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Investigate the impact of a 10-week whole-food plant-based (WFPB) community programme on weight and type 2 diabetes up to 36 months postintervention.
Randomised waitlist-controlled trial.
Community-based General Practice clinic classified as ‘Very Low-Cost Access’ in Gisborne, the main city of the Tairāwhiti region of New Zealand.
Adults (n=56) aged 30–72 years, with obesity (Body Mass Index (BMI) ≥30) and glycated haemoglobin (HbA1c≥40 mmol/mol) in the last 6 months. Of the participants, 59% identified as Māori and 5% as Pasifika.
A 10-week programme consisting of 2 hours, two times per week sessions (40 hours total), involving skills-based learning and health education.
Primary measures were changes in weight, BMI and HbA1c. Secondary measures included changes in cholesterol, waist circumference, exercise levels, plant-based and non-plant-based dietary scores and association with Big Five Inventory personality traits. The primary endpoint was assessed at post-treatment (10 weeks), with follow-up at 6 and 36 months postintervention.
Differences between the intervention and waitlist control groups at 10 weeks were compared with independent samples t-tests. In intention-to-treat analyses, the intervention group demonstrated significantly greater weight loss of 3.3 kg (95% CI (0.8 to 5.7), pp values
This 10-week WFPB diet community intervention decreased weight, BMI, HbA1c and cholesterol. The intervention produced a weight loss of 5 kg post-treatment, with 3 kg weight loss sustained at 36 months.
This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (https://anzctr.org.au); ACTRN12617000541303, date of registration 07/04/2017.
In countries with access to the electronic health record (EHR), both patients and healthcare professionals have reported finding errors in the EHR, so-called EHRrors. These can range from simple typos to more serious cases of missing or incorrect health information. Despite their potential detrimental effect, the evidence on EHRrors has not been systematically analysed. It is unknown how common EHRrors are or how they impact patients and healthcare professionals.
A mixed systematic review will be carried out to address the research gap. We will search PubMed, Web of Science and CINAHL for studies published since 2000, which report original research data on patient-identified and healthcare professional-identified EHRrors. We will analyse (1) the prevalence of EHRrors, (2) the types of EHRrors and (3) their impact on care. Quantitative and qualitative findings will be synthesised following the Joanna Briggs Institute Framework for Mixed Systematic Reviews. Identified studies will be critically appraised for meta-biases and risk of bias in individual studies. The confidence in the emerging evidence will be further assessed through the Grading of Recommendations Assessment, Development and Evaluation approach. Findings will be contextualised and interpreted involving an international team of patient representatives and practising healthcare professionals.
The study will not involve collection or analysis of individual patient data; thus, ethical approval is not required. Results will be published in a peer-reviewed publication and further disseminated through scientific events and educational materials.
CRD42024622849.
A consensus study to establish a Core Outcome Set for dysarthria after stroke identified four key outcome domains that should be measured in research and clinical practice: (1) intelligibility of speech, (2) ability to participate in conversations, (3) living well with dysarthria and (4) communication partners skills and knowledge (where relevant). This review aimed to systematically identify corresponding measurement instruments and to examine their clinical utility and psychometric properties.
Systematic review conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
CINAHL, EMBASE, MEDLINE, PsycInfo and Cochrane Stroke Group Trials Register, CENTRAL, Linguistics and Language Behavioral Abstracts (LLBA). Major trials registers: WHO ICTRP, ISRCTN registry and ClinicalTrials.gov searched March 2024.
We included trials that developed or used measurement instruments for poststroke dysarthria. We identified studies that could be included in an update of the Cochrane systematic review of interventions for non-progressive dysarthria to identify what measurement instruments were used in therapy trials for poststroke dysarthria.
Records were screened independently by three authors. Psychometric data were extracted, by two authors, from included studies and methodological quality was evaluated using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) and Core Outcome Measures in Effectiveness Trials (COMET) guidance. Assessment of clinical utility followed Outcome Measures in Rheumatology (OMERACT) guidance.
Following screening, 19 publications reporting 12 measurement instruments were identified. According to COSMIN standards, all 19 publications were rated as having low, very low or unknown quality of evidence. Three measurement instruments were identified as having the most relevant clinical utility to the population, the highest quality of evidence and had the potential to measure some specific aspects from three of the four agreed domains, intelligibility, conversations and living well with dysarthria from the patient and clinician perspective. These were the Frenchay Dysarthria Assessment II, the Communication Outcomes After Stroke Scale and the Therapy Outcome Measures for Dysarthria.
This review provides a comprehensive overview and appraisal of dysarthria measurement instruments to align with a Core Outcome Set. We only included English language-based measurement instruments. Many dysarthria measurement instruments were developed for non-stroke populations, including progressive dysarthria, with limited psychometric data for stroke. Measurement instruments with uncertain quality of evidence can still be considered for inclusion with a Core Outcome Set and three have been suggested. There is a need for further psychometric testing of these and the development of new measurement instruments to cover all aspects of intelligibility, conversations, living well with dysarthria and communication partner skills.
CRD42022302998.
To (1) synthesise the experiences of people with heart failure and those who care for them concerning participation in physical activity (2) develop a logic model for a future intervention which will support people with heart failure to feel confident and safe in being physically active.
A systematic review and meta-aggregation using Joanna Briggs Institute (JBI) methodology.
MEDLINE, Emcare and PsycINFO databases were searched through until June 2024 inclusively.
Studies with a qualitative design, including qualitative components of mixed-methods studies, which describe experiences of participation in physical activity by adults with chronic heart failure.
Two independent reviewers used standardised methods to search and screen studies. Data extraction included the PROGRESS-Plus items. The JBI checklist for qualitative studies was applied. Meta-aggregation guided by JBI methods was used to synthesise the data. This evidence, along with input from a patient and public involvement group, healthcare professionals and charity organisations, was used to develop a logic model.
We included 28 papers (25 studies) comprising 14 qualitative studies and 11 mixed-method studies describing the perspectives of 483 people with heart failure, 64 carers and 12 healthcare professionals.
The meta-aggregation produced seven synthesised findings describing the impact of physical symptoms, emotional factors, extrinsic factors, access to knowledge, self-motivation and peer/professional motivation and the positive impact of physical activity. The PROGRESS-PLUS tool identified significant inclusivity issues within the studies. The meta-aggregation with relevant contributor input informed behavioural determinants and potential intervention components of a logic model.
This study identifies behavioural determinants that underlie the actions of people with heart failure in their relationship with physical activity and potential intervention components for a novel intervention design to support this population. There is a lack of studies exploring health professionals’ and carers’ perspectives on this topic.
CRD42022342883.
Despite the high acuity of coronary care unit (CCU) patients and their risk of deterioration, little is known about how nurses assess them.
Increase understanding of the scope of nurses' assessments of deteriorating CCU patients.
Online mixed methods survey.
The mRAPIDS (modified Rescuing a Patient in Deteriorating Situations) tool was used to measure assessment scope in responses to a patient vignette with a higher mRAPID score signalling broader scope (maximum score 24). Reflections on day-to-day practice were collected concurrently and thematically analysed. Themes were integrated with scores using a joint display table and organised into domains. Comparing ‘fit’ between data showed expansion (overlap with broader nonoverlapping findings) and disconcordance (contradictory findings).
Thirty-four nurses responded, and scope of assessment was found to be narrow (median mRAPIDS 5). Two domains were identified that helped explain this finding ‘the act of assessment’ and ‘education and experience’. Participants emphasised the importance of education and experience, neither increased assessment scope.
This study showed that participant assessments were generally narrower than widely accepted best practice (ABCDE assessment).
Participant assessments did not reflect gold standard A-E assessment, which may partly reflect a need for assessment frameworks that are more compatible with real-world practice. Further research is required to understand the role of healthcare assistants in the care of deteriorating CCU patients. Clinical judgement is important, but not yet well understood in rapid response systems.
This study offers preliminary understanding of nurses' assessments of deteriorating patients in CCUs.
American Psychological Association, Mixed Methods Standards.
Reviewed protocol, aided result interpretation and shared ideas for future research.
To ascertain the current evidence about the support, education and learning needs of experienced registered nurses who are transitioning their work to intensive care nursing as a new context.
A scoping review was conducted using established frameworks from JBI, Arksey and O'Malley.
A search was conducted in CINHAL and MEDLINE (April 2023). Two researchers independently screened the records, extracted and cross-checked the data. The results were consolidated narratively in answer to the review questions. The PRISMA-ScR checklist was used to guide reporting.
Eight articles (seven research, one evaluation) were included. The data were widely heterogenous. Evidence pays more attention to education experiences and needs during transition than to mechanisms used informally to engender socialisation of experienced registered nurses into the intensive care team. Key education strategies include orientation, skill and knowledge development, self-directed learning, preceptorship and mentorship, situated clinical nurse education and expertise sharing from the wider intensive care team. Four papers related to the COVID-19 pandemic reported education related to patient surges; three papers described team or buddy nursing as an educational strategy. Several articles reported that learning needs and experiences evolve as transition occurs, and intensive care is a specialised learning environment where required skills and knowledge are domain specific. Reality shock can be encountered, education needs can be influenced by prior experience and social connection with and support from the team can make a difference.
This review has identified the current state of evidence regarding the support education and learning needs of experienced registered nurses who are transitioning to work in intensive care. The evidence is limited and very heterogeneous. Findings highlight several areas of evidence paucity and some basis for further research. Given the importance of this group to the intensive care workforce, it will be imperative to invest in future research.
Attending to the specific learning and support needs of experienced registered nurses who are making transitions to work in intensive care may impact their experiences of transition shock and quality of learning and may make some differences to recruitment and retention of staff.
By consolidating the evidence, this scoping review highlights important support, education and learning needs of experienced nurses who are transitioning to intensive care. Insight arising from the review will assist experienced nurses, and those working in education and management, as they seek to engage with and support registered nurses who are making transitions to this context of work. There are genuine gaps in research evidence which will require the investment of nursing researchers internationally.
Preferred Reporting Items for Systematic Reviews and Meta-Analyse extension for Scoping Reviews (PRISMA-ScR).
No patient or public contribution.
FreshRSS 