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The COVID-19 pandemic’s unprecedented nature has exposed significant vulnerabilities in most public health systems and highlighted the importance of coordinated responses across various levels of government. A global debate emerged on the types of health measures necessary to curb the rapid spread of contagious and/or lethal diseases. However, some of these measures involved restricting individual rights, raising significant ethical, legal and public health questions. The protocol of this systematic review aims to address a critical gap in the literature by analysing how Public Health Surveillance services worldwide implemented compulsory right-restricting measures during the COVID-19 pandemic, and what impacts these measures had on public health outcomes and individual rights.
This protocol focuses on studies about right-restricting measures enacted by Public Health Surveillance services during the COVID-19 pandemic. It will be unrestrictive as to period (starting in 2019, when the outbreak was identified), language or publication status in a preliminary stage. It will include only peer-reviewed publications, discarding opinion articles, editorials, conference papers and non-peer-reviewed publications. Considering the PICo strategy, the research question of this systematic review can be formulated as follows: Problem—right-restricting measures enacted by Public Health Surveillance services; Interest—implementation modalities and impacts on individual rights and public health outcomes; Context—COVID-19 pandemic. This protocol will use the following databases: Pubmed, Cochrane/CENTRAL, Embase, Scopus and Web of Science. Considering the various measures that may have been adopted, the following categories of analysis will be used: (i) Public Health Surveillance as a field, (ii) the various specific areas of Health Surveillance, (iii) law enforcement, (iv) right-restricting measures and consent, (v) interactions between right-restricting measures and routine Public Health Surveillance functions, (vi) differences between countries and (vii) Health Surveillance lessons learnt from the COVID-19 pandemic. These categories are not strictly mutually exclusive; however, each study will be assigned to the category most aligned with its primary focus. To ensure the validity and reliability of findings, each study will have its risk of bias assessed at both the study and outcome levels.
Patients and the public were not involved in the design, conduct, reporting or dissemination plans of this systematic review. The results will be presented in one or more articles to be submitted to scientific journals and may also be presented at scientific conferences and to public policy makers.
This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 20 November 2024 (registration number CRD42024613039).
Percutaneous coronary interventions (PCI) have become a cornerstone in the management of acute coronary syndromes (ACS), yet they carry risks of complications like stent thrombosis and reinfarction. Glycoprotein IIb/IIIa inhibitors, particularly tirofiban, have been employed as adjunctive therapies to reduce these risks. Despite its potential benefits, the use of tirofiban remains a subject of debate, with varying recommendations across major clinical guidelines.
We systematically searched five databases from 1 January 1992 to 1 April 2025, including Medline, Embase, Lilacs, Clinicaltrials.org and Cochrane Central Register of Controlled Trials (CENTRAL), in addition to three grey literature databases. Randomised controlled trials and cluster randomised trials investigating the use of intravenous or intracoronary tirofiban in patients with ACS, unstable angina or myocardial infarction were considered for inclusion. Only published studies in English, Portuguese, Spanish and French were included. Data selection and extraction will be performed independently by two researchers, with any inconsistencies resolved with consensus or by consulting a third senior researcher. The risk of bias will be assessed through the risk of bias measurement tool (Rob-2) for interventions and/or cluster trials by two researchers independently, and the overall certainty of evidence will be assessed by using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. A meta-analysis will be carried out if there is sufficient homogeneity between studies, with subgroup analysis being performed if significant heterogeneity is detected. Additionally, a metaregression model will be conducted if sufficient data are available.
As this study involves secondary analysis of published data, ethics approval is not required. The results will be disseminated through peer-reviewed publication, conference presentations and will be shared with relevant clinical guideline committees.
CRD42024585252.
Tras la Segunda Guerra Mundial, la creación de la ONU influyó en los movimientos de independencia colonial. Portugal resistió, teniendo que enfrentarse a la Guerra Colonial, que influyó en el desarrollo de la enfermería de rehabilitación. Objetivo: Analizar las prácticas precursoras de la enfermería de rehabilitación en la Guerra Colonial Portuguesa. Metodología: Utilización del método histórico para resumir el relato histórico. Resultados: La evolución de la asistencia sanitaria determinó la necesidad de una mejor "preparación técnica" mediante la creación de "Escuelas Técnicas de Enfermería". El "curso de enfermería y acción social colonial" abarcaba la "educación física" y los "agentes físicos". En 1961, las filas de las tropas paracaidistas pasaron a incluir enfermeras. Las enfermeras también desempeñaron un papel en las "inspecciones sanitarias" y en la colaboración con las Fuerzas Armadas en los comandos navales de las colonias, en el Servicio de Aduanas de Ultramar y en los navíos de guerra de la Guarda Fiscal. En 1963, el personal de enfermería del Hospital de Ultramar incluía enfermeras "fisioterapeutas" y "especializadas en ortopedia, rehabilitación...". En aquella época, en 1964, la situación sanitaria condujo a la regulación de los Servicios Sanitarios y Asistenciales de Ultramar, reconociendo la importancia de la enfermería especializada en los territorios de ultramar.
Conclusión: La enfermería de rehabilitación surgió en Portugal en 1965, influenciada por un contexto social y político previo que creó nuevas necesidades de salud.
by Hossein Mansourizadeh, Mohammad Reza Bakhtiarizadeh, Luciana Correia de Almeida Regitano, Jennifer Jessica Bruscadin
Different sheep breeds show distinct phenotypic plasticity in fat deposition in the tails. The genetic background underlying fat deposition in the tail of sheep is complex, multifactorial, and may involve allele-specific expression (ASE) mechanism to modulate allelic expression. ASE is a common phenomenon in mammals and refers to allelic imbalanced expression modified by cis-regulatory genetic variants that can be observed at heterozygous loci. Therefore, regulatory processes behind the fat-tail formation in sheep may be to some extent explained by cis- regulatory variants, through ASE mechanism, which was investigated in the present study. An RNA-Seq-based variant calling was applied to perform genome-wide survey of ASE genes using 45 samples from seven independent studies comparing the transcriptome of fat-tail tissue between fat- and thin-tailed sheep breeds. Using a rigorous computational pipeline, 115 differential ASE genes were identified, which were narrowed down to four genes (LPL, SOD3, TCP1 and LRPAP1) for being detected in at least two studies. Functional analysis revealed that the ASE genes were mainly involved in fat metabolism. Of these, LPL was of greater importance, as 1) observed in five studies, 2) reported as ASE gene in the previous studies and 3) with a known role in fat deposition. Our findings implied that complex physiological traits, like fat-tail formation, can be better explained by considering various genetic mechanisms, which can be more finely mapped through ASE analyses. The insights gained in this study indicate that biallelic expression may not be a common mechanism in sheep fat-tail development. Hence, allelic imbalance of the fat deposition-related genes can be considered a novel layer of information for future research on genetic improvement and increased efficiency in sheep breeding programs.by Dima Hadid, Rebecca H. Correia, Sarah D. McDonald, Elizabeth K. Darling, David Kirkwood, Aaron Jones, Andrea Carruthers, Cassandra Kuyvenhoven, Michelle Howard, Devon Greyson, Sujane Kandasamy, Meredith Vanstone
ObjectiveGestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and laboratory services, including GDM screening programs. Adapted GDM screening guidelines were introduced in many jurisdictions. This study examined changes in uptake, modality, and experiences of GDM screening in Ontario, Canada during the COVID-19 pandemic.
MethodsThis convergent mixed-method study involved a population-based retrospective cohort analysis of Ontario-based health administrative data to describe and compare gestational diabetes screening rates among 85,228 individuals with live, in-hospital births between January 1-March 31 before (2019) and during the COVID-19 pandemic (2021 and 2022). Descriptive analyses were conducted for GDM screening pathways aligning with usual and pandemic-adapted screening guidance. Qualitative descriptive interviews were conducted about experiences and decision-making of GDM screening with 43 Ontario residents who gave birth between May 2020 and December 2021. Data were integrated during the design and interpretation phases.
ResultsThere were small but significant increases in GDM screening during the pandemic; likelihood of screening completion using any modality increased in 2021 and 2022 compared to 2019. Testing modality shifted; the alternate screening strategies introduced during COVID-19 were adopted by clinicians. Interview participants perceived GDM screening to be important and obligatory but accompanied by a degree of stress about potential COVID-19 exposure.
ConclusionDespite health system challenges experienced in Ontario during the COVID-19 pandemic, GDM screening rates increased in the study population, demonstrating the success of adapted GDM screening guidelines. Decisions about screening modalities were driven by clinician expertise, and interview participants were satisfied to provide informed consent to these recommendations.
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