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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]

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]

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]

• 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]

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]

• High prevalence of involuntary treatment among community-dwelling older persons with dementia. • Specific caregiver and care recipient factors associated with involuntary treatment. • Urgent need for proactive measures and targeted interventions to enhance care quality. This systematic review and meta-analysis aimed to ascertain the prevalence of involuntary treatment among community-living older persons with dementia and explore associated factors. We comprehensively searched seven electronic databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, and Scopus) from their inception to October 17, 2023, with an update conducted on April 1, 2024. Meta-analysis synthesized prevalence estimates of involuntary treatment and its three subcategories, with 95% confidence intervals. This study included 11 research papers involving 12,136 community-dwelling individuals with cognitive impairment and dementia from 19 countries. The pooled prevalence of involuntary treatment among community-dwelling older persons with dementia was 45.2% (95% CI: 33.7−60.5%). Subcategories included physical restraints (9.8%, 95% CI: 5.1−18.8%), psychotropic medication (19.1%, 95% CI: 13.6−26.9%), and non-consensual care (34.3%, 27.6−42.7%). Factors influencing involuntary treatment were categorized as caregiver-related and care recipient-related. This study underscores the prevalent use of involuntary treatment among community-dwelling older persons with dementia, emphasizing its association with specific caregiver and care recipient factors. Addressing these findings underscores the importance of proactive measures and targeted interventions to improve the quality of care for this vulnerable population. [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]

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]

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]

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]

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]

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]

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]

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 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]

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]

Intensive-care-unit (ICU) patients exhibit disturbed sleeping patterns, often attributed to environmental noise, although the relative contribution of noise compared to other potentially disrupting factors is often debated. We therefore systematically reviewed studies of the effects of ICU noise on the quality of sleep to determine to what extent noise explains the observed sleep disruption, using the Cochrane Collaboration method for non-randomized studies. Searches in Scopus, PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library were conducted until May 2017. Twenty papers from 18 studies assessing sleep of adult patients and healthy volunteers in the ICU environment, whilst recording sound levels, were included and independently reviewed by two reviewers. We found that the numbers of arousals between the baseline and the ICU noise condition in healthy subjects differed significantly (mean difference 9.59; 95% confidence interval 2.48-16.70). However, there was considerable heterogeneity between studies (I2 94%, P < 0.00001), and all studies suffered from a considerable risk of bias. The meta-analysis of results was hampered by widely varying definitions of sound parameters between studies and a general lack of detailed description of methods used. It is, therefore, currently impossible to quantify the extent to which noise contributes to sleep disruption among ICU patients, and thus, the potential benefit from noise reduction remains unclear. Regardless, the majority of the observed sleep disturbances remain unexplained. Future studies should, therefore, also focus on more intrinsic sleep-disrupting factors in the ICU environment. [ABSTRACT FROM AUTHOR]

Up to one third of all stroke patients suffer from one or more psychosocial impairments. Recognition and treatment of these impairments are essential in improving psychosocial well-being after stroke. Although nurses are ideally positioned to address psychosocial well-being, they often feel insecure about providing the needed psychosocial care. Therefore, we expect that providing nurses with better knowledge to deliver this care could lead to an improvement in psychosocial well-being after stroke. Currently it is not known which interventions are effective and what aspects of these interventions are most effective to improve psychosocial well-being after stroke. To identify potentially effective interventions – and intervention components – which can be delivered by nurses to improve patients' psychosocial well-being after stroke. A systematic review and data synthesis of randomized controlled trials and quasi experimental studies was conducted. Papers were included according to the following criteria: 1) before-after design, 2) all types of stroke patients, 3) interventions that can be delivered by nurses, 4) the primary outcome(s) were psychosocial. PubMed, Embase, PsychInfo, CINAHL and Cochrane library were searched (August 2019–April 2022). Articles were selected based on title, abstract, full text and quality. Quality was assessed by using Joanna Briggs Institute checklists and a standardized data extraction form developed by Joanna Brigss Institute was used to extract the data. In total 60 studies were included, of which 52 randomized controlled trials, three non-randomized controlled trials, four quasi-experimental studies, and one randomized cross-over study. Nineteen studies had a clear psychosocial content, twenty-nine a partly psychosocial content, and twelve no psychosocial content. Thirty-nine interventions that showed positive effects on psychosocial well-being after stroke were identified. Effective intervention topics were found to be mood, recovery, coping, emotions, consequences/problems after stroke, values and needs, risk factors and secondary prevention, self-management, and medication management. Active information and physical exercise were identified as effective methods of delivery. The results suggest that interventions to improve psychosocial well-being should include the intervention topics and methods of delivery that were identified as effective. Since effectiveness of the intervention can depend on the interaction of intervention components, these interactions should be studied. Nurses and patients should be involved in the development of such interventions to ensure it can be used by nurses and will help improve patients' psychosocial well-being. This study was supported by the Taskforce for Applied Research SIA (RAAK.PUB04.010). This review was not registered. [ABSTRACT FROM AUTHOR]

To examine the research evidence about whether families were allowed to witness cardiopulmonary resuscitation on hospitalised adult and paediatric patients; and the views of patients, families and health professionals, about witnessed cardiopulmonary resuscitation. An umbrella review methodology of systematic reviews with sufficient methodological quality. Papers published in Spanish and English between, 1 January 2009 and 31 December 2018 were considered. The following databases were searched: PubMed, CINAHL, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, PsycInfo, Embase, the Central Supplier Database and the Joanna Briggs Institute, Evidence-based Practice Database. Two independent reviewers assessed the papers for methodological quality employing instruments from the Joanna Briggs Institute. Critical appraisal , extraction and synthesis were carried out, employing the established methods for umbrella reviews and the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO number CRD42019145610). The search identified 12 systematic reviews with moderate-to-high quality, which covered 110 original papers. Habitually, health professionals expressed controversial views and showed some reluctance to let families be present during cardiopulmonary resuscitation. In contrast, family members felt strongly that they should be present and patients agreed. Key factors that facilitated witnessed cardiopulmonary were a formal institutional policy, educating health professionals, and designating a health professional to support the family. Educational and cultural backgrounds influenced healthcare professionals' experiences and their attitudes towards witnessed cardiopulmonary resuscitation. In general, Anglo-Saxon countries showed greater support for this practice. These included the United States, which was the country that dominated the literature on this subject. The best available evidence supports allowing the family to be present during cardiopulmonary resuscitation. It is necessary to include this practice in educational curricula and to train emergency personnel in its implementation. Culturally sensitive policies need to be designed, and the public to be aware of their right to be present. [ABSTRACT FROM AUTHOR]

Background Although nursing has been an academic discipline for decades, the infrastructure for nursing research in many countries is still fragile and struggling. Postdoctoral nurses have difficulties developing sustaining careers in nursing research due to lack of career opportunities. Considerable research has been conducted on leadership and mentoring in various areas of nursing. We aimed to systematically review the literature investigating leadership programs and mentoring for postdoctoral nurse researchers, as well as the influence of leadership and mentoring on research productivity, research career development, leadership knowledge and skills, the nurses’ health and well-being, staff relationships, work culture and collaboration, salaries and postdoctoral nurses’ experiences. Methods A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted. The electronic databases PubMed, CINAHL and EMBASE were searched without time limits for eligible studies up to January 2016. Reference lists of included articles were also searched manually and authors were contacted to inquire about other relevant papers. Two authors independently assessed eligibility of studies for inclusion. Titles and abstracts were matched with the inclusion criteria: studies investigating leadership and mentoring programs for postdoctoral nurses and leadership and mentoring influencing research productivity, and career development; and leadership knowledge and skills and other outcomes. The quality of the studies was appraised using the Centre for Evidence-Based Medicine for surveys, the Critical Appraisal Skill Program Qualitative Appraisal Checklist for qualitative studies, and a critical appraisal list for mixed methods studies. Any disagreements were resolved by consensus. Data were extracted by two reviewers. Findings We screened 1775 titles and abstracts, resulting in 15 studies, which included quantitative, descriptive, qualitative and mixed methods designs and involved 3855 postdoctoral nurses. Two studies presenting mentoring programs for postdoctoral nurses were identified. Other studies investigated the influence of mentoring on various outcomes. The findings showed a positive influence of mentoring on research productivity, including increase in publications and grant writing and research career development, improved leadership skills and knowledge. Furthermore, mentoring positively influenced nurses’ health and well-being, staff relationships, work culture and collaboration. Postdoctoral nurses’ experience of mentoring, mentorship, leadership and peer-support is essential in supporting ongoing research activity. Conclusion Although there is a lack of studies with robust designs investigating leadership and mentoring programs, our results document some evidence of mentoring’s influence on research productivity, career development and other outcomes of postdoctoral nurses. [ABSTRACT FROM AUTHOR]

Objectives The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment – defined as factors that enhance or attenuate a nurse’s ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index’s use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. Design A narrative review of quantitative studies. Data sources PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI . Review methods Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Results Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. Conclusion The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. [ABSTRACT FROM AUTHOR]

Context The effectiveness of seclusion and restraint (SR) reduction programs has not been well established. Objective To examine the effectiveness of SR reduction programs in mental health settings. Data sources A systematic review of English and French articles, using CINALH, Web of Science, PubMed, Medline, Embase, and the Cochrane Library. Additional studies were added by searching the references of identified papers. Study selection All evaluative studies on SR reduction programs in mental health were included based on predefined criteria ( n = 23 articles). Data extraction Data extraction of articles was performed using predefined data fields. The three authors conducted quality assessments independently. Data synthesis In the 23 articles analyzed, six key components were predominant in SR reduction programs: 1) leadership, 2) training, 3) post-seclusion and/or restraint review, 4) patient involvement, 5) prevention tools, and 6) the therapeutic environment. Conclusion Despite wide variability in SR indicators and methodological rigor, it remains that the outcomes argue in favor of SR reduction program implementation. [ABSTRACT FROM AUTHOR]

Objectives To identify, describe, and assess the evidence regarding the effects that the Diabetes Conversation Map™ program, an educational tool that engages patients with diabetes in group discussions about diabetes-related topics, has over a range of patient outcomes. Study design A systematic review. Data sources Five databases, including PubMed, CINAHL, Scopus, EMBASE, and Cochrane Collaboration, were utilized to identify studies that evaluated the Conversation Map™ program. Additionally, the reference lists of the identified studies were manually reviewed. Review methods Studies that evaluated the Conversation Map™ program since 2005 were included. Non-English languages, non-journal papers, and studies that only included a description of the program were excluded. A quality assessment of relevant studies was performed. Outcomes were grouped into: objective (e.g., HbA1c levels), subjective (e.g., self-efficacy), and health behaviors (e.g., medication adherence). Results Of the 85 studies originally identified, 24 studies were included in the final sample. The overall methodological quality of the studies was intermediate (score: 17 of 28). Almost all studies examined objective health measures, with most indicating non-significant differences between the Conversation Map™ intervention and the control groups. Conflicting results were found regarding the influence the program had on HbA1c. The majority of studies reported no significant change in blood pressure and mixed results were found regarding other health indicators. Twelve studies examined subjective measures and 11 assessed the effects on health behaviors, mostly reporting non-significant or positive findings. Conclusions Our review shows that although the Diabetes Conversation Map™ program holds the potential to improve patient behaviors and outcomes, current research on the program provides limited support as to their relationship with positive patient outcomes. Larger, more sophisticated studies are needed in order to determine the potential influence Conversation Map™ can have on long-term health outcomes. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature on the effectiveness of a patient coach intervention on patient - physician communication in specialists consultations.Methods: PubMed, Cochrane, PsycInfo, Cinahl and Embase were searched until November 2015. Included were papers describing interventions directed at adult outpatients in secondary care with a variety of somatic diseases. Outcomes had to be measured in communication effectivity from a patient's perspective.Results: Seventeen publications met the inclusion criteria (involving 3787 patients), describing 13 unique interventions. Most interventions were single one-on-one sessions taking between 20 and 40min before consultation. Research quality in ten studies was high. These studies showed significant improvement on immediate, intermediate and long term patient - physician communication.Conclusion: We found limited evidence suggesting an improvement of patient - physician communication by having multiple patient coaching encounters during which questions are prepared and rehearsed and consultations are evaluated and reflected upon, sometimes supported by audio recording the consultation.Practice Implications: The results of this review contribute to the (re-)design of an effective model for patient coaching, a profile and training approach of patient coaches. Future research should aim at determining which patients will benefit most from coaching interventions. [ABSTRACT FROM AUTHOR]

The aim of this review was to examine the literature to identify what is known about midwives' experiences as academics and their perspectives of transition from clinical practice to university. Literature on health care practitioners, particularly nurses' transition from clinical experts to novice teachers suggests the transition to academia is challenging.Challenges reported by research studies have identified stress, uncertainty, and lack of a supportive and structured transition. There was a dearth of primary research evidence of midwives' perspectives. A scoping review using the Johanna Briggs Institute three step approach was employed. First, an initial limited search of Google Scholar and CINAHL was undertaken to identify articles on the topic. Second, the text words contained in the titles and abstracts of relevant articles and the index terms used to describe the articles were used to develop a complete search strategy in databases: EMBASE, MIDIRS, Scopus and PubMed. Finally, a manual search of the reference lists of all included sources of evidence was manually searched for additional studies. Ten papers that included midwives as the participants were located from Australia, The United Kingdom (UK) and the United States of America (USA) between 2006 and 2022. Analysis of the findings led to three themes: Theme 1: Challenges associated with the transition; Theme 2: Dichotomy of identity; and Theme 3: Fear of losing clinical credibility. In most studies midwives formed a subset of the sample meaning that the voices of midwifery academics are minimised by the experiences of other health practitioners. However, in depth details were located from four personal reflections which identified that transition from clinical practice to academia can result in a duality of roles while individuals come to terms with their new reality and overcome their fear of losing credibility as clinicians. New academics from health tend to hold onto their identity as clinicians rather than adopting their new persona as academics. Fear of losing credibility stems from the need to maintain competence for continued professional registration as clinicians. Further research is needed which focuses on midwives as the target sample to validate the research evidence from this scoping review. [ABSTRACT FROM AUTHOR]

Pressure injuries are potentially preventable but frequently occurring adverse events. Intensive care patients have major risk factors for pressure injury with a reported pressure injury prevalence of 12–33%. Multi-faceted interventions, also known as programs or care bundles, are recommended to prevent pressure injuries. This systematic review evaluated the effectiveness of pressure injury prevention programs in reducing pressure injury prevalence and incidence in the adult intensive care population. It also critically appraised the program components and strategies used to implement these programs. We searched PubMed, EMBASE (embase.com), Ovid MEDLINE, EBSCOhost CINAHL, and Cochrane Library databases separately for papers published in English and Chinese from the year of 2000 to May 2018. After removing duplicates, two authors independently screened the title and abstracts, then full-text against the inclusion and exclusion criteria. Data was extracted by one author and checked by a second author. Quality appraisal was conducted by two authors by using the Quality Improvement Minimum Quality Criteria Set, and the Mixed Methods Appraisal Tool. Content analysis was used to categorise program components. Implementation strategies were grouped into six classifications: dissemination strategies, implementation process strategies, integration strategies, capacity building strategies, sustainability strategies, and scale up strategies. Twenty-one peer reviewed papers (12 quality improvement projects, and 9 research papers from 8 studies) were included. Pressure injury prevention programs with 2–11 components were commonly implemented. Common components of the programs included: clarification of staff roles, introducing new roles, repositioning, staff and patient education, support surfaces use, pressure injury risk assessment, skin assessment, nutrition needs assessment, documentation, multidisciplinary team involvement, and mobilisation. Implementation strategies commonly used were education, audit and feedback, and standardising documentation. Five of the eight research studies and one of the quality improvement projects reported significant decrease in pressure injury prevalence, and/or increase in compliance to pressure injury prevention protocols and strategies. Two quality improvement papers reported cost savings of $1 million and £2.6 million respectively after the implementation of the programs. Much of the work on multicomponent pressure injury prevention programs has been undertaken as quality improvement projects and before and after research studies with limited rigour. However, positive outcomes and strong theoretical rationales for the components in the programs suggest that they are beneficial. This calls for future high-quality research such as randomised controlled trials to test the effectiveness of multicomponent interventions and their implementation strategies. Tweetable abstract : Some multicomponent pressure injury prevention programs were found to be effective; however, higher level of research evidence is needed. [ABSTRACT FROM AUTHOR]

Prosody serves central functions in language processing including linguistic functions (linguistic prosody), like structuring the speech signal. Impairments in production and comprehension of linguistic prosody have been described for persons with unilateral right (RHDP) or left hemisphere damage (LHDP). However, reported results differ with respect to the characteristics and severities of these impairments We conducted a systematic literature review focusing on production and comprehension of linguistic prosody at the prosody-syntax interface (i.e., phrase or sentence level) in LHDP and RHDP. In a systematic literature search we included: (i) empirical studies with (ii) adult RHDP and/or LHDP (iii) investigating production and/or comprehension of linguistic prosody at the (iv) phrase or sentence level (v) reporting quantitative data on prosodic measures. We excluded overview papers; studies involving participants with dysarthria, apraxia of speech, foreign accent syndrome, psychiatric diseases, and/or neurodegenerative diseases; studies focusing primarily on emotional prosody; and on lexical stress / word level; studies of which no full text was available and/or that were published in a language other than English. We searched the databases BIOSIS, MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Cochrane Library, PSYNDEX, PsycINFO and speechBITE, last searched on January 13th 2022.We found 2,631 studies without duplicates. We identified 43 studies which were included into our systematic review. For data extraction and synthesis of results, we grouped studies by (i) modality (production vs. comprehension), (ii) function (syntactic structure vs. information structure), and (iii) by experiment task. For production studies, outcome measures were defined as the productive use of the different prosodic cues (lengthening, pause, f0, amplitude). For comprehension studies, performance measures (accuracy and reaction times) were defined as outcome measures. In accordance with the PRISMA 2020 statement (Page et al., 2021), we conducted a quality check to assess study risk of bias. Our review was pre-registered with PROSPERO (CRD42019120308). Of the 43 studies reviewed, 30 studies involved RHDP (n = 309), assessing production in 15 studies and focusing on comprehension of prosody in 16 studies (one study investigated production and comprehension). LHDP (n = 438) were included in 35 studies of which 15 studied production and 21 evaluated comprehension of prosody (one study investigated production and comprehension). Despite the heterogeneity of results in the studies reviewed, our synthesis of results suggests that both LHDP and RHDP show limitations, but no complete impairment, in their production and/or comprehension of linguistic prosody. Prosodic limitations are evident in different areas of processing linguistic prosody, like syntactic disambiguation or the distinction between sentence types. There is a tendency towards more severe limitations in LHDP as compared to RHDP. We only included published studies into our review and did not perform an assessment of risk of reporting bias as well as systematic certainty assessments of the outcomes. Despite these limitations, we conclude that both groups show deficits in production and comprehension of linguistic prosody, but neither LHDP nor RHDP are completely impaired in their prosodic processing. This suggests that prosody is a relevant communicative resource for LHDP and RHDP worth being addressed in speech-language-therapy. [ABSTRACT FROM AUTHOR]

Objectives Improper placement of nasogastric tube used for feeding may lead to serious complications, including death of the patient. There are several different methods used to determine the appropriate length of nasogastric tube for optimal placement in adults. This integrative review of the literature was designed to identify the most accurate method to determine the internal length of nasogastric feeding tube in adults. Design An integrative review of the research literature (1979–2015) using the population–intervention–comparison-outcomes strategy. Data sources The literature search included the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Joanna Briggs, PubMed (MEDLINE), SCOPUS, and Web of Science electronic databases. Review methods Two researchers evaluated the literature to determine if an article met inclusion and exclusion criteria. The quality of the evidence was assessed using the Johns Hopkins Strength of the Evidence critical appraisal tool. Results Twenty studies, published between 1979 and 2014, met inclusion criteria. Of these, nine articles were expert opinion, seven were original research, three were review articles, and one was a guideline. Despite seven original research papers being found, only five reports were about the methods to determine the internal length of nasogastric feeding tube in adults. The literature suggests that four different methods for measuring the tube length are likely to result in proper placement of the tip of the tube in the stomach and all side ports inside it: [nose-to-ear-to-xiphisternum – 50] cm/2 + 50 cm]; [gender-weight and nose-umbilicus-flat]; [xiphisternum-to-ear-to-nose + 10 cm]; [earlobe to xiphisternum to umbilicus – tip of the nose to earlobe]. Four studies found nose-to-ear-to-xiphisternum was most likely to result in a tube that is positioned incorrectly, either ending in the esophagus, in the stomach but too close to the esophagus, or too far into the stomach or duodenum. Conclusions The nose-to-ear-to-xiphisternum and Hanson method should no longer be taught in nursing programs or used in practice by the nurse. The [gender-weight and nose-umbilicus-flat] method has been shown to be safer. [ABSTRACT FROM AUTHOR]

To define the role and scope of nursing practice within the global context of the euthanasia process by reviewing international legislation and scientific literature. Euthanasia is a controversial ethical topic that has been widely discussed. The provision of euthanasia involves a multidisciplinary health care team, in which nurses often have secondary roles. However, nurses play key roles in all major healthcare processes. As increasing numbers of countries are currently regulating or considering the inclusion of euthanasia as a healthcare service, there is an urgent need to define nurses' roles and participation in this process. A scoping review of research published in English, Spanish, French, Dutch, or Portuguese between 1992 and April 2021 was undertaken. Medline (PubMed), CinahlPlus, EMBASE, WoS, PsycInfo, and Scopus were searched for eligible articles. Data were analysed using an adapted version of Arksey and O'Malley's framework methodology. A total of 31 scientific papers, and 11 legislation documents were included. Analyses of current laws showed that few territories have legislation with well-defined nurses' roles. Based on the scientific research, we identified 15 roles and 80 tasks nurses assume during the euthanasia process. We divided our results into five categories: initial care and accompaniment, evaluation of patient's condition, euthanasia procedure, debriefing and notification, and overall role. Nurses perform tasks throughout the euthanasia process. The review of the current legislation and the existing body of scientific literature showed a lack of legislation of the roles nurses assume, thus leading them to participate in practices outside of the legal framework. Policymakers should take into consideration the wide range of roles and tasks nurses assume in the provision of euthanasia to meet their educational and support needs and ensure they are effectively included in this complex process. [ABSTRACT FROM AUTHOR]

To describe and examine the theories, components, and effectiveness of self-management support interventions for individuals experiencing cancer-related fatigue. A systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. CINAHL, PubMed, Cochrane CENTRAL, and EMBASE were searched (from inception to June 2021) for randomised controlled trials examining self-management support interventions for managing cancer-related fatigue. Data were screened, extracted, and appraised by two authors. Data extraction was guided by the Self-management Support Taxonomy (i.e., a modified version of the Practical Reviews in Self-Management Support Taxonomy tailored to cancer). The Revised Cochrane Risk of Bias tool was used for study appraisal. A critical narrative synthesis was conducted. Fifty-one papers representing 50 different studies (n = 7383) were identified. Most interventions were delivered post-treatment (40%) using in-person (i.e., 'face-to-face') encounters (40%), and were facilitated by health professionals (62%). A range of intervention approaches and self-management support strategies were used across studies. The average number of Self-management Support Taxonomy components used across studies was 6.1 (of 14). Thirty-one studies (62%) described a specific behavior change theory to guide their self-management support intervention development. Twenty-nine studies (n = 29/50; 58%) reported a positive intervention effect for fatigue immediately post-intervention. Of these 29 studies, 10 (34%) reported at least one sustained positive effect on fatigue over follow-up periods between two and 12 months. Self-management support that is delivered after cancer treatment, facilitated by health professionals, and incorporating at least one in-person contact appears to produce the most favourable fatigue and behavioral outcomes. However, further work is needed to better understand how individual self-management support strategies and the application of a behavioral theory influence behavior change. Program developers should guide self-management support with a behavioral theory, and describe their theory application in intervention development, implementation, and evaluation; ensure facilitators receive adequate support training; and seek the delivery preferences of cancer survivors. Future research should incorporate adequate follow-up to sufficiently evaluate the impact of programs on cancer-related fatigue and associated self-management behaviors. Findings from this review are relevant to all healthcare professionals, but are of most relevance to nurses as the largest cancer care workforce with a key role in delivering self-management support. [ABSTRACT FROM AUTHOR]

Background: In 2008, we conducted a systematic review on the effects of nurse prescribing using studies with a comparative design. In view of the growing number of countries that are introducing nurse prescribing and the fact that several studies into nurse prescribing have been conducted recently, there is a need for an updated review to reassess the available information on the effects of nurse prescribing when compared to physician prescribing. Objective: To identify, appraise and synthesise the evidence on the effects of nurse prescribing when compared to physician prescribing on the quantity and types of medication prescribed and on patient outcomes. Design: A systematic review. Data sources: In addition to the previous review, which covered the literature up to 2005, 11 literature databases and four websites were searched for relevant studies from January 2006 up to January 2012 without limitations as to language or country. Moreover, full-text copies of all studies included in the previous review were reviewed. Review methods: A three-stage inclusion process, consisting of an initial sifting, checking full-text papers for inclusion criteria and methodological assessment, was performed independently by two reviewers. Data on effects were synthesised using narrative and tabular methods. Results: Thirty-five studies met the inclusion criteria. All but five studies had a high risk of bias. Nurses prescribe in comparable ways to physicians. They prescribe for equal numbers of patients and prescribe comparable types and doses of medicines. Studies comparing the total amount of medication prescribed by nurses and doctors show mixed results. There appear to be few differences between nurses and physicians in patient health outcomes: clinical parameters were the same or better for treatment by nurses, perceived quality of care was similar or better and patients treated by nurses were just as satisfied or more satisfied. Conclusions: The effects of nurse prescribing on medication and patient outcomes seem positive when compared to physician prescribing. However, conclusions must remain tentative due to methodological weaknesses in this body of research. More randomised controlled designs in the field of nurse prescribing are required for definitive conclusions about the effects of nurse prescribing. [ABSTRACT FROM AUTHOR]

Objectives: Cancer treatment can impair fertility. The aim of this review was to investigate (1) fertility information needs, receipt and provision, (2) fertility information preferences, and (3) factors associated with receiving/providing fertility information. Cancer patients' and professional caregivers' perspectives were considered. Design: Mixed-methods systematic review. Data sources: Six electronic databases (PubMed, Web of Science, CINAHL, CRD, Embase) were systematically screened to retrieve articles published between January 2001 and March 2012. Reference lists and conference abstracts were checked for additional publications. Review methods: The principles outlined in the Cochrane Handbook for Systematic Reviews of Intervention were applied. Publications were included if they explored fertility-related information/communication in cancer patients/survivors of reproductive age or professional caregivers. The Critical Appraisal Skills Programme for Qualitative Studies and the Quality Assessment Tool for Quantitative Studies were used to assess the methodological quality. A standardised form based on the Cochrane guidelines for systematic reviews was used to extract the data. Two independent reviewers performed all methodological steps. Results: Of the 1872 papers found, 27 were included in this review. The majority (66- 100%) of the cancer patients wanted information about the impact of cancer therapy on fertility. The need and importance were higher in younger and childless patients, and in patients having childbearing plans. The number of patients receiving this information ranged from 0% to 85%. Several factors were associated with the lack of information receipt, including female gender and age 35 years or older. Patients preferred information via an individual consultation. In the diagnostic phase patients needed information about the impact of the treatment on fertility and preservation options. At the end or after the treatment, information needs shifted towards long term effects. Professional caregivers experienced several barriers in providing fertility information, including caregiver-, patient- and institutional-related factors. Nurses in particular, perceived difficulty in providing fertility-related information due to additional barriers associated with limited responsibility and opportunity in fertility information provision. Conclusion: Professional caregivers experienced multiple barriers that hinder information provision. Further exploration of the role of Advanced Nurse Practitioners/Midwifes and the development of an evidence based intervention to overcome caregiver-related barriers are recommended to improve information provision. [ABSTRACT FROM AUTHOR]

To meet the growing needs of a diverse population, it is critical that healthcare service provision is underpinned by innovative, cost-effective, and sustainable services and solutions. The role of the nurse practitioner creates an opportunity to meet the increasing demands of complex care and enables greater access to high quality care. Understanding how best to support nurse practitioner candidates to develop into the nurse practitioner role will create greater opportunities to transform service delivery and improve healthcare outcomes. To identify key factors that support and positively impact the implementation of nurse practitioner candidacy programs and candidate experiences. A scoping review of research and grey literature was conducted using Joanna Briggs Institute methodology. For the research literature, eight electronic databases (Embase, Medline, CINAHL, Web of Science, Cochrane Library, Joanna Briggs Institute, PubMed and PsycINFO) were searched followed by a hand search of the reference lists of published systematic reviews and relevant topical papers. A review of national and international grey literature sources was completed. Identification of a service gap, developing and promoting a clear role for the nurse practitioner candidate, integration into a multi-disciplinary team with strong mentorship/preceptorship support, continuing professional development, and evaluation of the program were identified as key factors in the research and grey literature. A well-designed candidacy program can facilitate transition of the candidate into an autonomous, fully independent nurse practitioner. Recommendations to support the implementation of these roles into the clinical setting have been generated. Tweetable abstract : Key to nurse practitioner candidate programs: Identification of a service gap, clear role, integration, mentorship, training and evaluation [ABSTRACT FROM AUTHOR]

Nurses work in stressful and demanding settings and often suffer from depression and burnout. Despite overlapping symptoms, research has been inconclusive regarding the discriminant validity of measures of burnout with regard to measures of depression. Such inconclusive discriminant validity might cause clinicians to fail to recognize and manage depression separately from burnout. This meta-analysis aimed to clarify the distinctiveness of burnout as a separate construct by examining the size of the relationship between burnout and depression among nurses as well as potential moderators. A stepwise method was used by searching 4 databases (PubMed, CINAHL, PsycINFO, and EMBASE) to retrieve published papers in English examining the relationship between burnout and depression among nurses and reporting the effect sizes of their findings. We identified a total of 37 eligible studies. The pooled estimate showed a positive association between burnout and depression among nurses (r = 0.403, 95% CI [0.327, 0.474], p < 0.0001) and a slightly higher correlation coefficient for the Emotional Exhaustion subscale of the Maslach Burnout Inventory (MBI) measure (0.494, 95% CI [0.41, 0.57]). This review confirms a large burnout - depression correlation in nursing samples, adding to existing literature encompassing a variety of occupations. Future studies should focus on path analysis to assess the causal relationship as well as investigate potential moderators. [ABSTRACT FROM AUTHOR]

• Internet-based prenatal interventions had a small effect on depression. • Websites and mobile devices were the most common internet-based prenatal education. • Promoting communications and social support enabled the bridge of online-based education. This study investigated the effect of internet-based prenatal interventions among pregnant women. Articles regarding randomized controlled trials of internet-based prenatal education interventions were investigated through a systematic review. A literature search was conducted in PubMed, CINAHL, Cochrane Library, Embase, ERIC, and RISS on material published between 1985 and 2020. The inclusion criteria were peer-reviewed papers in English regarding randomized controlled trials of internet-based prenatal education interventions. The exclusion criteria were studies in which high-risk pregnant women participated, interventions that were conducted face-to-face or only involved telephone contact, and studies that reported outcomes related to the baby's health. The quality of the included studies was evaluated using the Risk of Bias 2.0 methodology checklist. Heterogeneity testing suggested a homogeneous sample (I2 = 0%, p =.45). Meta-analysis through standardized mean differences showed that six studies had an effect on postpartum depression, with an effect size of −0.16 (95% CI, −0.26 to −0.05). Conclusion : This study demonstrated that internet-based prenatal interventions had an impact on maternal depression during the postpartum period. Therefore, antenatal care involving mobile-, web-, and internet-based materials may reduce maternal depressive symptoms. [ABSTRACT FROM AUTHOR]

Sexual and reproductive health of young people is an international concern with the increasing interest in healthy pregnancy and childbirth. mHealth interventions involve the use of mobile technologies for health support, have wide applications in clinical nursing practice, and play an increasingly important role in disseminating sexual and reproductive health-related information in emerging adulthood. However, there is a lack of evidence on the effects of mHealth intervention programs. This meta-analysis systematically assessed the effects of mHealth interventions on contraceptive use and pregnancy occurrence in emerging adulthood to identify the characteristics of a successful mHealth intervention program. We conducted a systematic review and meta-analysis of randomized controlled trials. Four central electronic databases (PubMed, Embase, CINAHL complete, and the Cochrane Library) were searched for relevant articles published from inception to May 2020. Data extraction and quality appraisal were performed independently by two reviewers. Eleven papers on the effects of mHealth interventions on sexual and reproductive health in emerging adulthood were selected. The included studies were assessed for the risk of bias with the Risk of Bias 2 (RoB 2) tool. Overall and subgroup meta-analyses were conducted using STATA 16.0. Heterogeneity within studies was calculated using I2. We tested the effect of mHealth interventions on contraceptive use and pregnancy occurrence to identify the impact of sexual and reproductive health. mHealth interventions improved the use of contraception (OR 1.21; 95% CI: 1.02–1.43, I 2 = 20.7%; p = 0.234) although the effect on pregnancy occurrence was not significant (OR 0.80, 95% CI: 0.61–1.05, I 2 = 0.0%, p = 0.950). In subgroup analysis, mHealth interventions especially improved oral contraceptive use (OR 1.43, 95% CI: 1.15–1.77, I 2 = 0.0%, p = 0.784). Regarding the communication type, two-way communication showed statistically significant results with the mHealth intervention in the experimental group (OR 1.28, 95% CI: 1.06–1.54, I 2 = 0.0%, p = 0.872). This meta-analysis found a positive effect of mHealth intervention on contraception, whereas the impact on pregnancy occurrences was limited. We also confirmed the factors underlying effective mHealth interventions from the results of our review. Our findings demonstrate that mHealth interventions may be suggested as a useful strategy to promote sexual and reproductive health in emerging adulthood. [ABSTRACT FROM AUTHOR]

Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. All studies describing nurses' experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses' require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce. [ABSTRACT FROM AUTHOR]

• International review of language and auditory processing skills in the cleft palate population. • Poorer outcomes in language and auditory processing compared with non-cleft peers. • Scores on standardized tests of language frequently fall within the normal range. • Limited correlations of skills in speech, language and auditory processing. • Lack of longitudinal data and comparison to other communication disorders. Cleft lip and/or palate (CL/P) is the most common congenital craniofacial condition. Children born with CL/P are at increased risk of persistent speech difficulties related to velopharyngeal incompetence (VPI) and compensatory articulation problems. It has also been reported that they achieve poorer results academically than their peers. There is a further body of evidence to suggest delayed language skills. These potentially related outcomes are often reported separately. To review published and unpublished research into the nature of difficulties related to spoken and written language across all non-syndromic cleft diagnoses. To review any evidence of associations between comorbidities. A scoping review was carried out in October 2016 and updated in June 2019 following published methodology (Arksey & O'Malley, 2005; Levac et al. 2010). A search of the literature over the two time points found 38 papers in total. Three main themes were found: oral language skills, reading and auditory processing difficulties. There is evidence of early language delay in children born with CL/P. Evidence of persistent oral language problems is less conclusive. Many studies have reported scores within the average range for language, auditory processing and reading but poorer outcomes when compared to non-cleft control groups. However, studies have used a range of outcome measures, making comparisons difficult. Moreover there is no clear evidence how these difficulties might relate to speech outcomes or educational achievement and no comparison to other populations with speech, language and communication needs (SLCN). [ABSTRACT FROM AUTHOR]

• Seven studies with 770 randomized patients with dementia were included, which compared valproic acid with placebo. • Valproic acid is generally well-tolerated in patients with dementia, even in long-term therapy for 24 months. • Insufficient evidences are found to support valproic acid in the treatment of dementia for symptoms or disease-modifying. • The anticipations for a success in the trial of valproic acid for dementia in the future look not optimistic. The neuroprotective effect of valproic acid has been observed in the animal models of neurodegeneration, which suggests it as a potential candidate for clinical trials. In this paper, we aimed to systematically analyze the efficacy and safety of valproic acid in the treatment of dementia. We searched the electronic databases PubMed, EMBASE, CINAHL, Cochrane Library and China National Knowledge Infrastructure until March 2020 for the eligible randomized controlled trials, as well as the unpublished and ongoing trials. We pooled the results using a random-effects model. We included seven studies with 770 randomized patients with dementia, which compared valproic acid with placebo. Indeed, there were no significant differences found in the scores of Mini–mental State Examination, Cohen-Mansfield Agitation Inventory and number of patients with adverse events. Valproic acid is generally well-tolerated in patients with dementia, even in long-term therapy for 24 months. Insufficient evidences are found to support valproic acid in the treatment of dementia for cognitive, psychiatric symptoms or disease-modifying. The anticipations for a success in the trial of valproic acid for dementia in the future look not optimistic based on the available evidence. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review was to synthesize the evidence on experiences of aging in place in the United States. Systematic review and meta-ethnography of qualitative studies. We searched six bibliographic databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, Sociological Abstracts), with no limits on publication date. Eligible studies reported peer-reviewed qualitative research on experiences of aging in place in the United States with full-text available in English. Three reviewers independently used Covidence software to screen titles and abstracts followed by full texts. We assessed quality and risk of bias using a modified version of the Joanna Briggs Institute Checklist for Qualitative Research. Qualitative data analysis was conducted using meta-ethnography, following Noblit and Hare's seven-step method of translation and synthesis to generate a novel conceptual model. Of 2659 papers screened, 37 unique studies were eligible for inclusion, reported in 38 publications. The studies were conducted in 16 states and published between 1994 and 2018. The included samples represented 1199 participants in total, with mean ages ranging from 48 to 91 years. The gender of the samples ranged from 20% to 100% female, with a median of 77%. One-third of the included studies did not report participants' race/ethnicity, and half of the remaining study samples were at least 90% white; however, 20% of the studies focused exclusively on experiences of racial/ethnic minority older adults. Using meta-ethnography, we developed a new conceptual model of aging in place in the United States as a dynamic process of balancing threats and agency in relation to experiences of identity, connectedness, and place. We found that people aging in place were engaged in significant work to cope with unpredictable needs and challenges by changing their mindset, adapting their home environment to accommodate new needs, and finding different ways to connect with important people in their lives. Agency was shaped by resources and restrictions on choice, and where threats to aging in place outweighed an individual's sense of agency, the consequences included feelings of uncertainty, isolation, and dislocation. To the best of our knowledge, this is the first systematic review of qualitative studies to evaluate experiences of aging in place in the United States. The findings of our meta-ethnographic synthesis led to the development of a new conceptual model of aging in place highlighting the dynamic tensions involved in balancing threats and agency. [ABSTRACT FROM AUTHOR]

Schizophrenia is a disabling neurological disorder. Patients with this disease are at higher risk to violence. This paper reviewed the recent literatures with respect to the heterogeneous nature of the abnormalities and pathophysiological and biological risk markers that link to violent behavior in patients with schizophrenia with a particular interest in lipid metabolism. We have focused on altered lipid profile including polyunsaturated fatty acids, which may have attributed to the development of aggressive behavior in patients with schizophrenia. We addressed questions on how aberrant lipid metabolism affects brain structure and function, and how lipids modulate neurotransmission activity during progression of this devastating disease. Many clinical studies have demonstrated that omega-3 fatty acids may reduce transition rate to psychosis and serve as additive to reduce the violence. We postulate that the beneficial effect of omega-3 fatty acid supplementation on violence may act through modulating neuronal membrane lipid structure and neurotransmission. A better understanding of the underlying mechanisms how these pathways modulate aggression may facilitate development of strategies to prevent, ameliorate or reduce the manifestation of violence. • Aberrant brain lipids affect brain structure and function in violent schizophrenia. • Omega-3 supplementation restores partially brain structure and neurotransmission. • Possible mechanisms underlying the beneficial effects of omega-3 supplementation • Timing of intervention may affect the degree of improvement in mental symptoms. [ABSTRACT FROM AUTHOR]

To review patient experiences of the architectural elements conducive to a supportive or healing-promoting environment in the context of ambulatory oncology care. A comprehensive review of original peer-reviewed qualitative studies conducted to reveal the meaning and significance of patient experience in this context was undertaken. Studies were identified through electronic databases including Ovid MEDLINE, CINAHL, PubMed and Embase. No time limit was applied and language was restricted to English. The generated records were screened at the titles and abstracts level by the first reviewer, with full text assessment conducted by both authors. Main themes were extracted in an excel file and a narrative synthesis strategy was used to systematically gather evidence and explain the findings. The guidelines of the Centre for Reviews and Dissemination have been followed in the searching and reporting of the essential matters relevant to this review. Eleven original studies were selected; in addition to these, fourteen other studies that did not fully meet the selection criteria, however held important information relevant to the scope of the review, were considered to expand the discussion with relevant information to ambulatory cancer facilities. The findings of these studies were synthesized into five major themes: stimulating and homely environments; flexibility and environmental enrichment; social support; complementary support and engagement; and physical and sensory support. The paper identified key architectural design qualities that have the potential to support treatment and empower patients, with particular reflection on patients undergoing intravenous anti-cancer treatment within ambulatory settings. It provides examples in which designing the built environment with people in mind and providing tailored solutions to meet their actual needs and preferences may help cancer patients cope with the emotional and physical challenges of the disease and its treatment and support a general experience of patient-centred care. A conceptual framework that articulates the principal constituents of a supportive environment is tentatively proposed, extending existing theoretical propositions to facilitate further investigation of this context. [ABSTRACT FROM AUTHOR]