The overall aim of the present project is to increase healthcare professionals’ ability to ask about exposure and to identify individuals exposed to intimate partner violence (IPV). The project will evaluate the effects of three different interventions that can be assumed to increase healthcare professionals’ ability to ask and identify individuals who have been or are exposed to IPV.

This project has a quasi-experimental design. After a 2-month baseline period, participating care units (primary health centres, maternal health clinics and youth guidance clinics) will be assigned to one of three interventions to potentially increase the ability to enquire and identify patient exposure to IPV: (1) healthcare professionals’ use of a standardised questionnaire about exposure to IPV in patient meetings, (2) training through the use of a virtual patient case tailored to health professionals and (3) a combination of (1) and (2) earlier. Preintervention (baseline) and postintervention measurements of the health professionals’ enquiry and identification of patients exposed to IPV will be used to explore the effect of the interventions. Focus group interviews with the participating health professionals will be used as a qualitative method, applying thematic analysis, to explore which intervention they perceive as most effective in increasing their ability to identify victims of IPV.

Data analysis will focus on a comparison of pre- and post-measurements regarding the number of patients asked about and identified patients in each intervention arm that have been or are exposed to IPV. Measurements will be carried out per care unit at the group level. Qualitative data from focus group interviews will be analysed using thematic analysis.

All participants will sign a written consent form and the study has been approved by the Swedish Ethical Review Authority (Dnr 2023-03399-01). The study will be conducted according to good clinical practice and the Declaration of Helsinki. The results of this study will increase knowledge about how identification of violence in close relationships can be improved in the clinical setting through publications in peer-reviewed journals and presentations at national and international scientific conferences.

Recruiting since May 2024. Expected trial termination December 2026.

NCT06322251.

To evaluate the association between exposure to occupational biomechanical factors and the incidence of surgically treated osteoarthritis (OA) treated with arthroplasty in the hip and knee among male construction workers.

Longitudinal register-based cohort study.

Male construction workers (n=291 062) who participated in a national Swedish occupational health examination programme between 1971 and 1993, delivered through multiple primary-level nationwide occupational health centres.

Hip and knee arthroplasties performed due to OA from 1987 to 2019 were identified through linkage with the Swedish National Patient Register. Data on age, smoking habits, body mass index, job title and self-reported biomechanical exposures were collected during the health examinations. Occupational biomechanical workload was assessed using eight factors from a job-exposure matrix. Poisson regression was applied to estimate adjusted incidence rate ratios (IRRs) associated with each type of occupational biomechanical exposure.

The study included 10 336 cases of hip arthroplasties and 8926 cases of knee arthroplasties. All studied biomechanical risk factors were associated with an increased risk of knee OA requiring arthroplasty, especially for individuals exposed to static work in non-neutral lumbar postures (IRR 1.38, 95% CI 1.16 to 1.65) and those with a high frequency of kneeling (IRR 1.27, 95% CI 1.12 to 1.45). In contrast, only a few biomechanical factors were associated with an increased risk of hip OA requiring arthroplasty. Similar results were observed when alternative exposure measures, such as occupational group and self-reported exposure assessments, were employed.

Occupational workload was associated with an increased risk of knee arthroplasty due to OA, whereas the association for hip arthroplasty remains unclear.

Time-lapse imaging (TLI) systems for embryo incubation and assessment are hypothesised to improve the success rates of in vitro fertilisation (IVF) treatment by providing undisturbed culture conditions for embryos and/or providing more information on embryo development (morphokinetic parameters) to improve predictive accuracy for embryo selection. Despite numerous aggregate meta-analyses showing uncertainty of benefit, IVF clinics globally continue to invest significant resources into this technology with little translation of evidence into guidelines or policy frameworks. This may be attributed to heterogeneity in participant populations and/or variations in the use of TLI, as highlighted in the aggregate meta-analyses.

Our research proposal for evidence synthesis using individual participant data meta-analysis will provide greater power than aggregate meta-analysis to detect differential treatment effects for effectiveness (live birth, clinical pregnancy) and safety (pregnancy loss, multiple births, congenital malformations) outcomes across three comparisons (overall effect, undisturbed culture and morphokinetic parameters). We will also analyse if there are specific subgroups of women who may benefit from the intervention and if variations in use of the intervention show any benefits. We have incorporated the results of the literature search used for the latest Cochrane review (7 January 2019) into this review and will include all the trials included therein. We will further update the literature search to include new evidence by searching the electronic databases MEDLINE, EMBASE, CINAHL and CENTRAL from 07/01/2019 to date, outcomes for all ongoing trials reported in the 2019 Cochrane review, trial registers for newer ongoing/completed trials and the citation lists of all the newly identified trials for any relevant references. The search strategy will include a combination of subject headings and text words relating to or describing the participants and the intervention, with no language restrictions. Two authors will independently screen the titles and abstracts, and full text of articles retrieved from the search, to finalise a list of trials suitable for inclusion in the review. We will include randomised controlled trials that assess TLI systems for either undisturbed culture and/or use of morphokinetic parameters for embryo selection in women having IVF/ICSI treatment using their own oocytes.

Ethical approval is not required for this study. We plan to disseminate the findings of the research to all stakeholders, including the National Institute for Health and Care Excellence and other international guideline development groups, through publication in peer-reviewed journals, presentation at conferences, newsletters, meetings and websites of the funders, fertility charities and patient support groups.

CRD42024564332.

Culture underpins social interaction between school health professionals and children. Both practice and research suggest that cultural variations, migration and intercultural interactions pose potential challenges in encounters between school health professionals and children and may relate to the health professionals’ understanding of their own culture as a factor in such encounters. Still, for the school health services (SHS), reviews collating existing research on school health professionals’ understanding of culture are lacking.

This review aims to identify, describe and analyse existing research on school health professionals’ (ie, school nurses, school social workers, school doctors and school psychologists) understanding of culture.

A scoping review of peer-reviewed and published scientific articles on school health professionals’ understanding of culture.

Articles published between 2013 and 2024 on culture, SHS and school nurses, school doctors, school social workers or school psychologists.

Searches were conducted in October 2023 and September 2024 in 10 databases. Two reviewers independently screened the article titles, abstracts and full texts for inclusion. Extracted data were analysed using descriptive statistics and qualitative content analysis. The qualitative content analysis focused on content related to theoretical considerations, key findings and conceptualisations of culture.

From 1784 screened articles, 100 articles were screened in full text and 21 articles fulfilled the eligibility criteria. After identifying two additional articles through manual searches, a total of 23 articles were included in the review. The findings show that the articles primarily applied a quantitative study design, focused on school psychologists and school nurses and were conducted in the USA and Nordic-Baltic area. Self-understanding was mainly studied using validated instruments, leaving the conceptualisation of culture to the researchers. Still, only about half of all the articles described the theoretical conceptualisation of culture. Studies of intercultural interaction focused on the challenges of encountering ‘diverse’ children and raised concerns about barriers and hindrances to the encounters.

This review shows that SHS professionals’ understanding of culture has mainly been studied within two SHS professions, within a narrow geographical sphere and without a theoretical stance on culture. Thus, more qualitative research, a clearer theoretical conceptualisation of culture and more research on SHS professionals’ practice and self-understanding are needed.