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by Bayley Levy, Dorothy Luong, Shauna Kingsnorth, Iveta Lewis, Gillian King, Evdokia Anagnostou, Nadia Lise Tanel, Brayden Levillard, Gillian Molzon, Himanshi Elugoti, Mariam Jawad, Sarah Munce
IntroductionImplementation science frameworks – including process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks – are increasingly used to guide the translation of evidence-based interventions into practice. In paediatric rehabilitation, where interventions are complex and often require multidisciplinary collaboration, these frameworks can support systematic and context-sensitive implementation. However, the extent to which these frameworks have been used has not been comprehensively reviewed.
ObjectiveDetermine the extent, nature, and specific contexts of the existing literature on the use of implementation science models, theories, and/or frameworks (MTFs) in paediatric rehabilitation.
MethodsThis scoping review will follow the Joanna Briggs Institute (JBI) methodological guidance for scoping reviews. A comprehensive search strategy will be developed with a health sciences librarian and applied across multiple electronic databases: MEDLINE (Ovid), Embase, CINAHL, PsycINFO, ACM Digital Library, Web of Science, the Cochrane Central Register of Controlled Trials, PEDro, and RehabData. We will search English language articles published since 2006. Studies will be included if they report on the application of implementation science MTFs in the context of paediatric rehabilitation. Screening of titles and abstracts and full texts will be performed independently and in duplicate using Covidence. Discrepancies will be resolved through discussion or a third reviewer. Data will be extracted using a standardized form. Quantitative data will be summarized using numerical counts. Qualitative data will be analyzed using content analyses.
ResultsThis review will report on the use of implementation science MTFs in paediatric rehabilitation, identifying trends on the specific types applied, highlight gaps and/or underutilization across domains or developmental stages, and potentially uncover emerging frameworks. Finally, the results may inform the development of future implementation strategies and capacity-building initiatives within the field.
by Verner N. Orish, Renosten E. Tetteh, David Adzah, Chinecherem A. Ndiokwelu, Emmanuel A. Allotey, Evans A. Yeboah, Sylvester Y. Lokpo, Kenneth Ablordey, Duneeh R. Vikpebah, Ekene K. Nwaefuna, Precious K. Kwadzokpui, Noble D. Dika, Elom Y. Dzefi, Kokou H. Amegan-Aho, Aninagyei Enoch, Senyo Tagboto
BackgroundToxoplasma gondii (T. gondii) is a successful protozoan parasite infecting up to a third of the human population. It has varied transmission routes including ingestion of food and water contaminated by cat feces containing oocysts of the parasite and ingestion of bradyzoites in poorly cooked meat. Blood transfusion is another possible route of transmission especially among people with medical conditions requiring blood transfusion, such as those with sickle cell disease (SCD). This study aimed at finding out the prevalence of T. gondii infection and the association of blood transfusion among patients with SCD.
MethodThis study was a cross-sectional study involving SCD patients attending the SCD clinic at the Ho Teaching Hospital in the Volta Region of Ghana. Questionnaire administration was employed to obtain sociodemographic information, cat ownership, consumption of poorly cooked meat, as well as blood transfusion history. A blood sample was collected and anti-T. gondii IgG and IgM were detected using Rapid Diagnostic Test (RDT), while Enzyme-linked Immunosorbent Assay (ELISA) was used as the gold standard and reference. Seropositivity was defined as either positive for IgG, IgM or both. Data was analyzed using SPSS version 23, with frequency distribution done for the sociodemographic variables and the prevalence of RDT and ELISA anti-T. gondii IgG and IgM. Pearson Chi-square analysis was performed to find any significant association between diagnosis of T. gondii infection with sociodemographic variables and blood transfusion. Logistic regression analysis was performed to investigate the odds of seropositivity (ELISA) with sociodemographic variables and blood transfusion.
ResultsA total of 156 SCD patients participated in this study of which 124 (79.5%) and 32(20.5%) were HbSS and HbSC respectively. Among the study participants, 105 (67.3%) had a history of blood transfusion. A total of 60 (38.5%) and 83 (53.2%) patients were positive for RDT and ELISA respectively. No significant association was seen between T. gondii diagnosis and cat ownership (RDT,20[37.7%], p = 0.891; ELISA, 27[50.9%], p = 0.673) and consumption of poorly cooked meat (RDT,37[41.6%],p = 0.370;ELISA,53[59.6%], p = 0.211). However there was a significant association between T. gondii diagnosis and age, with seropositive results predominantly seen among older patients (≥20 years) (RDT, 38[52.1%], p = 0.002; ELISA 49 [67.1%, p = 0.002]. Blood transfusion had a significant association with T.gondii diagnosis (RDT, p = 0.003; ELISA, p = 0.001). A total of 66 (62.9%) of SCD patients who had history of blood transfusion tested positive for ELISA and they had 3 times the odds of testing positive for ELISA (adjusted OR 3.14[95% CI 1.50–6.58]; p = 0.002).
ConclusionThe prevalence of T. gondii infection was higher by ELISA (53.0%) than by rapid diagnostic testing (RDT) (38.5%), and sickle cell disease patients with a transfusion history had higher odds of seropositivity. These findings highlight the need to strengthen transfusion safety protocols and consider screening strategies for T. gondii among high-risk populations such as patients with sickle cell disease. Also, there is the need for longitudinal research to help elucidate the true contribution of blood transfusion transmission of T. gondii since a cross-sectional study, causality could not be established.
Older adults can have difficulties understanding and recalling information prior to hospitalisation for elective treatment. Limited research exists regarding how older adults perceive the accessibility and comprehensibility of the information provided by the hospital prior to elective hospitalisation. This study aims to explore how older adults undergoing elective hospitalisation for transcatheter aortic valve implantation (TAVI) experience the information received from the hospital and their preferences for modes of information delivery.
A qualitative design was used. Data were collected through individual semistructured interviews with older adults prior to hospital discharge following elective TAVI. The data were analysed using reflective thematic analysis.
All patients scheduled for elective hospitalisation for TAVI at a public university hospital in Norway were screened for eligibility.
18 older adults participated in the study. Their median age was 82 years (range 67–91), and two thirds were males.
The data were categorised into four main themes: ‘The paper brochure is worth its weight in gold’, ‘Combination of different modes of information delivery increased understanding and recall’, ‘Trust reduced the need to access and understand information’ and ‘Family played a crucial role in accessing and interpreting health information’.
Older adults undergoing elective hospitalisation found the traditional brochure valuable, alone or in combination with the digital material, which included an animated film. The participants emphasised that support from family members was required to access the digital information.
Preventing loss of autonomy has become a public health issue due to the increase in healthcare costs associated with ageing. It has become even more pressing with the arrival of the baby-boomer generation. This has given rise to several initiatives. This is the background to the VIVADOM project. The project provides a complete kit for older adults aged 60 years and over living at home. First, the kit includes a technological package (telecare, light path and digital tablet). Then, these older adults benefit from personalised human support provided by postal workers trained in gerontology. The aim of this study will be to carry out a health economic assessment (HEA) of the VIVADOM project as part of the prevention of frailty and/or dependency (by comparing beneficiaries of the complete kit with non-beneficiaries). The comparator will be the fact of not benefiting from the complete kit. In addition, the efficiency of the project in preventing falls and cognitive problems will be studied. We will calculate three incremental cost-effectiveness ratios (ICER) for these three issues.
The economic model used will be the Markov model. Transition probabilities, average costs and average quality-adjusted life year (QALY) will be calculated for the two groups being compared. The ICER will be obtained by dividing the difference in average costs by the difference in average QALYs. Finally, ICERs will be compared with willingness-to-pay (WTP) to assess the efficiency of the system. Thus, the VIVADOM project will be efficient when these ICERs are lower than the WTP. Univariate and probabilistic sensitivity analysis will be carried out to ensure the robustness of the analysis results.
The HEA of the VIVADOM project has been approved by the research unit of the University of Limoges in France. The results will be published in a peer-reviewed journal and presented at relevant national and international conferences.
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