{
  "version": 1,
  "checkedOn": "2026-10-24",
  "scope": "Targeted feasibility and feature mapping for staff support and patient experience; not a systematic review or software efficacy validation.",
  "evidenceRequirement": "The owner requires applicable well-regarded double-blind studies for health-benefit claims. This requirement has not been relaxed. No reviewed study establishes a health or satisfaction benefit from Care.",
  "accreditation": "Sources are attributed. Citation does not confer accreditation, certification or endorsement on Care.",
  "claimDecisions": {
    "operationalWorkflow": "Synthetic descriptive workflow only; no efficacy claim.",
    "staffBurnoutOrFatigueTreatment": "Held: no qualifying applicable double-blind Care evidence located in this targeted review.",
    "patientExperience": "Implemented synthetic descriptive reports, team response and patient/caregiver-reported resolution. No validated satisfaction measure, direct patient portal or efficacy claim.",
    "mindBodyTreatmentOrHealingScore": "Held: no qualifying applicable evidence or validated model.",
    "satisfactionAsHealthSurrogate": "Rejected: satisfaction is not used as clinical status.",
    "confidentialStaffFeedback": "Implemented synthetic operational concerns restricted in Care to the author and an explicitly assigned designated reviewer; not anonymous. No wellbeing or employment score, clinical effect or efficacy claim."
  },
  "rightsPolicy": {
    "articleTextImported": false,
    "figuresImported": false,
    "questionnairesImported": false,
    "scoringKeysImported": false,
    "rawResearchDataImported": false,
    "thirdPartyBrandingImported": false,
    "futureImports": "Exact asset/version, commercial use, adaptation, redistribution, notices, API/database terms and trademark review required before import.",
    "trademarkClearance": "No comprehensive clearance or source endorsement claimed."
  },
  "sources": [
    {
      "id": "H01",
      "citation": "Djupedal ILR et al. Work-schedule changes and insomnia, sleepiness and fatigue. Sleep. 2024;47(7):zsae086.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/38581363/",
      "doi": "10.1093/sleep/zsae086",
      "design": "Cluster-randomized trial",
      "masking": "Not accepted as double-blind evidence for Care: visible schedules cannot establish masking of the operating workflow.",
      "finding": "Fewer short turnarounds yielded small improvements in insomnia (d=-0.13) and sleepiness (d=-0.14). Work-related fatigue did not improve significantly.",
      "limitations": "Substantial follow-up loss; a single hospital setting; self-reported endpoints. The study turnaround boundary is not a universal staffing rule.",
      "fundingAndConflicts": "Not fully checked in the accessible source; verify disclosures before approval.",
      "intendedUse": "Context for recording shift intervals; no fatigue threshold or Care efficacy claim.",
      "verification": "Primary abstract and publisher methods checked. Full funding/conflict review remains pending; context only.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false,
      "rights": "Original factual summary and bibliographic link only. No article text, figures, instrument items, scoring keys, raw data or third-party branding imported. Full asset imports remain held until exact commercial rights are verified."
    },
    {
      "id": "H06",
      "citation": "Kent KB et al. Hospital food-service workers’ psychosocial, organisational and environmental stressors. J Occup Environ Med. 2024;66:556–563.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/38595305/",
      "doi": "10.1097/JOM.0000000000003108",
      "design": "Cross-sectional survey and interviews",
      "masking": "Not randomized or double-blind.",
      "finding": "Reported pressures included infection concerns, increased demands, unpredictable schedules and financial insecurity.",
      "limitations": "Context-specific reports do not show that a Care feature reduces distress. Do not infer a worker’s finances or mental state from operational records.",
      "fundingAndConflicts": "PubMed reports no conflicts. Full funding statement not verified; context only.",
      "intendedUse": "Context for hospital kitchen demands, schedule predictability and communication. No individual distress inference.",
      "verification": "Primary abstract and conflict statement checked; pandemic setting and cross-sectional design limit inference.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false,
      "rights": "Original factual summary and bibliographic link only. No article text, figures, instrument items, scoring keys, raw data or third-party branding imported. Full asset imports remain held until exact commercial rights are verified."
    },
    {
      "id": "H08",
      "citation": "Wright SW et al. Melatonin after night-shift work: a randomized trial. Ann Emerg Med. 1998;32:334–340.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/9737496/",
      "doi": "10.1016/S0196-0644(98)70010-1",
      "design": "Randomized placebo-controlled crossover trial",
      "masking": "Reported double-blind.",
      "finding": "No significant improvement was found in the primary recovery rating; sleep and cognitive outcomes also showed no clear benefit.",
      "limitations": "Small, old, pharmacological study; not a trial of rostering, meal breaks or software. It cannot validate the proposed staff module.",
      "fundingAndConflicts": "Not fully checked in the accessible source; verify disclosures before approval.",
      "intendedUse": "Demonstrate that a double-blind drug trial cannot validate software relief or scheduling. No medication feature proposed.",
      "verification": "Primary abstract checked. Full disclosures pending; not a basis for a Care feature or health claim.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false,
      "rights": "Original factual summary and bibliographic link only. No article text, figures, instrument items, scoring keys, raw data or third-party branding imported. Full asset imports remain held until exact commercial rights are verified."
    },
    {
      "id": "P01",
      "citation": "Deutz NE et al. Readmission and mortality after a specialised oral supplement: NOURISH. Clin Nutr. 2016;35:18–26.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/26797412/",
      "doi": "10.1016/j.clnu.2015.12.010",
      "design": "Multicentre randomized placebo-controlled trial",
      "masking": "Reported double-blind.",
      "finding": "The main death/readmission composite did not differ significantly (26.8% versus 31.1%). Mortality at 90 days, a secondary result, was 4.8% versus 9.7%.",
      "limitations": "Selected population, specialised supplement and multiple endpoints. No proof that satisfaction, general hospital meals or this software improves survival.",
      "fundingAndConflicts": "Multiple primary-paper authors have Abbott Nutrition affiliations. Full funding/disclosure review remains pending; no product recommendation or efficacy claim approved.",
      "intendedUse": "Distinguish a specific supplement trial from software, patient satisfaction or mind-body benefit. Primary null result retained.",
      "verification": "Primary abstract, population, design, primary and secondary endpoints checked. Full sponsor/disclosure review pending.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false,
      "rights": "Original factual summary and bibliographic link only. No article text, figures, instrument items, scoring keys, raw data or third-party branding imported. Full asset imports remain held until exact commercial rights are verified."
    },
    {
      "id": "P02",
      "citation": "Bot M et al. Multinutrients and behavioural activation for depression prevention: MooDFOOD. JAMA. 2019;321:858–868.",
      "url": "https://jamanetwork.com/journals/jama/fullarticle/2726983",
      "doi": "10.1001/jama.2019.0556",
      "design": "Multicentre 2×2 factorial randomized trial",
      "masking": "Supplement allocation masked to participants, therapists and researchers. Behavioural therapy was not participant-blinded; outcome assessors were masked.",
      "finding": "Neither supplements nor the behavioural intervention significantly reduced new major depressive episodes over one year.",
      "limitations": "Outpatient prevention population differs from hospital nutrition; therapy was not participant-blinded, supplement masking was imperfect, and attrition limits interpretation.",
      "fundingAndConflicts": "EU FP7/NIHR support; some authors disclose outside commercial relationships or therapy-manual royalties.",
      "intendedUse": "Assess the diet/mental-health proposal; neither the masked supplement arm nor unblinded therapy validates a Care intervention.",
      "verification": "Primary publisher methods, limitations, results and funding/conflict sections checked.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false,
      "rights": "Original factual summary and bibliographic link only. No article text, figures, instrument items, scoring keys, raw data or third-party branding imported. Full asset imports remain held until exact commercial rights are verified."
    },
    {
      "id": "P05",
      "citation": "Porter J, Haines TP, Truby H. Protected Mealtimes: a stepped-wedge cluster trial. BMC Med. 2017;15:25.",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5295189/",
      "doi": "10.1186/s12916-017-0780-1",
      "design": "Stepped-wedge cluster-randomized trial",
      "masking": "Outcome data collectors reported as blinded; participants/staff not double-blinded.",
      "finding": "The principal energy/protein comparisons did not establish improvement. A favourable secondary analysis did not resolve the negative primary findings.",
      "limitations": "Interruption reduction alone should not be advertised as sufficient to improve intake. No urgent care should be delayed to satisfy a meal schedule.",
      "fundingAndConflicts": "Australian NHMRC fellowship support; authors declare no competing interests.",
      "intendedUse": "Avoid claiming that interruption control alone improves intake. Do not reproduce the named policy or its training materials.",
      "verification": "Primary full text, design, principal null results, funding, conflicts and license checked.",
      "rights": "Article states CC BY 4.0; no article text, figures, policy, questionnaires, software or raw data imported. Separate assets and named policy are not automatically cleared.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false
    },
    {
      "id": "P06",
      "citation": "Neaves B, Bell JJ, McCray S. Room service and hospital food outcomes: a pre/post evaluation. Nutr Diet. 2022;79:187–196; online 2021.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/34609060/",
      "doi": "10.1111/1747-0080.12705",
      "design": "Single-site retrospective quality-assurance comparison",
      "masking": "Not randomized or double-blind.",
      "finding": "Higher reported intake and satisfaction and lower waste were observed after the service change.",
      "limitations": "Single-site pre/post quality-assurance study; not randomized or double-blind; service changes and confounding limit causal interpretation.",
      "fundingAndConflicts": "Not fully checked in the accessible source; verify disclosures before approval.",
      "intendedUse": "Context for exploring meal choice and patient feedback; observed satisfaction changes do not establish a causal Care benefit.",
      "verification": "Bibliographic record and primary-publication abstract metadata checked; full funding/conflict and asset-rights review pending.",
      "checkedOn": "2026-10-24",
      "supportsCareEfficacyClaim": false,
      "rights": "Original factual summary and bibliographic link only. No article text, figures, instrument items, scoring keys, raw data or third-party branding imported. Full asset imports remain held until exact commercial rights are verified."
    }
  ],
  "workflowPolicy": "/people-workflow-policy.json"
}