducted prior to the intervention and within two weeks post-intervention. Surveys assessed knowledge and attitudes about concurrent disorders using a validated instrument and questions developed by the study team. Descriptive statistics alongside paired and independent t-tests and two-way ANOVAs were used to compare survey scores before and after the intervention. RESULTS: Findings indicate that the intervention was effective in improving participants' knowledge and attitudes toward patients with concurrent disorders across participant groups. CONCLUSIONS: Enhancing care and outcomes for patients with concurrent disorders is a global priority. Brief educational interventions aimed at nurses can provide an effective, low-barrier mechanism to address knowledge gaps that contribute to harmful care and adverse outcomes.

Factors Predicting Blood Culture Positivity in Children With Enteric Fever.

BACKGROUND: Blood culture, despite low sensitivity, is the gold standard for enteric fever diagnosis. Understanding predictors of blood culture positivity may help design strategies to optimize enteric fever diagnosis. METHODS: A cohort of 6760 children aged 0.5-15 years was followed for 3 years for enteric fever with blood cultures in an automated system, for fevers >3 days. Factors affecting test positivity in fevers and participant-level predictors for culture refusals were analyzed using regression models. RESULTS: Overall, 6097 suspected typhoid/paratyphoid fever (STF) episodes were reported, of which 5703 (93.5%) STFs had sampling for blood cultures, with 394 (6.5%) refusals. Salmonella enterica serovar Typhi/Paratyphi positivity was culture-confirmed in 3.8% (218/5703) of STF episodes. Older children (odds ratio [OR], 1.96 [95% CI, 1.39-2.77]), larger blood volume inoculated (OR, 2.82 [95% CI, 1.71-4.66]), higher temperatures during fever (OR, 3.77 [95% CI, 2.89-4.91]), and fevers diagnosed as suspected typhoid or acute undifferentiated fever (OR, 6.06 [95% CI, 3.11-11.78]) had a higher probability of culture positivity. Antibiotics before culture did not decrease culture positivity. Blood culture refusals were higher for children from wealthier households or with milder illness. CONCLUSIONS: Performing blood cultures in older children with fever, especially those fevers with toxic presentation and increasing blood volume for inoculation are strategies to improve enteric fever detection in surveillance settings.

Use of Asynchronous Virtual Mental Health Resources for COVID-19 Pandemic-Related Stress Among the General Population in Canada: Cross-Sectional Survey Study.

BACKGROUND: The COVID-19 pandemic has resulted in profound mental health impacts among the general population worldwide. As many in-person mental health support services have been suspended or transitioned online to facilitate physical distancing, there have been numerous calls for the rapid expansion of asynchronous virtual mental health (AVMH) resources. These AVMH resources have great potential to provide support for people coping with negative mental health impacts associated with the pandemic; however, literature examining use prior to COVID-19 illustrates that the uptake of these resources is consistently low. OBJECTIVE: The aim of this paper is to examine the use of AVMH resources in Canada during the COVID-19 pandemic among the general population and among a participant subgroup classified as experiencing an adverse mental health impact related to the pandemic. METHODS: Data from this study were drawn from the first wave of a large multiwave cross-sectional monitoring survey, distributed from May 14 to 29, 2020. Participants (N=3000) were adults living in Canada. Descriptive statistics were used to characterize the sample, and bivariate cross-tabulations were used to examine the relationships between the use of AVMH resources and self-reported indicators of mental health that included a range of emotional and coping-related responses to the pandemic. Univariate and fully adjusted multivariate logistic regression models were used to examine associations between sociodemographic and health-related characteristics and use of AVMH resources in the subgroup of participants who reported experiencing one or more adverse mental health impacts identified in the set of self-reported mental health indicators. RESULTS: Among the total sample, 2.0% (n=59) of participants reported accessing AVMH resources in the prior 2 weeks to cope with stress related to the COVID-19 pandemic, with the highest rates of use among individuals who reported self-harm (n=5, 10.4%) and those who reported coping "not well" with COVID-19-related stress (n=22, 5.5%). Within the subgroup of 1954 participants (65.1% of the total sample) who reported an adverse mental health impact related to COVID-19, 54 (2.8%) reported use of AVMH resources. Individuals were more likely to have used AVMH resources if they had reported receiving in-person mental health supports, were connecting virtually with a mental health worker or counselor, or belonged to a visible minority group. CONCLUSIONS: Despite substantial government investment into AVMH resources, uptake is low among both the general population and individuals who may benefit from the use of these resources as a means of coping with the adverse mental health impacts of the COVID-19 pandemic. Further research is needed to improve our understanding of the barriers to use.

Study to assess the knowledge of caretakers regarding corticosteroid therapy in children with congenital adrenal hyperplasia - 21 hydroxylase deficiency.

BACKGROUND: The primary aim of treating congenital adrenal hyperplasia (CAH) due to 21 hydroxylase deficiency is to replace the deficient glucocorticoids and mineralocorticoids, to minimize the excess androgen production and to facilitate normal growth. Children with CAH require daily treatment lifelong and increased dosage plan during acute stress, in order to obtain the benefit of optimal outcome from the ongoing treatment schedule. This emphasizes the need for the parents of affected children to be empowered with adequate knowledge regarding such lifesaving therapy. AIMS & OBJECTIVES: This study was aimed to assess their knowledge regarding corticosteroid therapy. Materials and methods. Caretakers of children with CAH were recruited by using purposive sampling technique. Data was collected by using structured interview technique. RESULTS: It was observed that only 10% of study group had adequate knowledge about therapy and the majority of them were from rural areas, lacking in awareness of essential steps of management. CONCLUSION: It was concluded that these caretakers need to be given appropriately planned education regarding corticosteroids, drug actions, and the need for enhanced steroid dosage during stress situations. They should also be given relevant instructional materials to read for improving their knowledge about their child's disorder.

Effectiveness of yogic visual concentration (Trataka) on cognitive performance and anxiety among adolescents.

Background Cognition is the mental process of acquiring knowledge, understanding senses and synchronizing all the electrical activity that is constantly received and generated through the eye. Purpose of the present study was to assess the effectiveness of yogic visual concentration (Trataka) on cognitive performance and anxiety among adolescents studying in selected schools at Chennai. Methodology This study was designed to assess cognitive performance and anxiety among students using quantitative approach. True Experimental study design was used for this study. Pretest assessment of cognitive performance and anxiety was done by standardized tools (Stroop color word test, Hamilton anxiety scale) for Experimental and Control groups. Intervention of yogic visual concentration (Trataka) was experimented in one group. Control group were kept on routine activities. Post test assessment of cognitive performance and anxiety by standardized tools was performed on experimental and control groups. The data were analyzed by descriptive statistics and inferential statistics. The 0.05 level of significance was used. Results A significant difference in the mean difference of color word score, color score, word score and inference score between the study and control groups at the level of p<0.0001 was observed. Results indicate an association in the cognitive performance (word) with background variables such as, gender, father's occupation in the study group during the post test and no association in the control group. There were no associations between anxiety cognitive performance (color and word) and demographic variables in both groups. Conclusion The study concluded that there is a greater effect on Yogic visual concentration (Trataka) on cognitive performance and anxiety among adolescent students, therefore the study proved the hypothesis.

Effectiveness of video game on bio- physiological parameters during intravenous cannulation among preschool children.

Background Hospitalization is a completely new experience for infants and young children; they are too young to understand the stress of hospitalization. Distractions or diversions seek to divert the child's attention to interesting or challenging tasks to draw attention away from painful or distressful medical procedure. Therefore, the present study assesses the effectiveness of video game on bio-physiological parameters during intravenous cannulation among preschool children admitted in paediatric ward. Methods A randomized true experimental research design was used to assess the effectiveness of video game technique on pain and bio-physiological parameters during Intravenous Cannulation among preschool children admitted in paediatric ward at Sri Ramachandra Hospital in Chennai. The collected data were grouped and analysed using descriptive and inferential statistics, to assess the effectiveness of video games. Results There was a significant difference in the mean score of oxygen saturation of post-test compare to pre-test for both groups. The number of children feeling severe pain was more in the control group during intervention and this difference was highly significant. Oxygen saturation was more in control but not significant, but the heart rate was significantly higher in control group during intervention. There was no association during pre- post-test and oxygen saturation, with selected demographic variables of the preschool children in both groups, apart from the fact that children from low income group had significant low heart rate during pre- and post-test Discussion Video game is an effective method in reducing pain in children undergoing intravenous cannulation. In this framework, the intervention (showing video game) reduced perception of pain and changes in bio-physiological parameters such as, heart rate and oxygen saturation, during intravenous cannulation.

Effectiveness of planned teaching program among primary school teachers regarding awareness of learning disabilities in children.

PURPOSE: To assess the awareness of learning disabilities of children before and after the planned teaching program among primary school teachers. RESEARCH DESIGN: A pre-experimental, nonrandomized, one group pretest and post-test design were used. MATERIALS AND METHODS: The accessible populations were all teachers working in private primary schools at Montfort Matriculation School, Chennai. Purposive sample technique was used to select the 40 samples. The instrument consisted of two sections-Part-I: demographical variables, Part-II: awareness questionnaire on learning disabilities in children. The collected data were grouped and analyzed using descriptive statistics and inferential statistics and a paired t-test was used to determine the difference between pretest and post-test in the group. RESULT: The study indicates that the majority of the primary school teachers had inadequate awareness regarding learning disabilities and 10% had moderate level of awareness, whereas in the post-test, 7.5% had moderate level of awareness and 92.5% had adequate level of awareness. There was a significant association between awareness of learning disabilities among primary school teachers. CONCLUSION: The planned teaching program is an effective method in enhancing the awareness of primary school teachers regarding the care of awareness of learning disabilities.

Effectiveness of structured teaching programme on knowledge and practice regarding care of children with leukemia among mothers.

OBJECTIVE: Since, it is essential to create awareness about chemotherapy among parents, this study assesses the effectiveness of structured teaching programme for mothers on knowledge and practice relating to care of child with leukemia. Pretest was conducted using structured questionnaire on knowledge about care of Leukemia. Teaching was administered to mothers on different aspects of cancer diagnosis and follow up. There was a statistically significant difference in knowledge and practice in post test and a significant correlation of knowledge and practice in post test, but not during pre test. Considering different aspects of care, mothers had only around 50 % knowledge which was close to 100 % post test. The study revealed that there was a significant association between knowledge with age of the child and number of the children, and in practice, association was found in gender of the child and the educational status of the mother. The current study results proved that willingness of parents to receive educational intervention on care of children with Acute Lymphoblastic Leukemia would definitely result in improvement of the quality of life of childhood survivors.

Why do participants drop-out: findings from a prospective pediatric cohort for fever surveillance established at Vellore, southern India.

BACKGROUND: Cohort studies are pivotal in understanding the natural history, and to thereby determine the incidence of a disease. The conduct of large-scale community-based cohort studies is challenging with reference to money, manpower and time. Further, attrition inherent to cohort studies can affect the power, and thereby the study's validity. Our objective was to estimate the percentage of participant withdrawal and to subsequently understand reasons for the same in the Vellore Typhoid Surveillance (VTS) cohort. METHODS: VTS study, a prospective community-based pediatric cohort, was established in a semi-urban settlement of Vellore to estimate the incidence rate of typhoid fever. An active weekly surveillance identified children with fever, and blood cultures were performed for fevers of ≥3 days. Reasons for participant drop-out in the cohort were documented. Nine focus group discussions (FGD), each with 5 to 7 parents/primary caregivers of former as well current participants were conducted separately, to understand reasons for consent withdrawal as well as the good aspects of the study that the current participants perceived. A descriptive, as well as an interpretative account of the themes that emerged from the FGDs were done. RESULTS: Of the 5639 children in the VTS cohort, 404 (7.2%) withdrew consent during the 12-month surveillance. Of these, 50% dropped out due to migration from study area; 18.1% as their parents were unhappy with the blood draws for blood culture; and 14.4% did not clearly put forth the reason for consent withdrawal. Being from an orthodox background, high socio-economic status and joint family were associated with a decision to drop-out. Frequent and voluminous blood draws, male field research assistants (FRA) making weekly home-visits, the perception that inquiring about fever made their child fall sick, and that the study clinic did not initiate antibiotics immediately, were the important themes that emerged from the FGDs conducted among drop-outs. CONCLUSION: Our study showed that specific beliefs and behaviours within the community influenced the drop-out rate of the VTS cohort. Background characteristics and perceptions that exist, along with attrition data from previous cohort studies in the specific community are important to be considered while implementing large-scale cohort studies.

Calcium-to-Creatinine Ratio in a Spot Sample of Urine, for Early Prediction of Hypertensive Disorders of Pregnancy: A Prospective Study.

BACKGROUND: Hypertensive disorders complicate 5-10 % of all pregnancies. Various methods for screening have been studied to identify pregnant women at risk of development of preeclampsia, but no ideal screening test has been identified so far. The objective of this study was to determine the efficacy of urinary calcium-to-creatinine ratio, in a spot urine sample, for the prediction of preeclampsia in asymptomatic pregnant women between 18 and 24 weeks of gestation. METHODS: This study was done on 112 patients presenting to the antenatal clinic in the Department of Obstetrics and Gynecology at Bangalore Baptist Hospital. A random urinary calcium-to-creatinine ratio of all the patients was analyzed. The urinary calcium level was analyzed by Arezano method, while creatinine was estimated by Jaffes method. A value of ≤0.04 was considered positive. RESULTS: 116 patients were recruited in the study. Out of the 11 subjects with urinary CCR < 0.04, 7 developed gestational hypertension, 3 developed preeclampsia, and 1 remained normotensive. In 101 patients with CCR > 0.04, 1 developed gestational hypertension, none preeclampsia and 100 were normotensive. Four were lost to follow-up. INTERPRETATION AND CONCLUSION: On statistical analysis, it was found that when CCR alone is taken as high-risk factor for prediction of preeclampsia, P < 0.001 was statistically significant, sensitivity was 80 %, specificity 98.04 %, PPV 80 %, NPV 98.04 %, and diagnostic accuracy 96.43 %. So this test was satisfactory as an early predictor for the development of preeclampsia.

Effectiveness of "palliative care information booklet" in enhancing nurses' knowledge.

CONTEXT: Patients diagnosed with a disease like cancer require not only physical control of disease but also they need psychological reassurance, social and spiritual support in coming to terms with their disease. Nurses working in the specialized cancer hospitals play a significant role in the care of terminally ill patients. They must be knowledgeable, skilled and sensitive to the needs of these patients and their families in order to provide active, holistic care. AIMS: In this study, we attempted to assess the level of knowledge about palliative care among nurses working in the oncology department using a self administered structured questionnaire and also to assess the effectiveness of information booklet designed on various aspects of palliative care on their knowledge. SETTINGS AND DESIGN: Indo American Cancer Hospital, Hyderabad, AP, India. The design adopted for this study was One Group pretest - posttest, pre - experimental design. MATERIALS AND METHODS: Hundred nurses working in Indo American Cancer Hospital, Hyderabad, AP, India were selected by using the non probability purposive sampling technique. A structured self administered questionnaire was prepared and administered as a pretest. An information booklet was developed pertaining to the general concepts of palliative care, care components (physical, social, emotional and spiritual) and role of the nurse in palliative care and it was given to the participants. As a post test, the same questionnaire was re-administered after four days to the same study subjects. Pretest and post test knowledge scores were compared and the findings were analyzed statistically. STATISTICAL ANALYSIS USED: Microsoft Excel and Statistical Package for Social Science package. RESULTS: The post test scores were significantly higher than the pretest knowledge scores, which indicate that the developed information booklet regarding palliative care was highly effective in enhancing the knowledge levels of the nurses. CONCLUSIONS: The information booklet was effective in enriching the knowledge of nurses on palliative care. Enhancing the nurse's knowledge about palliative care will promote their understanding of the needs of the advanced stage patients and will enable them to provide quality care.