Background: The global push to scale up telemedicine services is challenged by complex, multilevel, multifaceted implementation and a lack of consensus on what the evidence-based essential building blocks of implementation are. Objective: We aimed to evaluate the evidence base supporting telemedicine implementation knowledge tools; identify shared conceptual constructs and outliers; and formulate recommendations to guide the design, development, and optimization of telemedicine services. Methods: We conducted implementation research using a rapid umbrella review, that is, an overview of systematic reviews, in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). In total, we searched 3 databases (PubMed, Web of Science, and Scopus) for studies focusing on telemedicine implementation frameworks, models, and tools, collectively referred to as "knowledge tools." Reviews meeting the operational definition of a systematically undertaken, secondary evidence synthesis, such as systematic and scoping reviews, and those published from January 2018 to May 2024 were considered. A meta-aggregative qualitative analysis was undertaken, comprising inductive thematic synthesis. Results: In total, 18 reviews were selected, encompassing 973 primary studies. Global perspectives were reflected in 61% (n=11) of the reviews, while 33% (n=6) focused on low- and middle-income country contexts. The primary research included in the reviews represented 63 countries, spanning the Americas, Europe, Africa, the Middle East, and Asia and the Pacific. Findings indicated substantial heterogeneity across the identified telemedicine implementation theories, models, and frameworks. However, following evidence synthesis, considerable convergence was observed, highlighting a state-of-the-art understanding of the essential requirements for a national telemedicine implementation ecosystem. These were categorized into "process" and "thematic" dimensions. Process dimensions included readiness and needs assessment, road map and planning, managing change, implementing telemedicine services, and continuous improvement and measuring performance. Thematic dimensions covered human and sociocultural aspects; organization, operations, management, and leadership; communication and coordination; policy, legal, and financial considerations; clinical health condition and quality of care; and the wider context. Conclusions: The findings of this study inform a pressing translational research knowledge gap in telemedicine implementation, hindering the implementation of high-quality, sustainable, and scalable telemedicine systems. The study contributes to building global consensus on the state of the art of key constructs in telemedicine implementation and recommends that future research focus on field-testing the evidence-based implementation tools to evaluate their usability and adaptability across diverse telemedicine contexts.

Objectives: The relationship between the volume of medical procedures conducted in hospitals and the resulting health outcomes has been described for various surgical and non-surgical medical interventions. As a policy response to this, several countries have implemented minimum volume standards. However, there is currently a lack of systematically compiled evidence assessing their impact. To close this research gap, we conducted a systematic review on the effects of minimum volume standards in hospitals. Design: Systematic review using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data sources: MEDLINE, PubMed Central and Bookshelf (PubMed), EMBASE (Elsevier), CENTRAL (Cochrane Library), CINHAL (EBSCO), EconLIT (EBSCO), PDQ-Evidence for Informed Health Policymaking, Health Systems Evidence and three trial registries were searched until June 2023. Additionally, manual searches were conducted. Eligibility criteria for selecting studies: For inclusion in this review, studies must investigate the effects of minimum volume standards. We accepted all categories of outcomes. Following the Cochrane Effective Practice and Organisation of Care (EPOC) criteria, only a strict set of study designs, namely randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series studies, were included. No restrictions were placed on language, publication date or publication status. Data extraction and synthesis: Two reviewers independently screened titles and abstracts for eligibility, reviewed the full texts and performed data extraction of the included articles. Risk of bias was assessed using the 'Risk Of Bias In Non-Randomised Studies-of Interventions' (ROBINS-I) tool. Certainty of evidence was rated using the GRADE approach. For data synthesis and statistical analyses, we adhered to the EPOC guidance. Results: We included nine studies into our systematic review. Overall, the outcomes reported in the studies are heterogeneous, which did not allow for a meta-analysis, resulting in a narrative analysis of the found evidence. While travel distance increased and length of stay decreased, other reported outcomes such as complications or reoperations were not affected by the introduction of minimum volume standards. Overall, the risk of bias was considered serious for results on outcomes of seven out of the nine included studies and moderate for the remaining two. The certainty of evidence was rated low for complications, reoperations, length of stay and travel distance and very low for mortality (in-hospital; 30 days). Conclusion: This systematic review does not provide conclusive evidence on the effects of minimum volume standards in hospitals regarding any outcomes. The certainty of evidence for mortality (in-hospital; 30 days) is very low and low for complications, reoperations and travel distance. The results are based on a relatively small number of studies for most outcomes. There is a need for studies researching the effects of minimum volume standards based on a robust study design. Prospero registration number: CRD42022318883.

Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Background As hospitals expand their roles within transforming health systems, their governance structures must adapt to changing demands, with novel leadership structures evolving to meet new challenges. Objective This review aims to provide a comprehensive overview on the evidence of the influence of hospital C-level positions on key organisational performance parameters. It maps key concepts from the existing literature relating to hospital performance and leadership and identifies mediators and moderators of top management team impacts based on the Upper-Echelons-Theory. Methods The scoping review was conducted according to the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, covering studies from 1990 to the present. Eligible studies addressed at least one identifiable hospital C-Suite role and one hospital-wide leadership effect. Results Out of 5,430 articles identified, 60 were included. The analysis covers seven distinct C-Suite roles and their effects on six performance dimensions: quality of care, structural quality, patient satisfaction, work satisfaction, financial performance, and process efficiency. Conclusions The findings suggest that the influence of C-Suite positions on hospital performance is multifaceted, with the Chief Executive Officer's influence extending beyond financial performance to shaping the quality of care. Additionally, the impact of newer roles such as the Chief Quality Officer, as well as leadership roles like the Chief Medical Officer and Chief Nursing Officer, appear to depend on a collaborative approach and alignment with the Chief Executive Officer. From a policy perspective, the findings emphasise that hospital governance, shaped by regulations, determines key performance indicators and strategic priorities.

Background: Electrophysiology (EP) procedures, including cardiac implantable electronic devices (CIEDs) and ablations, are widely used to manage arrhythmias and heart failure. These interventions, though effective, require substantial resources, prompting the need for systematic economic evaluations to inform healthcare decision-making. Methods: A systematic review of studies from 2007 to 2024 was conducted in two phases. Phase one assessed trends in economic evaluations of EP procedures, analyzing 129 studies across regions and timeframes. Phase two focused on cost-effectiveness analyses of implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy defibrillators (CRT-Ds), and atrial fibrillation (AF) ablation, examining outcomes like quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs), while identifying factors influencing economic results. Results: EP procedures generally demonstrated favorable cost-effectiveness, particularly in high-income regions. Studies on ICDs and CRT-Ds consistently supported their economic value for patients with arrhythmias or heart failure, while AF ablation showed potential for long-term benefits, particularly when compared to medical therapies. However, results varied by region, reflecting differences in healthcare systems, costs, and patient populations. Conclusions: The review highlights the overall cost-effectiveness of EP procedures in many settings but underscores the need for tailored economic evaluations in low- and middle-income countries. Simplified methodologies and greater attention to regional contexts are recommended to guide resource allocation and policy development globally.

Introduction: The concept of transition refers to the shift from hospital-based care to home-based palliative care, encompassing the physical, emotional, and logistical adjustments patients and families face. This study aimed to synthesize the experiences of people in palliative situations at home. Methods: A systematic review using thematic synthesis was guided using Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) to organize the extracted information. Preparation of the qualitative synthesis followed ENTREQ-Enhancing transparency in reporting the synthesis of qualitative research recommendations. The literature search was carried out in MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection, ProQuest, and Worldcat, until October 31, 2023, for articles addressing the experiences of people over 18 years of age in a palliative situation at home. Data analysis employed thematic synthesis, involving inductive coding, development of themes, and interpretative synthesis to provide a comprehensive understanding of patient experiences. Results: Of the 441 articles identified, 17 studies were included. Data analysis was guided by Meleis 's Theory of Transitions, and six distinct categories were included in the conditions of the transition (facilitators or inhibitors): "Personal Facilitators," "Community Facilitators," "Social Facilitators," "Personal Inhibitors," "Community Inhibitors," and "Social Inhibitors." Conclusions: Findings indicate that the unique nature of the palliative condition and self-perception requires nursing care adapted to the person's experiences. The data collected and the analysis carried out in this thematic synthesis of the literature collectively contributed to identifying the facilitating and inhibiting factors regarding the complex transition process, considering the Theory of Transitions. The findings highlight the importance of personalized care approaches that address patients' emotional, social, and logistical needs during the transition to home-based palliative care. They underscore the need for enhanced communication, caregiver support, and accessible healthcare resources to improve patient and family experiences, guiding future interventions and policy development in palliative care.

Objective: By studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance. Methods: A stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies. Results: The study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation. Conclusion: This study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.

Background and objective: The introduction of immune checkpoint inhibitors (ICIs) in oncology presents a critical healthcare policy challenge for resource allocation due to their substantial financial burden. This study assessed the reporting quality of health economic evaluation (HEE) studies of ICIs. Methods: This study conducted a systematic literature search of four databases (PubMed, EMBASE, Cochrane CENTRAL, and the International HTA Database) for studies published between January 1, 2014 and December 31, 2022. All ICIs approved up to December 31, 2022, in the USA, EU, China, and Japan were included. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards published in 2013 (CHEERS 2013), which is the most widely recognised and implemented reporting guideline for HEE studies. Subgroup analyses were also performed based on the risk of sponsorship bias or citation of CHEERS 2013. Results: A total of 5368 records were identified, 252 of which were included after full-text review. The study design, setting, and ICIs most frequently observed were cost-effectiveness and cost-utility analyses (63.5%), the USA (46.0%), and pembrolizumab (38.1%), respectively. Of the 24 items of CHEERS 2013, fully reported items were limited, particularly in the Methods section. Setting and location were not reported in 94.4% of the records. Subgroup analyses also revealed insufficient reporting of items in the Methods section, particularly "Setting and location". Conclusion: Health economic evaluation studies on ICIs between 2014 and 2022 had limited reporting across the 24 items of CHEERS 2013, regardless of sponsorship bias risk or citations. The items on setting and location in the Methods were particularly underreported, emphasising the need for transparent reporting in HEE studies of ICIs.

摘要：目的 探讨与敌草快(diquat,DQ)急性中毒患者预后有关的影响因素,为辨别预测效能高、可靠性稳定的预后指标,合理诊疗急性DQ中毒患者提供循证依据.方法 以"敌草快""中毒""危险因素""预后""影响因素"等中文及相应的英文检索词为主题词或自由词,检索中国知网、万方医学网、维普数据库、中国优秀硕士学术论文全文数据库、中国生物医学数据库、PubMed、Embase、Web of science、The Cochrane Library等数据库截至2024年1月1日收录的相关文献,依据纳入排除标准提取数据资料,并评价文献的质量;应用R软件,对急性敌草快中毒患者预后影响因素进行meta分析.结果 初步检索到759篇文献,最终纳入11篇文献,其中英文文献2篇,中文文献9篇,均来自中国,且均为高质量文献.纳入759例急性DQ中毒患者,其中死亡组296例,存活组463例.依据加尔布雷斯图结果、敏感性分析结果,剔...

Background: Head nurses face challenging job content while executing their roles as nurses, managers and leaders. However, no European compilation for portraying head nurses' job content within a hospital setting is available. Objectives: This study aimed to develop and validate a compilation that portrays the job content of head nurses employed in European hospitals. Methods: A scoping review was conducted according to Arksey and O'Malley's (2005) five-stage framework. Articles focusing on the job content of head nurses with 24-h first-line organizational and hierarchical responsibility for one or two units in a hospital setting were included. An electronic search was performed via PubMed, CINAHL and Embase. The Journal of Nursing Administration, Journal of Nursing Management, Journal of Healthcare Management and Nursing Management were screened manually to identify additional articles. Subsequently, a two-round multinational Delphi study following the methodology of Yussof (2019) was carried out. Eligible opinion leaders originated from Europe and included head nurses, as well as second-line nurse managers and hospital executives with head nurse experience. Twenty-three opinion leaders participated in the first round of the Delphi study, and 16 opinion leaders from the initial round subsequently participated in the second round. The item-level content validity index and scale-level content validity index based on the average method were calculated. Results: The scoping review included 90 articles published between 1934 and 2024. In total, 64 terms were found to name the head nurse position. Job content could be categorized according to four main themes: operational management, patient care, human resources management and unit-level policy development. Fifteen subthemes were determined, namely quality and safety management, staff planning, administrative and financial management, resource and technology management, care planning, direct and indirect patient care, individual and general staff management, learning opportunities, strategic management, creative thinking, and change management. After two Delphi rounds, the final compilation comprises four main themes, 10 subthemes and 53 task descriptions, excluding staff planning, care planning, direct patient care, administrative management and financial management. Conclusions: Head nurses' job content mapped by international evidence differs from the job content considered relevant by European opinion leaders. Fragmentation in what European opinion leaders considered relevant within the head nurses' job content became apparent. The compilation can be tailored to different countries or types of hospitals and serve as a guide for second-line nurse managers and hospital executives to determine the key job content based on the priorities and strategic direction of the hospital.

目的：检索、评价并总结终末期肝病病人营养管理的最佳证据，为临床应用提供参考。方法：根据“6S”证据模型，自上而下检索数据库中有关终末期病人术后营养管理的临床决策、指南、专业共识、系统评价和原始研究等证据。由4名研究者对文献的方法学质量进行独立评价，并根据主题提取和汇总证据。结果：共纳入文献23篇，包括指南及专家共识5篇、系统评价及Meta分析6篇，随机对照试验12篇，从多学科营养管理、营养筛查与评估、营养物质推荐量、营养支持与评价、健康教育5个维度汇总30条证据。结论：总结了终末期肝病病人营养管理的最佳证据，建议临床人员结合医疗情境及病人自身情况等制订符合个体化营养管理方案。

Background: White light (conventional) colonoscopy (WLC) is widely used for colorectal cancer screening, diagnosis and surveillance but endoscopists may fail to detect adenomas. Our goal was to assess and synthesize overall and subgroup-specific adenoma miss rates (AMR) of WLC in daily practice. Methods: We conducted a systematic review in MEDLINE, EMBASE, Cochrane Library, and grey literature on studies evaluating diagnostic WLC accuracy in tandem studies with novel-colonoscopic technologies (NCT) in subjects undergoing screening, diagnostic or surveillance colonoscopy. Information on study design, AMR overall and specific for adenoma size, histology, location, morphology and further outcomes were extracted and reported in standardized evidence tables. Study quality was assessed using the QUADAS-2 tool. Random-effects meta-analyses and meta-regression were performed to estimate pooled estimates for AMR with 95% confidence intervals (95% CI) and to explain heterogeneity. Results: Out of 5,963 identified studies, we included sixteen studies with 4,101 individuals in our meta-analysis. One in three adenomas (34%; 95% CI: 30-38%) was missed by WLC in daily practice individuals. Subgroup analyses showed significant AMR differences by size (36%, adenomas 1-5 mm; 27%, adenomas 6-9 mm; 12%, adenomas ≥ 10 mm), histology (non-advanced: 42%, advanced: 21%), morphology (flat: 50%, polypoid: 27%), but not by location (distal: 36%, proximal: 36%). Conclusions: Based on our meta-analysis, one in three adenomas could be missed by WLC. This may significantly contribute to interval cancers. Our results should be considered in health technology assessment when interpreting sensitivity of fecal occult blood or other screening tests derived from studies using WLC as "gold standard".

目的：检索、评价并总结终末期肝病病人营养管理的最佳证据，为临床应用提供参考。方法：根据“6S”证据模型，自上而下检索数据库中有关终末期病人术后营养管理的临床决策、指南、专业共识、系统评价和原始研究等证据。由4名研究者对文献的方法学质量进行独立评价，并根据主题提取和汇总证据。结果：共纳入文献23篇，包括指南及专家共识5篇、系统评价及Meta分析6篇，随机对照试验12篇，从多学科营养管理、营养筛查与评估、营养物质推荐量、营养支持与评价、健康教育5个维度汇总30条证据。结论：总结了终末期肝病病人营养管理的最佳证据，建议临床人员结合医疗情境及病人自身情况等制订符合个体化营养管理方案。

Background: Population-wide newborn blood spot screening programmes are a successful public health intervention used to detect whether the baby is at risk of certain rare conditions, with the aim of earlier diagnosis and provision of optimal care and treatment. Evaluating candidate conditions to include in newborn blood spot and genetic sequencing raises questions regarding acceptability to parents/carers. Methods: In the context of the possible expansion of the newborn blood spot screening programme in the United Kingdom, this review aimed to systematically review research on the acceptability to parents of newborn blood spot screening and genetic sequencing. A protocol was developed prior to commencing the review and was registered on the PROSPERO database. A team of researchers carried out the review, with checking at all stages carried out by at least two individuals. We included research published after 2013 with participants who were pregnant or a recent parent of a newborn and were resident in a high-income country. We included quantitative and qualitative studies that investigated the acceptability to parents/carers of newborn blood spot screening or genetic sequencing. Quantitative studies were narratively synthesised, and theories/frameworks identified and evaluated. Qualitative studies were analysed for recurring themes, and a meta-synthesis was carried out to compare and contrast these two types of data. We quality appraised included articles using tools appropriate for their study design. Results: Searches were carried out in September to November 2023 and screening identified 25 relevant research articles. Just over half were from North America, with four existing reviews and nine qualitative studies. Domains of acceptability described in the literature were: support for screening; level of anxiety, information and knowledge; consent; views of the procedure; and support after screening. The research indicated consensus support for blood spot screening, and for expanding to some other conditions, although some parental anxiety was reported. Parents/carers mostly perceived that they had received sufficient information, but the timing of this could be improved. While parents indicated interest in genomic screening, studies highlighted the need for clearer consent procedures and greater support for parents following genomic screening than for blood spot screening. Only three included studies reported using any kind of theoretical framework. Discussion: Most parents/carers found newborn blood spot screening programmes to be acceptable and favoured their large-scale implementation. A minority of parents/carers expressed concerns regarding the acceptability of processes underpinning newborn blood spot screening, such as consent, the timing of receiving information and support available after testing. More research is needed regarding the acceptability of newborn genomic sequencing screening programmes, which are less established compared with newborn blood spot screening programmes. Limitations: The over-representation of studies conducted in the United States has implications for the applicability of findings to other countries where testing is not typically mandatory and health systems differ considerably. Most studies were of cross-sectional design and there was limited representation of people from lower incomes and non-white ethnicity. While the inclusion of studies only in populations of future or very recent parents provided coherence to the findings, unclear reporting of participants may have resulted in under- or overinclusion of some studies. Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR159927.

Background: Dementia is a group of chronic diseases characterised by cognitive impairment that progressively disrupts daily functioning and requires increasing levels of healthcare, social support, and long-term care. Support for people with dementia can be provided by formal support systems although most of the care process relies upon informal care givers. Despite the availability of formal support systems and healthcare workers, the utilization of dementia care services remains suboptimal. Factors such as non-compliance, lack of awareness, and poor care coordination contribute to this issue. Understanding these barriers is crucial for improving service utilization and alleviating the economic burden on families and national health systems. Methods: This systematic review analysed the literature, published from 2013 to 2023, on barriers in Alzheimer and other dementia healthcare system, conducted on people living with a dementia, their caregivers, or healthcare workers in dementia care settings in Europe, following PRISMA guidelines. Searches in PubMed, Embase, PsycINFO, Health Technology Assessment Database, and Web of Science used terms related to Alzheimer's, dementia, and access barriers. Rayyan AI supported full-text review, with quality assessed via the Mixed Methods Appraisal Tool. Results: Over 1298 articles, 29 studies met the inclusion criteria. These studies highlighted several barriers to dementia care, categorised into information, organizational, cultural, stigma-related, financial, and logistical challenges. Informational and educational barriers included a lack of awareness and knowledge among caregivers. Organizational barriers involved poor care coordination and unclear access procedures. Cultural and stigma-related barriers were linked to societal attitudes towards dementia. Financial barriers were associated with the high costs of care, and logistical barriers included limited availability and accessibility of support services. Conclusions: To enhance the quality of life for individuals living with dementia, it is crucial to address these identified barriers through tailored interventions and management programs. Improving care coordination, communication, and training for healthcare professionals, alongside reducing systemic delays, are essential steps toward more effective dementia care. Easing the burden of care with tailored interventions and management programmes is mandatory to improve the quality of life of persons living with dementia and their families.

目的 系统评价不同干预措施对慢性阻塞性肺病（以下简称“慢阻肺”）的疾病负担情况。方法 计算机检索CNKI、VIP、WanFang Data、PubMed、Web of Science和Cochrane Library等数据库，搜集慢阻肺疾病负担相关的随机对照试验（RCT），检索时限均从建库至2023年10月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 16软件和R语言进行网状Meta分析。结果 最终纳入69个RCT，包括6 689例患者，涉及常规治疗、无创正压通气治疗、有创通气治疗、营养支持方案等26项干预措施，偏倚风险评估均为“风险未知”。网状Meta分析结果显示，和有创通气治疗相比，无创正压通气治疗[SMD=-3.84,95%CI（-5.16，-2.52）]和二陈止咳清肺颗粒[SMD=-3.04,95%CI（-5.89，-0.20）]能够降低慢阻肺患者的住院经济费用，差异有统计学意义（P<0.05）。健脾益肺冲剂、咪达唑仑、目标氧疗、无创正压通气治疗和营养支持方案对降低慢阻肺患者死亡率的效果优于常规治疗[RR=4.50,95%CI(1.02,...

目的 整合阴道分娩产妇产后会阴疼痛管理的最佳证据，为临床开展有效会阴疼痛管理提供依据。方法 系统检索临床支持决策系统、国内外指南网站、专业学会或协会网站及相关数据库等，获取阴道分娩产妇产后会阴疼痛管理的相关文献，包括临床决策、证据总结、最佳实践、指南、专家共识、系统评价，检索时限为建库至2023年11月。由2名研究者对文献独立进行质量评价，4名研究者按照标准化提取表格进行证据提取并整合，小组讨论确定最终的最佳证据。结果 纳入20篇文献，其中临床决策3篇，证据总结4篇，指南4篇，专家共识4篇，系统评价5篇。最终从会阴创伤的预防、会阴伤口的缝合、疼痛评估、非药物干预、药物干预、产后健康教育及人员培训7个方面总结了26条证据。结论 总结的阴道分娩产妇产后会阴疼痛的最佳证据较为科学、全面，临床医护人员可结合实际临床情景和患者需求选择证据，制订相关疼痛管理措施，以降低产妇会阴疼痛程度。

目的 对信息框架效应理论在健康管理领域内的应用进行范围综述，为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法，系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库，检索时间为建库至2023年12月，收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献，最终共纳入16篇文献。其中英文15篇，中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息，自我护理，决策支持3个方面；应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式；结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面，健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的，能显著提高患者的健康行为和健康信念，应用前景广阔；但我国研究与国外研究尚存在较大差距，我国学者应重视对该理论的解读，并在其指导下启动在健康管理方面的实践研究。

目的 总结糖尿病前期人群生活方式管理的最佳证据，为医护人员对糖尿病前期人群生活方式干预提供参考。方法 应用循证护理方法，对国内外循证资源和文献数据库进行检索，对符合质量评价的文献，由2名研究者独立对证据进行提取并总结出最佳证据。结果 最终纳入16篇文献，包括2篇指南、6篇专家共识、6篇系统评价、2篇证据总结。共提炼出生活方式干预目标、体质量管理、饮食管理、运动管理、健康教育、睡眠管理、社会支持、定期随访8个主题共30条证据。结论 本研究总结的最佳证据可为医护人员、患者及家属对糖尿病前期人群生活方式管理提供参考。在证据转化过程中应充分考虑个体的差异性，为目标人群制订个体化的生活干预方案。