PRISM | Institutional Repository
Communities in PRISM
Select a community to browse its collections.
Recent Submissions
Item type: Item , Access status: Open Access , Quality of life among people with tuberculosis in the Eastern Cape, South Africa: a qualitative study(2026-03-12) Bedingfield, Nancy; Fiphaza, Kuhle; Girma, Mahilet; Majiza, Liyabuya; De Vos, Lindsey; Olivier, Dawie; Kipp, Aaron M.; Medina-Marino, Andrew; Daftary, AmritaAbstract Background Quality of life (QoL) for people affected by tuberculosis (TB) is generally poor. However, little is known about when and why it changes during treatment. Such knowledge is key to the development and implementation of meaningful interventions. We sought to explore perceptions of QoL amongst people with pulmonary TB during and after treatment. Methods This study was embedded within a larger study exploring multilevel determinants on TB cascade-of-care outcomes in Eastern Cape, South Africa. Between November 2023 and April 2024, 33 adults were purposively sampled for individual semi-structured interviews early, mid, and at the conclusion of treatment. Questions explored perspectives on current QoL and changes in specific domains (e.g., role functioning, mental wellbeing) during illness and treatment. Inductive and deductive techniques were combined in thematic analysis which incorporated QoL and chronic illness frameworks. Results Participants described a common trajectory in QoL changes; however, overall assessments of QoL were highly personal. Shared trajectory was characterized by four phases: ‘progressive disability to diagnosis’, ‘treatment challenges and QoL bottom’, ‘inflection and hope’, and ‘stability and incomplete resolution’. TB symptoms limited functional mobility, causing a financial crisis for many. Intense need for caregiving, emotional, and financial support persisted for weeks and months until physical gains eased problems in other domains. However, many who had completed treatment described continued weakness and inability to work. Participants provided highly varied assessments of current QoL rooted in personal priorities and individual circumstances. While few clear trends were noted, those with recurrent TB (48%, n = 16) were more often dissatisfied with their wellbeing. By the end of treatment, participants were no more likely to evaluate QoL positively compared to those earlier in treatment. Conclusions Adaptable interventions that can be tailored to individual needs are required to help those with TB feel good about their life position. Intervention components should be delivered in the setting of long-term relationships with providers and prioritize financial wellbeing and counselling. High levels of support are needed during early treatment but supports must remain accessible through treatment completion and beyond.Item type: Item , Access status: Open Access , Correction: The impact of sustainable organic agriculture on food security in sub-Saharan africa: a mixed methods systematic review with meta-analysis(2026-03-09) Renzaho, Andre M. N.; Abdulai, Rashid; Rahaman, Kh S.; Das, Sanjay K.; Noor, Ramadhani; Salami, Bukola; Chitekwe, StanleyItem type: Item , Access status: Open Access , Assessing attitudes towards elements of the overdose response hotlines/applications (ORHAs)(2026-02-07) Dhanoa, Avnit; Viste, Dylan; Seo, Boogyung; Rider, Nathan; Ghosh, S. M.Abstract Introduction In response to the overdose epidemic, novel strategies including Overdose Response Hotlines and Applications (ORHAs) have been introduced to help mitigate the crisis. These technologies enable individuals with a phone to access harm reduction support via smartphones and applications. Such supports include overdose monitoring, access to social services, mental health referrals, and more. This study analyzed data from the Canadian National Questionnaire on Overdose Monitoring (CNQOM), a large bilingual national survey, to evaluate the perspectives of people who use unregulated substances currently (PWUS-C), people who used unregulated substances previously (PWUS-P), and addiction service provider (ASP) on the importance of specific ORHA features. Methods One component of the CNQOM pertained to the importance of specific ORHA service elements. Examined categories included accessibility and technological features, overdose response functionality, data privacy and philosophies of care, additional support services, and substance usage. Each group responded to 33 questions on a 5-point Likert scale, and the data was analyzed using descriptive statistics involving percentages and ordinal logistical regression analysis. Results The study involved 971 participants: 840 PWUS-C, 298 PWUS-P, and 169 ASP. The majority of respondents from the key groups considered all ORHA elements important. Generally, the groups ranked the elements in a similar order of importance, with only minor variations. The highest-ranked elements in each element category with regards to importance were: 24/7 availability (84% of PWUS-C, 88% of PWUS-P, and 90% of ASP), the ability of EMS to resuscitate individuals during an overdose (81% of PWUS-C, 83% of PWUS-P, 85% ASP), non-judgmental support (87% of PWUS-C, 87% of PWUS-P, and 91% of ASP), access to mental health support (82% of PWUS-C, 84% of PWUS-P, and 90% of ASP), and feeling safer when using substances (80% of PWUS-C, 81% of PWUS-P, and 88% of ASP). Conclusion This paper highlights the importance multiple groups place on various elements of ORHAs, reflecting critical elements that should be considered when standardizing these virtual harm reduction technologies. The results of this study provide insight into opportunities to enhance virtual platforms, making them more responsive, accessible, and trusted as harm reduction resources.Item type: Item , Access status: Open Access , Supporting the implementation of a Maternal Early Warning System (MEWS) protocol using Human-Centred Design(2026-02-25) Mc Intyre, Donalee; Spiegel, Ashley; Kapellas, Sophia; Ghali, Brianna; Mazzietti, Kate; Fortune, Ruth-Lynn; Haas, Sabrina; Cérat, Stéphanie; Sugars, Emily; Campbell-Clarke, Kylie; Deliscar, Suzanne; Mehdizadeh, Mozhdeh; Williams, Nicole; Awwad, Fatima; Stimson, Michelle; Wan, Michelle; Lawford, Karen; Tatum, Ali; Tunde-Byass, Modupe; Tresierra, Millie; Simon, Diane; Finch, Robert; Maxwell, Cynthia; Nielssen, Ingrid; Morency, Anne-Maude; Frew, Melissa; Vedam, Saraswathi; D’Souza, Rohan; Malhamé, IsabelleAbstract Background Maternal Early Warning System (MEWS) protocols enable a systematic and standardized approach to medical emergencies in pregnancy. Such protocols have been associated with a decrease in severe maternal morbidity and related inequities. However, MEWS protocols are complex to implement. Methods We adopted a Human-centred design (HCD) approach to support the implementation of a MEWS protocol at a tertiary care centre. In Phase I (Discover), we aimed to understand the needs, challenges, and desires of clinicians, as well as persons with lived experience (PWLE) of pregnancy and support people, in order to identify gaps in care and generate ideas for potential solutions. In Phase II (Design), we validated findings, co-created sustainable solutions to be tested, and engaged in collaborative work to shape the future implementation. In Phase III (Prepare), we equipped the clinical team with resources for upcoming implementation. Across these phases, we organized 10 interactive activities (including semi-structured interviews, an asynchronous activity, and online/in-person group sessions) with clinicians and PWLE of pregnancy and support people. An Advisory Sharing Circle, focusing on health equity and inclusivity, shared insights and provided feedback that was integrated throughout the project. Results In total, 38 clinicians and 8 PWLE and support people participated in planned activities. We identified several care gaps that would need to be addressed to optimize implementation of the MEWS protocol, including opportunities to improve communications, documentation, and collaboration. PWLE and support people wanted to be empowered with information, participate in specific tasks, and have more agency in their care. We co-developed solutions to facilitate upcoming implementation, including a mechanism for patient-led activation of the MEWS protocol, and visual resources to encourage patients and support people to share any concerns. We also created a quick reference guide with action and education items to prepare the clinical team. Conclusions Using HCD, we successfully engaged with knowledge users, including clinicians, PWLE, and support people, to plan the implementation a MEWS protocol into clinical care. This novel approach, fostering a justice framework, has the potential to reduce the knowledge-to-action gap and enhance sustainability by co-developing solutions with those directly impacted by the problem and change.Item type: Item , Access status: Open Access , Artificial intelligence in emergency surgery: a scoping review within the artificial intelligence in emergency and trauma surgery (ARIES) project(2026-02-07) De Simone, Belinda; Kasongo, Lucienne; Gumbs, Andrew A.; Vecchio, Fabrizio; De Franceschi, Alberto; DèAngelis, Nicola; Kirkpatrick, Andrew W.; Wachs, Juan P.; Loftus, Tyler J.; Abu-Zidan, Fikri M.; Latifi, Rifat; Deeken, Genevieve; Chouillard, Elie; Litvin, Andrey; Sartelli, Massimo; Pantalone, Desiree; Leppäniemi, Ari; Eryilmaz, Mehmet; Rasa, Kemal; Isik, Arda; Kaafarani, Haytham M.; Fraga, Gustavo; Coimbra, Raul; Moore, Ernest E.; Biffl, Walter L.; Catena, FaustoAbstract Aim To map and critically appraise the current literature on Artificial Intelligence (AI) applications in emergency general surgery, with a focus on clinical decision-support tools for preoperative risk stratification and intraoperative assistance, and to identify ethical, structural, and regulatory barriers to implementation. Methods A scoping review was conducted within the ARIES project, following established methodological frameworks. Relevant studies evaluating AI-based tools in emergency surgical settings were systematically identified and analyzed. Results The literature describes AI applications mainly in two domains: preoperative decision support, including risk prediction and diagnostic or triage models for acute abdominal and traumatic conditions, and intraoperative assistance, largely focused on computer vision–based systems for anatomical recognition, safety guidance, and navigation in minimally invasive emergency procedures. Additional contributions address training and telementoring platforms, as well as cross-cutting ethical, legal, and regulatory considerations relevant to AI adoption in emergency surgical care. Conclusions AI has the potential to complement emergency surgeons’ clinical judgment, but its routine adoption in emergency surgical practice remains limited. Addressing methodological, ethical, and regulatory challenges, together with the development of robust data infrastructures and targeted training pathways, is essential to support safe, effective, and equitable implementation in acute care settings. In addition, the lack of dedicated investment and sustainable funding models for large-scale clinical implementation and prospective evaluation represents a critical barrier to the translation of AI from research into routine emergency surgical practice.
