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Background: The global impact of COVID-19 has been profound, with efforts to manage and contain the virus placing increased pressure on healthcare systems and Emergency Medical Services (EMS) in particular. There has been no previous review of studies investigating EMS interventions or experiences during pandemics. The aim of this scoping review was to identify and present published quantitative and qualitative evidence of EMS pandemic interventions, and how this translates into practice. Methods: Six electronic databases were searched from inception to July 2022, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. A narrative synthesis of all eligible quantitative studies was performed and structured around the aims, key findings, as well as intervention type and content, where appropriate. Data from the qualitative studies were also synthesised narratively and presented thematically, according to their main aims and key findings. Results: The search strategy identified a total of 22,599 citations and after removing duplicates and excluding citations based on title and abstract, and full text screening, 90 studies were included. The quantitative narrative synthesis included seven overarching themes, describing EMS pandemic preparedness plans and interventions implemented in response to pandemics. The qualitative data synthesis included five themes, detailing the EMS workers' experiences of providing care during pandemics, their needs and their suggestions for best practices moving forward. Conclusions: Despite concerns for their own and their families' safety and the many challenges they are faced with, especially their knowledge, training, lack of appropriate Personal Protective Equipment (PPE) and constant protocol changes, EMS personnel were willing and prepared to report for duty during pandemics. Participants also made recommendations for future outbreak response, which should be taken into consideration in order for EMS to cope with the current pandemic and to better prepare to respond to any future ones. Trial registration: The review protocol was registered with the Open Science Framework (osf.io/2pcy7). [ABSTRACT FROM AUTHOR]

Background: Neonatal inter‐hospital transport is associated with heightened stress for parents whose needs may remain unmet around this time. Aim: To identify interventions which are used to support parents whose infants require neonatal inter‐hospital transport. Study Design: A systematic literature review approach was used. Six online databases (CINAHL, EMBASE, EMCARE, Medline, PsycINFO, Web of Science) were searched up to February 2022. The eligibility criteria included interventional studies published in the English language. Methodological quality was assessed by the Critical Appraisal Skills Programme checklists. Data were extracted using a predefined framework and synthesized narratively because of heterogeneity of reported outcomes. Results: A total of 671 articles were screened, with five meeting the eligibility criteria. Three interventions were reported within the five studies: a communication‐based intervention before transport represented by 223 parents in one study, Kangaroo Care during transport, which was carried out with 136 infants in three studies, and video calls after transport evaluated by one study in seven parents versus a control group. The effectiveness of the interventions could not be reliably determined. Neonatal nurses were the main providers of all the interventions pre‐, peri‐, and post‐transport. Conclusions: Limited evidence of mixed quality and inconsistent outcome measurements is available. Future research should focus on developing a contemporary intervention, determining the optimum timing for its implementation, and evaluating it using a robust study design. Relevance to Clinical Practice: Neonatal nurses need to be aware of the importance of their role in supporting parents through the distressing time of neonatal transport. [ABSTRACT FROM AUTHOR]

Background: Guillain‐Barré syndrome (GBS) is a rare inflammatory peripheral nerve disorder with variable recovery. Evidence is lacking on experiences of people with GBS and measurement of these experiences. Objective: We aimed to develop and validate an instrument to measure experiences of people with GBS. Design: We used a cross‐sectional design and online self‐administered questionnaire survey. Question domains, based on a previous systematic review and qualitative study, covered experiences of GBS, symptom severity at each stage, healthcare and factors supporting or hindering recovery. Descriptive, exploratory factor and reliability analyses and multivariable regression analysis were used to investigate the relationships between variables of interest, explore questionnaire reliability and validity and identify factors predicting recovery. Setting and Participants: People with a previous diagnosis of GBS were recruited through a social media advert. Results: A total of 291 responders, of different sexes, and marital statuses, were included, with most diagnosed between 2015 and 2019. Factor analysis showed four scales: symptoms, information provided, factors affecting recovery and care received. Positive social interactions, physical activity including physiotherapy and movement, changes made at home and immunoglobulin treatment were important for recovery. Multivariable models showed that immunoglobulin and/or plasma exchange were significant predictors of recovery. Employment and recovery factors (positive interactions, work support and changes at work or home, physical activity and therapy), though associated with recovery, did not reach statistical significance. Conclusion: The questionnaire demonstrated good internal reliability of scales and subscales and construct validity for people following GBS. Patient Contribution: Patients were involved in developing and piloting the questionnaire. [ABSTRACT FROM AUTHOR]

The Recorded Consultation Assessment (RCA) was rapidly developed to replace the Clinical Skills Assessment (CSA) for UK general practice licencing during COVID-19. We aimed to evaluate candidate perceptions of the RCA and relationships with performance. We conducted a cross-sectional survey of RCA candidates with attitudinal, demographic, and free text response options, undertaking descriptive and factor analysis of quantitative data with qualitative thematic analysis of free text. Binomial regression was used to estimate associations between RCA pass, candidate characteristics and questionnaire responses. 645 of 1551 (41.6%) candidates completed a questionnaire; 364 (56.4%) responders permitted linkage with performance and demographic data. Responders and non-responders were similar in exam performance, gender and declared disability but were significantly more likely to be UK graduates (UKG) or white compared with international medical (IMG) or ethnic minority graduates. Responders were positive about the digital platform and support resources. A small overall majority regarded the RCA as a fair assessment; a larger majority reported difficulty collecting, selecting, and submitting cases or felt rushed during recording. Logistic regression showed that ethnicity (white vs minority ethnic: odds ratio [OR] 2.99,95% confidence interval [CI] 1.23, 7.30, p = 0.016), training (UK vs IMG: OR 6.88, 95% CI 2.79, 16.95, p < 0.001), and English as first language (OR 5.11, 0% CI 2.08, 12.56, p < 0.001) were associated with exam success but questionnaire subscales, consultation type submitted, or extent of trainer review were not. The RCA was broadly acceptable but experiences were variable. Candidates experienced challenges and suggested areas for improvement. [ABSTRACT FROM AUTHOR]

Background: There are an estimated 46.8 million people worldwide living with dementia in 2015, being cared for usually by family members or friends (informal caregivers). The challenges faced by informal caregivers often lead to increased levels of stress, burden and risk of care-recipient institutionalisation. Aim: The overarching aim of this study was to explore the experiences and perceptions of informal caregivers of people with dementia when interacting with the health care system, and whether the support received acted as a mediator of caregiver stress. The secondary aim was to investigate healthcare professionals' views and current practice regarding people with dementia and their interactions with informal caregivers. Method: We employed a qualitative research design, using focus groups and one face-to-face interview with a purposive sample of informal caregivers and healthcare professionals in Lincolnshire, UK. Data were collected between March and July 2015. We used the stress-process model of stress in caregivers as a theoretical framework. Results: We interviewed 18 caregivers and 17 healthcare professionals. Five themes, mapped to the stress-process in caregivers' model, captured the main challenges faced by caregivers and the type of support they wanted from health care services. Primary stressors included the challenge of diagnosing dementia; caregivers' needs and expectations of an in-depth knowledge and understanding of dementia from healthcare professionals; and need for carer education. Secondary role strain included lack of support and mismatch of communication and expectations. Caregiver involvement in monitoring care and disease was a potential mediator tool. Conclusions: Fragmentation of dementia care services, lack of training for healthcare professionals and the dearth of information for caregivers means health care services are only partially fulfilling a support role. In turn, lack of support may be intensifying caregiver stress leading to worsening in their health and well-being; thus, potentially increasing the risk of institutionalisation of their care-recipient. [ABSTRACT FROM AUTHOR]

Insomnia is common in patients with tinnitus and negatively affects tinnitus symptoms and quality of life. This systematic review aimed to synthesise evidence of the effectiveness of cognitive behavioural therapy (CBT) based interventions on insomnia in adults with tinnitus. We conducted a comprehensive database search (MEDLINE, CINAHL, Web of Science, CENTRAL, ClinicalTrials.gov and PROSPERO) for published, unpublished and ongoing randomised controlled trials of CBT in adults with tinnitus. Five trials met the inclusion criteria for the systematic review, with four of these providing data for the meta-analysis. This demonstrated a statistically significant reduction in Insomnia Severity Index (a standard diagnostic questionnaire of insomnia used in clinical settings) following CBT (-3.28, 95% CI -4.51, -2.05, P=<0.001). There was no evidence of statistical heterogeneity (I2 = 0%). Risk of bias was considered low in all categories except blinding of participants, personnel, and/or the assessment of outcomes. Here, for the first time, we demonstrate that CBT-based interventions can significantly improve sleep in adults with tinnitus. [ABSTRACT FROM AUTHOR]