79 research outputs found

    Public health intelligence challenges for local public health authorities responding to disease outbreaks: a mixed-methods systematic review protocol [version 2; peer review: 1 approved, 2 approved with reservations]

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    Background: Information management capacity is crucial for controlling risks from health emergencies. But little is known about how sub-national public health bodies overcome public health intelligence challenges when responding to disease outbreaks. This paper describes a protocol for a mixed-methods systematic review to fill this knowledge gap. In addition to describing the evidence base and characterising public health intelligence responses, it will explore reported facilitators and barriers to response. Methods: Research on sub-national public health intelligence disease outbreak responses will be synthesised. The review will be limited to articles published in English, during or after 2019. Key electronic databases will be searched for peer-reviewed, primary research studies. Two reviewers will independently screen articles for relevance. Articles that refer to a public health intelligence response to a propagated disease outbreak by a sub-national Public Health Authority will be included. Quality assessment of included articles will be undertaken using published tools. Data integration will be by the Pillar Integration Process (PIP). Discussion: This review will describe and synthesise the recent literature on sub-national Public Health Authorities’ responses to propagated disease outbreaks. The systematic design will limit bias and the inclusion of data from quantitative, qualitative and mixed-methods studies will ensure relevant evidence is considered regardless of the methodology used to produce it. The review is part of a larger research project which aims to explore the role of sub-national Public Health Intelligence during the COVID-19 pandemic and investigate how public health intelligence preparedness could be improved in the future. This could provide information to support the development of training, preparedness indicators and/or ways of implementing directives. PROSPERO registration: CRD42022308042 (08/02/2022

    Effective service provision and partnerships in service providers for children and young people with special educational needs and disabilities: a mixed methods systematic review protocol

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    It is widely recognized that provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) are enhanced when services such as healthcare, social care, and education collaborate and interact effectively, rather than separately. In the UK, while there have been significant changes to policy and provision which support and improve collaboration, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance and a logic model or framework to illustrate how effective multi-agency working could, or should, work. This systematic review aims to identify the ‘key ingredients’ for effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. In addition, the review will highlight interventions that lead to improved service outcomes; and the conditions in the local area (organisational or geographical) that support and encourage success. This protocol has been written following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols guidelines. Searches will be conducted on several health, care, education and applied social science databases from the year 2012 onwards. Citation chaining will be undertaken, as will broader grey literature searching to enrich the findings. Qualitative, quantitative, and mixed methods studies will be included, assessed independently and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data will be extracted using a standardized, pre-piloted data extraction form. A convergent segregated approach to synthesis and integration will be used in which the quantitative and qualitative data will be synthesized independently, and then integrated using a joint display integration matrix. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0–25 can most effectively collaborate and improve service outcomes. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.PROSPERO registration: CRD42022352194

    Effectiveness of web-based personalised feedback interventions for reducing alcohol consumption among university students: A systematic review and meta-analysis

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    Issues: Meta-analysis was conducted to examine standalone web-based persona-lised feedback interventions (PFI) delivered in non-structured settings for reducing university students' alcohol consumption. Subgroup analyses by gender-focus, type-of-content and accessibility were conducted. Characteristics of the sample, the intervention and study quality were examined as moderators. Approach: Ten databases were searched from 2000 to 2023. Eligible articles involved only randomised controlled trials. Random-effects meta-analysis was conducted to calculate the effect size on weekly alcohol consumption comparing web-PFIs and non-active controls. Meta-regressions were applied to explore effect moderators. Key Findings: Thirty-one studies were included in the narrative synthesis, 25 of which were meta-analysed. Results found significant effect size differences on weekly alcohol consumption in favour of the intervention group in the short-(SMD = 0.11, 95% confidence interval [CI] 0.06, 0.15) and long-term period (SMD = 0.09, 95% CI 0.02, 0.15). Subgroup analyses identified that interventions which were gender-specific, multicomponent and had unlimited access had higher and significant effect sizes, although they were very similar with respect to comparative groups. Moderator analyses showed that times feedback was accessed significantly contributed to the effectiveness of the intervention. Effects diminished over time, although they remained significant. Implications: The meta-analysis evidences the effectiveness of web-PFI for addressing university students' alcohol use, decreasing by 1.65 and 1.54 drinks consumed per week in the short-and long-term, respectively. Conclusions: The results offer empirical evidence that supports the significant, although small, effect of web-PFI delivered remotely in universities. Futur

    The Assessment of Post-Vasectomy Pain in Mice Using Behaviour and the Mouse Grimace Scale

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    Background: Current behaviour-based pain assessments for laboratory rodents have significant limitations. Assessment of facial expression changes, as a novel means of pain scoring, may overcome some of these limitations. The Mouse Grimace Scale appears to offer a means of assessing post-operative pain in mice that is as effective as manual behavioural-based scoring, without the limitations of such schemes. Effective assessment of post-operative pain is not only critical for animal welfare, but also the validity of science using animal models. Methodology/Principal Findings: This study compared changes in behaviour assessed using both an automated system (‘‘HomeCageScan’’) and using manual analysis with changes in facial expressions assessed using the Mouse Grimace Scale (MGS). Mice (n = 6/group) were assessed before and after surgery (scrotal approach vasectomy) and either received saline, meloxicam or bupivacaine. Both the MGS and manual scoring of pain behaviours identified clear differences between the pre and post surgery periods and between those animals receiving analgesia (20 mg/kg meloxicam or 5 mg/kg bupivacaine) or saline post-operatively. Both of these assessments were highly correlated with those showing high MGS scores also exhibiting high frequencies of pain behaviours. Automated behavioural analysis in contrast was only able to detect differences between the pre and post surgery periods. Conclusions: In conclusion, both the Mouse Grimace Scale and manual scoring of pain behaviours are assessing th

    Stable carbon Isotope evidence for neolithic and bronze age crop water management in the eastern mediterranean and southwest asia

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    In a large study on early crop water management, stable carbon isotope discrimination was determined for 275 charred grain samples from nine archaeological sites, dating primarily to the Neolithic and Bronze Age, from the Eastern Mediterranean and Western Asia. This has revealed that wheat (Triticum spp.) was regularly grown in wetter conditions than barley (Hordeum sp.), indicating systematic preferential treatment of wheat that may reflect a cultural preference for wheat over barley. Isotopic analysis of pulse crops (Lens culinaris, Pisum sativum and Vicia ervilia) indicates cultivation in highly varied water conditions at some sites, possibly as a result of opportunistic watering practices. The results have also provided evidence for local land-use and changing agricultural practices
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