Health professionals’ attitudes toward religiosity and spirituality: a NERSH Data Pool based on 23 surveys from six continents

Background In order to facilitate better international and cross-cultural comparisons of health professionals (HPs) attitudes towards Religiosity and/or Spirituality (R/S) we updated the NERSH Data Pool. Methods We performed both a network search, a citation search and systematic literature searches to find new surveys. Results We found six new surveys (N=1,068), and the complete data pool ended up comprising 7,323 observations, including 4,070 females and 3,253 males. Most physicians (83%, N=3,700) believed that R/S had “some” influence on their patients’ health (CI95%) (81.8%–84.2%). Similarly, nurses (94%, N=1,020) shared such a belief (92.5%–95.5%). Across all samples 649 (16%; 14.9%–17.1%) physicians reported to have undergone formal R/S-training, compared with nurses where this was 264 (23%; 20.6%–25.4%). Conclusions Preliminary analysis indicates that HPs believe R/S to be important for patient health but lack formal R/S-training. Findings are discussed. We find the data pool suitable as a base for future cross-cultural comparisons using individual participant data meta-analysis.

The Relationship between Financial Wellbeing and Mental Health: A Systematic Literature Reviews

The aim of this study is to identify and appraise existing relationship between Financial well-being and mental health. Despite abundance of studies on financial wellbeing and mental health, efforts to systematically review this study are still lacking. This article attempts to fill the gap in understanding and identifies the variables that influences the financial wellbeing and mental health. Systematic literature searches in Psychinfo, Scopus and Google Scholar databases were performed using the combinations words of “Financial well-being” „Indebtedness? or „Mental disorder? „Debt? and „Health? or „Depression? „Mental illness? or „Anxiety? or „Stress? or „Distress? or „Mental Health were used. The majority of studies (7 of 32) used questionnaires commonly used for measuring the variables between financial measures and mental health measures. The review identified 32 papers examining the associations of the relationship between financial wellbeing and mental health. findings also differed by the tools of measurement that using for each financial wellbeing and mental health. A total of 6 instruments for financial wellbeing and 12 instruments for mental health were found. Most instruments assessed different dimensions of mental well-being, with different subscales. This review provides a comprehensive review of relationships between financial well-being and mental health and also instruments used in assessing financial wellbeing and mental well-being

GRAPPA Treatment Recommendations: An Update From the 2020 GRAPPA Annual Meeting

Throughout 2020, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has been working to update the GRAPPA treatment recommendations for psoriasis and psoriatic arthritis (PsA). The planned methodology for this update was published previously, and herein we provide an update on progress so far, including details of the systematic literature searches undertaken. GRAPPA is committed to regular updates of its treatment recommendations to incorporate the many significant therapeutic advances that have taken place in the PsA literature since the previous recommendation publication in 2015. The development and updating of treatment recommendations for optimal treatment approaches for patients with PsA has been an important mission of the GRAPPA since its inception. GRAPPA is currently finalizing domain-specific recommendations with an aim to produce updated treatment recommendations for publication in 2021.

Delay and bias in PubMed medical subject heading (MeSH®) indexing of respiratory journals

IntroductionPubMed is a primary global open-access literature research database. Articles on PubMed are indexed manually with medical subject headings (MeSH®) to facilitate more complete literature searches. We aimed to determine the length of delay from publication to MeSH® indexing for key respiratory journals and to investigate whether delays are increasing over time and whether there are country or impact-factor specific biases in indexing.MethodsPubMed was searched for the keyword ‘asthma’ for the 10 year period June 2009 to June 2019. MEDLINE fields including journal title, publication date, PubMed entrez date and MeSH® indexing date were extracted and delay in indexing was calculated in days.ResultsTwenty-nine respiratory journals had delay from publication to MeSH® indexing ranging from an average of 153.6 days to 409.9 days; 5/29 (17.2%) had never been indexed for PubMed. There was a significantly longer delay in MeSH® indexing for UK-based publications (mean delay of 281.7 days) compared to USA-based publications (mean delay of 214.9 days; mean difference 66.8 days, 95% CI 60.8, 72.8, P < 0.0001). Delays in MeSH® indexing increased over time.ConclusionThere are long and increasing delays in PubMed MeSH® indexing of respiratory journals. All PubMed users should be aware that systematic literature searches that rely on MeSH® search terms or utilise PubMed filters are likely to exclude recent research and citations from key journals. Researchers and clinicians need to be aware of these delays and biases to ensure their literature searches are both up-to-date and complete.

P0769ESTABLISHING AN AFRICAN NETWORK FOR CHRONIC KIDNEY DISEASE EPIDEMIOLOGY: THE CKD-AFRICA COLLABORATION

Background and Aims Chronic kidney disease (CKD) is a global public health problem, disproportionately affecting individuals of African ancestry. Unfortunately, due to the lack of data in various African countries or the limitations of available data, the true magnitude of CKD on the continent is still unknown. Although there has been an increase in the number of reports on CKD prevalence in recent years, up to now there has been no coordinated effort to provide reliable estimates to adequately support the health service and policy solutions to address the adverse consequences of CKD in Africa. The Chronic Kidney Disease in Africa Collaboration (CKD-AFRICA Collaboration), which is an initiative of the South African Medical Research Council, seeks to address this issue by collating data, at individual participant data (IPD) level, from existing African studies. Thus, the main aims for establishing this platform are, (1) to utilize the available data from all relevant prevalence studies of CKD, to provide an updated and comprehensive synthesis on the burden of CKD in Africa, and (2) to bring together active investigators in the field of CKD epidemiology and prevention, by providing a platform to plan, in a more coordinated way, future observational and interventional studies on CKD across the continent. Method To establish the CKD-AFRICA Collaboration as a continental resource, a stepwise approach was utilized, which included, 1) the identification of data sources through various systematic literature searches and contacting health agencies to access publicly available population-based measurement surveys; 2) establishing a database platform, by inviting active CKD research groups to contribute data on CKD at IPD level; 3) data processing and quality control and 4) piloting the consortium, by using the data from existing studies to determine the prevalence of CKD in the African adult population, by two-stage IPD meta-analysis. Results Through extensive systematic literature searches, 134 potential collaborators were identified. These included studies conducted in general adult populations and high-risk sub-populations, such as those with HIV/AIDS, hypertension and diabetes. Of those identified, 101 principal investigators (PIs) were contacted, via email, to gauge their interest in collaborating in the consortium, as 33 PIs lacked contact information. Of the 101 PIs, 42 responded positively to the call and have agreed to participate in the consortium, spanning 12 African countries, namely Ghana, Kenya, Nigeria, Burundi, Cameroon, Maputo, Sudan, South Africa, Egypt, Uganda, Senegal and Tanzania (Figure 1). To date, the consortium has potential access to 27,346 IPD, with 11,810 IPD already received. Conclusion The strength of this Consortium has far-reaching potential for Africa. Indeed, by harnessing IPD from numerous African studies, important research questions can be explored, and by connecting active CKD researchers, this platform could aid a more coordinated way of developing future observational and interventional studies on CKD in Africa. The research obtained from this collaboration will therefore permit the exploration in understanding the diversity of clinical manifestations of CKD in Africa.

Critical appraisal and meta-analysis of biological variation studies on glycosylated albumin, glucose and HbA1c

ObjectivesNumerous biological variation (BV) studies have been performed over the years, but the quality of these studies vary. The objectives of this study were to perform a systematic review and critical appraisal of BV studies on glycosylated albumin and to deliver updated BV estimates for glucose and HbA1c, including recently published high-quality studies such as the European Biological Variation study (EuBIVAS).MethodsSystematic literature searches were performed to identify BV studies. Nine publications not included in a previous review were identified; four for glycosylated albumin, three for glucose, and three for HbA1c. Relevant studies were appraised by the Biological Variation Data Critical Appraisal Checklist (BIVAC). Global BV estimates were derived by meta-analysis of BIVAC-compliant studies in healthy subjects with similar study design.ResultsOne study received BIVAC grade A, 2B, and 6C. In most cases, the C-grade was associated with deficiencies in statistical analysis. BV estimates for glycosylated albumin were: CVI=1.4% (1.2–2.1) and CVG=5.7% (4.7–10.6), whereas estimates for HbA1c, CVI=1.2% (0.3–2.5), CVG=5.4% (3.3–7.3), and glucose, CVI=5.0% (4.1–12.0), CVG=8.1% (2.7–10.8) did not differ from previously published global estimates.ConclusionsThe critical appraisal and rating of BV studies according to their methodological quality, followed by a meta-analysis, generate robust, and reliable BV estimates. This study delivers updated and evidence-based BV estimates for glycosylated albumin, glucose and HbA1c.

Do protocols for new randomised trials take previous similar trials into account? Cohort study of contemporary trial protocols

ObjectiveTo investigate to what extent evidence from previous similar trials or systematic reviews was considered before conducting new trials.DesignCohort study of contemporary protocols for trials with ethical approval.MethodsAll protocols for randomised trials approved by the five ethical committees in Denmark between January 2012 and March 2013 were screened for eligibility. Included protocols were read in full to determine whether a systematic search had been conducted and references were checked to evaluate whether trial rationale and design could be challenged for not adequately considering previous evidence. To investigate whether protocols cited relevant trials, we used simple search strategies that could easily be conducted by researchers without experience with literature searches.ResultsSixty-seven protocols were included. Only two (3%) of the protocols explicitly stated to have conducted a literature search and only one (1%) provided information that allowed the search to be replicated. Eleven (16%) of the protocols described trials where we found the information insufficient to judge if the trial was ethically justified, either due to a comparator that was not supported by the presented evidence (six protocols), because they did not present a rationale for conducting the trial (two protocols), or for both reasons (three protocols). For eight (12%) of the protocols, our search identified trials that could have been relevant to cite as justification.ConclusionsWhile most protocols seem to adequately consider existing evidence, a substantial minority of trials might lack a sufficient evidence base. Very few trials seemed to have been based on a literature search which makes it impossible to know whether all relevant previous trials had been considered. Rules for ethical approval should include requirements for systematic literature searches to ensure that research participants are not exposed to sub-optimal treatments or unnecessary harms as well as to reduce research waste.

From substance to process: A meta-ethnographic review of how healthcare professionals and patients understand placebos and their effects in primary care

Research suggests that a ‘placebo’ can improve conditions common in primary care including pain, depression and irritable bowel syndrome. However, disagreement persists over the definition and clinical relevance of placebo treatments. We conducted a meta-ethnographic, mixed-research systematic review to explore how healthcare professionals and patients understand placebos and their effects in primary care. We conducted systematic literature searches of five databases – augmented by reference chaining, key author searches and expert opinion – related to views on placebos, placebo effects and placebo use in primary care. From a total of 34 eligible quantitative, qualitative and mixed-methods articles reporting findings from 28 studies, 21 were related to healthcare professionals’ views, 11 were related to patients’ views and two were related to both groups. In the studies under review, healthcare professionals reported using placebos at markedly different frequencies. This was highly influenced by how placebos were defined in the studies. Both healthcare professionals and patients predominantly defined placebos as material substances such as ‘inert’ pills, despite this definition being inconsistent with current scientific thinking. However, healthcare professionals also, but less prevalently, defined placebos in a different way: as contextual processes. This better concurs with modern placebo definitions, which focus on context, ritual, meaning and enactivism. However, given the enduring ubiquity of substance definitions, for both healthcare professionals and patients, we question the practical, clinical validity of stretching the term ‘placebo’ towards its modern iteration. To produce ‘placebo effects’, therefore, primary healthcare professionals may be better off abandoning placebo terminology altogether.

Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients

The presence of xerostomia and hyposalivation is frequent among diabetes mellitus (DM) patients. It is not clear if the presence of xerostomia and hyposalivation is greater in DM than non-DM patients. The aims of this systematic review are (1) to compare the prevalence rates of xerostomia, (2) to evaluate the salivary flow rate, and (3) to compare the prevalence rates of hyposalivation in DM versus non-DM population. This systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in biomedical databases from 1970 until January 18th, 2016. All studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, 12.5%–53.5% versus 0–30%. Studies that analyzed the quantity of saliva in DM population in relation to non-DM patients reported higher flow rates in non-DM than in DM patients. The variation flow rate among different studies in each group (DM/CG) is very large. Only one existing study showed higher hyposalivation prevalence in DM than non-DM patients (45% versus 2.5%). In addition, quality assessment showed the low quality of the existing studies. We recommend new studies that use more precise and current definitions concerning the determination and diagnosis of DM patients and salivary flow collection.