Protocol for a three-phase prospective study to develop educational resource of antimicrobial resistance and stewardship for medical programme

INTRODUCTION: Antimicrobial resistance (AMR) is one of the critical medical issues of the 21st century. Medical professionals are the primary prescribers of antimicrobials; their undergraduate education of antimicrobial stewardship (AMS) is considered one of the fundamental approaches in combating the issue of AMR. This education level provides a platform to bridge any gaps in their knowledge and competency in AMS. This study aims to develop an educational resource on microbes, hygiene and prudent antimicrobial use for the undergraduate medical programme. The guideline produced will then be assimilated into the existing curriculum which will help to improve the quality of education which in turn will improve rationale as the use of antimicrobials in the future. METHODS AND ANALYSIS: A three-step approach consensus approach will be adopted for this study for the development of a validated medical curriculum guideline on AMR. A preliminary curriculum for the programme will be drafted from reviews of published literature including syllabi as well as national and international guidelines. A total of 26 potential sources were found to be relevant, and selected for this study. Subsequently, the drafted curriculum will be subjected for validation via online surveys by various infectious disease experts. Finally, a Delphi technique will be employed to obtain consensus on heterogeneous findings to the revised curriculum. The quantitative and qualitative responses will be analysed and discussed among the panel of researchers. ETHICS AND DISSEMINATION: This study protocol has been approved by the Institute of Health Sciences Research Ethics Committee of Universiti Brunei Darussalam (Reference: UBD/PAPRSBIHSREC/2020/124). Informed consent declaration will be collected prior to data collections as indication of agreement of participation in the study. Results will be made available to medical educators and also researchers on AMR and stewardship. The results also will be disseminated at feedback sessions to officers at Ministry of Health and Ministry of Education, Brunei Darussalam

Mapping the evidence on assessment of fitness to work at heights: A scoping review protocol

Introduction Falls from height are a leading cause of serious injury and fatality globally. In South Africa, work at heights is regulated by occupational health and safety legislation, which places responsibility on employers to ensure their workers are fit for high-risk work. There is however no formal procedure or consensus on how fitness to work at heights should be assessed. This paper presents an a priori protocol for a scoping review that seeks to identify and map the current evidence base around the assessment of fitness to work at heights. It forms the initial phase of a PhD study aimed at developing an interdisciplinary consensus statement for assessing fitness to work at heights in the South African construction industry. Methods and analysis This scoping review will follow the Joanna Briggs Institute (JBI) scoping review framework and will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping reviews (PRISMA-ScR) checklist. An iterative search will be conducted in a selection of multidisciplinary databases including, Proquest Central, PubMed, Scopus, Science Direct, Web of Science, PsychINFO and Google Scholar. Thereafter, searches for grey literature will be performed in Google.com and websites of various national and international agencies, governing bodies and professional organisations with an interest in occupational health and work at heights. Where appropriate, targeted requests for clarification for further information will be undertaken with information sources. A descriptive qualitative content analysis of the results will be conducted and a level of evidence rating will be assigned to each study using the JBI approach. This will allow us to provide some commentary on the rigour of the existing evidence base. Ethics and dissemination Ethics approval for the PhD study was granted by the Research Ethics Committee, Faculty of Health Sciences, University of Pretoria, ethics reference number, 486/2021. Results of the scoping review will be submitted to a scientific journal for publication. Trial registration number This protocol is registered on the Open Science Framework at osf.io/yd5gw

Smoking cessation interventions in south Asian countries: Protocol for scoping review

Introduction: Unfortunately, like many other health risks, smoking rate has been on the rise in developing countries. Half of current smokers in the world reside in only three countries of Asia that include India. Many smoking cessation interventions that were developed and successfully implemented in the context of developed countries have not been equally successful in South Asia. Hence, there is a dire need of culturally relevant smoking cessation interventions. We propose a scoping review with objectives to explore the extent and nature of interventions for smoking cessation and its associated factors in South Asian Region by systematically reviewing the available published and unpublished literature.Methods and analysis: The review has been registered in Joanna Briggs Institute (JBI) systematic reviews register and details are given in the Methodology section. The updated framework of JBI for scoping review methodology will be used as guide for conduct of this scoping review. Electronic databases (PubMed, CINAHL plus, Proquest Theses and Dissertations, EBSCO Dentistry and Oral Sciences, and Wiley Cochrane Library), reference lists of selected studies and grey literature will be considered for inclusion in this review. The literature search is anticipated to be carried out in December-January 2020. Initially, two reviewers in consultation with a librarian will develop search syntax followed by search from the selected sources. Consequently, the reviewers will screen all the titles, abstracts and full articles to establish relevance of each study for inclusion. Factors associated with smoking cessation will be coded and categorised applying qualitative content analysis, while interventions extracted from the literature will be described with the stated level of effectiveness

Clinical Librarianship (CL): A Historical perspective

Introduction A number of previous studies have collected data on a hospital’s use of databases and the librarian’s role in the process. These studies express common themes and suggest activities for librarians wishing to promote the use of new technologies. The first theme: While it seems clear that some physicians are competent and satisfied users of new computer search systems, many more, unfortunately, are unaware of the potential time saving features and powerful search capabilities of their search systems. Health sciences librarians have been advocating the use of indexes and abstracts for as long as these products have been available. More than twenty years ago, the National Library of Medicine pioneered online access to the literature with the introduction of Medlars online (Medline). Medline initially consisted of a subset of 236 of the top medical journals indexed in Index Medicus and was viewed as an interesting supplement to manual searching; it now is used routinely as the preferred method of access by thousands of Librarians and health care professionals. Some faculty, though, still rely on the traditional methods of asking a colleague, scanning a personal copy of a journal and, of course, going to the library. Traditionally, CD-ROM systems were only available in the library and doctors and librarians met each other there to discuss problems for searching. The results of a Canadian survey indicated that physicians in Ontario made little use of Libraries because they had no time to search for information beyond that they could obtain quickly from colleagues or from reference material in their own collections. Other studies found that the primary reason of a clear preference for hospital libraries, either medical school or medical society libraries where information was used for both clinical and research purposes, was that the library was the most important place of locating printed sources on which doctors still rely for browsing the literature. Over the past few decades, the role of the medical librarian has become increasingly complex, due to the explosion of information, and the way information is now digitized, libraries are increasingly virtual. Now the additional problem is that clinicians need information but not any information. They need evidence from high quality research. The information is available, but they may have not time to search effectively. To meet their needs, the librarian must adopt the role of going out of the library to meet the clinicians, themselves

Value and effectiveness of National Immunization Technical Advisory Groups in low- and middle-income countries : A qualitative study of global and national perspectives

© The Author(s) 2019. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.The Global Vaccine Action Plan proposes that every country establish or have access to a National Immunization Technical Advisory Group (NITAG) by 2020. The NITAG role is to produce evidence-informed recommendations that incorporate local context, to guide national immunization policies and practice. This study aimed to explore the value and effectiveness of NITAGs in low- and middle-income countries (LMICs), identifying areas in which NITAGs may require further support to improve their functionality and potential barriers to global investment. A multi-methods study design was used, comprising 134 semi-structured interviews and 82 literature review sources that included 38 countries. Interviews were conducted with 53 global/regional and 81 country-level participants able to provide insight into NITAG effectiveness, including NITAG members, national immunization programme staff, and global agency representatives (e.g. the World Health Organisation, the Bill and Melinda Gates Foundation, Gavi the Vaccine Alliance). The review, including published and unpublished sources on NITAGs in LMICs, was conducted to supplement and corroborate interview findings. Data were analysed thematically. NITAGs were described as valuable in promoting evidence-informed vaccination decision-making, with NITAG involvement enhancing national immunization programme strength and sustainability. Challenges to NITAG effectiveness included: (1) unreliable funding; (2) insufficient diversity of member expertise; (3) inadequate conflicts of interest management procedures; (4) insufficient capacity to access and use evidence; (5) lack of transparency; and (6) limited integration with national decision-making processes that reduced the recognition and incorporation of NITAG recommendations. LMIC NITAGs have developed significantly in the past decade. Well-functioning NITAGs were trusted national resources that enhanced country ownership of immunization provision. However, many LMIC NITAGs require additional technical and funding support to strengthen quality and effectiveness, while maintaining impartiality and ensuring sufficient integration with national decision-making processes. Barriers to sustainable global support need to be addressed for LMIC NITAGs to both continue and develop further.Peer reviewedFinal Published versio

Conscientious objection – does it also apply to nursing students?

The conscientious clause in nursing can be defined as a kind of special ethical and legal regulation which gives nurses right to object to actively perform certain medical procedures which are against their personal system of values. Usually these values are associated with nurses’ religious beliefs, but not always. Scope of this regulation differs throughout the world. However, it is emphasized that right to the conscientious objection is not absolute and this regulation can not be used in cases of danger to life or serious damage to the health of the patient. Medical procedures to which nurses hold conscientious objection are often within reproductive health services. However, we can also find reports on the use of this right i.e. in end-of-life care and in the process of the implementation of medical experiments. The main issue underlined in the discussion regarding practising conscientious objection in the clinical setting is the collision of two human rights: the right to conscientious objection of medical personnel and the right of patients to specific medical procedures which are legal in their country. If a procedure is legally available in a country it means that patients can expect to receive it, on the other hand, all citizens, including health care workers, have the right to protect their moral identity and the right to object to the implementation of a procedure to which they have a specific objection. It is very difficult to find good ethical and legal balance between these two perspectives

Academic careers: the value of individual mentorship on research career progression

The paper discusses how individual mentoring may impact positively on career pathway development for potential and future clinical academic researchers in nursing and allied health professions. Methods: The paper draws on a number of data sources and methodologies in order to fulfil the aims. Firstly, international literature provides an insight into mentoring processes and impact on career development. This is followed by a review of the mentoring experiences based on a UK study on the professorial populations in nursing and allied health professions. The final section reports on results of interviews with early and advanced researchers on their experiences of mentoring. Results: Individual mentoring is valued highly by health care professionals at all stages of career development. It is considered particularly useful when people are in transition towards a more challenging career role.Individuals in receipt of mentoring both formal and informal, report improved confidence in their cability to achieve their career goals. Mentees report improved levels of competence achieved through knowledge aquisition, networking and ability to probelm solve. Conclusions/Summary: Mentoring is considered an important process for health care professionals at all stages of their career. Opportunities to access and receive mentoring support for health care staff in the UK remain limited and sporadic in nature. There are examples of excellent mentoring schemes in place within some institutons and organisations but a national strategy to support mentoring has yet to be developed Key words: Clinical academic careers, mentoring, nursing, allied health profession