Effects of computerised clinical decision support systems (CDSS) on nursing and allied health professional performance and patient outcomes: a systematic review of experimental and observational studies

Objective Computerised clinical decision support systems (CDSS) are an increasingly important part of nurse and allied health professional (AHP) roles in delivering healthcare. The impact of these technologies on these health professionals’ performance and patient outcomes has not been systematically reviewed. We aimed to conduct a systematic review to investigate this. Materials and methods The following bibliographic databases and grey literature sources were searched by an experienced Information Professional for published and unpublished research from inception to February 2021 without language restrictions: MEDLINE (Ovid), Embase Classic+Embase (Ovid), PsycINFO (Ovid), HMIC (Ovid), AMED (Allied and Complementary Medicine) (Ovid), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), Cochrane Database of Systematic Reviews (Wiley), Social Sciences Citation Index Expanded (Clarivate), ProQuest Dissertations & Theses Abstracts & Index, ProQuest ASSIA (Applied Social Science Index and Abstract), Clinical Trials.gov, WHO International Clinical Trials Registry (ICTRP), Health Services Research Projects in Progress (HSRProj), OpenClinical(www.OpenClinical.org), OpenGrey (www.opengrey.eu), Health.IT.gov, Agency for Healthcare Research and Quality (www.ahrq.gov). Any comparative research studies comparing CDSS with usual care were eligible for inclusion. Results A total of 36 106 non-duplicate records were identified. Of 35 included studies: 28 were randomised trials, three controlled-before-and-after studies, three interrupted-time-series and one non-randomised trial. There were ~1318 health professionals and ~67 595 patient participants in the studies. Most studies focused on nurse decision-makers (71%) or paramedics (5.7%). CDSS as a standalone Personal Computer/LAPTOP-technology was a feature of 88.7% of the studies; only 8.6% of the studies involved ‘smart’ mobile/handheld-technology. Discussion CDSS impacted 38% of the outcome measures used positively. Care processes were better in 47% of the measures adopted; examples included, nurses’ adherence to hand disinfection guidance, insulin dosing, on-time blood sampling and documenting care. Patient care outcomes in 40.7% of indicators were better; examples included, lower numbers of falls and pressure ulcers, better glycaemic control, screening of malnutrition and obesity and triaging appropriateness. Conclusion CDSS may have a positive impact on selected aspects of nurses’ and AHPs’ performance and care outcomes. However, comparative research is generally low quality, with a wide range of heterogeneous outcomes. After more than 13 years of synthesised research into CDSS in healthcare professions other than medicine, the need for better quality evaluative research remains as pressing

Gendered representations in Hawai‘i’s anti-GMO activism

The aim of this article is to analyse some of the representations of intersectional gender that materialise in activism against genetically modified organisms (GMOs). It uses the case of Hawai‘i as a key node in global transgenic seed production and hotspot for food, land and farming controversies. Based on ethnographic work conducted since 2012, the article suggests some of the ways that gender is represented within movements against GMOs by analysing activist media representations. The article shows how gender, understood intersectionally, informs possibilities for movement-identification, exploring how themes of motherhood, warrior masculinities and sexualised femininities are represented within these movements. The article suggests that some activist representations of gender invoke what could be considered as normative framings of gender similar to those seen in other environmental, food and anti-GMO movements. It is suggested that these gendered representations may influence and limit how different subjects engage with Hawai'i anti-GMO movements. At the same time, contextual, intersectional readings demonstrate the complex histories behind what appear to be gender normative activist representations. Taken together, this emphasis on relative norms of femininities and masculinities may provide anti-GMO organising with familiar social frames that counterbalance otherwise threatening campaigns against (agri)business in the settler state. Understood within these histories, the work that gender does within anti-GMO organising may offer generative examples for thinking through the relationships between gendered representations and situated, indigenous-centred, food and land-based resistances

Meat science from 1976: a history of the journal

The journal Meat Science was first published in 1976/77 and it initially comprised 4 issues per year. The first issue contained 4 papers and the first volume (4 issues) contained 27 articles, a mixture of papers and research notes. Its growth/popularity increased, and it has continued to thrive and in 2016 of the 1010 papers processed 292 were accepted. Over 90% of the papers published in the first volume were concerned with muscle biochemistry/meat properties. During the last years of the 20th century, meat products and their properties became a far larger proportion of the submissions as did those concerned with nutrition and safety. More recently there has been a resurgence of papers concerned with meat quality. Over the last 40years, the journal has reported on the major developments in meat science research and this paper will discuss both the history of the journal, and aspects of meat research as reflected in its publications. Possible future research trends are also discussed

Microstructure and thermal characteristics of Thai indigenous and broiler chicken muscles

The microstructure and thermal characteristics of Thai indigenous (Gallus domesticus) and broiler chicken (commercial line CP707) biceps femoris and pectoralis muscles were determined. Perimysium thicknesses were 14.2 mum for biceps femoris muscle and 7.10 mum for pectoralis muscle of indigenous chicken muscles, thicker than those of broiler muscles, which were 9.93 mum for biceps femoris muscle and 3.87 mum for pectoralis muscle (P < 0.05). Five endothermic peaks with peak transition temperatures (T-p) of 54.9, 61.7, 65.4, 70.6, and 76.1degreesC were obtained for broiler pectoralis muscle, whereas only 3 endothermic peaks (T-P of 56.6, 62.6, and 74.9degreesC were obtained for broiler biceps femoris muscle. Thai indigenous biceps femoris and pectoralis muscles had endothermic peaks with T-P ranges of 53.5 to 54.8, 60.7 to 61.9, and 75.9 to 76.9degreesC. The fiber diameters of Thai indigenous chicken muscles were greater (P < 0.05) than those of the broiler, 31.7 vs. 20.4 mum for biceps femoris muscle and 28.9 vs. 26.6 pm for pectoralis muscle, respectively. After cooking at 80degreesC for 10 min, the fiber diameter of indigenous chicken muscles significantly decreased while those of the broiler significantly increased. The mean of sarcomere lengths of the raw muscles ranged from 1.56 to 1.64 mun and decreased to 0.92 to 1.32 mum (P < 0.001) for broiler muscles and 1.22 to 1.35 mum (P < 0.001) for indigenous chicken muscles after cooking. The perimysium and endomysium of broiler muscles melted after cooking at 80degreesC, however, only slight disintegration was observed in these tissues in the indigenous chicken muscles