Corrigendum to "Uptake of community pharmacist prescribing over a three-year period" [Exploratory Research in Clinical and Social Pharmacy, Volume 9, March 2023, 100221].

[This corrects the article DOI: 10.1016/j.rcsop.2023.100221.].

Recommendations for accelerating open preprint peer review to improve the culture of science.

Peer review is an important part of the scientific process, but traditional peer review at journals is coming under increased scrutiny for its inefficiency and lack of transparency. As preprints become more widely used and accepted, they raise the possibility of rethinking the peer-review process. Preprints are enabling new forms of peer review that have the potential to be more thorough, inclusive, and collegial than traditional journal peer review, and to thus fundamentally shift the culture of peer review toward constructive collaboration. In this Consensus View, we make a call to action to stakeholders in the community to accelerate the growing momentum of preprint sharing and provide recommendations to empower researchers to provide open and constructive peer review for preprints.

Role of gene therapy in sickle cell disease.

BACKGROUND: Gene therapy is an emerging treatment for sickle cell disease that works by replacing a defective gene with a healthy gene, allowing the body to produce normal red blood cells. This form of treatment has shown promising results in clinical trials, and is a promising alternative to traditional treatments. Gene therapy involves introducing a healthy gene into the body to replace a defective gene. The new gene can be delivered using a viral vector, which is a modified virus that carries the gene. The vector, carrying the healthy gene, is injected into the bloodstream. The healthy gene then enters the patient's cells and begins to produce normal hemoglobin, the protein in red blood cells that carries oxygen throughout the body. METHODOLOGY: We conducted an all-language literature search on Medline, Cochrane, Embase, and Google Scholar until December 2022. The following search strings and Medical Subject Heading (MeSH) terms were used: "Sickle Cell," "Gene Therapy" and "Stem Cell Transplantation". We explored the literature on Sickle Cell Disease for its epidemiology, etiopathogenesis, the role of various treatment modalities and the risk-benefit ratio of gene therapy over conventional stem cell transplant. RESULTS: Gene therapy can reduce or eliminate painful episodes, prevent organ damage, and raise the quality of life for those living with the disease. Additionally, gene therapy may reduce the need for blood transfusions and other traditional treatments. Gene therapy has the potential to improve the lives of those living with sickle cell disease, as well as reduce the burden of the disease on society.

Investigating mechanisms of the attentional repulsion effect: A diffusion model analysis.

This article investigates the decisional and attentional drivers of the attentional repulsion effect (ARE) using the diffusion decision model (DDM). The ARE is a phenomenon in which a subjective expansion of space is experienced outside the focus of attention. It is thought to occur due to changes in the functioning of visual cell receptive fields. The DDM is a model of the decision-making process that assumes responses are selected by sequentially sampling an encoded representation of a stimulus until sufficient evidence has been accumulated favoring one response alternative over the other. The model decomposes observed choice and response times into different latent variables corresponding to the rate of evidence accumulation, response caution, response bias, and the time course of stimulus encoding and response execution. In this article, we interpret changes in the rate of evidence accumulation as primarily reflecting perceptual-driven changes in stimulus representation. We interpret changes in response bias as primarily reflecting decision-level changes. We utilize the DDM's ability to estimate these variables independently to explore how they are each affected by cueing manipulations to clarify whether the ARE emerges due to attentional or decisional drivers, or some combination of the two. The results of this study could shed light on the mechanisms underlying the ARE, and has implications in our understanding of spatial attention.

The effect of prevalence on distractor speeded search termination.

Visual search can be disrupted by irrelevant salient stimuli. Recently, Moher (Psychological Science, 31(1), 31-42, 2020) found salient distractors to speed search when a target was absent and increase error rates when the target was present. That is, distractors lowered search-quitting thresholds. Nonetheless, the salient distractors Moher used were present on 50% of all trials. Since distractor prevalence has been found to influence search processes more broadly, here, we aimed to test the effect of distractor prevalence on this distractor-quitting threshold effect (QTE). To do so, we conducted two experiments. Experiment 1 compared the performance of individuals in a search task where the target was present on 50% of trials across two distractor-prevalence conditions (25% vs. 75% prevalence). Experiment 2 followed the same procedure, except with a wider probability margin (10% vs. 90% prevalence). In Experiment 1, distractor prevalence did not modulate the QTE. Critically, in Experiment 2, the QTE was modulated. For high-prevalence distractors (90%), a QTE was observed. However, as low-prevalence distractors (10%) did not speed search, no QTE was observed. One potential reason no QTE was observed was because low-prevalence distractors have significantly greater attentional capture, which washed out speeded termination effects.

Emphasizing responder speed or accuracy modulates but does not abolish the distractor-induced quitting effect in visual search.

When a highly salient distractor is present in a search array, it speeds target absent visual search and increases errors during target present visual search, suggesting lowered quitting thresholds (Moher in Psychol Sci 31(1):31-42, 2020). Missing a critical target in the presence of a highly salient distractor can have dire consequences in real-world search tasks where accurate target detection is crucial, such as baggage screening. As such, the current study examined whether emphasizing either accuracy or speed would eliminate the distractor-generated quitting threshold effect (QTE). Three blocks of a target detection search task which included a highly salient distractor on half of all trials were used. In one block, participants received no instructions or feedback regarding performance. In the remaining two blocks, they received instructions and trial-by-trial feedback that either emphasized response speed or response accuracy. Overall, the distractor lowered quitting thresholds, regardless of whether response speed or response accuracy was emphasized in a block of trials. However, the effect of the distractor on target misses was smaller when accuracy was emphasized. It, therefore, appears that while the distractor QTE is not easily eradicated by explicit instructions and feedback, it can be shifted. As such, future research should examine the applicability of these and similar strategies in real-world search scenarios.

How exposure to body neutrality content on TikTok affects young women's body image and mood.

Body neutrality aims to encourage a non-judgmental attitude towards the body and prioritize functionality over appearance. This study examined the impact of exposure to TikTok body neutrality content on young women's body image and mood. The sample comprised 189 undergraduate women (Mage = 19.25, SD = 1.98) who were randomly assigned to view one of three compilation TikTok videos on body neutrality, thin ideal, or art. Controlling for pre-test measures, results showed that women in the body neutrality group reported higher functionality appreciation and body satisfaction than women in the thin ideal and art control groups. Higher levels of positive mood and fewer upward appearance comparisons were reported by women in the body neutrality group relative to the thin ideal group. Although women in the body neutrality and thin ideal groups thought about their appearance and what they were wearing whilst viewing the videos, women in the body neutrality group reported that those thoughts were more positive than those in the thin ideal group. Findings demonstrate that brief exposure to body neutrality content on TikTok may induce immediate positive body image and mood in young women whilst providing a useful alternative to the unrealistic beauty standards popularized on such platforms.

Unveiling the Impact of COVID-19 Vaccines: A Meta-Analysis of Survival Rates Among Patients in the United States Based on Vaccination Status.

The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a significant number of cases and deaths worldwide. Vaccination is the most effective preventive measure against the disease. This study aimed to assess the mortality rates of COVID-19 patients in the United States and the effectiveness of Pfizer (Pfizer, NY, USA), Moderna (Moderna, MA, USA), and Janssen (Johnson & Johnson, NJ, USA) vaccines in preventing mortality. A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-2020) guidelines. Eligible studies reporting on the effectiveness of COVID-19 vaccines on patient outcomes were included. The search was performed in PubMed, Cochrane, and Google Scholar databases. The data were extracted, and risk ratios (RR) were calculated for mortality outcomes. The analysis was performed using Review Manager software, and bias assessments were conducted using the Joanna Briggs Institute (JBI) Meta-Analysis tools. A total of seven studies with 21,618,297 COVID-19 patients were included in the meta-analysis. The odds ratio (OR) for mortality among unvaccinated patients compared to vaccinated patients was 2.46 (95% CI: 1.71-3.53), indicating that unvaccinated patients were 2.46 times more likely to die from COVID-19. The findings of this study support the effectiveness of COVID-19 vaccination in reducing mortality among infected individuals. Unvaccinated patients had a significantly higher risk of mortality compared to vaccinated patients. Vaccination remains a crucial strategy to mitigate the severity of the disease and reduce mortality rates. Efforts should be made to address vaccine hesitancy and ensure widespread vaccine coverage.

Delayed onsets are not necessary for generating distractor quitting thresholds effects in visual search.

Salient distractors lower quitting thresholds in visual search. That is, when searching for the presence of a target among filler items, a large heterogeneously coloured distractor presented at a delayed onset produces quick target-absent judgements and increased target-present errors. The aim of the current study was to explore if the timing of the salient distractor modulates this Quitting Threshold Effect (QTE). In Experiment 1, participants completed a target detection search task in the presence or absence of a salient singleton distractor that either appeared simultaneously with other search items or appeared at a delayed onset (i.e., 100 ms or 250 ms after other array items appeared). In Experiment 2, a similar method was used, except that the salient singleton distractor appeared simultaneously, 100 ms before, or 100 ms after the other array items. Across both experiments, we observed robust distractor QTEs. Regardless of their onset, salient distractors decreased target-absent search speeds and increased target-present error rates. In all, the present findings suggest that delayed onsets are not required for lowered quitting thresholds in visual search.

Telehealth for Breastfeeding Support and Lessons for Digital Equity.

This Viewpoint examines the current state of telelactation and its role in digital equity.

A qualitative study exploring perceived barriers and enablers to fidelity of training and delivery for an intervention to reduce non-indicated imaging for low back pain.

BACKGROUND: Non-specific low back pain (LBP) commonly presents to primary care, where inappropriate use of imaging remains common despite guideline recommendations against its routine use. Little is known about strategies to enhance intervention fidelity (i.e., whether interventions were implemented as intended) for interventions developed to reduce non-indicated imaging for LBP. OBJECTIVES: We aim to inform the development of an intervention to reduce non-indicated imaging among general practitioners (GPs) and chiropractors in Newfoundland and Labrador (NL), Canada. The study objectives are: [1] To explore perceived barriers and enablers to enhancing fidelity of training of GPs and chiropractors to deliver a proposed intervention to reduce non-indicated imaging for LBP and [2] To explore perceived barriers and enablers to enhancing fidelity of delivery of the proposed intervention. METHODS: An exploratory, qualitative study was conducted with GPs and chiropractors in NL. The interview guide was informed by the National Institutes of Health Behavior Change Consortium fidelity checklist; data analysis was guided by the Theoretical Domains Framework (TDF). Participant quotes were coded into TDF domains, belief statements were generated at each domain, and domains relevant to enhancing fidelity of provider training or intervention delivery were identified. RESULTS: The study included five GPs and five chiropractors from urban and rural settings. Barriers and enablers to enhancing fidelity to provider training related to seven TDF domains: [1] Beliefs about capabilities, [2] Optimism, [3] Reinforcement, [4] Memory, attention, and decision processes, [5] Environmental context and resources, [6] Emotion, and [7] Behavioural regulation. Barriers and enablers to enhancing fidelity to intervention delivery related to seven TDF domains: [1] Beliefs about capabilities, [2] Optimism, [3] Goals, [4] Memory, attention, and decision processes, [5] Environmental context and resources, [6] Social influences, and [7] Behavioural regulation. CONCLUSION: The largest perceived barrier to attending training was time; perceived enablers were incentives and flexible training. Patient pressure, time, and established habits were perceived barriers to delivering the intervention as intended. Participants suggested enhancement strategies to improve their ability to deliver the intervention as intended, including reminders and check-ins with researchers. Most participants perceived intervention fidelity as important. These results may aid in the development of a more feasible and pragmatic intervention to reduce non-indicated imaging for GPs and chiropractors in NL.

Uptake of community pharmacist prescribing over a three-year period.

Objectives: Pharmacists in Nova Scotia have had legislated authority to prescribe since 2011. This study aimed to describe the prescribing activities of pharmacists and the characteristics of patients who used pharmacist prescribing services. Methods: Using provincial health administrative databases we identified all community pharmacists who prescribed during the study period (October 2016 to March 2020) and correspondingly patients who had medications prescribed by a pharmacist during this period. Differences in, and predictors of the quantity of pharmacist prescribing over three fiscal years (April 2017 to March 2020) were described. Pharmacist prescribing activity was compared across the fiscal years of the study period with One-way Analysis of Variance. Negative binomial regression examined patient factors associated with use of pharmacist prescribing services. Analysis was carried out using SAS ENTERPRISE GUIDE v.8.2 (SAS Institute Cary, NC, USA). Key findings: A total of 1182 pharmacist prescribers were identified, who on average prescribed 24.6, 26.3, and 32.5 (p < 0.001) times per month in fiscal years 2018, 2019, 2020, respectively. The patient cohort contained 372,203 Nova Scotians over the 3-year period. For approved common and minor ailment prescribing in Nova Scotia, gastroesophageal reflux disease, vaccines (non-travel), contraceptive management, herpes zoster treatment, and allergic rhinitis had the highest number of prescriptions over the study period. Patient factors most strongly related to receiving more prescribing services by a pharmacist included receiving income assistance without copay (Incidence rate ratio (IRR) = 1.70), having >2 comorbidities (IRR = 1.51), male sex (IRR = 1.03), and greater age (IRR = 1.01). Those from an urban area (IRR = 0.92) or having a higher income (IRR = 0.95) received fewer pharmacist prescribing services (all p < 0.0001). Conclusions: Pharmacist prescribing increased over the 3-year period. Patients who were older and those with multiple comorbidities used pharmacist prescribing services most often. Prescribing activities represent an increasingly utilized role for pharmacists in primary care.

The spatial extent of focused attention modulates attentional disengagement.

Attention can be flexibly changed to optimize visual processing: it can be oriented, resized, or even divided. Although much is known about these processes individually, much less is known about how they interact with one another. In the present study we examined how the spatial extent of the attentional focus modulates the efficiency of the first component of attentional orienting, the disengagement of attention. To this end, we used abrupt-onset stimuli of different sizes to trigger the reflexive resizing of the attentional focus (Castiello and Umiltà in Acta Psychol 73:195-209, 1990), combined with a gap task to assess the efficiency of attentional disengagement (Mackeben and Nakayama in Vis Res 33:85-90, 1993). The results of five experiments showed that the magnitude of the gap effect is significantly greater when the scope of attention is small than when it is large, indicating that disengaging attention is delayed when attention is highly focused. Furthermore, these findings highlight that different aspects of attentional control interact with one another, emphasizing the importance of studying them in conjunction.

Changes in Breastfeeding and Lactation Support Experiences During COVID.

Background: We surveyed parents who gave birth from 2019 to 2021 to examine changes in breastfeeding experiences and professional and lay breastfeeding support services due to the coronavirus disease 2019 (COVID-19) pandemic. We also examined racial and ethnic disparities in breastfeeding support. Materials and Methods: A cross-sectional opt-in survey of 1,617 parents was administered on Ovia's parenting app in January 2022. Respondents were 18-45 years of age and delivered in one of three birth cohorts: August-December 2019, March-May 2020, or June-August 2021. We fit linear and logistic regression models wherein the outcomes were six breastfeeding support and experience measures, adjusting for birth cohort and respondent demographics. Results: Parents who gave birth in the early pandemic versus those in the prepandemic had reduced odds of interacting with lactation consultants (odds ratio [OR]: 0.63; 95% confidence interval [CI]: 0.44-0.90), attending breastfeeding classes (OR: 0.71; 95% CI: 0.54-0.94), meeting breastfeeding goals (OR: 0.65; 95% CI: 0.46-0.92), and reporting it was easy to get breastfeeding help (estimate: -0.36; 95% CI: -0.55 to -0.17). Birth cohort was not associated with use of donor milk or receipt of in-hospital help. The later pandemic cohort differed from the prepandemic cohort for one outcome: they were less likely to meet their breastfeeding goals (OR: 0.67; 95% CI: 0.48-0.95). There were racial and ethnic disparities in the use of multiple types of breastfeeding support. Although one-third of respondents felt that the pandemic facilitated breastfeeding because of more time at home, 18% felt the pandemic posed additional challenges including disruptions to lactation support. Conclusions: Parents who gave birth in the later pandemic did not report significant disruptions to professional breastfeeding support, likely as a result of the growth of virtual services. However, disparities in receipt of support require policy attention and action.

COVID-19 vaccine uptake and attitudes among pregnant and postpartum parents.

BACKGROUND: Pregnancy poses increased risks from COVID-19, including hospitalization and premature delivery. Yet pregnant individuals are less likely to have received a COVID-19 vaccine. OBJECTIVE: This study aimed to investigate COVID-19 vaccine uptake and reasons for delay or refusal among perinatal parents. STUDY DESIGN: A total of 1542 eligible parents who delivered between 2019 and 2021 were surveyed through the Ovia parenting app, which has a nationally representative user base. Adjusted and nationally weighted means were calculated. Multivariate logistic regression and survival models were used to examine uptake. RESULTS: At least 1 dose of the COVID-19 vaccine was received by 70% of the parents. Those with a bachelor's or graduate degree were significantly more likely to have received a vaccine relative to those with some college or less (adjusted odds ratio for bachelor's degree, 1.854; 95% confidence interval, 1.19-2.90; adjusted odds ratio for graduate degree, 2.833; 95% confidence interval, 1.69-4.75). Parents living in rural areas were significantly less likely to have received a vaccine relative to those living in urban areas (adjusted odds ratio for small city, 0.62; 95% confidence interval, 0.45-0.86; adjusted odds ratio for rural area, 0.56; 95% confidence interval, 0.35-0.89); 56% (281/502) of unvaccinated parents considered that the vaccine "was too new." Among those pregnant in 2021, 44% (258/576) received at least 1 dose, and 34% (195/576) reported that pregnancy had "no impact" on their vaccine decision. CONCLUSION: There was significant heterogeneity in vaccine uptake and attitudes toward vaccines during pregnancy by sociodemographics and over time. Public health experts need to consider and test more tailored approaches to reduce vaccine hesitancy in this population.

Barriers to following imaging guidelines for the treatment and management of patients with low-back pain in primary care: a qualitative assessment guided by the Theoretical Domains Framework.

BACKGROUND: Low back pain (LBP) is a leading cause of disability and is among the top five reasons that patients visit their family doctors. Over-imaging for non-specific low back pain remains a problem in primary care. To inform a larger study to develop and evaluate a theory-based intervention to reduce inappropriate imaging, we completed an assessment of the barriers and facilitators to reducing unnecessary imaging for NSLBP among family doctors in Newfoundland and Labrador (NL). METHODS: This was an exploratory, qualitative study describing family doctors' experiences and practices related to diagnostic imaging for non-specific LBP in NL, guided by the Theoretical Domains Framework (TDF). Data were collected using in-depth, semi-structured interviews. Transcripts were analyzed deductively (assigning text to one or more domains) and inductively (generating themes at each of the domains) before the results were examined to determine which domains should be targeted to reduce imaging. RESULTS: Nine family doctors (four males; five females) working in community (n = 4) and academic (n = 5) clinics in both rural (n = 6) and urban (n = 3) settings participated in this study. We found five barriers to reducing imaging for patients with NSLBP: 1) negative consequences, 2) patient demand 3) health system organization, 4) time, and 5) access to resources. These were related to the following domains: 1) beliefs about consequences, 2) beliefs about capabilities, 3) emotion, 4) reinforcement, 5) environmental context and resources, 6) social influences, and 7) behavioural regulation. CONCLUSIONS: Family physicians a) fear that if they do not image they may miss something serious, b) face significant patient demand for imaging, c) are working in a system that encourages unnecessary imaging, d) don't have enough time to counsel patients about why they don't need imaging, and e) lack access to appropriate practitioners, community programs, and treatment modalities to prescribe to their patients. These barriers were related to seven TDF domains. Successfully reducing inappropriate imaging requires a comprehensive intervention that addresses these barriers using established behaviour change techniques. These techniques should be matched directly to relevant TDF domains. The results of our study represent the important first step of this process - identifying the contextual barriers and the domains to which they are related.

Ray Amputation in a Traumatic Diabetic Foot.

Diabetic foot is a complex syndrome that is co-morbid with other diabetic complications such as peripheral arterial disease (PAD) and peripheral neuropathy. Patients with the diabetic foot are increasingly prone to diabetic foot ulcers (DFUs) due to a high infection susceptibility and poor wound healing possibly prompting the need for minor or major amputations. We herein highlight the case of a 47-year-old male with a traumatic diabetic foot who necessitated a Ray amputation (RA). The notable aspects of this case are the late presentation of a patient with uncontrolled diabetes who could have avoided this complication if he went to seek help earlier and how diabetic foot is controlled and managed in a low-income resource setting. This case also highlights how physicians can better diagnose and treat diabetic foot complications with a scoring metric.

Exploring factors influencing chiropractors' adherence to radiographic guidelines for low back pain using the Theoretical Domains Framework.

BACKGROUND: The inappropriate use of lumbar spine imaging remains common in primary care despite recommendations from evidence-based clinical practice guidelines to avoid imaging in the absence of red flags. This study aimed to explore factors influencing ordering behaviours and adherence to radiographic guidelines for low back pain (LBP) in chiropractors in Newfoundland and Labrador (NL), Canada. METHODS: We conducted two focus groups in December 2018 with chiropractors in different regions of NL (eastern, n = 8; western, n = 4). An interview guide based on the Theoretical Domains Framework (TDF) served to identify perceived barriers to, and enablers of, target behaviours of guideline adherence and managing LBP without X-rays. We conducted thematic analysis of chiropractors' statements into relevant theoretical domains, followed by grouping of similar statements into specific beliefs. Domains key to changing radiographic guideline adherence, LBP imaging behaviours, and/or informing intervention design were identified by noting conflicting beliefs and their reported influence on the target behaviours. RESULTS: Six of the 14 TDF domains were perceived to be important for adherence to radiographic guidelines and managing non-specific LBP without imaging. Participating chiropractors reported varying levels of knowledge and awareness of guidelines for LBP imaging (Knowledge). Many chiropractors based their decision for imaging on clinical presentation, but some relied on "gut feeling" (Memory, attention, and decision processes). While chiropractors thought it was their role to manage LBP without imaging, others believed ordering imaging was the responsibility of other healthcare providers (Social/professional role and identity). Contrasting views were found regarding the negative consequences of imaging or not imaging LBP patients (Beliefs about consequences). Communication was identified as a skill required to manage LBP without imaging (Skills) and a strategy to enable appropriate imaging ordering behaviours (Behavioural regulation). Chiropractors suggested that access to patients' previous imaging and a system that facilitated better interprofessional communication would likely improve their LBP imaging behaviours (Behavioural regulation). CONCLUSION: We identified potential influences, in six theoretical domains, on participating chiropractors' LBP imaging behaviours and adherence to radiographic guidelines. These beliefs may be targets for theory-informed behaviour change interventions aimed at improving these target behaviours for chiropractors in NL.