Equity and gender mainstreaming in public policy: A scoping review protocol.

BACKGROUND: Despite growing attention paid to health equity and efforts to promote gender mainstreaming-a global strategy to promote gender equality-how policymakers have 'institutionalized' this in their work is less clear. Therefore, this planned scoping review seeks to search the peer-reviewed and grey literature to compile evidence on the ways in which policymakers have routinely or systematically considered equity and/or gender in their work. METHODS: A scoping review will be undertaken by drawing on the PRISMA guidelines for Scoping Reviews (PRISMA-ScR). With the expert guidance of a research librarian, Ovid MEDLINE, Ovid EMBASE, PAIS Index, and Scopus databases will be searched, in addition to custom Google searches of government documents. The search will be conducted from 1995 and onwards, as there were no hits prior to this date that included the term "gender mainstream*" in these databases. The inclusion criterion is that: (i) texts must provide information on how equity and/or gender has been considered by government officials in the development of public policy in a routine or systematic manner (e.g., descriptive, empirical); (ii) both texts produced by government or not (e.g., commentary about government action) will be included; (iii) there are no restrictions on study design or article type (i.e., commentaries, reports, and other documents, would all be included); and (iv) texts must be published in English due to resource constraints. However, texts that discuss the work of nongovernmental or intergovernmental organizations will be excluded. Data will be charted by: bibliographic information, including the authors, year, and article title; country the text discussed; and a brief summary on the approach taken. DISCUSSION: This protocol was developed to improve rigour in the study design and to promote transparency by sharing our methods with the broader research community. This protocol will support a scoping review of the ways in which policymakers have routinely or systematically considered equity and/or gender in their work. We will generate findings to inform government efforts to initiate, sustain, and improve gender and equity mainstreaming approaches in policymaking.

What are the barriers and facilitators to community handwashing with water and soap? A systematic review.

Handwashing with water and soap (HWWS) is an effective method of cleaning and disinfecting the surface of the hands. HWWS is effective in infection control and prevention transmission, such as in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). However, rates of handwashing compliance vary globally. This systematic review aimed to identify the barriers and facilitators to community HWWS globally. We conducted a comprehensive search strategy in OVID Medline, OVID Embase, Web of Science Core Collection, and Scopus using keywords and subject headings related to handwashing. Studies were excluded if they reported hand hygiene among healthcare or food service workers, considered the use of alcohol rubs, or involved an intervention in a healthcare or food preparation setting. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool, and data were extracted from the articles and analyzed using the Theoretical Domains Framework and inductive thematic analysis. The search strategy yielded a total of 11,696 studies, and 46 studies met the eligibility criteria. Study dates ranged from 2003 to 2020 and included 26 countries; the most frequently represented were Bangladesh, India, and Kenya. A total of 21 barriers and 23 facilitators to HWWS were identified and organized into the Theoretical Domains Framework. The most frequently cited domains were environmental context and resources, goals, and knowledge. Nine themes emerged from these barriers and facilitators: resource availability, cost and affordability, handwash station design and infrastructure, accessibility, gender roles, champions, health promotion, time management, and knowledge, beliefs, and behaviors. This review uncovered multiple barriers and facilitators around a determinant framework to observe and create an in-depth, multidimensional image of a community-based hand hygiene situation. New comprehensive interventions and implementation strategies can be developed using the findings to target the contextual barriers and facilitators to improve and increase HWWS rates. Stakeholders (i.e., practitioners, researchers, policymakers) can use the findings to revise, design, or evaluate new or existing projects, interventions, and policies to improve HWWS. Registration: A protocol for this systematic review was developed and uploaded onto the PROSPERO-International prospective register of systematic reviews database (Registration number: CRD42020221210).

In utero acetaminophen exposure and child neurodevelopmental outcomes: Systematic review and meta-analysis.

BACKGROUND: Acetaminophen is a frequently used analgesic for pain and fever. There have been reports of adverse neurodevelopmental outcomes associated with in utero acetaminophen exposure. However, it is unclear whether this association is related directly to acetaminophen use, or the reasons for use. OBJECTIVES: To summarise the literature on the association between in utero acetaminophen exposure and child neurodevelopmental outcomes, and assess the extent to which the association is due to confounding by indication. DATA SOURCES: OVID for Medline, Embase, and PsycINFO, and EBSCO for CINAHL, from inception to August 18, 2022. STUDY SELECTION AND DATA EXTRACTION: We searched for peer-reviewed, English-language studies on in utero acetaminophen exposure and child neurodevelopmental outcomes. Data were extracted using a standardised form created a priori, and quality was assessed using the Systematic Assessment of Quality in Observational Research. SYNTHESIS: We generated pooled risk ratios (RR) for outcomes examined by ≥3 studies using random-effects models; outcomes that could not be meta-analysed were narratively summarised following Synthesis Without Meta-Analysis guidelines. RESULTS: Twenty-two studies including 23 cohorts were eligible (n = 367,775 total participants; median: 51.7% with acetaminophen exposure). Studies were primarily prospective cohort studies from Europe and the US, with attention deficit/hyperactivity disorder (ADHD) being the most common outcome. Quality assessments resulted in 13.6% of studies being classified as high, 59.1% as medium, 22.7% as low, and 4.5% as very low quality. In utero acetaminophen exposure was associated with an elevated risk of ADHD (unadjusted pooled RR 1.32, 95% confidence interval [CI] 1.20, 1.44; I2  = 47%, n = 7 studies), with little difference after adjusting for confounders, including indications for acetaminophen use (adjusted pooled RR 1.34, 95% CI 1.15, 1.55; I2  = 50%, n = 4 studies). CONCLUSIONS: Confounding by indication did not explain the association between in utero acetaminophen exposure and child ADHD. Further, high-quality research is needed on this and other neurodevelopmental outcomes.

Conceptual approaches in combating health inequity: A scoping review protocol.

INTRODUCTION: What are the different ways in which health equity can be sought through policy and programs? Although there is a central focus on health equity in global and public health, we recognize that stakeholders can understand health equity as taking different approaches and that there is not a single conceptual approach. However, information on conceptual categories of actions to improve health equity and/or reduce health inequity is scarce. Therefore, this study asks the research question: "what conceptual approaches exist in striving for health equity and/or reducing health inequity?" with the aim of presenting a comprehensive overview of approaches. METHODS: A scoping review will be undertaken following the PRISMA guidelines for Scoping Reviews (PRISMA-ScR) and in consultation with a research librarian. Both the peer-reviewed and grey literatures will be searched using: Ovid MEDLINE, Scopus, PAIS Index (ProQuest), JSTOR, Canadian Public Documents Collection, the World Health Organization IRIS (Institutional Repository for Information Sharing), and supplemented by a Google Advanced Search. Screening will be conducted by two independent reviewers and data will be charted, coded, and narratively synthesized. DISCUSSION: We anticipate developing a foundational document compiling categories of approaches and discussing the nuances inherent in each conceptualization to promote clarified and united action.

What is the health impact of COVID-19 among Black communities in Canada? A systematic review.

OBJECTIVE: The objective of this systematic review was to identify the health impact of COVID-19 on mortality, morbidity, hospital admission, and hospital readmission rates in the Black population across Canada. METHODS: A comprehensive search strategy consisting of relevant subject headings and keywords was executed in five databases: OVID Medline, OVID Embase, EBSCO CINAHL Plus, Web of Science, and Scopus. Additional searches were conducted for gray literature in ProQuest Dissertations and Theses Global, Google Scholar, and an advanced customized Google search for Canadian government documents. All eligible studies included in this review underwent quality assessment. RESULTS: Clinical health outcomes identified included mortality, morbidity, and hospital admission rates; none of the studies reported hospital readmission rates. The search identified 616 citations, and following the removal of duplicates and screening according to our inclusion/exclusion criteria, four articles were eligible for inclusion in the review. All of these studies were conducted in Canada. Study dates ranged from 2020 to 2021. CONCLUSION: A systematic review of studies on the impact of COVID-19 on the Black population in Canada highlights two key points. First, the collection and availability of race-based data are necessary to clarify the impact of COVID-19 and other diseases on Black populations in Canada. Second, with the limited available data, studies suggest that COVID-19 disproportionately impacts Black populations in Canada, making up high shares of cases, deaths, and hospitalizations compared to most of the population.

RéSUMé: OBJECTIF: L'objectif de cette revue systématique était d'identifier l'impact de la COVID-19 sur les taux de mortalité, de morbidité, d'admission à l'hôpital et de réadmission à l'hôpital dans la population noire au Canada. MéTHODES: Une stratégie de recherche complète composée des vedettes-matières et des mots-clés pertinents a été exécutée dans cinq bases de données : OVID Medline, OVID Embase, EBSCO CINAHL Plus, Web of Science et Scopus. Des recherches supplémentaires ont été effectuées pour la littérature grise dans ProQuest Dissertations and Theses Global, Google Scholar et une recherche Google personnalisée pour les documents du gouvernement canadien. Toutes les études éligibles incluses dans cette revue ont fait l'objet d'une évaluation de la qualité. RéSULTATS: Les résultats de santé cliniques identifiés comprenaient les taux de mortalité, de morbidité et d'admission à l'hôpital; aucune des études n'a rapporté de taux de réadmission à l'hôpital. La recherche a identifié 616 citations et à la suite de la suppression des doublons et de la sélection selon nos critères d'inclusion/exclusion, quatre articles étaient éligibles pour l'inclusion dans la revue. Toutes ces études ont été menées au Canada. Les dates des études allaient de 2020 à 2021. CONCLUSION: Une revue systématique des études sur l'impact de la COVID-19 sur la population noire au Canada met en évidence deux points clés. Premièrement, la collection et la disponibilité de données fondées sur la race sont nécessaires pour mieux comprendre l'impact de la COVID-19 et d'autres maladies sur les populations noires au Canada. Deuxièmement, avec les données disponibles, les études suggèrent que la COVID-19 a un impact disproportionné sur les populations noires au Canada, représentant des proportions élevées de cas, de décès et d'hospitalisations par rapport à la plupart de la population.

Evaluating healthy cities: A scoping review protocol.

BACKGROUND: The Healthy Cities project supports municipal policymakers in the struggle to safeguard the health of urban citizens around the world (and in other limited geographies such as islands). Although Healthy Cities has been implemented in thousands of settings, no synthesis of implementation experiences have been conducted. In this article, we develop a scoping review protocol that can be applied to collect evidence on process evaluations of Healthy Cities. METHODS: To develop a scoping review protocol that could identify experiences evaluating the Healthy Cities project, we followed the PRISMA guidelines for Scoping Reviews (PRISMA-ScR). We applied these guidelines in consultation with a research librarian to design a search of the peer-reviewed literature, specifically Ovid Medline, Ovid Embase, Web of Science Core Collection, and Scopus databases, and a grey literature search. DISCUSSION: In addition to the aim of collecting evidence on Healthy Cities process evaluation experiences, the broader goal is to spark discussions and inform future evaluations of Healthy Cities. This work can also inform other evaluations of initiatives seeking to raise socio-political change, such as those focused on enhancing intersectoral and multisectoral action.

Perinatal mental illness and maternal autoimmune disease: A review of current evidence and avenues for future research.

This review summarizes evidence on the association between perinatal mental illness and maternal autoimmune disease and identifies avenues for future research. Perinatal mental illness has several characteristics in common with autoimmune disease, including increased incidence in the early postpartum period, recurrence across pregnancies, evidence of elevated immune-mediated cytokines, and familial risk, as well as the general predominance of mental illness in females versus males. Several studies have demonstrated elevated risk of maternal autoimmune disease in women with perinatal mental illness, and of perinatal mental illness in those with autoimmune dysfunction, suggesting a bi-directional relationship. Further research is needed to elucidate the importance of the specific diagnosis, severity, and timing of perinatal mental illness and specific diagnosis of autoimmune disease, as well as the relative importance of perinatal versus non-perinatal mental illness. Such research could have implications for prevention, treatment, and follow-up of perinatal mental illness.

What are the barriers and facilitators to polio vaccination and eradication programs? A systematic review.

Global efforts to eradicate polio by the Global Polio Eradication Initiative agency partners and country-level stakeholders have led to the implementation of global polio vaccination programs. This study presents the findings of existing studies regarding the barriers and facilitators that countries face when implementing polio interventions. A comprehensive search was conducted in OVID Medline, OVID Embase, EBSCO CINAHL Plus, and Web of Science. Eligible studies underwent quality assessment. A qualitative evidence synthesis approach was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR). The search identified 4147 citations, and following the removal of duplicates and screening according to our inclusion/exclusion criteria, 20 articles were eligible for inclusion in the review. Twelve countries were represented in this review, with India, Nigeria, Pakistan, Ethiopia, and Afghanistan having the most representation of available studies. We identified 36 barriers and 16 facilitators. Seven themes emerged from these barriers and facilitators: fear, community trust, infrastructure, beliefs about the intervention, influential opinions, intervention design, and geo-politics. The most frequently cited CFIR constructs for the facilitators and barriers were knowledge and beliefs about the intervention, followed by available resources. This study identified a wide range of barriers and facilitators to polio vaccination implementation across the globe, adding to the scarce body of literature on these barriers and facilitators from an implementation perspective and using a determinant framework. The diversity of factors among different groups of people or countries highlights the relevance of contexts. Implementers should be conversant with the contexts within which polio eradication programs boost intervention coverage and capacity. This study provides policymakers, practitioners, and researchers with a tool for planning and designing polio immunization programs. Trial registration: A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD42020222115).

Barriers and facilitators to implementation of oral rehydration therapy in low- and middle-income countries: A systematic review.

BACKGROUND: Oral rehydration therapy (ORT) is an effective and cheap treatment for diarrheal disease; globally, one of the leading causes of death in children under five. The World Health Organization launched a global campaign to improve ORT coverage in 1978, with activities such as educational campaigns, training health workers and the creation of designate programming. Despite these efforts, ORT coverage remains relatively low. The objective of this systematic review is to identify the barriers and facilitators to the implementation of oral rehydration therapy in low and middle-income countries. METHODS: A comprehensive search strategy comprised of relevant subject headings and keywords was executed in 5 databases including OVID Medline, OVID Embase, OVID HealthStar, Web of Science and Scopus. Eligible studies underwent quality assessment, and a directed content analysis approach to data extraction was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR) to facilitate narrative synthesis. RESULTS: The search identified 1570 citations and following removal of duplicates as well as screening according to our inclusion/exclusion criteria, 55 articles were eligible for inclusion in the review. Twenty-three countries were represented in this review, with India, Bangladesh, Egypt, Nigeria, and South Africa having the most representation of available studies. Study dates ranged from 1981 to 2020. Overarching thematic areas spanning the barriers and facilitators that were identified included: availability and accessibility, knowledge, partnership engagement, and design and acceptability. CONCLUSION: A systematic review of studies on implementation of ORT in low- and middle-income countries (LMICs) highlights key activities that facilitate the development of successful implementation that include: (1) availability and accessibility of ORT, (2) awareness and education among communities, (3) strong partnership engagement strategies, and (4) adaptable design to enhance acceptability. The barriers and facilitators identified under the CIFR domains can be used to build knowledge on how to adapt ORT to national and local settings and contribute to a better understanding on the implementation and use of ORT in LMICs. The prospects for scaling and sustaining ORT (after years of low use) will increase if implementation research informs local applications, and implementers engage appropriate stakeholders and test assumptions around localized theories of change from interventions to expected outcomes. REGISTRATION: A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD420201695).

Rapid silica atomic layer deposition on large quantities of cohesive nanoparticles.

Conformal silica films were deposited on anatase titania nanoparticles using rapid silica atomic layer deposition (ALD) in a fluidized bed reactor. Alternating doses of tris(tert-pentoxy)silanol (TPS) and trimethylaluminum (TMA) precursor vapors were used at 175 degrees C. In situ mass spectroscopy verified the growth mechanism through a siloxane polymerization process. Transmission electron microscopy revealed highly conformal and uniform silica nanofilms on the surface of titania nanoparticles. A growth rate of approximately 1.8 nm/cycle was achieved for an underdosed and incomplete polymerization reaction. Primary nanoparticles were coated despite their strong tendency to form dynamic agglomerates during fluidization. Methylene blue oxidation tests indicated that the photoactivity of anatase titania particles was mitigated with the ALD films.