Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

Introduction: Cannulation is an essential part of haemodialysis with arteriovenous access. Patients’ experiences of cannulation for haemodialysis are problematic but poorly understood. This review aims to synthesise findings related to patients’ experiences of cannulation for haemodialysis from qualitative studies, providing a fuller description of this phenomenon. Methods: Eligibility criteria defined the inclusion of studies with a population of patients with end-stage kidney disease on haemodialysis. The phenomena of interest was findings related to patients’ experiences of cannulation for haemodialysis and the context was both in-centre and home haemodialysis. MedLine, CINAHL, EMBASE, EMCARE, BNI, PsycInfo and PubMed were last searched between 20/05/2019 and 23/05/2019. The quality of studies was assessed using the using Joanna Briggs Critical Appraisal Checklist for Qualitative Research. Meta-aggregation was used to synthesise findings and CERQual to assess the strength of accumulated findings. Results: This review included 26 studies. The subject of included studies covered cannulation, pain, experiences of vascular access, experiences of haemodialysis and a research priority setting exercise. From these studies, three themes were meta-aggregated: (1) Cannulation for haemodialysis is an unpleasant, abnormal and unique procedure associated with pain, abnormal appearance, vulnerability and dependency. (2) The necessity of cannulation for haemodialysis emphasises the unpleasantness of the procedure. Success had multiple meanings for patients and patients worry about whether the needle insertion will be successful. (3) Patients survive unpleasant, necessary and repetitive cannulation by learning to tolerate cannulation and exerting control over the procedure. Feeling safe can help them tolerate cannulation better and the cannulator can invoke feeling safe. However, some patients still avoid cannulation, due to its unpleasantness. Conclusions: Cannulation is a pervasive procedure that impacts on patients’ experiences of haemodialysis. This review illuminates further patients’ experiences of cannulation for haemodialysis, indicating how improvements can be made to cannulation. Registration: PROSPERO (CRD42019134583).

Abundance of the Resplendent Quetzal Pharomachrus mocinno (Trogoniformes, Trogonidae) in the tourist sector of a cloud forest reserve

The Resplendent Quetzal (Pharomachrus mocinno) exhibits characteristics that are common to species prone to extinction, such as occurring at low densities, presenting strict ecological requirements, and inhabiting locations with high rates of degradation. The lack of data on the abundance of threatened species makes it difficult to make management decisions and does not allow to know trends over time, which is essential for conservation in their distribution areas. The abundance and density of the Resplendent Quetzal was estimated from audio/visual detections analyzed with distance sampling techniques. Data was collected in the public use sector of La Tigra National Park, a reserve of virgin and secondary growth cloud forest in Honduras, Central America. A population N = 136 was found with a density of 40 quetzals per km2. There are no systematic studies on the population size and density of the species for this site since 1979, in which a population of 145 quetzals was reported. The estimation of the Resplendent Quetzal population for the total area of the park is a main research priority, which will make it possible to evaluate the viability of the species and the establishment of a new baseline for conservation policies and environmental education efforts in the area of influence.

What do we know about evidence-informed priority setting processes to set population-level health-research agendas: an overview of reviews

Background This overview aimed to synthesize existing systematic reviews to produce a draft framework of evidence-informed health priority setting that supports countries in identifying appropriate steps and methods when developing and implementing national research agendas. Main body We searched Ovid MEDLINE® and the WHO Institutional Repository for Information Sharing from 2010 to 2020 for critical or systematic reviews that evaluated research priority setting exercises. We adapted the AMSTAR checklist to assess the quality of included reviews and used adapted frameworks for data extraction and analysis. The search resulted in 2395 titles, of which 31 were included. Populations included in the reviews typically involved patients, families and carers, researchers, clinicians, policymakers and research funders. The topics covered in the reviews varied from specific diseases or conditions, approaches for healthcare practice or research priority setting methods itself. All the included systematic reviews were of low or critically low quality. The studies were thematically grouped based on their main focus: identifying and engaging with stakeholders; methods; context; and health area. Conclusion Our overview of reviews has reconfirmed aspects of existing frameworks, but has also identified new concepts for countries to consider while developing their national research agendas. We propose a preliminary framework for consideration that highlights four key phases: (1) preparatory, (2) priority setting, (3) follow-up phase and (4) sustainability phase, which have thirteen sub-domains to consider.

Identification of Research Priorities during the COVID-19 Pandemic: Implications for Its Management

Novel coronavirus disease 2019 (COVID-19) pandemic has had a great impact on global production and life in the past period. Countless researchers devoted themselves to rescuing patients and reducing its impact. Analyzing the literature published during the pandemic and identifying the research priorities is of great significance to quickly discover research gaps, rationally allocate scientific research resources, and promote the development of the global research platform. To understand the swing of research priorities during the pandemic, this paper proposed a research priorities identification framework for pandemic based on scientific literature text analysis. Moreover, a research priority metric model was proposed to measure the characteristics of research priorities, and the empirical analysis from COVID-19 scientific literature was conducted to identify the research priorities during the pandemic. As a result, the research priorities identified by the method proposed in this paper discovered the fine-grained dynamic characteristics along with the process in the pandemic outbreak, and based on this, the emergency scientific research response strategies were discussed to give implications for the public health emergency scientific research and management.

Below Average Cognitive Ability—An under Researched Risk Factor for Emotional-Behavioural Difficulties in Childhood

Children with below average cognitive ability represent a substantial yet under-researched population for whom cognitive and social demands, which increase in complexity year by year, may pose significant challenges. This observational study examines the longitudinal relationship between early cognitive ability and emotional-behavioral difficulties (EBDs) between the age of three and nine. Participants include 7134 children from the population-based cohort study growing up in Ireland. Cognitive ability was measured at age three using the Picture Similarities Scale. A t-score one to two standard deviations below the mean was defined as below average cognitive ability (n = 767). EBDs were measured using the Strengths and Difficulties Questionnaire (SDQ) at three, five, and nine years of age. Generalized linear mixed models and logistic regression were used to examine the relationship. Below average cognitive ability was an independent predictor of higher longitudinal SDQ scores. After adjustment, children with below average cognitive ability were 1.39 times more likely (AOR 1.39, 95% CI 1.17–1.66, p < 0.001) to experience a clinically significant EBD between the ages of three to nine years. This study demonstrates the increased risk of EBDs for children with below average cognitive ability. A scalable method of early identification of at-risk children should be a research priority for public health, enabling early intervention for cognitive and adaptive outcomes.

Cardiotoxicity and Chemotherapy—The Role of Precision Medicine

Cancer and cardiovascular disease are the leading causes of death in the United Kingdom. Many systemic anticancer treatments are associated with short- and long-term cardiotoxicity. With improving cancer survival and an ageing population, identifying those patients at the greatest risk of cardiotoxicity from their cancer treatment is becoming a research priority and has led to a new subspecialty: cardio-oncology. In this concise review article, we discuss cardiotoxicity and systemic anticancer therapy, with a focus on chemotherapy. We also discuss the challenge of identifying those at risk and the role of precision medicine as we strive for a personalised approach to this clinical scenario.

Research priority setting in obesity: a systematic review

Aim Obesity research priority setting, if conducted to a high standard, can help promote policy-relevant and efficient research. Therefore, there is a need to identify existing research priority setting studies conducted in the topic area of obesity and to determine the extent to which they followed good practice principles for research priority setting. Method Studies examining research priority setting in obesity were identified through searching the MEDLINE, PBSC, CINAHL, PsycINFO databases and the grey literature. The nine common themes of good practice in research priority setting were used as a methodological framework to evaluate the processes of the included studies. These were context, use of a comprehensive approach, inclusiveness, information gathering, planning for implementation, criteria, methods for deciding on priorities, evaluation and transparency. Results Thirteen articles reporting research prioritisation exercises conducted in different areas of obesity research were included. All studies reported engaging with various stakeholders such as policy makers, researchers and healthcare professionals. Public involvement was included in six studies. Methods of research prioritisation commonly included both Delphi and nominal group techniques and surveys. None of the 13 studies fulfilled all nine of the good practice criteria for research priority setting, with the most common limitations including not using a comprehensive approach and lack of inclusivity and evaluating on their processes. Conclusion There is a need for research priority setting studies in obesity to involve the public and to evaluate their exercises to ensure they are of high quality.