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Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. Arksey and O′Malley's scoping review framework. A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of ' leaving no one behind' in post-pandemic and future responses. [ABSTRACT FROM AUTHOR]

BACKGROUND: Reach Out and Read (ROR) is an evidence-based literacy promotion intervention that leverages the near-universal access to children of primary care practices to promote optimal child development. While several studies document ROR's effectiveness, its implementation remains understudied. OBJECTIVE: This scoping review examines the existing literature to better understand ROR implementation. DATA SOURCES: PubMed, ERIC, Web of Science, Academic Search Premier, ProQuest Education Database, and CINAHL. STUDY SELECTION: We included peer-reviewed English-language papers focusing on ROR in an ambulatory setting in North America. DATA EXTRACTION: Extracted variables were informed by the Template for Intervention Description and Replication checklist and included publication year, title, author(s), clinic location, study design, study aim, ROR implementation, modifications, implementation assessment, barriers, facilitators, and outcomes. RESULTS: Seventy-one papers were included, of which 43 were research articles. We identified substantial variation in ROR implementation including differences in components delivered. A considerable number of research articles did not assess ROR implementation. The most common barriers to ROR implementation were at the system level (ie, financing and inadequate time). Modifications and enhancements to ROR are emerging; most address barriers at the clinician and family level. LIMITATIONS: This review was limited to published English language papers focusing on ROR. CONCLUSIONS: ROR implementation varies across studies, and many did not assess implementation. Consistent reporting and assessment of ROR implementation could create opportunities to better understand the mechanisms underlying ROR's effects and inform other early childhood interventions that seek to promote optimal development at the population level. [ABSTRACT FROM AUTHOR]

Rapid internet penetration and technological advancements have facilitated accessibility to internet-enabled devices globally. Since Asia lacks comprehensive data on internet addiction among college students, this review aims to estimate its pooled prevalence. This was a systematic review and meta-analysis. Searches were conducted in PubMed, Scopus, CINAHL, and MEDLINE from their inception through August 2022 using terms appropriate to internet addiction and Asian countries/territorial for publications in English peer-reviewed journals. The studies included those done on current college students and provided unambiguous indicators of the threshold of internet addiction. The pooled prevalence was calculated through a random-effects meta-analysis by RStudio software, and I 2 statistic was used to assess heterogeneity. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment. Overall, between 2007 and 2021, 39 papers comprising 45 effect sizes and totaling 58,058 participants met the inclusion criteria. The pooled prevalence of internet addiction among Asian college students was 24.3% (95% confidence interval: 19.8%–29.5%, Q = 6234, df = 44, τ2 = 0.79, I 2 = 99.29%), and strikingly, this percentage increased over time. A high degree of heterogeneity was seen, and no publication bias was found. To our knowledge, this is the first comprehensive review report on Asian college students, which found that one-fifth suffer from internet addiction. The findings emphasize the significance of multidisciplinary prevention and management strategies to mitigate the harmful effects of internet addiction. Further research is warranted to develop a standardized diagnostic tool for a more precise estimation of internet addiction among this population. [ABSTRACT FROM AUTHOR]

Discussions between health professionals and nursing home (NH) residents or their families about the current or future goals of health care may be associated with better outcomes at the end of life (EOL), such as avoidance of unwanted interventions or death in hospital. The timing of these discussions varies, and it is possible that their influence on EOL outcomes depends on their timing. This study synthesized current evidence concerning the timing of goals of care (GOC) discussions in NHs and its impact on EOL outcomes. Systematic review. Adult populations in NH settings. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. We searched PubMed, Embase, and Cumulative Index of Nursing and Allied Health from January 2000 to September 2022. We included studies that examined timing of GOC discussions in NHs, were peer-reviewed, and published in English. Quality of the studies was assessed using the Newcastle-Ottawa Scale. Screening of 1930 abstracts yielded 149 papers that were evaluated for eligibility. Of the 18 articles, representing 16 distinct studies that met review criteria, 12 evaluated the timing of advance directives. There was variation in the timing of GOC discussions and compared with discussions that occurred within a month of death, earlier discussions (eg, at the time of facility admission) were associated with lower rates of hospitalization at the EOL and lower health care costs. The timing of GOC discussions in NHs varies and evidence suggests that late discussions are associated with poorer EOL outcomes. The benefits of goal-concordant care may be enhanced by earlier and more frequent discussions. Future studies should examine the optimal timing for GOC discussions in the NH population. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

Substance use is common in patients with cancer. Caring for patients with co-occurring cancer and substance use disorder (SUD) is complex. The detrimental effects of stigma on people with SUD are far-reaching; impacting on the quality of care and inter-personal relationships, reducing quality of life. Despite this, most healthcare professionals (HCP) know little about how to avoid stigmatizing interactions with patients. The purpose of this integrative literature review was to summarize what is known about substance use by patients with cancer and present the consequences of SUD stigma for oncology patients. In addition, to highlight approaches to reduce HCP stigma. This literature review was designed using the PRISMA guidelines for integrative reviews. Google Scholar, PubMed and CINAHL Ultimate were used to search for related key terms. Inclusion criteria were; published after 2013, written in English, full text available. The initial search was augmented by crosschecking the references section of relevant articles. Eligible papers were then subjected to the Cochrane risk-of-bias assessment. Ninety unique papers were read in full and summarized into the research themes. Prevalence estimates of substance use in patients with cancer range from 2% to 35%, varying by cancer site, type of substance, patient demographics and metrics of substance use. Patients with co-occurring cancer and SUDs have multiple clinical factors that can complicate clinical care including 'chemical coping', delayed diagnosis, compromised treatment adherence, decreased immune function and interaction between illicit substances and cancer drugs. Stigma related to SUD can result in exclusion and marginalization of these individuals. It can lead to social isolation, inequitable access to healthcare and sub-optimal treatment, resulting in poor health outcomes and reduced quality of life. Various educational approaches are recommended to reduce SUD stigma in HCP, but changing HCP language would seem the simplest and most impactful. Perhaps the most powerful tool Radiation Therapists can use to reduce SUD stigma is the choice of language when communicating with patients and other HCPs. Learning from our professional experiences when talking with patients about sexual health, or sexual and gender diversity, the first step to a meaningful conversation is ensuring the patient feels comfortable disclosing their lived experiences and need for support. If we fail to eliminate SUD stigma in our own clinical interactions, then we will be unable to improve wellness in this vulnerable population and promote healthy behaviours in the patients we care for. [ABSTRACT FROM AUTHOR]

It is an updated systematic review with meta-analysis that compared supervised exercise therapy (SET) vs non-supervised exercise therapy (NSET) programs for patients with distal radius fracture. The purpose of this systematic review is to appraise the current literature to determine if SET program is more effective than a NSET program for pain relief, improvement of range of movement, function and grip strength, both in the short or medium term for patients following distal radius fractures. Systematic review. The following electronic databases were searched: Medline/Pubmed, PEDro, Cinahl, Embase, CENTRAL, and Lilacs. PICOT strategy was used for trial selection. The searches were conducted on August 22, 2021, and May 26, 2022. Two researchers performed an independent search for papers from the references of the chosen trials. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used for assessing the quality of evidence. The search strategy identified 2786 potentially eligible studies and 15 studies met our inclusion criteria. The results did not show that the SET program was more effective than the NSET program for all outcomes, in both terms for patients after distal radius fractures. GRADE showed that all analyses presented very low-quality evidence. Even the results showing there was no difference between the two programs analyzed, the available evidence for randomized controlled trials was insufficient to support these results. • The trials selected have very low methodological quality. • It was not possible to conclude that there is no difference between the programs. • Future clinical trials are needed to conclude the effectiveness of the programs. • The non-supervised programs used very different methods. • Instructions, videos, booklets and advice were used as methods. [ABSTRACT FROM AUTHOR]

Emergency departments (EDs) are often first to feel the intra-hospital effects of disasters. Compromised care standards during disasters eventuate from increased demands on health resources; the facilities, supplies, equipment and manpower imperative for a functioning healthcare facility. Emergency departments must understand the effect of disasters on their health resources. This paper examines the impact on resources within the ED as a result of a disaster and provides a review against the United Nations Office for Disaster Risk Reduction's Sendai Framework for Disaster Risk Reduction 2015–2030 priorities. An integrative literature review design was utilised. Articles were extracted from databases and search engines. The Preferred Reporting Items of Systematic reviews and Meta-Analysis Guidelines for systematic literature reviews were used. Seven papers met inclusion criteria. Disaster consumable stocking was used to mitigate disaster risk and improve resilience. Logistical challenges were exacerbated by poor building design. Ineffective human resource management, communications failure, insufficient ED space, diminished equipment and supplies and unreliable emergency power sources were described. Disaster planning and preparedness strategies can address health resource deficits, increasing ED resilience. Further retrospective case studies are required to greater understand the effects of disasters on ED health resources. [ABSTRACT FROM AUTHOR]

Intuitive eating interventions aim to improve individual health and promote sustainable changes to one's relationship with food. However, there is no evidence-based consensus on the impact of intuitive eating interventions on diet quality. This systematic review aimed to investigate intuitive eating interventions and their impact on diet quality. PubMed, Embase, CINAHL, PsycInfo, and Cochrane databases were systematically searched to October 2021 for studies reporting interventions that encompassed the principles of intuitive eating and measured diet quality. Other health outcomes were used for secondary analysis. Findings were synthesized narratively. Seventeen papers reporting 14 intervention studies (n = 3,960) were included in the review. All studies found a positive or neutral effect on diet quality following an intuitive eating intervention. A favorable change in eating behavior following these interventions was also observed. Intuitive eating promotes an attunement to the body, which aids in improving diet quality because of increased awareness of physiological cues. The reduction of emotional and binge eating may also increase diet quality. Findings from the current review suggest that intuitive eating interventions are most effective face-to-face, in a group setting, and sustained for at least 3 months. [ABSTRACT FROM AUTHOR]

• Families of people entering and living in residential aged care settings have complex and dynamic bereavement care needs, and there is paucity of evidence-based bereavement support intervention, specifically focussed on this population. • The quality of care provided to an older person at the end of their life and after death care can influence family caregivers' grief reactions. • The aged care workforce should consider the complexities involved in decision-making strategies that support death preparedness and bereavement support as a part of care planning and provision. • There is a need for government agencies and research entities to work together in developing and implementing a comprehensive approach to grief, loss, and bereavement care, focussing on the residential aged care sector. The grief, loss and bereavement needs of the families of those living and dying in residential aged care setting is not very well understood. This systematic review examines grief, loss, and bereavement experience of, and interventions relating to, family caregivers of those entering, living and dying in residential aged care. Out of 2023 papers that were identified, 35 met the inclusion criteria which included (n=28) qualitative and (n=7) quantitative intervention studies. The qualitative findings indicated quality of care provided to the resident at the end of their life, and after death care influenced family caregivers' grief reactions. The intervention studies revealed that educational interventions have the potential to lead to some benefits in the context of grief loss and bereavement outcomes. Recognizing the emotional experiences and support needs of families and carers may enhance the understanding of the ageing, caring, dying, grieving pathway for older people and their families. [ABSTRACT FROM AUTHOR]

• Sex differences: females had lower MMOS than males among healthy elderly individuals. • Age impact: MMOS decreases with age, indicating reduced mouth-opening strength. • Dysphagia impact: dysphagic individuals showed significantly lower MMOS compared to healthy elderly. • Data insufficiency : limited reliable data on mouth-opening strength across populations. • Research need: further studies are needed to understand mouth-opening performance. To characterize mouth-opening muscular performance (MOMP) in adults and elderly individuals with dysphagia and healthy controls. We searched the PubMed, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science databases from inception to Jan. 26, 2023. Two independent researchers considered the titles, abstracts, and full texts of potentially eligible papers from 1451 search results. Twenty-five studies that evaluated mouth-opening maximal strength (MOMS) in healthy adults, elderly individuals, and patients with dysphagia met the inclusion criteria. We found comparable, reliable values with significant sex differences in maximal mouth opening strength (MMOS) in the meta-analysis for healthy elderly patients (females 5.31 ± 0.47 kg vs. males 7.04 ± 0.70 kg; mean difference of 0.84 kg). Age has also emerged as an essential factor in reducing strength. There was a significant reduction in the MMOS score in the only study that compared dysphagic individuals to healthy elderly individuals. In another study, the MMOS score was comparable to the meta-analysis of healthy elderly individuals. Both sex and age play significant roles in the MMOS. There is no reliable data on the normal mouth-opening strength and endurance of healthy adults, patients with dysphagia, or individuals with other relevant clinical problems. [ABSTRACT FROM AUTHOR]

This scoping review aimed to explore the interprofessional curriculum content and teaching approaches specific to wound care education in baccalaureate health courses internationally. Interprofessional education is defined as occurring when future health practitioners learn with, from and about each other with the goal of improving health outcomes. The management of wounds is a global public health issue with the World Health Organization recognising wound care is best managed by an interprofessional team. The preparedness of health professional graduates to engage in interprofessional education is essential to design and deliver coordinated health services that are person-centred and improve health outcomes. There is a lack of evidence however about how to prepare baccalaureate students in an interprofessional context, specifically in wound care. A scoping review was conducted using the framework of Arksey and O'Malley and reported using the PRISMA checklist for scoping reviews. A comprehensive search of the literature was conducted in MEDLINE (via EBSCOhost), CINAHL PLUS (via EBSCOhost), Pubmed and Embase databases published between 2012 and October 2023. Reference lists of included studies were also searched. Studies which were peer reviewed, written in English with a focus on interprofessional education in wound care were included in the review. The process of reviewing titles and abstracts was conducted by two independent reviewers. Data were extracted, key characteristics mapped and a narrative analysis of findings was reported. Three studies were included in this review. All the reviewed papers reported collaborative learning activities between different health professional groups relating to wound care, although there was no consistent approach to what wound care content was delivered or how it was delivered. Only one study reported that the delivery of content was completed by staff from multiple professional groups. Evaluation of the included studies related to either the effectiveness of the interprofessional education or wound care rather than both concepts. Due to the limited number of studies included in this review, it was difficult to draw conclusions about the effectiveness of interprofessional approaches to wound care. It may be possible that interprofessional wound care is currently being undertaken but not formally evaluated. This itself is problematic. It is imperative to equip healthcare students with the knowledge and skills necessary to provide safe, effective interprofessional care. Evidence on the effectiveness of educational programs is urgently needed. to be included in abstract after acceptance. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a meta-analysis of clinical trials on the effect of nonpharmaceutical treatments on outcomes for multiple sclerosis (MS). The CINAHL, Mantis, Medline, PEDro, PubMed, and Scopus databases were searched. Final papers meeting inclusion criteria were scored with the Physiotherapy Evidence Database for quality and included in a meta-analysis. Forty papers in the meta-analysis totaled 1673 participants. The interventions were grouped into 6 subcategories: physical activity, technology, rehabilitation, alternative, resistance training, and psychological. The combined effect of interventions produced a large overall effect size for the outcome fatigue; medium effect sizes for functionality, balance, and quality of life; and no effect on pain or spasticity. Physical activity had the greatest effect, improving fatigue, function, and balance. Rehabilitation and resistance training had a large effect on functionality. Comparatively, psychological approaches had only a small effect on improving quality of life. Sample sizes of included papers tended to be small with large variability in design. Therefore, results should be interpreted cautiously. Our results suggest there may be effective nonpharmaceutical treatment options available that can improve the symptoms of fatigue, poor functionality, balance, and quality of life. We found that physical activity, alternative approaches, rehabilitation, and resistance training were effective for improving the management of a number of MS symptoms. [ABSTRACT FROM AUTHOR]

Globally there are mounting concerns about nurses' job satisfaction because of its pivotal role in nurse turnover and the quality of care of patients. To identify a more comprehensive and extensive knowledge of the job satisfaction of qualified general nurses working in acute care hospitals and its associated factors drawing upon empirical literature published in the last five years. Literature review. A comprehensive electronic database search was conducted in PubMed (2012–2017), Web of Science (2012–2017), CINAHL (2012–2017), Embase (2012–2017), PsycINFO (2012–2017) and the Applied Social Sciences Index (2012–2017), CNKI (2012–2017), WanFang (2012–2017), SinoMed (2012–2017) and VIP (2012–2017) to retrieve relevant articles published in both English and Chinese between January 2012 and October 2017. Key terms and phrases associated with job satisfaction, occupational stress, professional commitment, role conflict and role ambiguity were utilized in the subject search in combination with nurses following guidelines for searching the OVID interface. The abstracts or full texts of research papers were reviewed prior to their inclusion in the review according to inclusion criteria and quality assessment using the Strobe guidelines. A total of 59 papers were included in this review. The impact of job satisfaction upon sickness absence, turnover intention, as well as the influencing factors of job satisfaction such as working shift and leadership, job performance, organizational commitment, effort and reward style has been identified in a number of research studies yielding equivocal findings. Job satisfaction of hospital nurses is closely related to work environment, structural empowerment, organizational commitment, professional commitment, job stress, patient satisfaction, patient-nurse ratios, social capital, evidence-based practice and ethnic background. Various mediating or moderating pathways have been identified with nurses' job satisfaction being mediated by various factors. It is vital to increase nurses' job satisfaction because this has the potential both to improve patients' perceptions of care quality and ensure an adequate nursing workforce. The indirect relationships and predictors of job satisfaction contribute to a more comprehensive understanding of the complex phenomenon of job satisfaction, which in turn may aid the development of effective strategies to address the nursing shortage and increase the quality of patient care. [ABSTRACT FROM AUTHOR]

To review the current evidence on the relationship between specialty nurse certification and outcomes. A structured and comprehensive systematic review was undertaken using the Joanna Briggs Institute framework to include both published research studies and expert opinion papers. Four electronic databases CINAHL, MEDLINE, PubMed, and PsychINFO were searched between 2000 and 2018. The search for expert opinion papers included nursing organizations, OaLster, Grey Literature Report, and The National Database of Nursing Quality Indicators. The records generated through the search were exported to EndNote X8 and duplicates were removed. Title and abstracts of the records were screened by three reviewers for eligibility using the selection criteria. In the absence of an abstract, records were retained for full text review. Full text assessment of each paper was conducted by two reviewers with a third referee, if necessary, to review any discrepancies. In the case of multiple articles drawing on one set of primary data, only one article was included. A review of each article was completed using the JBI Quality Appraisal checklists to assess internal and external reliability and validity. Both quality appraisal and data extraction were conducted by the review team independently and were validated by one other member of the team. Discrepancies were resolved through rigorous discussion between the reviewers. Forty one original research studies were included in the final analysis of the literature. The findings from the included articles were synthesized into three major categories and subsequent sub-categories: Patient outcomes, nurse outcomes and organizational outcomes. Twenty seven findings contributed to the sub-category of specialty nurse certification and patient outcomes. Patient outcomes were further classified into nurse sensitive outcomes, patient mortality and patient satisfaction. Fifty-four findings related to nurse outcomes with the sub-categories: personal and professional factors, knowledge and skills, organizational commitment, job satisfaction, empowerment and confidence. Six findings related to organizational benefits: including the sub-categories of nursing turnover and vacancy rates, perception of healthcare, and costs to the organization. The current model risks driving further proliferation of specialty certifications and certifying organizations without questioning the assumptions underlying the goals of certification. The challenges of measuring impact and the cost and value to individual nurses and healthcare organizations are key areas for consideration. [ABSTRACT FROM AUTHOR]

Background Dehydration in the older people is a prevalent problem that is often associated with physiological changes, physical limitations and environmental conditions. Objectives The scoping review was carried out to identify risk factors associated with dehydration in older people living in nursing homes. Design The revised scoping methodology framework of Arksey and O’Malley (2005) was applied. Study selection was carried out in accordance with Davis et al. (2009) and focused on the inclusion criteria (people over 65 years old and living in nursing homes). Risk factors were classified using the geriatric assessment. Data sources An electronic database search was performed in PubMed, Scopus and CINAHL. The literature search was carried out between October 2016 and January 2017. Review methods Thematic reporting was performed and study findings were validated through interdisciplinary meetings of experts. The quality of the papers consulted was also evaluated using the Newcastle-Ottawa Scale adapted for cross-sectional, cohort and case-control studies. Results In all, 16 papers were analysed, all of which were observational studies. The risk of bias ranged from very low (n = 1), to medium (n = 13) and high (n = 2). The risk factors were classified in line with the different components of the geriatric assessment. In the socio-demographic characteristics age and gender were identified. In the clinical component, infections, renal and cardiovascular diseases and end-of-life situations were the most common factors highlighted in the papers analysed. With reference to the functional component, its limitation was associated with dehydration, while for factors of mental origin, it was related to dementia and behavioural disorders. Finally, the factors relating to the social component were institutionalisation, requiring a skilled level of care and it being winter. Conclusions The most commonly repeated factors highlighted in the review were age, gender, infections, end of life and dementia, with it being important to highlight the large number of factors in the clinical component. Even so, the great majority of the factors were unmodifiable conditions associated typically associated with the physiology of ageing. [ABSTRACT FROM AUTHOR]

Objectives Analyze and synthesize the research evidence to understand the reproductive decisions made by women living with HIV from the beginning of the epidemic to the present. Evaluate the barriers and the facilitators for reproductive decision-making. Identify areas of strength, improvement, and those requiring further research. Design and data sources Systematic review following the PRISMA guideline. PubMed, CINAHL, PsycINFO, Cochrane Library, SocINDEX, Embase, and Scopus databases were searched from 1985 to 2016 using the following Keywords: HIV, AIDS, pregnancy, reproduction, and decision-making. Study selection A total of 42 research papers were included in this review. Initially, 1563 papers were identified for the review by database (n = 1544) and hand (n = 19) searches. With three review levels, 1521 papers were excluded (title review, n = 1272; abstract review, n = 136; and full paper review, n = 113). Studies published in English in peer-reviewed journals using both quantitative and qualitative methods and addressing reproductive decisions in women living with HIV were included. Thirdly, inclusion eligibility was assessed by title, abstract, and full text. Review methods Random allocation conducted by the primary researcher assigned an equal number of papers to each researcher for review, including detailed instructions with an abstraction form. Discrepancies were resolved by two researchers. Research quality was assessed using the NCHBL Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, the Critical Appraisal Skills Programme for the qualitative studies and its version for systematic reviews Results The review included 42 papers, both quantitative (n = 24) and qualitative methods (n = 14). Most studies were completed by physicians (n = 16) or nurses (n = 15). More than two-thirds of the studies were performed in urban settings with predominantly African-American women (n = 27). Eight factors were identified as influencing the reproductive decision-making process in women living with HIV: ‘Socio-demographic, Health status and Pregnancy’, ‘Religion and spirituality’, ‘Beliefs and Attitudes about Antiretroviral Therapy’, ‘Healthcare providers’, ‘Significant others’, ‘Motherhood and fulfillment’, ‘Fear of perinatal infection and infection of partner(s)’, ‘Birth control and pregnancy management’. Conclusions Health care providers are not providing patient-centered care by applying scientific evidence to their practice when advising women with HIV in making reproductive decisions. Despite the strong evidence indicating pregnancy for women with HIV results in a safe birthing trajectory, one not likely to jeopardize the health of the either the mother or fetus, providers continue to recommend the women with HIV avoid pregnancy and neglect to invite partners to participate in the discussion. [ABSTRACT FROM AUTHOR]

Over 1 billion doses of COVID-19 vaccines have been already administered across the United States, the United Kingdom and the European Union at the time of writing. Furthermore, 1.82 million booster doses have been administered in the US since 13th August, and similar booster programmes are currently planned or under consideration in the UK and the EU beginning in the autumn of 2021. Early reports showed an association between vaccine administration and the development of ipsilateral axillary and supraclavicular lymphadenopathy, which could interfere with the diagnosis, treatment and follow-up of breast cancer patients. In this paper, we review the available evidence on vaccine-related lymphadenopathy, and we discuss the clinical implications of the same on breast cancer diagnosis and management. A literature search was performed – PubMed, Ovid Medline, Scopus, CINHAL, Springer Nature, ScienceDirect, Academic Search Premier and the Directory of Open Access Journals were searched for articles reporting on regional palpable or image-detected lymphadenopathy following COVID-19 vaccination. Separately, we compiled a series of case studies from the University Hospitals of Derby and Burton, United Kingdom and the Mayo Clinic in Minnesota, United States of America, to illustrate the impact that regional lymphadenopathy post-COVID-19 vaccination can have on the diagnosis and management of patients being seen in diagnostic and therapeutic breast clinics. From the literature search, 15 studies met the inclusion criteria (n = 2057 patients, 737 with lymphadenopathy). The incidence of lymphadenopathy ranged between 14.5% and 53% and persisted for >6 weeks in 29% of patients. Clinicians managing breast cancer patients should be aware that the COVID-19 vaccination may result in regional lymphadenopathy in a significant number of patients, which can result in unnecessary investigations, treatment and increased patient anxiety. An accurate COVID-19 vaccination history should be collected from all patients where regional lymphadenopathy is a clinical and/or an imaging finding and then combined with clinical judgement when managing individual cases. • Most cases of adenopathy after the COVID-19 vaccine were detected during the PET-CT scan. • True incidence of COVID-19 vaccine adenopathy is 2–3 times higher than in the trials. • Old, immunosuppressed patients with single vaccine doses have low rates of adenopathy. • Young, immunocompetent, fully vaccinated patients have high rates of adenopathy. • Lymphadenopathy can persist >10 weeks following the last vaccine in 29% of patients. [ABSTRACT FROM AUTHOR]

Background Globally, perinatal death is on a decline. However, its impact on the healthcare profession is huge. The existing literature focuses on examining perinatal death from parents’ perspectives and patient death from the perspectives of nurses and a few doctors in critical care, oncology, and neonatology in the West. Due to the unique setting of maternity units where death is not routinely anticipated, as well as distinctive socio-cultural views surrounding death, there is a need to comprehensively review literature examining the impact of perinatal death on the perspectives of healthcare professionals working in maternity units. Objectives To examine available literature on the needs and experiences of healthcare professionals working in maternity units who have experienced perinatal death. Design A scoping review of published and unpublished data. Data sources A systematic literature search from 1st January 1996 to 5th August 2016 was made in the following databases: PubMed, CINAHL, Embase, PsycINFO, ScienceDirect, and Web of Science. Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews, York Centre for Reviews and Dissemination, Open Grey, ProQuest Dissertation and Theses, and Mednar were reviewed for grey literature. A hand search of the reference lists of the included papers was performed. Review methods Based on the pre-set inclusion criteria, 1519 articles were screened for their titles and abstracts. Eighty-five full-text papers were reviewed, resulting in 30 papers included for this review. The data were extracted and cross-checked between the reviewers. Any discrepancy between the authors’ views would be discussed with a third reviewer until consensus was reached. Thematic analysis was used to categorise the results into themes. Results Two major themes emerged from the review: the experiences and needs of healthcare professionals. Six subthemes emerged from the experiences of healthcare professionals: 1) psychological impact, 2) physical impact, 3) positive feelings, 4) coping strategies, 5) personal factors influencing the experience, and 6) cultural factors influencing the experience. Three subthemes including 1) social support, 2) training and education, and 3) other needs explained the needs of healthcare professionals. Studies focusing on the experiences and needs of physicians were scarce. Conclusions Perinatal death has a profound impact on the psychological and physical wellbeing of healthcare professionals. They have unmet needs that need to be addressed. Though they use internal and external resources to combat their stress, institutional support acknowledging their stress and their needs is essential. Culturally-sensitive education and training are needed to provide support to these professionals. [ABSTRACT FROM AUTHOR]

Background To provide adequate nursing care it is important for nursing staff to communicate effectively with people with dementia. Due to their limited communication skills, people with dementia have difficulties in understanding communication and expressing themselves verbally. Nursing staff members often report communication difficulties with people with dementia, which emphasises the urgent need for interventions to improve their communication with people in this specific target group. Objectives To provide an up-to-date overview of communication interventions that are applicable during daily nursing care activities, irrespective of care setting, and to describe the effects on communication outcomes in people with dementia and nursing staff. Design Systematic literature review Data sources The Cochrane Library, CINAHL, PsycINFO, and Pubmed databases were searched for all articles published until the 23rd of February 2016. Review methods Papers were included, if: (1) interventions focused on communication between nursing staff and people with dementia and were applicable during daily nursing care; (2) studies were (randomised) controlled trials; (3) papers were written in English, Dutch, or German. Data were extracted on content and communication outcomes of interventions, and on methodological quality of the studies. The data extraction form and methodological quality checklist were based on the Method Guidelines for Systematic Reviews for the Cochrane Back Review Group. Results Six studies on communication interventions were included. All of the studies incorporated a communication skills training for nursing staff with a broad range in frequency, duration and content. In addition, there was wide variation in the communication outcome measures used. Four studies measured non-verbal communication, all found positive effects on at least some of the communication outcomes. Four studies measured verbal communication, of which three found positive effects on at least one of the measured outcomes. Methodological quality assessment demonstrated a high risk of bias in five of the six studies. Conclusions Few studies have been identified with wide variation in interventions and outcome measures. In addition, the methodological shortcomings make it difficult, to draw conclusions about the effectiveness. More research is needed to develop and evaluate communication interventions. Additionally, it is useful to reach consensus on defining and measuring communication. [ABSTRACT FROM AUTHOR]

Nurses are the largest health professional body globally. Despite the significant role they play in healthcare, nurses exhibit poor dietary habits and have high rates of chronic diseases. Understanding the factors underlying healthy eating for nurses in the workplace is important to implement effective interventions. To identify enablers and barriers related to healthy eating among nurses employed in a hospital setting. A systematic literature review of qualitative, quantitative, and mixed methods research (PROSPERO ID: CRD42021290913). A comprehensive systematic search was conducted across PubMed, CINAHL, Embase, Web of Science and ProQuest databases for papers published after January 2015. Two authors independently screened titles and abstracts of 4139 deduplicated studies, performed critical appraisals on eligible studies using the Mixed Methods Appraisal Tool and extracted data relevant to the research question. This review includes papers that examined nurses' eating behaviours specifically, were conducted in a hospital setting and distinguished healthy eating from other behaviours. Data synthesis was conducted through descriptive summarisation of studies and enablers and barriers were classified according to the socio-ecological model. A total of 29 studies were identified with 8024 participants. 8 studies were qualitative, 18 quantitative, and 3 were mixed method design. At an environmental level, barriers were high accessibility and availability of unhealthy foods, high cost and low availability of healthy foods and lack of storage and preparation facilities, while an enabler was close proximity to healthy options. Novel organisational enablers were considered roster planning which allowed for established routines around meals, and structured workplace programs that encouraged improvement in health behaviours, while barriers were shift work, inconsistent rosters and high work demands. An interpersonal enabler was supportive networks while barriers were work culture, social norms of celebrations and gifts of food from patients. Finally, intrapersonal barriers were stress and fatigue, personal values, beliefs, attitudes, and individual characteristics, with the latter two also acting as enablers. This review identifies the complexity and interconnectedness of enablers and barriers to healthy eating across four domains of the socio-ecological model. Multi-faceted strategies which address factors across several domains are recommended for healthcare organisations to facilitate healthy eating among nurses. Further research is needed to assess these strategies and understand the extent to which eating behaviours can be improved. [ABSTRACT FROM AUTHOR]

Systematically synthesize research about factors that influence CPD over a nursing career. Continuing professional development (CPD) in nursing is defined as 'a life-long process of active participation in learning activities that assist in developing and maintaining continuing competences, enhancing professional practice and supporting achievement of career goals'. Research has shown that inability to access resources and activities for CPD influences quality of care and adversely affects nurses' satisfaction, recruitment and retention. Although more and more research regarding CPD is done, a comprehensive overview about the needs of nurses for successful CPD is missing. Scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews ensuring all quality standards are met. Between February and April 2020 the electronic databases CINAHL, PubMed, Scopus, Psychinfo and Eric were searched as well as reference lists of included papers. Papers published in peer-reviewed journals were included without restrictions on publication date, design or setting. Thematic analysis was done to synthesize the data. The search yielded 2673 papers of which 60 papers were included. Analyses showed that factors that influence CPD differ over a nursing career, which led to the identification of three groups: newly graduated nurses; experienced nurses; and experienced nurses with ambitions for advanced roles. Furthermore, analyses showed that factors for all three groups are related to personal and contextual facilitators and barriers. Newly graduated nurses find it important to be an accepted member of the team. They experience barriers when integrating into the nursing profession, where they for instance experience workplace incivility. Experienced nurses experience contextual barriers related to a lack of supportive structures and inaccessibility of CPD resources. There is limited time and availability of role models and a lack of support from managers and other colleagues. Moreover, the clinical care dynamics influence their ability to pursue CPD. For the experienced nurses with ambitions for advanced roles, an important barrier is that nursing culture emphasizes direct patient care. Often it is unclear what the value is of new nursing roles which makes it difficult for them to develop these. All nurses strive for CPD. However, organizations need to recognize nurses' personal goals and unique strategies as this leads to different needs in CPD. In addition, resources must be made available and accessible before CPD can be successfully pursued by all nurses. Factors that influence Continuing Professional Development differ over a nursing career and are related to personal and contextual facilitators and barriers. All nurses pursue CPD, but all have personal goals, use unique strategies and therefore have different needs. [ABSTRACT FROM AUTHOR]

Objectives The aim of this systematic literature review is to investigate older residents’ thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Design Systematic literature review. Data sources We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Review methods Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Results Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential emotional discomfort brought on by witnessing this behavior. Conclusions Relatively little work has been published on older residents’ perspectives regarding aged sexuality in institutionalized elderly care. If, however, we wish to devote ourselves to individualized or person-centered nursing care, we will have to gain more insight into the patient's perspective and take notice of the needs, expectations, attitudes, experiences and behaviors of residents with regard to (aged) sexuality. Hence more research is needed that depicts the issue of aged sexuality in institutionalized elderly care from a patient's and thus resident oriented perspective. [ABSTRACT FROM AUTHOR]

Stuttering may have a holistic effect on the quality of life of a person who stutters by limiting participation in social situations, resulting in feelings of isolation and frustration, leading to difficulties in education and employment and increasing the likelihood of mental health problems. Even young children who stutter may have negative experiences of speaking. Therefore, it is important to treat stuttering behavior effectively in both children and adults. The purpose of this paper was to systematically review group and case studies about the effectiveness of behavioral stuttering interventions to provide evidence-based guidelines for clinicians. Systematic data retrieval was conducted in four electronic databases (PsycINFO, CINAHL, PubMed, Cochrane). The assessment of search results was conducted according to predetermined inclusion and exclusion criteria by two independent judges. The methodological quality of each paper was assessed using strict criteria to include only high-quality research. The search revealed 2293 results, and 38 papers (systematic reviews N=3, group design studies N=21 and case studies N=14) with acceptable methodological quality were included. The data show that there is most evidence about the treatment of early childhood stuttering, very little evidence about school-aged children and some evidence about adults. The most convincing evidence is about the Lidcombe Program in the treatment of young children who stutter, but also other methods have promising evidence. Our data imply that in the treatment of adults who stutter, holistic treatments may influence speech fluency and overall experience of stuttering behavior. Speech restructuring treatments may have a positive effect on overt characteristics of stuttering, but not on covert stuttering behavior. The results of this review agree with earlier reviews about the treatment of young children. However, due to different inclusion criteria, this review also shows the benefits of holistic treatment approaches with adults and adolescents. [ABSTRACT FROM AUTHOR]

Background Laboratory-based measurement of standing balance is used to assess postural control in people with and without pathology, including knee osteoarthritis. However, no summary of available data has been reported in this patient population. This study aimed to summarize available data and testing methods for individuals with knee osteoarthritis. Methods Medline (OvidSP and PubMed), Embase, CINAHL, and Web of Science were searched from 1994 to October 25, 2014 to identify studies containing a quantifiable measure of standing balance. Methodological quality was assessed using a modified 17-item Downs & Black quality index. Studies scoring < 50% were eliminated. Findings The search strategy initially yielded 1523 unique papers; 21 met all inclusion and quality assessment criteria. The variables measured in three or more of the 21 papers were anteroposterior centre of pressure (COP) velocity, mediolateral COP velocity, mean COP velocity, anteroposterior range of COP, mediolateral range of COP, anteroposterior COP standard deviation, mediolateral COP standard deviation, COP path length, COP area, Biodex anteroposterior score, Biodex mediolateral score, and overall Biodex score. In general, people with knee osteoarthritis exhibited worse standing balance compared to healthy controls. However, there remained much discrepancy in testing procedures across studies. Interpretation These findings indicate that people with knee osteoarthritis exhibit altered postural control. However, no conclusions could be made on the differences between radiographic severities. That said, these findings provide an opportunity for future researchers and clinicians to compare their findings with the currently published data. [ABSTRACT FROM AUTHOR]

Objectives: To investigate paediatric nurses’ postoperative pain management practices with the aim of identifying the factors associated with undermanaged paediatric postoperative pain. Design: Systematic search and review. Data sources: PsychInfo, CINAHL, PubMed, EMBASE and hand searching. Review methods: English peer-reviewed quantitative, qualitative, or mixed methods research articles published between 1990 and 2012 exploring registered nurses’ paediatric postoperative pain management practices were included. Articles with a primary focus on nurses’ pain management practices in the neonatal or paediatric intensive care units, recovery room, and/or focused on children with cognitive impairment were excluded. The search terms used were: postoperative pain; nurs*; paediatrics; pediatrics; children; pain assessment; non-pharm*; analges*. Titles and abstracts were used for initial screening. Two researchers conducted data extraction and assessment of rigour for each paper. Results: From the initial 248 citations, 27 studies were included. Most studies were descriptive and examined relationships between personal factors and nurses’ pain management practices. Observational data from four papers added insights beyond that provided in self-report studies. Two articles used experimental designs with vignettes. Data were categorised into four topics: pain assessment; pharmacological practices; nonpharmacological practices; and factors affecting practices. Despite improvements in analgesic administration over the past 20 years, practices remain suboptimal. Children’s behaviour appears to influence nurses’ pain assessment more than validated measures. A significant proportion of children did not have pain scores recorded in the first 24-h postoperatively. Children receive more analgesia when ordered around the clock compared to as required. However, around the clock analgesia prescription did not guarantee administration. Nurses reported using several non-pharmacological strategies routinely but some are not evidence based. Conclusions: The results of this review indicate nurses’ assessment and management of children’s pain is not consistent with published guidelines. Results of studies exploring nurse and child related factors are inconclusive. Research needs to examine the impact of organisational factors on nurses’ pain care practices. Intervention studies are needed to determine the most effective strategies to support and improve nurses’ pain care for children. [ABSTRACT FROM AUTHOR]

Background: Pressure ulcers are considered to be an adverse outcome of care that should never occur in clinical practice. The formation of a pressure ulcer is also perceived to be an indicator of poor quality nursing care. Therefore, pressure ulcer prevention is a priority for nurses, healthcare professionals and healthcare organisations throughout the world. A key factor in pressure ulcer prevention and management is individual nurse decision making. Objectives: To synthesise the literature on the judgement and decision making of nurses in relation to the assessment, prevention, grading and management of pressure ulcers in all care settings (hospital and community). Design: A systematic search of published literature relating to judgement and decision making in nurses, with a focus on the prevention and management of pressure ulcers. Methods: A search of electronic databases from 1992 to present, together with hand searching of the reference lists of retrieved publications, to identify published papers that reported results of studies evaluating the decision making of nurses in relation to the prevention and management of pressure ulcers. Abstracts were independently reviewed by two authors and full text of potentially relevant articles retrieved. Each paper included in this systematic review was evaluated using recognised appraisal criteria relevant to the specific study design. Included papers provided empirical data on key aspects of nurses' pressure ulcer related judgements and decision making. Data were synthesised into themes using narrative analysis. Results: Sixteen studies and one systematic review were included in the review, focusing on pressure ulcer risk assessment, pressure ulcer prevention, grading of pressure ulcers and treatment decisions. The results indicated that assessment tools were not routinely used to identify pressure ulcer risk, and that nurses rely on their own knowledge and experience rather than research evidence to decide what skin care to deliver. Conclusions: Emphasising pressure ulcer risk assessment and pressure ulcer grading in clinical practice is unlikely to deliver improved outcomes. Further research into nurses' pressure ulcer related judgements and decision making is needed and clinicians must focus on the consistent delivery of high quality care to prevent and mange pressure ulcers to all patients in clinical practice. [ABSTRACT FROM AUTHOR]

The purpose of this study was to conduct a systematic review of studies to determine whether sitting time measured objectively (by laboratory controlled time trial, direct observation, or wearable sensor) is associated with the immediate increase in low back pain (LBP) (determined by pain scale rating) in people >18 years of age. Four databases (PubMed, EMBASE, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature) were searched from inception to September 1, 2018. Randomized controlled trials and cohort and cross-sectional studies, where objectively measured sitting time was temporally matched with a measure of LBP in adults, were included. Studies without a control session conducted on a separate day were excluded. Screening, full-text review, data extraction, and risk of bias assessment (Quality In Prognosis Studies) of included papers were performed independently by 2 reviewers, with a third available to resolve disagreements. In total, 609 articles were identified, 361 titles/abstracts were screened,75 full-text articles were assessed for eligibility, and 10 met the inclusion criteria. All but 1 reported sitting time to be associated with an immediate increase in LBP. Six of these reported clinically relevant pain levels (n = 330). Half of the included studies were rated as having a low risk of bias and the remaining were rated as having a moderate risk of bias. Prolonged sitting increases immediate reporting of LBP in adults; however, no conclusion between sitting and clinical episodes of LBP can be made. Based upon these findings, we recommend that future prospective studies should match objectively measured sitting with temporally related pain measurements to determine whether prolonged sitting can trigger a clinical episode of LBP. [ABSTRACT FROM AUTHOR]

Delirium is a multifactorial syndrome closely associated with negative hospitalisation outcomes. Given the global growth of the ageing population, delirium becomes increasingly prevalent among older persons. Nurses play a pivotal role in delirium management and receive direct impacts of delirious presentations. Yet, there is a dearth of literature reviewing nurses' experiences. To synthesise the best available evidence exploring nurses' experiences in managing delirium of older persons in acute care wards. Systematic review of qualitative studies and meta-aggregation. Published and unpublished literature between January 2010 and December 2020 were identified from PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO and ProQuest. A systematic search strategy was applied in October 2020, with an update in January 2021. Two reviewers independently screened the titles and abstracts and selected the eligible studies after reading the full texts. This review included studies focusing on licensed nurses providing care to patients aged 65 and above, having any type of delirium during their hospitalisation stays in acute care settings. Studies included are qualitative papers with research designs such as phenomenology, ethnography, qualitative descriptive and grounded theory. The eligible studies were appraised independently using The JBI Critical Appraisal Checklist for Qualitative Research. Data of included studies were extracted by two independent reviewers using a standardised form. Findings were synthesised by the meta-aggregative approach. Thirty-one papers that considered nurses' (n = 464) experiences in managing older persons' delirium were included. A total of 375 findings were extracted, aggregated into 23 categories, and developed 5 synthesised findings: (i) delirium detection could be hindered when nurses possess a narrowed view of delirium, (ii) nurses navigate through complexity when providing multi-faceted care, (iii) nurses carry personal emotions, assumptions, and identities, (iv) various stakeholders have double-edged influences, and (v) nurses display preferences in their learning needs. This review informed about nurses' perceptions of delirium, delirious older persons, and their nursing management which were specific to older persons and acute care settings. Nurses should practise self-awareness regarding their own knowledge and attitudes while performing delirium management in older adults. Meanwhile, healthcare professionals and policymakers should make a concerted effort in cultivating a better working environment. Future research of delirium care that specifically investigates with a geriatric perspective would better contribute to the improvement of evidence-based nursing practices for older persons. [ABSTRACT FROM AUTHOR]

Mental health and psychosocial concerns such as domestic violence in pregnancy and after birth are significant issues. Maternal health, social and environmental contexts have a direct influence on child development and long-term health. However, midwives, nurses and other health professionals lack confidence and skills in assessing, supporting and referring women with perinatal psychosocial concerns. The aim of the scoping review is to review educational innovations and teaching strategies used to build skills and knowledge in health professionals and students to address psychosocial concerns including perinatal mental health, domestic violence and drug and alcohol misuse. A scoping review was undertaken to help identify the breadth of papers reporting educational innovations and strategies particularly to address psychosocial concerns. Four databases CINAHL, PsychoInfo, PubMed, OvidMedline and the grey literature were searched using a diverse range of terms for papers published in English between January 2009 and December 2020. This yielded 2509 papers and after review, 34 papers were included in the scoping review. The 34 papers in this review found a diversity of educational initiatives and strategies delivered either face-to-face, online or in a blended mode addressing the learning needs of health professionals working with women with complex psychosocial concerns. The following characteristics in the papers were examined; focus of education, design and development, length, target audience including interprofessional focus, self-care, sensitive topics, debriefing, involving lived experience consumers and evaluation measures. In the studies indicated that they benefited from hearing about the individuals' lived experiences, opportunities for simulated practice and valued interprofessional learning experiences for both content and teamwork. The emergence of virtual modes offered some innovative and engaging ways to create a safe space for psychosocial education. However, the research does not provide guidance as to the best mode of delivery or length of program This scoping review provides a broad overview of innovative and diverse educational methods and strategies being used in the nursing, midwifery and health disciplines to engage students and practitioners in learning in the areas of perinatal mental health and psychosocial care. Involvement of lived experience consumers in the design and delivery of education programs can positively impact learners' knowledge and understandings of sensitive psychosocial topics. These diverse approaches could be used to shape the development and evaluation of future education programs. [ABSTRACT FROM AUTHOR]

Abstract: Background: Chronic obstructive pulmonary disease is a common, chronic and burdensome condition requiring the individual to engage in a range of self-management strategies. The capacity to engage in self-management is dependent on a range of internal (e.g. personal) and external (e.g. health service) factors. Objectives: This paper seeks to define self-management, identify the determinants which influence the individual''s ability to cope and adjust to living with chronic obstructive pulmonary disease in the community, and identify implications for clinical practice and research. Design: Integrative review. Data sources: Medline, Embase, PubMed, CINAHL, Google Scholar. Review methods: Integrative review using prospective research questions. Papers were included in the review if they were published in peer reviewed journals and written in English between 2000 and 2010. Articles were accepted for inclusion if they discussed the determinants that influenced self-management of chronic obstructive pulmonary disease in the community. Confirmation of results and discussion themes was validated by specialists in chronic obstructive pulmonary disease and complex care. Findings: Self-management is less well characterised in chronic obstructive pulmonary disease compared with other chronic conditions. Functional limitation and the need to balance disease management with everyday life are the two key elements that patients face in managing their condition. Provider characteristics, socioeconomic status and health literacy are sparsely discussed yet are known to influence chronic obstructive pulmonary disease self-management. Conclusions: Chronic obstructive pulmonary disease self-management must be a key focus internationally as the disease incidence increases. Collaborative care is required between patients and health providers in order facilitate patients in confident management of their condition. [Copyright &y& Elsevier]

Pain management after total knee arthroplasty and total hip arthroplasty is pivotal, as it determines the outcome of the recovery process after surgery. Ineffective pain control results in many postoperative complications and hinders successful recovery. In recent years, the transition from opioids to a multimodal pain management approach after total knee and total hip arthroplasty has increasingly become an alternative. This is due to the multitude of adverse effects associated with opioids. As a result, the use of non-opioid interventions such as acetaminophen, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, gabapentinoids, and ketamine, and techniques such as peripheral nerve block and local infiltration analgesia have become more favorable. This paper aims to summarize literature around the effectiveness of non-opioid interventions as part of a multimodal pain management after total knee and total hip arthroplasty. A literature review was conducted to provide evidence-based information with respect to pain management during the postoperative period in order to enhance the pain recovery process. The literature chosen was extracted through the electronic databases PubMed, CINAHL, and Embase. Twenty-seven eligible articles were identified that met the inclusion and exclusion criteria. Literary evidence shows that non-opioid interventions such as acetaminophen, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, gabapentinoids, ketamine, peripheral nerve blocks, and local infiltration analgesia benefit patients after total knee and total hip arthroplasty for pain management. However, further quality research trials are necessary for more conclusive evidence-based information. Selective literature supports the use of non-opioid interventions as part of a multimodal analgesics regimen for effective pain management after total knee and total hip arthroplasty. [ABSTRACT FROM AUTHOR]

Evidence-based therapies for posttraumatic stress disorder are underutilized and at times unavailable in specialty settings. We reviewed the literature on interventions to treat PTSD within primary care to make recommendations on their effectiveness as treatment modalities or ways to improve engagement in specialty care. We searched PubMed, PsychInfo, CINHAL, and Cochrane Reviews databases using search terms related to PTSD and primary care. We excluded clinical guidelines and studies of screening only or subthreshold PTSD. 524 articles were identified. Twenty-one papers on 15 interventions met review criteria. Seven interventions focus on individual therapies studied via small feasibility studies to prepare for full-scale intervention research. Eight describe treatment programs in primary care based on collaborative care that included medication management, tracking outcomes, referral services, and for some psychotherapy (versus psychotherapy referral). Ten interventions were feasibility studies which precludes meaningful comparison of effect sizes. Of the four RCTs of treatment programs, only two including some psychotherapy found improvements in PTSD symptoms. More research is needed to adapt treatment for PTSD to primary care. Collaborative care may be a promising framework for improving the reach of PTSD treatments when psychotherapy is offered within the collaborative care team. [ABSTRACT FROM AUTHOR]

From a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses' delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, this evidence-base has not been systematically identified, appraised, and integrated. To systematically identify, appraise and synthesise the available empirical evidence about mental health nurses, medical emergencies, and the severely physiologically deteriorating patient. A systematic review in accordance with relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases (CINAHL; PubMed; MedLine; Scopus, ProQuest Dissertations and Theses) were searched using comprehensive terms. Inclusion criteria: English language papers describing empirical studies (any design) about i) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of emergency medical care or care for the severely deteriorating patient; or ii) mental health nurses' emergency medical care-related knowledge, skills, experience, attitudes, or training needs. Further information was sought from study authors. Included studies were independently assessed for quality. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative synthesis of study findings was conducted. A total of 22 studies, all but one published since 2011, met inclusion criteria. Ten were intervention studies and twelve were cross-sectional observational or qualitative studies. Intervention studies were all of weak quality overall and utilised pre- post designs mostly with limited post intervention follow-up time. Observational and qualitative studies were generally of good quality but only parts of the evidence from these studies were relevant to emergency physical care since most focused on mental health nurses and their routine physical healthcare practice. There are currently no validated instruments to investigate mental health nurses' emergency medical care-related attitudes. More rigorous controlled trials of interventions are needed to better establish an evidence-base for educational interventions to improve this groups' emergency care-related practice. [ABSTRACT FROM AUTHOR]

Technology use can impact human performance and cognitive function, but few studies have sought to understand the electronic health record's impact on these dimensions of nurses' work. The purpose of this review was to synthesize the literature on the electronic health record's impact on nurses' cognitive work. Integrative review. MEDLINE/PubMed, CINAHL, Embase, Web of Science, and PsycINFO. The literature search focused on 3 concepts: the electronic health record, cognition, and nursing practice, and yielded 4910 articles. Following a stepwise process of duplicate removal, title and abstract review, full text review, and reference list searches, a total of 18 studies were included: 12 qualitative, 4 mixed-methods, and 2 quantitative studies from the United States (13), Scandinavia (2), Australia (1), Austria (1), and Canada (1). The Mixed Methods Appraisal Tool was used to assess the quality of eligible studies. Five themes identified how nurses and other clinicians used the electronic health record and perceived its impact: 1) forming and maintaining an overview of the patient, 2) cognitive work of navigating the electronic health record, 3) use of cognitive tools, 4) forming and maintaining a shared understanding of the patient, and 5) loss of information and professional domain knowledge. Most studies indicated that forming and maintaining an overview of the patient at both the individual and team level were difficult when using the electronic health record. Navigating the volumes of information was challenging and increased clinicians' cognitive work. Information was perceived to be scattered and fragmented, making it difficult to see the chronology of events and to situate and understand the clinical implications of various data. The template-driven nature of documentation and limitations on narrative notes restricted clinicians' ability to express their clinical reasoning and decipher the reasoning of colleagues. Summary reports and handoff tools in the electronic health record proved insufficient as stand-alone tools to support nurses' work throughout the shift and during handoff, causing them to rely on self-made paper forms. Nurses needed tools that facilitated their ability to individualize and contextualize information in order to make it clinically meaningful. The electronic health record was perceived by nurses as an impediment to contextualizing and synthesizing information, communicating with other professionals, and structuring patient care. Synthesizing and communicating information at the individual and team levels are known drivers of patient safety. The findings from this review have implications for electronic health record design. [ABSTRACT FROM AUTHOR]

The objective of this review is to explore, review and synthesize the empirical literature that reports on the concept of woman centred care. Integrative review of the empirical literature on the concept of woman centred care. A comprehensive search strategy was conducted using the phrase 'woman-centred care' 'women-centred care' (and all associated spelling variants) in the relevant databases including PubMed, Cumulative Index to Nursing and Allied Health, Intermid, Scopus, Informit and Web of Science. A concurrent search using the phrase 'patient-centred care' (and associated spelling variants) was also conducted, to ensure all studies about care of a woman in pregnancy, labour and postpartum were captured. A comprehensive five stage integrative review methodology was used to review primary studies which addressed woman-centred care as either an intervention or an outcome. The quality of included studies was assessed using the appropriate Critical Appraisal Skills Programme tool. Initial searching located 1205 papers. Seventeen studies met the inclusion criteria (qualitative n=12 and quantitative n=5). The studies were conducted in Australia (n=5), Ireland (n=1), Japan (n=2), Netherlands (n=2), New Zealand (n=1), South Africa (n=1), Sweden (n=1), Switzerland (n=1), United Kingdom (n=1), and the United States of America (n=2). The quality of the studies varied. NVivo software was employed to abstract and synthesize the data. Analysis revealed 10 subthemes synthesized under three pre-determined main themes of clinical practice (choice and control, empowerment, protecting normal birth, relationships and the individual midwife), maternity service (model of care, continuity of care and maternity care systems) and education (registered practitioners and student midwives). This review integrates the empirical literature to illuminate the concept of woman-centred care as it currently applies to clinical practice, maternity service, and education. The concept of woman- centred care is intertwined in the themes and subthemes identified in the studies. There is wide variation in how woman-centred care is interpreted and this contributes to the confusion and tokenism with which it is discussed in health policy documents and frameworks. Further research is also warranted in the development of a universal definition of woman-centred care and in how woman-centred care behaviours are developed in practitioners. [ABSTRACT FROM AUTHOR]

This paper aims to systematically review the illness perceptions of stroke patients and to examine the association between illness representation and psychological distress in empirical research studies. Patients' perceptions of health threats determine their coping behavior. Several recent studies have focused on illness belief and distress in stroke patients. This information is suitable for a meta-analysis to further understand stroke patients' illness perceptions. Systematic review and meta-analysis. An electronic literature search was conducted using the CINAHL, MEDLINE, PubMed, Cochrane library, and Google Scholar databases. Search strategies were title (stroke or cerebrovascular accident or CVA or cerebral vascular event or transient ischemic attack or TIA) and keyword (disease or illness) and keyword (perceptions or attitudes or opinion or experience or view or reflection or beliefs). The literature search covers the period of January 1990 to October 2018. Seven articles were included in the meta-analysis and Fisher's z was calculated with correlation coefficient or regression coefficient values for eight illness representation dimensions and psychological distress. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) version 3.0 software. A total of 49 studies were reviewed, and seven studies with a total of 507 participants were eligible for the meta-analysis. For patients' perceived anxiety and depression, six of seven studies, with 285 to 461 participants, were examined in terms of the average corrected correlation coefficient across the studies. It was found that stroke patients' perception of a strong illness identity, timeline-acute/chronic, timeline-cyclical, consequences, and emotional responses were significantly and positively related to anxiety and depression. The pooled z -value ranged from 0.189 to 0.460. Conversely, for protective-related factors, such as stroke patients' perceived personal control, treatment control, and illness coherence, only perceived illness coherence was significantly negatively associated with depression (z -value, -0.122; 95% CI: -0.241, -0.002). For patients' perceived overall distress, three of seven studies with 173 participants showed that there were significant and positive associations between identity, consequence, emotions, and distress (z -value ranges = 0.493–0.711) as well as a significant and negative association between illness coherence and overall distress (z -value, -0.226; 95% CI: -0.379, -0.073). An association between illness representation and distress exists in stroke patients. Risk factors are the most significant in terms of this relationship, and protective factors do not have a protective health impact. Protection factors need to be promoted to reduce patient distress. [ABSTRACT FROM AUTHOR]

It has been suggested that climate change is the biggest threat to public health for the 21st Century; increased demand on health services will impact on already overstretched resources and systems will need to be able to respond. However limited attention is given to climate change and sustainability in nursing education; there is no clear guidance on curricula content for nurses or recommendations regarding the skills and competencies that will be required. Literature published in Dutch, English, German, and Spanish was searched and 32 papers met the inclusion criteria for the review. Results suggests that holistic/systems thinking is relevant to healthcare so bringing a 'sustainability lens' to nursing curricula could be seen as being consistent with wider determinants of health. The literature review has identified the educational approaches necessary to provide a broad based curriculum and a cross-disciplinary approach. The findings suggest that topics such as the use of resources, food, health promotion, globalism, disease management, and the environmental impact of delivering healthcare, if embedded in nursing education could support the nursing profession's response for this new and important aspect of healthcare. • Climate change will affect the supply of health service resources. • Education for Sustainable Development methodology is adaptable to nursing curricula. • Nurses need to have knowledge, skills and competence in environmental sustainability. • Student centred learning and multidisciplinary approach are appropriate for this topic. [ABSTRACT FROM AUTHOR]

Systematic review. The rehabilitation of patients following flexor tendon injury has progressed from immobilization to true active flexion with the addition of wrist motion over the last 75 years. This review specifically intended to determine whether there is evidence to support one type of exercise regimen, early passive, place and hold, or true active, as superior for producing safe and maximal range of motion following flexor tendon repair. The preferred reporting items for systematic review and meta-analysis (PRISMA-P 2015) checklist was utilized to format the review. Both reviewers collaborated on all aspects of the research, including identifying inclusion/exclusion factors, search terms, reading and scoring articles, and authoring the paper. Articles were independently scored by each reviewer using the Structured Effectiveness Quality Evaluation Scale (SEQES). A total of nine intervention studies that included a rehabilitative comparison group were systematically reviewed: one pediatric, four comparing passive flexion protocols to place and hold flexion, and four comparing true active flexion to passive and/or place and hold flexion. This review provides moderate to strong evidence that place and hold exercises provide better outcomes than passive flexion protocols for patients with two to six-strand repairs. The studies included in this review suffered from methodological limitations including short timeframes for follow-up, unequal group distribution, and limited attention to repair site strength. Based on a lack of superior benefits following true active motion regimens, there is not sufficient evidence to support true active motion as an effective or preferable choice for flexor tendon rehabilitation at this time. • Minimal number of true intervention studies available for review. • Moderate to high evidence for place and hold exercise. • Lacking sufficient evidence to support true active motion as an effective or preferable choice. • Suggest transition to consistent terminology: early passive, place and hold, or true active. • Active, functional performance should be consistently used to evaluate outcomes. [ABSTRACT FROM AUTHOR]

Objective: To explore patient and health professional views and experiences of antidepressant treatment with particular focus on barriers and facilitators to discontinuing use.Design: Systematic review with thematic synthesis DATA SOURCES: MEDLINE, PubMed, Embase, PsycINFO, CINAHL, AMED, Health Management Information Consortium, OpenGrey, and the Networked Digital Library of Theses and Dissertations from inception until February 2017. Updated searches were carried out in July 2018.Eligibility Criteria: Primary studies, published in English, that used qualitative data collection and analysis, and had data on attitudes, beliefs, feelings, perceptions on continuing or discontinuing antidepressant use, of patients (aged 18 or above, who received treatment with antidepressants for at least 6 months) or any health professionals.Data Extraction: One reviewer extracted data and assessed study quality, which was checked by a second reviewer.Findings: Twenty two papers were included in the review. A thematic synthesis was performed for patient perspectives only, due to insufficient data from a health professional perspective. The thematic synthesis yielded nine themes: (1) psychological and physical capabilities; (2) perception of antidepressants; (3) fears; (4) intrinsic motivators and goals; (5) the Doctor as a navigator to maintenance or discontinuation; (6) perceived cause of depression; (7) aspects of information that support decision-making; (8) significant others - a help or a hindrance; and (9) support from other health professionals.Limitations: Coding and development of subthemes and themes was performed by one researcher and further developed through discussion between two researchers.Conclusions: Barriers and facilitators to discontinuing antidepressant use are numerous and complex, and likely to require detailed conversations between patients and their general practitioners (GPs). These conversations are more likely to happen if GPs raise the issue of discontinuation. Further research from a health professional perspective including, but not limited to GPs, is needed. [ABSTRACT FROM AUTHOR]

Abstract Objectives The aim of this meta-ethnographic review was to examine refugee women's experiences negotiating motherhood and maternity services in a new country with a view to identifying the specific needs of refugee women accessing maternity care in high income countries. Design A meta-ethnographic synthesis of qualitative research. Data sources Five databases were searched for papers published in English between January 2000 and January 2017. Review methods The synthesis process was guided by the seven steps of meta-ethnography. The quality of included studies was assessed using the COREQ tool. Results One overarching theme and three major themes emerged from the synthesis. The overarching theme "Living between two cultures" conveyed women's experience of feeling "in between" cultures and described refugee women's experience of striving to maintain a strong cultural identity from their country of origin while simultaneously adapting to their new context and country. This theme permeated the following three major themes: 1) "Constructing maternal identity across cultures" which discusses the cultural conflict experienced by refugees accessing maternity services in their host country; 2) "Understanding in practice" which describes reciprocal issues in communication between women and health professionals; and 3) "Negotiating care" which illustrates a mix of coping mechanisms which refugee women utilise to navigate health services in the context of high income countries. Conclusion Liminality is a ubiquitous experience for refugee women seeking maternity care in high income countries. It impacts feelings of belonging and connection to services and society. It is often a challenging experience for many women and a time in which they reformulate their identity as a citizen and a mother. This review found that the experience of liminality could be perpetuated by social factors, and inequality of healthcare provision, where communication and cultural barriers prevented women accessing care that was equal, accessible, and meaningful. Findings revealed both positive and negative experiences with maternity care. Continuity, culturally appropriate care, and healthcare relationships played an important role in the positive experiences of women. The review also revealed the damaging effects of disparities in care experienced by refugee women. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this paper is to systematically review studies that discuss the experiences of vulnerable populations participating in research on sensitive topics. Design Systematic review performed according to PRISMA guidelines. Data sources Thirteen databases were searched, locating 197 articles. Following removal of duplicates, screening and full text review, 31 studies remained to be critically appraised. Review methods As there was a mix of qualitative and quantitative articles, the Critical Appraisal Skills Program (CASP) toolkit and Effective Public Health Practice Project (EPHPP) tool were used to appraise the methodological quality of the articles. Following critical appraisal, the remaining 11 articles were synthesised narratively to identify common themes across the studies. Results Despite some reports of distress, responses from participants were overwhelmingly positive. There was a strong link between symptomatology and potential for distress; however, the majority of those who did experience some level of discomfort stated they would still participate in future research. Three major themes were extracted: "It was worth it"; "Even if it hurt, I would do it again" and "Risk or benefit: fixing the location on the continuum". Conclusion Although researchers frequently experience obstacles and the phenomenon known as "gatekeeping" when attempting to conduct research amongst vulnerable populations, there is little evidence of harm to participants. On the contrary, there is evidence of benefit for participants and evidence that they are willing to participate if given the opportunity. Although well-meaning, the actions of gatekeepers are not only paternalistic, they could be further marginalising vulnerable populations by denying them the benefits to be gained from research designed to identify and begin addressing their needs. [ABSTRACT FROM AUTHOR]

The aim of this integrative review is to explore how formative online multiple-choice tests used in nurse education promote self-regulated learning and report on pedagogies that support their design. Online multiple-choice tests are widely used as learning and formative assessment tools in a range of educational contexts. However, little is known about how these tools are used to promote patterns of learner self-regulation. It is important that nurses and nursing students develop the capability to self-regulate learning to be effective lifelong learners and navigate complex and unfamiliar practice environments. A five-stage approach guided this integrative review: problem identification, literature search, data evaluation, data analysis and presentation. A systematic search of ERIC, Web of Science, Ovid Medline, Scopus, PubMed, Embase and CINAHL was conducted in February 2021. Seventeen peer-reviewed papers were identified that discussed formative online multiple-choice tests in nurse education. Purposive sampling and ancestry searching identified an additional paper. Articles were analysed and sorted into themes of outcomes (presented as components of self-regulated learning theory) and pedagogy. Formative online multiple-choice tests are used with good effect in nurse education as measured by knowledge gain and exam performance, increased confidence and learner satisfaction. There was no literature that explored metacognitive outcomes and minimal literature considered behavioural outcomes. Pedagogy supporting the implementation of multiple-choice tests was lacking in most articles. Formative online multiple-choice tests are widely used with good effect in nurse education. However, opportunities for further research on how these tools can encourage metacognition and self-regulatory behaviours is warranted. [ABSTRACT FROM AUTHOR]

To examine the literature on intergenerational learning between older people and student nurses. Intergenerational activities offer opportunities for intergenerational learning and help reduce ageism. There are several older person/school children intergenerational learning initiatives. However, there is less known about how intergenerational learning occurs in nurse education programmes outside of service provision. Whittemore and Knafl's (2005) integrative review framework was used to guide the review process. Population, intervention, context and outcome (PICO) was used to develop the review question, search strategy and inclusion/exclusion criteria. Database (CINAHL, Cochrane library, Medline, PubMed, Scopus and PsychInfo) searches and hand searching occurred from 2012 to 2023. Screening, appraisal and data extraction was undertaken according to Prisma guidelines. Nine papers were included (North American (n = 5), Canadian (n = 1) Chinese (n = 2), Taiwanese (n = 1)). Mixed methods designs were included. Four themes were identified: 1) Seeing beyond first glance; 2) Connecting and getting to know each other; 3) Learning together; and 4) Challenges for intergenerational learning. This review demonstrates the relevance of intergenerational learning in nurse education and highlights the importance of embedding initiatives which will promote and support mutual learning. Innovative intergenerational initiatives enable students to explore their underlying attitudes and views in a way that they may not be able to in the more traditional service and care giving learning situations. [ABSTRACT FROM AUTHOR]

This systematic review will establish how Fitness to Practise (FtP) processes are applied in UK Higher Education Institutions (HEI), in relation to both Health and Care Profession Council or Nursing and Midwifery Council approved programmes. Healthcare students are required to complete both practice and theory elements, in order to gain their degree and qualify as a healthcare practitioner such as a nurse. It is a requirement of UK HEIs which provide healthcare programmes, to provide evidence to the appropriate regulatory body that FtP policies and processes are in place, and that they review and manage any concerns in relation to a student's standard of practice. Regulatory bodies provide HEIs with strategic guidance on policy which can be interpreted and incorporated into existing policies; this means that there is no standard approach to the FtP process in HEI settings, allowing individual policies and procedures to exist. A systematic review, registered on PROSPERO (CRD42022291532 on the 21st January 2022). Peer reviewed studies published in ten databases were used which included: Medline, Cochrane Library, PubMed, ScienceDirect, Education Source, PsycInfo and Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete. Citation searching also occurred. This systematic review utilised Preferred Reporting items for Systematic reviews and Meta-Analysis (PRISMA) techniques. The Critical Appraisal Skills Programme (CASP) checklists were used to appraise the quality of the research. In total twenty-five articles were retrieved including five papers that were finally selected for review. A thematic analysis identified three themes: a lack of identification of what FtP expectations are; the importance of collaborative working between Higher Education Institutions and practice; the inconsistencies with Higher Education Institution processes in managing FtP concerns. A lack of understanding of what FtP expectations are for students was identified. Collaborative working between Higher Education Institutions and practice is necessary to ensure healthcare students meet FtP requirements consistently in order to protect the public. Although HEIs FtP processes contain similar principles, it has been identified that there are inconsistencies in this process across universities in the UK. These differences include: what initiates the FtP process, to the outcomes. This could have an impact on patient care and safety, the need for review of national guidance, and potential amendments being required to the policies and procedures of both NHS Trusts and private organisations. [ABSTRACT FROM AUTHOR]

Pressure ulcers are a common complication with a high impact on well-being and quality of life in people with impaired mobility and/or dysfunctional pain sensations. Prevention is therefore crucial. However, persons at risk seem to experience difficulties in adhering to self-management regimens that can help to prevent or diminish the development of pressure ulcers. Self-management support interventions might help to improve their self-management skills. To review the content, components and effectiveness of self-management support interventions on clinical and behavioral outcomes for people at risk of pressure ulcers. A systematic literature search for the period of January 2000 to February 2020 was conducted in five databases (CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science). Inclusion criteria were: (1) studies including persons at a high risk of pressure ulcers; (2) studies investigating interventions focused on self-management support; (3) studies describing clinical and behavioral outcomes related to prevention and care of pressure ulcers. All studies were independently screened on title, abstracts and full text by two researchers. The PRISMS taxonomy of 14 components was used to code intervention content. The search yielded 5297 papers, which resulted in the inclusion of 16 papers on self-management support interventions for persons at risk of pressure ulcers. Interventions focused mostly on 'Information about condition and/or management' (13 interventions), 'Training in practical self-management activities' (7 interventions), and 'Training in psychological strategies' (6 interventions). 'Provision of equipment' was not investigated. The intensity of the interventions varied in delivery mode, frequency and duration. Improvements were found in clinical outcomes in four studies and in behavioral outcomes in ten studies. Four studies showed improvements in clinical outcomes and ten studies in behavioral outcomes. Knowledge was positively influenced in eight studies. Self-management support interventions show potential. The extensiveness and intensity of the interventions seem to be predictive for the effectiveness, but specific content components cannot be recommended. This review revealed recommendations for future research and international consensus should be reached about patient-relevant outcomes. [ABSTRACT FROM AUTHOR]

Background: Delirium is a common neuropsychiatric disorder associated with prolonged hospital stays, and increased morbidity and mortality. Diagnosis is frequently missed due to varying disease presentation and lack of standardized testing. We examined biomarkers as diagnostic or prognostic indicators of delirium, and provide a rational basis for future studies.Method: Systematic review of literature published between Jan 2000 and June 2019. Searches included: PubMed; Web of Science; CINAHL; EMBASE; COCHRANE and Medline. Additional studies were identified by searching bibliographies of eligible articles.Results: 2082 relevant papers were identified from all sources. Seventy-three met the inclusion criteria, all of which were observational. These assessed a range of fourteen biomarkers. All papers included were in the English language. Assessment methods varied between studies, including: DSM criteria; Confusion Assessment Method (CAM) or CAM-Intensive Care Unit (ICU). Delirium severity was measured using the Delirium Rating Scale (DRS). Delirium was secondary to post-operative dysfunction or acute medical conditions.Conclusion: Evidence does not currently support the use of any one biomarker. However, certain markers were associated with promising results and may warrant evaluation in future studies. Heterogeneity across study methods may have contributed to inconclusive results, and more clarity may arise from standardization of methods of clinical assessment. Adjusting for comorbidities may improve understanding of the pathophysiology of delirium, in particular the role of confounders such as inflammation, cognitive disorders and surgical trauma. Future research may also benefit from inclusion of other diagnostic modalities such as EEG as well as analysis of genetic or epigenetic factors. [ABSTRACT FROM AUTHOR]

Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for advanced practice nurses. More knowledge is needed regarding the role of advanced practice critical care nurses in European countries. The aim of the study was to review the literature describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related policy. We performed a scoping review including papers published in 1992–2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area) and Europe (geographical origin). Main sources of evidence were PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, SweMed+, Scopus, ERIC and Social Sciences Citation Index. We also searched grey literature, webpages, reference lists and performed hand-search. The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only few were area specific to critical care. Advanced practice critical care nurses were often unable to fulfil their role because education, supportive policy and legislation were lacking. This scoping review informs the policy makers and the INACTIC study of existing advanced practice in critical care nursing in Europe. The advanced role in critical care nursing is characterized by inconsistency regarding policy, education, titles, roles, scope of practice, skills and competencies. Levels of practice and areas of specialization need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any profession. Task-shifting from physician to nurse needs to be more clearly defined and patient outcomes described. Given the scarcity of papers in our target area, we believe it might be too early to conduct a systematic review at this time. [ABSTRACT FROM AUTHOR]

Abstract Involving and supporting the family members and caregivers of people with mental illness is essential to high-quality mental health services. However, literature suggests that there is a lack of engagement between family members and mental health nurses (MHNs). Lack of knowledge among MHNs is often cited as one of the main reasons for this lack of engagement. The aim of this review was to explore the knowledge, skills and attitudes that are required by MHNs to enable to them to work more effectively with families affected by mental illness. A literature based critical review was used to access and review 35 papers in order to extract concepts that could inform the design of eLearning materials to assist MHNs advance their knowledge in this area. Two overarching themes were identified; 'Mental health problems and the family' and 'Working with the family'. From these themes, the knowledge, skills and attitudes required to work more effectively with families are described. The findings from this review provide a descriptive account of the knowledge skills and attitudes that are required for effective family work. In addition, the review provides an empirical foundation for education programmes in the area. Highlights • Mental health nurses often lack the knowledge and skills to support families. • Well-designed education programmes increase knowledge, reduce stress and burden. • Education programmes need to prepare mental health nurses more effectively with families. [ABSTRACT FROM AUTHOR]

Objective: To provide an integrative review of literature on health communication in East Asia and detail culturally-specific influences.Methods: Using PRISMA model, search of PubMed, PsychInfo, Web of Knowledge, ERIC and CINAHL databases were conducted for studies between January 2000 and March 2017, using the terms 'clinician/health professional-patient', 'nurse/doctor-patient, 'communication' and 'Asia'.Results: 38 studies were included: Mainland China, Hong Kong, Japan, South Korea, and Taiwan. The existing body of research on clinician patient communication in East Asia can be classified: 1) understanding the roles and expectations of the nurse, clinician, patient, and family in clinician-patient consultations: a) nurse-patient communication; b) doctor-patient communication; c) the role of family member; and 2) factors affecting quality of care: d) cultural attitudes towards death and terminal illnesses; e) communication preferences affecting trust, decision-making and patient satisfaction; f) the extent to which patient centred care is being implemented in practice; and g) communication practices in multilingual/multi-disciplinary environments.Conclusion: The review detailed the complexity and heterogeneity of clinician-patient communication across East Asia. The studies reviewed indicate that research in East Asia is starting to move beyond a preference for Western-based communication practices.Practice Implications: There is a need to consider local culture in understanding and interpreting medical encounters in East Asia. The paper highlights the need for a specific culturally-appropriate model of health communication in East Asia which may significantly improve relationships between clinicians and patients. [ABSTRACT FROM AUTHOR]