Report of a mixed methods systematic review of literature to inform the development of ‘sustainable safe staffing’ improvement resource in learning disability (LD) services for NHS Improvement

Purpose The purpose of this mixed methods systematic review of literature is to summarise the best evidence available on sustainable safe staffing levels for multi-disciplinary learning disability teams in order to inform the development of setting-specific sustainable safe staffing guidance for the NHS Improvement National Safe Sustainable Staffing Guidance Programme Board for England. Firstly, the systematic literature review sought to uncover and synthesise any evidence on, sustainable safe staffing levels in learning disability services. Secondly, the review sought to identify themes of relevance to learning disability teams, and the delivery of sustainable, safe, and effective care for people with learning disabilities could be surfaced from national and international literature. Finally, the review sought to assess if any of the emerging evidence affirm or negate the context of care tool as an MDT model of care. Methods The Joanna Briggs Institute’s (JBI) systematic review protocols were used to appraise studies. The PRISMA process was used to select the literature for review. Empirical (quantitative, qualitative, mixed methods) studies, synthesised evidence (literature reviews) and opinion papers, (n = 37) were included in the review. A mixed methods approach to the review and synthesis was used due to the heterogeneous nature of the evidence. Quantitative data was converted into themes and presented with qualitative data through meta-aggregation using a narrative approach. JBI tools were used to pool findings and rate them for quality. Meta-synthesis was used to produce the synthesised findings. Foundational coding families of cause, context and process were used as a framework (Glasser 1978) for presenting the findings. Findings No empirical evidence was located that directly relate to sustainable safe staffing. Three core themes emerged from the review. The first theme; service models, is underpinned by three categories (service design and implementation strategies; clarity of professional roles and service collaboration / integration mechanisms; stakeholder and service user engagement). Four categories underpin the second theme; standards of care (understanding of the context of care; delivering effective care; ensuring effective communication; ensuring high standards of care). The third theme; resources, is made up of three categories (processes for managing resources; developing professional competence; values-based recruitment and retention practices). Conclusions The conclusions from this review leave a number of questions unanswered. The concept of sustainable safe staffing in LD services must be clearly understood from the very complex nature of the models of care, the extent of the number professionals and healthcare agencies involved in meeting the healthcare needs of people with LD. Implications for practice Without an appropriate service model of healthcare provision, clear standards of care, and adequate processes for deploying resources sustainable, safe, effective and efficient staffing may be challenging or unachievable. Implications for research The lack of robust empirical evidence regarding sustainable safe staffing in LD services mean the need for robustly designed research in this area cannot be overemphasised. Research needs to focus on the context of care, the relationships between sustainability, safety, effectiveness, efficiency and staffing levels, the hub and spoke model of healthcare service provision, and hospital communication passports. Recommendations Although the level and quality of evidence from all the literature included in this review is low, we have made appropriate recommendations given the significance and rationale of the topic under consideration

Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia

ObjectiveContinuous glucose monitoring (CGM) is the standard of care for glucose monitoring in children with diabetes, however there are limited data reporting their use in hyperinsulinaemic hypoglycaemia (HH). Here, we evaluate CGM accuracy and its impact on quality of life in children with HH.MethodsReal-time CGM (Dexcom G5 and G6) was used in children with HH aged 0-16years. Data from self-monitoring capillary blood glucose (CBG) and CGM were collected over a period of up to 28days and analysed. Quality of life was assessed by the PedsQL4.0 general module and PedsQL2.0 family impact module, completed by children and their parents/carers before and after CGM insertion. Analysis of accuracy metrics included mean absolute relative difference (MARD) and proportion of CGM values within 15, 20, and 30% or 15, 20, and 30 mg/dL of reference glucose values >100 mg/dL or ≤100 mg/dL, respectively (% 15/15, % 20/20, % 30/30). Clinical reliability was assessed with Clarke error grid (CEG) analyses.ResultsProspective longitudinal study with data analysed from 40 children. The overall MARD between reference glucose and paired CGM values (n=4,928) was 13.0% (Dexcom G5 12.8%, Dexcom G6 13.1%). The proportion of readings meeting %15/15 and %20/20 were 77.3% and 86.4%, respectively, with CEG analysis demonstrating 97.4% of all values in zones A and B. Within the hypoglycaemia range (<70 mg/dL), the median ARD was 11.4% with a sensitivity and specificity of 64.2% and 91.3%, respectively. Overall PedsQL child report at baseline and endpoint were 57.6 (50.5 – 75.8) and 87.0 (82.9 – 91.2), and for parents were 60.3 (44.8 – 66.0) and 85.3 (83.7 – 91.3), respectively (both p<0.001).ConclusionUse of CGM for children with HH is feasible, with clinically acceptable accuracy, particularly in the hypoglycaemic range. Quality of life measures demonstrate significant improvement after CGM use. These data are important to explore use of CGM in disease indications, including neonatal and paediatric diabetes, cystic fibrosis and glycogen storage disorders

Panic buying research: A systematic review of systematic reviews

Panic buying is an emerging and ever-evolving phenomenon during emergencies covering several perspectives of life and academic domains. However, it hasn’t got adequate attention reflected by a handfuls number of studies on it. We aimed to assess the systematic reviews that have been performed on panic buying. A search was conducted in PubMed, Scopus, Web of Science Core Collection, and Google Scholar on 30 June 2021, with the search terms “panic buying”, ”systematic review” using the Boolean function ‘AND’. The search was also supplemented by hand searching from the reference lists. We included only systematic reviews on panic buying. We identified and assessed five systematic reviews conducted on panic buying. A major focus in these reviews was psychological factors, precipitating reasons, and the inter-disciplinary nature of the phenomenon. The role of social media and social learning have been emphasized in the genesis of panic buying behavior. Panic buying has got recent attention as newer studies are coming out. However, further robust studies are warranted to understand this transdisciplinary construct and therefore, inter-sectoral collaboration in research is required to understand its genesis and prevention strategies

COVID-19 and risk factors of suicidal behaviour in UK: A content analysis of online newspaper

Background: Suicide is a serious global burden of disease. Recent COVID-19 pandemic has been associated with increased psychological distress among general population in UK and suicide is one of them. This research aimed to look into the suicide metrics in UK by analyzing the online news portals, retrospectively. Methods: Six UK online news portals were selected purposively to include in the study and news of suicides were searched retrospectively. Search was conducted by the term “suicide news”. News portals were initially searched with the search term retrospectively. After removal of the repetitions data is inputted into software. Results: Since 2020 January to November 2020, eighty-nine reports were scrutinized. Mean age was 37.91 (± 19.940) years ranging from 10-95 years. About 57.3% of the reported cases were less than 40 years of age, 58.4% were male, 41.6% were female, 40.4% of the respondents had mental health issues, covid-19 lockdown and restrictions accounts for 26.96% of suicides, 14.6% had health issues and 3.4% ongoing family issues. Previous suicide attempts were reported in 12.4% reports. Multiple number of persons involved in the suicidal acts in about 13.4% of the respondents. Highest suicide rate was reported in November 2020 with 21.34% of suicides. Conclusions: Early adult and male gender are more vulnerable. Mental health issues, covid-19 lockdown and restrictions, and health issues drew attention as risk factors. Suicide rate was higher in November 2020

Intimate Partner Violence and Pregnancy Termination among Tajikistan Women: Evidence from Nationally Representative Data

Intimate partner violence is the most common kind of violence and a significant public health issue. The relationship between intimate partner violence and pregnancy termination among Tajikistan women was investigated in this study. The data for this research was collected from the Tajikistan Demographic and Health Survey 2017. This research has used the data of married women aged between 15 to 49 years. The findings from the study indicate that around 23.2% of married women in Tajikistan have experienced physical violence. The respondent’s age, region, and employment status was significantly associated with pregnancy termination (p < 0.05). Similarly, women who can refuse sex with their partner and ask their partner to use a condom are more likely to terminate pregnancy (p < 0.05). The characteristics of the husband or partner that had a significant positive association with pregnancy termination of married women in Tajikistan are age, educational level, and alcohol drinking status of their husbands (p < 0.05). This study also establishes the significant relationship between pregnancy termination and physical or emotional violence experienced by women (p < 0.05). The dynamics of domestic abuse need to be understood by healthcare providers to aid women in making decisions on whether or not to terminate their pregnancy

Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia

Objective: Continuous glucose monitoring (CGM) is the standard of care for glucose monitoring in children with diabetes, however there are limited data reporting their use in hyperinsulinaemic hypoglycaemia (HH). Here, we evaluate CGM accuracy and its impact on quality of life in children with HH. Methods: Real-time CGM (Dexcom G5 and G6) was used in children with HH aged 0-16years. Data from self-monitoring capillary blood glucose (CBG) and CGM were collected over a period of up to 28days and analysed. Quality of life was assessed by the PedsQL4.0 general module and PedsQL2.0 family impact module, completed by children and their parents/carers before and after CGM insertion. Analysis of accuracy metrics included mean absolute relative difference (MARD) and proportion of CGM values within 15, 20, and 30% or 15, 20, and 30 mg/dL of reference glucose values >100 mg/dL or ≤100 mg/dL, respectively (% 15/15, % 20/20, % 30/30). Clinical reliability was assessed with Clarke error grid (CEG) analyses. Results: Prospective longitudinal study with data analysed from 40 children. The overall MARD between reference glucose and paired CGM values (n=4,928) was 13.0% (Dexcom G5 12.8%, Dexcom G6 13.1%). The proportion of readings meeting %15/15 and %20/20 were 77.3% and 86.4%, respectively, with CEG analysis demonstrating 97.4% of all values in zones A and B. Within the hypoglycaemia range (<70 mg/dL), the median ARD was 11.4% with a sensitivity and specificity of 64.2% and 91.3%, respectively. Overall PedsQL child report at baseline and endpoint were 57.6 (50.5 – 75.8) and 87.0 (82.9 – 91.2), and for parents were 60.3 (44.8 – 66.0) and 85.3 (83.7 – 91.3), respectively (both p<0.001). Conclusion: Use of CGM for children with HH is feasible, with clinically acceptable accuracy, particularly in the hypoglycaemic range. Quality of life measures demonstrate significant improvement after CGM use. These data are important to explore use of CGM in disease indications, including neonatal and paediatric diabetes, cystic fibrosis and glycogen storage disorders. Highlight

Pornography—Is It Good for Sexual Health? A Systematic Review

Aim: The topic of pornography use is controversial. It is important to understand how young people use pornography and determine whether pornography use has adverse effects on health and well-being. Methods: A comprehensive systematic literature search was conducted in 4 electronic databases (PubMed, Google Scholar, CINAHL plus, and Cochrane library) with appropriate MeSH terms “sexual health” and “pornography” and Boolean operators “AND” and “OR,” using SPIDER search strategy tools (sample, phenomenon of interest, design, evaluation, and research type). 11 articles were proceeded with systematic review after critical appraisal following PRISMA guidelines. Results: The major findings of the study imply that traditional and unimaginative activities depicted in some pornography and sexualized media are harmful because they impose restricted and circumscribed concepts of sex and sexuality. As a result, sexism, sexual objectification, neoliberal sexual consumerism, and sexual variety are reproduced and reinforced rather than promoted. FPU is linked to better levels of sexual comfort and self-acceptance and reduced levels of anxiety, shame, and guilt over sexual behavior. Pornography consumption has also been linked to increased arousal and orgasm responses, a greater interest in sex, acceptance of various sexual acts, and more sexual experimentation. Conclusion: Watching pornography may be a healthy phenomenon if it is occasional, not impairing the personal and social life; however, it can become pathological if watched excessively and impairs the individual’s functioning

Pornography and Sexual Violence Against Women in India: A Scoping Review

In recent decades, surge in the usage of pornography is promoting a severe negative impact on health and well-being throughout the world. In recent times, there is a surge in rape cases in India. There may be a relation between pornography addiction and an increase in sexual crime against women. This review aims to document the association between sexual violence and addiction to pornography in India. Six original articles were retrieved from databases for the initial review of the literature, such as PubMed, EMBASE, EBSCOhost, CINAHL plus, and PubMed Central. Out of the six included cross-sectional research, 50% reported primary (sample sizes range from 100 to 600), 33.3% secondary data, and 16.7% study assessed data from Google trend. Only 16.7% of included articles unveiled a significant association between the number of Internet users and increased sexual violence (rapes and or crimes) toward females that revealed an insignificant association when variables were controlled. About 33.3% of studies reported that the male gender was more vulnerable to pornography addiction among medical students than females. Pornography search had no significant association with literacy level. Female population ratio in Scheduled Castes and Scheduled Tribes positively and urbanization and female workforce participation negatively impacted crime against women

Depression among the Non-Native International Undergraduate Students Studying Dentistry in Bangladesh.

BACKGROUND: Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh. METHODS: This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812. RESULTS: The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p < 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value < 0.01). CONCLUSION: This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years

Problematic smartphone usage, prevalence and patterns among university students: A systematic review

Background In the last decade, smartphones have become an indispensable part of our daily life. However, little is known of when smartphone usage becomes problematic and how it can affect mental and physical health. Therefore, this paper aims to analyse to which extent university students suffer from problematic smartphone usage (PSU) and if there are recognisable patterns or predictive factors. Methods This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. To identify eligible primary research studies, a pre-defined search strategy was carried out in four databases, including Cochrane databases, CHINAL Plus, MEDLINE, and PubMed. The obtained literature was screened using inclusion and exclusion criteria and critically appraised with the AXIS tool resulting in 11 peer-reviewed studies in English. Results The prevalence of PSU in university students varied between 36.5% and 67%, with a mean of 52%. Across the literature, PSU was significantly associated with mental health problems like depression, and anxiety. Furthermore, smartphone overuse can lead to physical problems (e.g., neck pain or eye strain) and negatively influence university students' academic performance and sleep quality. Our results suggest that the duration spends on the phone is a potential predictive factor for PSU. Limitations Most studies in this systematic review are cross-sectional; therefore, no causal explanations can be given. Moreover, the measurement scales used are based on self-reported answers, which carry the risk of recall bias. Conclusion This study demonstrates that PSU is very common and needs to be considered in the population group of university students. More longitudinal studies are required in order to identify causal relationships between PSU and possible predictive factors.</p