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To provide a primer specifically for the field of maternal perinatal health on heat stress and heat indices. An updated review of maternal health studies (n=374) and heat indices (n=25) was carried out using Scopus, in addition to the PubMed review carried out in Cherisch et al., 2020. Here, the methodology is outlined for the scoping review.

Additional file 1: Box 1. Anthropometry data cleaning criteria. Figure S1. Directed Acyclic Graph representing the hypothesized relationships, 2012–2014, South Africa. Figure S2. Study cohort profile of HIV exposed uninfected infants from 6-weeks to 18-months postpartum, 2012–2014, South Africa. Table S1. Proportion of underweight children from 6-weeks to 18-months postpartum by in-utero antiretroviral exposure status, 2012–2014, South Africa. Table S2. Proportion of stunted children from 6-weeks to 18-months postpartum by in-utero antiretroviral exposure status, 2012–2014, South Africa. Table S3. Frequency of maternal antiretroviral treatment over time by baseline maternal antiretroviral categories, 2012–2014, South Africa

Background: The National Department of Health, in March 2015, launched the implementation of Rationalisation of Register, aimed at reducing the amount of time invested in completing the registers and collecting data. Therefore, the number of registers used in the South African healthcare facilities was reduced from 56 to 6. Objectives: This study explored the effect of the rollout of Rationalisation of Register on the documentation and reporting of Prevention of Mother-to-Child Transmission (PMTCT) programme data with the existing source documents during the transitional period, especially with routine data collected and reported at various health care system levels. Methods: A mixed-method research approach was used, and three source documents, namely: Tally sheet, Antenatal care (ANC) register, and Tick register used for collecting and reporting PMTCT data, were reviewed. An in-depth interview was conducted with healthcare workers in four sub-districts of the Amathole district, Eastern Cape province of South Africa. Results: All selected facilities completed the three source documents. The facilities consolidated their PMTCT data monthly before reporting to the District Health Information System (DHIS). Less than half of the facilities had already started using the rationalised registers. However, they did not transition entirely because they still use other registers, especially the ANC register. Reasons for not displaying facility performance include clinicians not properly completing the clients’ information, and a shortage of staff to collect, report, and analyse data. Conclusions: PMTCT data management and reporting were challenging during the transitioning phase of implementing the rationalised registers because of different timelines instituted in the facilities and non-availability of source documents in some facilities. Capacity of the clinic staff involved in data collection should be built on programme care pathways, data monitoring, data capturing into the Routine Health Information System and complemented with coaching, mentoring, and supportive supervision for improved programme outputs and outcomes.

Background and Objectives People living with dementia have historically been excluded from qualitative research and their voices ignored due to the perception that a person with dementia is not able to express their opinions, preferences and feelings. Research institutions and organizations have contributed by adopting a paternalistic posture of overprotection. Furthermore, traditional research methods have proven to be exclusionary towards this group. The objective of this paper is to address the issue of inclusion of people with dementia in research and provide an evidence-based framework for dementia researchers based on the five principles of human rights: Participation, Accountability, Non-discrimination and equality, Empowerment and Legality (PANEL). Design This paper adapts the PANEL principles to the research context, and uses evidence from the literature to create a framework for qualitative research in people with dementia. This new framework aims to guide dementia researchers in designing studies around the needs of people with dementia, to improve involvement and participation, facilitate research development and maximize research outcomes. Results A checklist is presented with questions related to the five PANEL principles. These questions cover ethical, methodological and legal issues that researchers may need to consider while developing qualitative research for people with dementia. Conclusions The proposed checklist offers a series of questions and considerations to facilitate the development of qualitative research in patients with dementia. It is inspired by current human rights work of recognized dementia researchers and organizations who have been directly involved in policy development. Future studies need to explore its utility in improving participation, facilitating ethics approvals and ensuring that outcomes are relevant to people with dementia.

Supplementary Appendix 1b contains Supplementary Appendices 1-4, Videos 1,all input datasets, and all output datasets at 100 meterand 1 kilometer resolution for Oliphant NP, Ray N, Curtis A et al. Optimising scale and deployment of community health workers in Sierra Leone: a geospatial analysis. 2022. Files are available under the Creative Commons Attribution 4.0 International License. Tab "Readme" in the file "Supplementary Appendix 1bMetadata" contains a description of all datasets contained in Supplementary Appendix 1b.

Background: To date, there is a wealth of evidence that patients have been invited to take an active role in prompting handwashing of hospital staff, but there is insufficient evidence on what happens in practice and whether this is acceptable to both staff and patients. Objective: To understand the role of patient involvement in the promotion of hand hygiene among nurses in the hospital setting. Methods: This qualitative interpretive study comprised of focus group discussions conducted with nurses (n = 36) and interviews with patients (n = 21). Data from nurses were analysed using inductive thematic analysis. Data from patients were analysed by critical incident analysis. Results: Experiences from nurses and patients can be summarised into 4 themes (1) both nurses and patients acknowledged the patients’ right to ask, (2) both groups reported concerns that asking about hand hygiene could have an adverse impact on the nurse-patient relationship, (3) patients reported negative reactions from nurses when promoting handwashing, and (4) patients reported that the promotion of hand hygiene was not only offensive and upsetting for nurses, but also embarrassing for patients. Conclusions: Findings from this study suggest that patients are expected to adopt a passive role in infection control and remain silent when observing non-compliance to hand hygiene within the hospital setting, to avoid being embarrassed, offensive and upsetting to nurses.

Additional file 4: Supplementary file 4. Distributionof QI catalogue indicators by MDs, QSs, indicator classification, and servicelevel

Additional file 3: Supplementary file 3. Listof prioritized clinical content areas for the selection of measures

Aims. To explore what factors influence mothers' decisions to seek antibiotics for their young children. Design. Qualitative case study using postcode boundaries. Methods. Thematic analysis of qualitative data from mothers of children under 5, recruited via community playgroups within the case. Data were collected between October 2018 and May 2019, from six focus groups (n = 19) and one-to-one interviews (n = 14). Thematic analysis of the data consisted of six phases: data familiarization; generating initial codes; searching for themes; reviewing themes; defining and naming themes; and producing the report. Results. Mothers were influenced by their belief and trust in antibiotics. Antibiotics were identified as symbolic of recovery, healing and of providing protection and safety. Conclusion. By understanding the symbolic power of antibiotics on maternal decision making, all antibiotic prescribers may be able to offer and provide reassuring alternative and acceptable treatment options to mothers, rather than using antibiotics. Impact. This paper introduces the concept of antibiotics as powerful symbols which influence antibiotic seeking behaviour. This in turn may result in inappropriate use of antibiotics which contributes to the risk of antimicrobial resistance developing. Although the majority of antibiotics are still prescribed by doctors, the number of nurse prescribers has been increasing. Therefore, an increased awareness of antibiotic symbolism, in all prescribing clinicians, is important to enable future local and national strategies to be developed, to support maternal decision making and reduce antibiotic seeking behaviour.

Additional file 1: Supplementary file 1. Summary of standards and quality statements

Internationally, health authorities and governments are warning older people that they are at a higher risk of more serious and possible fatal illness associated with COVID‐19. Mortality data from Oxford COVID‐19 Evidence Service (25/3/20) indicate a risk of mortality of 3.6% for people in their 60s, which increases to 8.0% and 14.8% for people in their 70s and over 80s. Therefore, the global recommendation for older populations includes social isolation, which involves staying at home and avoiding contact with other people, possibly for an extended period of time, currently estimated to be between three and four months.

Exclusive breastfeeding (EBF) during the first 6 months of life is crucial for optimizing child growth, development and survival, as well as the mother's wellbeing. Mother's employment may hinder optimal breastfeeding, especially in the first 6 months. We assessed the effectiveness of a baby-friendly workplace support intervention on EBF in Kenya. This pre-post intervention study was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of workplace support policies and programme interventions including providing breastfeeding flexi-time and breaks for breastfeeding mothers; day-care centres (crèches) for babies near the workplace and lactation centres with facilities for breast milk expression and storage at the crèches; creating awareness on available workplace support for breastfeeding policies; and home-based nutritional counselling for pregnant and breastfeeding women. EBF was measured through 24-h recall. The effect of the intervention on EBF was estimated using propensity score weighting. The study included 270 and 146 mother-child dyads in the nontreated (preintervention) group and treated (intervention) group, respectively. The prevalence of EBF was higher in the treated group (80.8%) than in the nontreated group (20.2%); corresponding to a fourfold increased probability of EBF [risk ratio (RR) 3.90; 95% confidence interval (CI) 2.95-5.15]. The effect of the intervention was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23-15.64) than among those aged

Additional file 6. Ethical approval of local institutional review boards, EN-BIRTH study.

Additional file 3. STROBE guidelines checklist.

Additional file 2. EN-BIRTH study exit survey questions.

Additional file 6. Ethical Approval of local Institutional Review Boards.

Additional file 2. Selection of women with a livebirth surviving the neonatal period.

Additional file 3. Birth registration in-depth interview guides, EN-BIRTH study.

Additional file 4. Birth registration thematic content analysis, EN-BIRTH study.

Additional file 1. EN-BIRTH study sites – National mortality rates and hospital context.

Supplemental Material, sj-pdf-1-chc-10.1177_13674935211000882 for Maternal incarceration: Impact on parent���child relationships by Cathrine Fowler, Chris Rossiter, Tamara Power, Angela Dawson, Debra Jackson and Michael A Roche in Journal of Child Health Care

Additional file 1. Background overview of the four HDSS sites.

Additional file 5. Gap analysis for birth registration in EN-INDEPTH survey, by site.

Additional file 5. Exit survey-reported birth notification and certificate coverage, stratified by education level and socioeconomic status.

Additional file 4. Additional results.

BACKGROUND: Measuring public response during COVID-19 is an important way of ensuring the suitability and effectiveness of epidemic response efforts. An analysis of social media provides an approximation to public sentiment during an emergency like the current pandemic. The measures introduced across the globe to help curtail the spread of the coronavirus have led to the development of a situation labelled as a 'perfect storm', triggering a wave of domestic violence. As people use social media to communicate their experiences, analyzing public discourse and sentiment on social platforms offers a way to understand concerns and issues related to domestic violence during the COVID-19 pandemic. OBJECTIVE: This study was based on an analysis of public discourse and sentiment related to domestic violence during the stay-at-home periods of the COVID-19 pandemic in Australia in 2020. It aimed to understand the more personal self-reported experiences, emotions and reactions towards domestic violence, that were not always classified/collected by official public bodies during the pandemic. METHODS: We searched social media posts in Australia using key terms related to domestic violence and COVID-19 during 2020 using digital analytics tools to determine sentiments related to domestic violence during this period. RESULTS: The study showed that the use of sentiment and discourse analysis to assess social media data is useful in measuring the public expression of feelings and sharing of resources in relation to the otherwise personal experience of domestic violence. Heightened awareness of this could help agencies tailor and target messaging to maximize impact. Negative or neutral sentiment centered on the sharp rise in domestic violence during different lockdown periods of the 2020 pandemic with neutral to positive sentiment centered around praise of efforts to raise awareness of domestic as well as the positive actions of domestic violence charities and support groups in their campaigns. There were calls for positive and proactive handling (rather than a mishandling of) of the pandemic and results indicated a high level of public discontent related to the rising rates of the violence and the lack of services during the pandemic. CONCLUSIONS: This study provided a timely understanding of public sentiment related to domestic violence during the COVID-19 lockdown periods in Australia using social media analysis. Social media represents an important avenue for dissemination of information that can be widely dispersed and easily accessed by a range of different communities who are often difficult to reach. Improved understanding of these issues is important for future policy direction.

BACKGROUND: We analysed the impact of breastfeeding, antiretroviral drugs and health service factors on cumulative (6 weeks to 18 months) vertical transmission of HIV (MTCT) and 'MTCT-or-death', in South Africa, and compared estimates with global impact criteria to validate MTCT elimination: (1) 6 weeks to 18 months) was 1.7% (95% CI 1.2% to 2.4%). Cumulative 'MTCT-or-death' was 6.3% (95% CI 5.5% to 7.3%); 81% and 62% of cumulative MTCT and 'MTCT-or-death', respectively, occurred by 6 months. Postnatal MTCT increased with unknown maternal CD4-cell-count (adjusted HR (aHR 2.66 (1.5-5.6)), undocumented maternal HIV status (aHR 2.21 (1.0-4.7)) and exclusive (aHR 2.3 (1.0-5.2)) or mixed (aHR 3.7 (1.2-11.4)) breastfeeding. Cumulative 'MTCT-or death' increased in households with 'no refrigerator' (aHR 1.7 (1.1-2.9)) and decreased if infants used nevirapine at 6 weeks (aHR 0.4 (0.2-0.9)). CONCLUSIONS: While the

Intervention coverage-the proportion of the population with a health-care need who receive care-does not account for intervention quality and potentially overestimates health benefits of services provided to populations. Effective coverage introduces the dimension of quality of care to the measurement of intervention coverage. Many definitions and methodological approaches to measuring effective coverage have been developed, resulting in confusion over definition, calculation, interpretation, and monitoring of these measures. To develop a consensus on the definition and measurement of effective coverage for maternal, newborn, child, and adolescent health and nutrition (MNCAHN), WHO and UNICEF convened a group of experts, the Effective Coverage Think Tank Group, to make recommendations for standardising the definition of effective coverage, measurement approaches for effective coverage, indicators of effective coverage in MNCAHN, and to develop future effective coverage research priorities. Via a series of consultations, the group recommended that effective coverage be defined as the proportion of a population in need of a service that resulted in a positive health outcome from the service. The proposed effective coverage measures and care cascade steps can be applied to further develop effective coverage measures across a broad range of MNCAHN services. Furthermore, advances in measurement of effective coverage could improve monitoring efforts towards the achievement of universal health coverage.

Background: Focus group discussions for data collection in nursing research has increased. Data from focus groups provides rich in-depth understanding of a phenomenon, which can inform clinical practice. Guidance on facilitating focus groups has been developed, however there is a lack of guidance on techniques of translating, analysing and presenting focus group data from countries with linguistic differences. Aim: To explore contemporary examples of translating, analysing and presenting focus group data from countries with linguistic differences and provide an in-depth example of the decision making process from one study with focus group data from two countries. Methods: A discussion paper to guide recommendations for focus group data analysis from countries with linguistic differences. Discussion: The experience from undertaking focus groups across two countries and contemporary nursing research has highlighted the need for a clear rationale and transparency in the reporting of translating, analysing and presentation of data. Detailed and transparent reporting needs to include not only the translation process, but when this occurred, either pre or post analysis, and when or if the data was amalgamated. Implications for research/practice: There is a clear need for evidence-based guidance on the reporting of translation, transcription and analysis of focus group data from countries with linguistic difficulties.

At the time writing this editorial, COVID‐19 has spread around the world with virtually no region left untouched. The speed of the spread and the alarming death rates have seen many countries and jurisdictions introduce measures to prevent the spread of COVID‐19, and hand washing features very strongly in all of these. Hand washing has received considerable attention during the COVID‐19 pandemic. It is a simple, primary preventive measure that most people can do independently.

© 2019 Elsevier Ltd Evidence-based practice underscores a modern approach to nursing to ensure delivery of safe, up-to-date and person-centred care in the evolving clinical environment. While most entry-to-practice nursing courses incorporate elements of evidence-based research curricula, nursing students commonly struggle to see the relevance of research in their training. This study sought to understand nursing students' satisfaction and perspectives on research after an undergraduate research subject was redesigned to make overt the connection between research and professional nursing practice. Satisfaction significantly improved on routinely collected satisfaction surveys over a one-year period (mean increase 0.57, 95% CI 0.40–0.77, P < 0.001; medium effect size, 0.64). Open-ended questions elicited five themes: change to preconceived ideas of research to something accessible and useful; clear link between research and clinical and professional nursing practice; comments on subject format and scaffolded learning; increased skills in effective searching and extracting evidence; and improvements for the future. Student satisfaction increased when the connection between research learning and professional practice was made overt in a core research subject. This approach, along with scaffolded activities to increase confidence, had a marked positive impact on student's attitude and understanding of the utility of evidence-based practice and confidence in scrutinising practice in the clinical environment.

Actual number of missed visits (MV-frequency) presented according to the number of scheduled (exposed) visits. The number and percentage of participants who missed a specific number of visits out of the total number of scheduled visits they were expected to attend (exposed visits). The description of ‘exposed visits’ is given in Methods under ‘Describing patterns of ‘missed visits” sub-heading. For example, a total of 23 participants were expected to have attended only 3 visits (3 was their total number of exposed visits), 7 of these attended all the three visits (MV-frequency = 0) and 16 missed 1 visit. (PDF 53 kb)

© 2018 British Association of Critical Care Nurses Background: The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the factors that influence nurses' intentions to leave adult critical care areas is limited. Aim: To explore factors that may influence nurses' intentions to leave adult critical care areas. Objectives: To appraise existing evidence and highlight gaps in knowledge regarding factors that may influence nurses' intentions to leave adult critical care areas. Methods: A systematic mixed-method literature review was conducted. The search strategy was developed using the List, Keep and Delete approach, a framework used to identify search terms for systematic health care reviews. The following key words were used: intentions to leave, nurses, adult and critical care. The databases searched were BNI, CINAHL, PubMed, PsycINFO, Embase and Health B Elite from 2005 to 2016. Primary data from non-critical care areas and neonatal and paediatric critical care areas were excluded. Comprehensive supplementary searching was performed. Papers were critically appraised using the NICE (2012) checklists. Data were analysed using the Braun and Clarke (2006) thematic framework. Results: A total of 15 studies, including 13 cross-sectional studies and 2 qualitative studies, were reviewed. Three main themes emerged following data analysis. These themes were quality of the work environment, nature of working relationships and traumatic/stressful workplace experiences. Conclusions: The literature review highlighted the need for further research and greater understanding of how these themes may impact critical care nurses. Nurse managers and leaders should consider these findings when developing strategies to improve nurse retention. Relevance to practice: The shortage of critical care nurses is currently a global issue impacting costs and quality of patient care.

BACKGROUND: Continuity of care is important for child well-being in all settings where postnatal retention of mother-infant pairs in care remains a challenge. This analysis reports on completeness of patient-held infant Road to Health Booklets (RtHBs), amongst HIV exposed and unexposed infants during the first two years after the RtHB was launched country-wide in South Africa. METHODS: Secondary data were analysed from two nationally representative, cross-sectional surveys, conducted in 2011-12 and 2012-13. These surveys aimed to measure early effectiveness of the national programme for preventing vertical HIV transmission. Participants were eligible for this analysis if they were 4-8 weeks old, receiving their six-week immunisation, not needing emergency care and had their RtHBs reviewed. Caregivers were interviewed and data abstracted from RtHBs. RtHB completeness across both surveys was defined as the proportion of RtHBs with any of the following indicators recorded: infant birth weight, BCG immunisation, maternal syphilis results and maternal HIV status. A partial proportional odds logistic regression model was used to identify factors associated with completeness. Survey sampling weights were included in all analyses. RESULTS: Data from 10?415 (99.6%) participants in 2011-12 and 9529 (99.2%) in 2012-13 were analysed. Overall, recording of all four indicators increased from 23.1% (95% confidence interval (CI) ?=?22.2-24.0) in 2011-12 to 43.3% (95% CI?=?42.3-44.4) in 2012-13. In multivariable models, expected RtHB completeness (ie, recording all four indicators vs recording of

Background Targeted clinical interventions have been associated with a decreased risk of neonatal morbidity and mortality. In conflict-affected countries such as South Sudan, however, implementation of lifesaving interventions face barriers and facilitators that are not well understood. We aimed to describe the factors that influence implementation of a package of facility- and community-based neonatal interventions in four displaced person camps in South Sudan using a health systems framework. Methods We used a mixed method case study design to document the implementation of neonatal interventions from June to November 2016 in one hospital, four primary health facilities, and four community health programs operated by International Medical Corps. We collected primary data using focus group discussions among health workers, in-depth interviews among program managers, and observations of health facility readiness. Secondary data were gathered from documents that were associated with the implementation of the intervention during our study period. Results Key bottlenecks for implementing interventions in our study sites were leadership and governance for comprehensive neonatal services, health workforce for skilled care, and service delivery for small and sick newborns. Program managers felt national policies failed to promote integration of key newborn interventions in donor funding and clinical training institutions, resulting in deprioritizing newborn health during humanitarian response. Participants confirmed that severe shortage of skilled care at birth was the main bottleneck for implementing quality newborn care. Solutions to this included authorizing the task-shifting of emergency newborn care to mid-level cadre, transitioning facility-based traditional birth attendants to community health workers, and scaling up institutions to upgrade community midwives into professional midwives. Additionally, ongoing supportive supervision, educational materials, and community acceptance of practices enabled community health workers to identify and refer small and sick newborns. Conclusions Improving integration of newborn interventions into national policies, training institutions, health referral systems, and humanitarian supply chain can expand emergency care provided to women and their newborns in these contexts. Electronic supplementary material The online version of this article (10.1186/s12884-018-1953-4) contains supplementary material, which is available to authorized users.

© 2017 Australian College of Nursing Ltd Background: Pressure injury is a common problem. Its prevention and treatment is predominantly focussed on views, perceptions and knowledge of healthcare staff rather than on patient experience, particularly those patients living in their own homes. Aim: This paper reports findings on patients experiences and perceptions of loss associated with PI. These findings are drawn from a larger study of pressure injury patients living and receiving care in the community. Methods: Qualitative interviews with 12 participants with pressure injury and five carers. Data was audio recorded and thematically analysed. The study is reported in accordance with the COREQ guidelines. Findings: Having a pressure injury negatively affected many aspects of life for our participants resulting in multiple losses. These losses included loss of mobility and independence, privacy and dignity, and social engagement and ability to engage in preferred activities. Discussion: Although the effects of a pressure injury may be similar for many people, the most important issues will differ from person-to-person thus treatment and prevention of pressure injury requires a multidisciplinary team having a holistic care approach. Some patients’ pressure injury will never heal and it is increasingly important to involve the patient to find out what matters most to them and how their wound is impacting on them, to jointly develop a holistic, person-centred plan. Conclusion: Policy and practice should recognise and reflect that patients living with a pressure injury at home have different challenges and needs to those in acute or long term care. Pragmatic solutions in the delivery of pressure injury care are needed to compliment the drive to move healthcare from the hospital-to-home.

PURPOSE: Adolescent females aged 15-19 account for 62% of new HIV infections and give birth to 16 million infants annually. We quantify the risk of early mother-to-child transmission (MTCT) of HIV among adolescents enrolled in nationally representative MTCT surveillance studies in South Africa. METHODS: Data from 4,814 adolescent (≤19 years) and 25,453 adult (≥20 years) mothers and their infants aged 4-8 weeks were analyzed. These data were gathered during three nationally representative, cross-sectional, facility-based surveys, conducted in 2010, 2011-2012, and 2012-2013. All infants were tested for HIV antibody (enzyme immunoassay), to determine HIV exposure. Enzyme immunoassay-positive infants or those born to self-reported HIV-positive mothers were tested for HIV infection (total nucleic acid polymerase chain reaction). Maternal HIV positivity was inferred from infant HIV antibody positivity. All analyses were weighted for sample realization and population live births. RESULTS: Adolescent mothers, compared with adult mothers, have almost three times less planned pregnancies 14.4% (95% confidence interval [CI]: 12.5-16.5) versus 43.9% (95% CI: 42.0-45.9) in 2010 and 15.2% (95% CI: 13.0-17.9) versus 42.8% (95% CI: 40.9-44.6) in 2012-2013 (p

To maximize the benefits of test and treat strategies that utilize community-based HIV testing, clients who test positive must link to care in a timely manner. However, linkage rates across the HIV treatment cascade are typically low and little is known about what might facilitate or hinder care-seeking behavior. This qualitative study was conducted within a home-based HIV counseling and testing (HBHCT) intervention in South Africa. In-depth interviews were conducted with 30 HBHCT clients who tested HIV positive to explore what influenced their care-seeking behavior. A set of field notes for 196 additional HBHCT clients who tested HIV positive at home were also reviewed and analyzed. Content analysis showed that linkage to care is influenced by a myriad of factors at the individual, relationship, community, and health system levels. These factors subtly interact and at times reinforce each other. While some factors such as belief in test results, coping ability, social support, and prior experiences with the health system affect clients' desire and motivation to seek care, others such as limited time and resources affect their agency to do so. To ensure that the benefits of community-based testing models are realized through timely linkage to care, programs and interventions must take into account and address clients' emotions, motivation levels, living situations, relationship dynamics, responsibilities, and personal resources.

INTRODUCTION: Adolescents and youth receiving antiretroviral treatment (ART) in sub-Saharan Africa have high attrition and inadequate ART outcomes, and evaluations of interventions improving ART outcomes amongst adolescents are very limited. Sustainable Development Goal (SDG) target 3c is to substantially increase the health workforce in developing countries. We measured the effectiveness and cost-effectiveness of community-based support (CBS) provided by lay health workers for adolescents and youth receiving ART in South Africa. METHODS: A retrospective cohort study including adolescents and youth who initiated ART at 47 facilities. Previously unemployed CBS-workers provided home-based ART-related education, psychosocial support, symptom screening for opportunistic infections and support to access government grants. Outcomes were compared between participants who received CBS plus standard clinic-based care versus participants who received standard care only. Cumulative incidences of all-cause mortality and loss to follow-up (LTFU), adherence measured using medication possession ratios (MPRs), CD4 count slope, and virological suppression were analysed using multivariable Cox, competing-risks regression, generalized estimating equations and mixed-effects models over five years of ART. An expenditure approach was used to determine the incremental cost of CBS to usual care from a provider perspective. Incremental cost-effectiveness ratios were calculated as annual cost per patient-loss (through death or LTFU) averted. RESULTS: Amongst 6706 participants included, 2100 (31.3%) received CBS. Participants who received CBS had reduced mortality, adjusted hazard ratio (aHR) = 0.52 (95% CI: 0.37 to 0.73; p

CareCAT – tool introduction standard. Standardized instructions used to introduce the tool to the study participants. (DOCX 38 kb)

In-depth interview guide. (DOCX 113 kb)

Focus group discussion guide. (DOCX 114 kb)

Additional file 1. Survey_questionnaire.

© 2018 Background: Patient safety is a core principle of health professional practice and as such requires significant attention within undergraduate curricula. However, patient safety practice is complex requiring a broad range of skills and behaviours including the application of sound clinical knowledge within a range of health care contexts and cultures. There is very little research that explores how this is taught within Australian nursing curricula. Objectives: To examine how Australian nursing curricula address patient safety; identify where and how patient safety learning occurs; and describe who is responsible for facilitating this learning. Design: A cross-sectional study. Setting: Eighteen universities across seven Australian States and Territories. Participants: The sample consisted of 18 nursing course coordinators or those responsible for the inclusion of patient safety content within a Bachelor of Nursing course at Australian universities. Methods: An online survey was conducted to evaluate the patient safety content included and teaching methods used in Australian pre-registration nursing curricula. Results: Approaches to teaching patient safety vary considerably between universities where patient safety tended to be integrated within undergraduate nursing course subjects rather than explicitly taught in separate, stand-alone subjects. Three-quarters of the surveyed staff believed patient safety was currently being adequately covered in their undergraduate nursing curricula. Conclusion: Although there is consensus in relation to the importance of patient safety across universities, and similarity in views about what knowledge, skills and attitudes should be taught, there were differences in: the amount of time allocated, who was responsible for the teaching and learning, and in which setting the learning occurred and was assessed. There was little indication of the existence of a systematic approach to learning patient safety, with most participants reporting emphasis on learning applied to infection control and medication safety.

© 2017 John Wiley & Sons Australia, Ltd Aims: Examine the growth and diffusion of research on the concept of nurse rounding and provide definitional clarity on forms of nurse rounding. Methods: Bibliometric and content analysis of primary research on nurse rounding were used to map development of the field. Manuscripts were identified from a keyword search of MEDLINE, CINAHL, and PsycINFO databases for the period 2000 to 2015. Titles, country of origin, and year of publication along with details on the characteristics and sample of each study were coded on a database. Content analyses were performed on the coded data to derive a taxonomic understanding and identify publication trends. Results: Thirty-eight primary research studies were identified. Overall, there has been an increase in the number and diversity of studies on nursing rounding. A typology of 4 variants of nurse rounding was devised to enhance clarity and enable comparative analysis. Conclusion: There has been continued interest in nurse rounding and its potential benefits. However, poor definitional clarity is evident in this body of research, with various label used interchangeably in studies reporting similar rounding designs. The field would benefit from improved conceptual clarity and investigation into forms of nurse rounding that remain largely unexamined.