Search

Background: Up to 40% of older women living in the community experience urinary incontinence. In community settings, urinary incontinence impacts the quality of life, morbidity, and mortality rates. However, little is known about urinary incontinence and its impact on older women admitted to hospitals. Objectives: This scoping review aims to establish the current knowledge of urinary incontinence during hospital admission for women (⩾ 55 years of age) with three key objectives: (a) What is the prevalence/incidence of urinary incontinence? (b) What health conditions are associated with urinary incontinence? (c) Is there an association between urinary incontinence and mortality? Eligibility criteria: Empirical studies were included in assessing the incidence/prevalence of urinary incontinence during hospital admissions and its related morbidities and mortality rates. Studies which only included men or younger women (< 55 years of age) were excluded. Only articles written in English and conducted between 2015 and 2021 were included. Sources of evidence: A search strategy was developed, and CINAHL, MEDLINE, and Cochrane databases were searched. Charting methods: Data from each article meeting the criteria were pulled into a table, including study design, study population, and setting, aims, methods, outcome measures, and significant findings. A second researcher then reviewed the populated data extraction table. Results: Overall, 383 papers were found: 7 met inclusion/exclusion criteria. Prevalence rates ranged from 22% to 80% depending on the study cohort. Several conditions were associated with urinary incontinence, including frailty, orthopaedics, stroke, palliative care, neurology, and cardiology. There was a potential positive association between mortality and urinary incontinence, although only two papers reviewed reported mortality. Conclusion: A dearth of literature determined the prevalence, incidence, and mortality rates for older women admitted to hospitals. Limited consensus on associated conditions was found. Further research is needed to fully explore urinary incontinence in older women during hospital admissions, particularly concerning prevalence/incidence and its association with mortality. [ABSTRACT FROM AUTHOR]

Introduction: Violence against healthcare workers in the workplace is a complex issue affecting various healthcare professionals. Workplace violence (WPV) poses significant occupational hazards to healthcare employees. Objectives: To identify the causes, types, and perpetrators of WPV and explore the effects of violence on healthcare workers' well-being. Methods: This literature review analyzes 15 selected research papers published between 2015 and 2020, focusing on WPV against healthcare workers, and gathers insights from healthcare professionals with prior experience of WPV. Through an analysis of the selected research papers, this study provides a comprehensive overview with WPV in the healthcare setting. The respondents in the included studies were healthcare professionals who had encountered WPV in their work. Results: While nurses remain particularly vulnerable to violence due to their constant patient interaction, this study reveals that verbal violence is the most prevalent type, significantly impacting the well-being of healthcare workers as a whole. The identified causes of WPV include long waiting times, understaffing, miscommunication, inadequate security measures, high patient expectations, and overcrowding. Respondents emphasized the importance of education, security enhancements, and administrative support to address or prevent WPV. Conclusion: The findings strongly highlight the crucial role of administrative support in reducing the incidence of WPV. It is crucial to implement broader measures to ensure the safety and well-being of all healthcare workers. [ABSTRACT FROM AUTHOR]

Listening effort (LE) describes the cognitive resources needed to process an auditory message. Our understanding of this notion remains in its infancy, hindering our ability to appreciate how it impacts individuals with hearing impairment effectively. Despite the myriad of proposed measurement tools, a validated method remains elusive. This is complicated by the seeming lack of association between tools demonstrated via correlational analyses. This review aims to systematically review the literature relating to the correlational analyses between different measures of LE. Five databases were used– PubMed, Cochrane, EMBASE, PsychINFO, and CINAHL. The quality of the evidence was assessed using the GRADE criteria and risk of bias with ROBINS-I/GRADE tools. Each statistically significant analysis was classified using an approved system for medical correlations. The final analyses included 48 papers, equating to 274 correlational analyses, of which 99 reached statistical significance (36.1%). Within these results, the most prevalent classifications were poor or fair. Moreover, when moderate or very strong correlations were observed, they tended to be dependent on experimental conditions. The quality of evidence was graded as very low. These results show that measures of LE are poorly correlated and supports the multi-dimensional concept of LE. The lack of association may be explained by considering where each measure operates along the effort perception pathway. Moreover, the fragility of significant correlations to specific conditions further diminishes the hope of finding an all-encompassing tool. Therefore, it may be prudent to focus on capturing the consequences of LE rather than the notion itself. [ABSTRACT FROM AUTHOR]

Introduction: In the COVID-19 era, burnout is a major occupational hazard among healthcare workers. This scoping review intended to investigate the pertinent literature concerning COVID-19 burnout among healthcare workers (HCWs) and the measures to prevent and reduce HCW burnout during the COVID-19 pandemic. Methods: The databases CINAHL, PubMed, ScienceDirect, and Scopus were systematically searched and screened for relevant papers. Additionally, manual searching was employed to supplement the electronic database results. The researchers examined 21 publications to answer the research question, "What have been the measures to prevent and reduce healthcare worker burnout during the COVID-19 pandemic?" The PRISMA 2020 checklist was used to guide the reporting of this scoping review. Results: It was found that to diminish healthcare workers' burnout, it is vital to use multilevel, evidence-based approaches. These interventions may include increasing awareness of the risks and preparing for potential occupational stress and burnout; promoting mindfulness and self-care practices to enhance mental well-being; enhancing organizational policies and procedures to address burnout among healthcare workers; and ensuring the availability of optimal mental health services, including the use of digital technologies to address workplace stress and facilitate mental health interventions. Conclusion: The interventions to prevent and reduce HCW burnout during the COVID-19 pandemic include supporting HCWs individually, improving work environments, and addressing health system factors contributing to burnout complemented by interventions aimed at enhancing work culture. [ABSTRACT FROM AUTHOR]

Sexual wellbeing is an integral part of a person's overall sense of wellbeing. It is closely linked to physical, sexual, and mental health. Despite this, sexual wellbeing remains underexplored, including among young people (aged 16–24). This review aims to gain a greater understanding of young people's experiences of sexual wellbeing. We will include qualitative research on young people's lived experiences related to sexual wellbeing. We will search PROSPERO, Medline, CINAHL, PsycINFO, and SocINDEX utilising an iterative search approach. If the volume of eligible studies for inclusion is too large to permit in-depth analysis, the team will purposively sample studies to prioritise heterogeneity and richness. The lead author will assess the eligibility of studies, carry out data extraction, and assess the methodological quality of all studies. The wider research team will independently screen papers' title and abstract, extract data, and conduct methodological quality assessments of a subset of papers. Two reviewers will independently assess inclusion of all papers at full text. We will draw on the QuART tool to assess the methodological quality of included studies. We will utilise a thematic synthesis approach to synthesise the data and produce analytical statements. We will apply GRADE-CERQual to evaluate our confidence in each of the synthesis' analytical statements. The team will adopt a reflexive approach throughout all stages of the qualitative evidence synthesis (QES). Research will be written up in line with ENTREQ and PRISMA-S standards. The protocol for this QES was prospectively published in the International Prospective Register of Systematic Reviews (PROPERO) database under registration number CRD42022315593. [ABSTRACT FROM AUTHOR]

Healthcare provides a rich, and constantly increasing, number of written documents, which are underutilized in research data for health and nursing sciences, but previous literature has only provided limited guidance on the process of document analysis. The aim of this paper is to provide a methodological framework for analyzing health care documents as written data, based on a systematic methodological review and the research team's experience of the method. Based on the results, the methods consist of seven phases: (i) identify the purpose, (ii) determine the document selection strategy, (iii) select or design an extraction matrix, (iv) carry out pilot testing, (v) collect and analyze the data, (vi) consider the credibility, and (vii) ethics of the study. The framework that has been developed can be used to carry out document analysis studies that are both feasible and credible. [ABSTRACT FROM AUTHOR]

Objectives: Idiopathic childhood constipation is a prevalent condition that initially brings the child under the care of the primary health care team. Although it is acknowledged that health education is crucial to reducing chronicity, the range of evidenced-based non-pharmacological health education provided to families has not previously been reviewed. For this scoping review, 4 research questions sought to identify papers that provide information on the utilization of guidelines, the range of health education, who provides it, and whether any gaps exist. Methods: Following a registered protocol and using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, searches of 10 online databases, reference lists, Google Scholar, and book chapter references were made. Eligible papers were original research published in English between January 2000 and December 2022. Results: Twelve worldwide studies (2 qualitative and 10 quantitative) reported that: evidence-based guidelines are not consistently used by primary care providers; the range of non-pharmacological health education provided is inconsistent; the non-pharmacological health education is provided by doctors, nurses, and pharmacists; and that gaps exist in non-pharmacological health education provision. Conclusion: This review demonstrates that rather than a lack of guideline-awareness, decreased specific idiopathic childhood constipation knowledge (and possibly time) may be responsible for inconsistent non-pharmacological health education. Inappropriate treatment and management of some children escalates risk for chronicity. Improving health education provision however, may be achieved through: increased collaboration; better utilization of nurses; and through developing the child's health literacy by involving both child and family in all aspects of health education and decision-making. [ABSTRACT FROM AUTHOR]

Background: No systematic summary exists on childhood physical activity and later-life multimorbidity risks. We primarily investigated the association of physical activity in childhood and adolescence and the development of multimorbidity in adulthood. Secondarily, we examined whether physical activity level differ in children and adolescents with and without multimorbidity and whether there is a cross-sectional association between physical activity and multimorbidity. Methods: Following Cochrane Handbook guidelines and adhering to PRISMA recommendations, we included cross-sectional, case-control and longitudinal studies that investigated the association between physical activity in children and adolescents and development of multimorbidity. Results were summarized narratively and we assessed the certainty of the evidence using the GRADE approach. The protocol was registered in PROSPERO, CRD42023407063. Results: Of 9064 studies identified, 11 were included in 13 papers. Longitudinals studies suggested that being physically active in childhood and adolescence was associated with a lower risk of multimorbidity in adulthood. Three out of five studies reported lower physical activity level in children and adolescents with multimorbidity compared to those without, and two did not find a between-group difference. Cross-sectional evidence on the association between multimorbidity and lower physical activity was uncertain. Overall, the evidence certainty for all outcomes was considered low due to the indirectness and inconsistency in findings. Conclusions: Childhood and adolescence physical activity appeared to be linked with a reduced risk of later-life multimorbidity but the certainty of the evidence is low. These results support the promotion of physical activity during childhood and adolescence. [ABSTRACT FROM AUTHOR]

Background: The management of subglottic stenosis (SGS) in granulomatosis patients with polyangiitis (GPA) has no clear guidelines. This systematic review aimed to identify different surgical techniques and evaluate the outcomes of applied procedures. Methods: An electronic search was performed using 3 major databases, CINAHL, PubMed, and Clinical key, to include relevant studies published from the databases from inception through January 2017. All primary studies reporting treatment of SGS in cases with GPA were included. Articles were excluded if not relevant to the research topic or if they were duplicates, review articles, editorials, short comments, unpublished data, conference abstracts, case reports, animal studies, or non-English studies. Results: Thirteen papers were included in our systematic review with a total of 267 cases for the qualitative review Endoscopic approaches showed favorable outcomes with the need to use multiple procedures to achieve remission. The open transcervical approach showed excellent results mainly after failure of other endoscopic techniques. Tracheostomy was necessary for severe respiratory obstruction symptoms. Medical treatment was essential for stabilizing the active disease and therefore may enhance the success rate postoperatively. Conclusion: Subglottic stenosis in patients with GPA requires a multidisciplinary approach to provide optimal management regarding disease activity, grade of stenosis, and severity of symptoms. [ABSTRACT FROM AUTHOR]

Background: Uptake of influenza vaccination reduces staff absenteeism as well as mortality of patients and healthcare workers (HCWs); however, adherence of HCWs to annual influenza vaccination is poor and some healthcare facilities are now considering mandatory influenza vaccination policies. Aim: The purpose of this study was to identify the perceived and reported barriers to the implementation of a mandatory influenza vaccination policy for HCWs. Methods: An integrative review of the literature was conducted. Databases including CINAHL, Cochrane Library, Medline and PubMed were searched using key terms. The quality of papers was assessed utilising the Standard Quality Assessment Criteria for Evaluating Primary Research papers for a Variety of Fields which consisted of 10 questions with a possible total score of 20. PRISMA guidelines were used to report the search outcomes. Results: A total of 68 papers were identified from the database search. Seven papers were relevant, following screening. The quality scores of these were in the range of 15–20. A number of barriers are reported to prevent the effective implementation of mandatory influenza vaccination policies including ethical and legal considerations, logistics, healthcare burden, leadership and management, and human factors such as HCWs' perspectives. Conclusions: By comprehensively identifying these, barriers can be addressed to allow effective implementation of such policies in healthcare facilities to ensure improved outcomes. The results of the review indicated the need for further research to ensure that barriers are addressed cohesively. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has impacted access to and use of maternal, newborn, and child health services. Due to lockdowns and travel restrictions implemented during the first wave of the pandemic, the provision of essential maternal health services such as family planning was critically affected. Unlike most healthcare, contraception-related services are impractical for virtual care provision as women need to attend the clinic in person. Therefore, most women across the world might have been left with an unmet need for contraception during the lockdown period. Interruptions in contraception services have led to an increased number of unintended pregnancies. With the emergence of several pocket studies, it is essential to pool the available evidence reporting the effects of COVID-19 on contraception to inform maternal health policy and practice. Objective: The aims of this review are (1) to determine the effects of the COVID-19 pandemic on access to contraceptives among sexually active women and (2) to identify the magnitude of unintended pregnancy linked to interruptions of contraceptives due to the COVID-19 pandemic. Methods: The protocol for this systematic review was registered in PROSPERO (CRD42021267077). Electronic databases such as MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and Google Scholar will be searched for articles using appropriate key terms. The identified articles will be assessed against the eligibility criteria. Two reviewers (A.B. and T.B.) will independently screen titles and abstracts of all retrieved articles followed by a full-text review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The quality of the papers will be assessed by using the Risk of Bias Assessment tool for Non-Randomized Studies. Quantitative findings will be pooled using a random-effects model meta-analysis, while qualitative findings will be presented using a narrative synthesis. Ethics and dissemination: Ethical approval is not required. The findings will be disseminated through conference presentations and peer-reviewed publications. Discussion: This systematic review will present current data needed to design evidence-based programmes for improving access to contraception and preventing unintended pregnancy during the COVID-19 pandemic and future emergencies. Systematic review registration: PROSPERO CRD42021267077. [ABSTRACT FROM AUTHOR]

Introduction: Cadaver dissection in anatomy, a cornerstone of medical school education, has been replaced by digital technologies. This study aimed to determine the learning outcomes nursing students could achieve through cadaveric dissection practice (CDP). Methods: This scoping review was carried out using the checklist outlined in the Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews through August 2023. Articles from PubMed, ERIC, and CINAL were included. This scoping review included studies that focused on the learning effects of nursing students' experiences with cadaver dissection, written in English, and covered all study types. Results: The cadaveric dissection exercise resulted in a strong interest in the human body and a thorough understanding of anatomy and physiology. It also allows for creating an image of care for the patient before death, the meaning of existence after death, acceptance that death is not frightening, and an understanding of the afterlife. Furthermore, the cadaveric dissection exercise has been reported to improve confidence in patient care, lead to a better understanding of what other professions practice, and involve the development of professional identity. Conclusions: Studies on the learning effects of CDP have differed in subject matter and educational methodologies. In the future, while determining how the experience of CDP is related to nursing practice of nursing students and graduates, we must explore effective CDP and develop educational methodologies that can achieve similar learning effects. [ABSTRACT FROM AUTHOR]

Background: Worldwide disparities in surgical capacity are a significant contributor to health inequalities. Safe surgery and infection prevention and control depend on effective sterile processing (SP) of surgical instruments; however, little is known about SP in low- and middle-income countries (LMICs), where surgical site infection is a major cause of postoperative morbidity and mortality. Aim: To appraise and synthesise available evidence on SP in LMICs. Methods: An integrative review of research literature was conducted on SP in LMICs published between 2010 and 2020. Studies were appraised and synthesised to identify challenges and opportunities in practice and research. Results: Eighteen papers met the inclusion criteria for qualitative analysis. Challenges to advancing SP include limited available evidence, resource constraints and policy-practice gaps. Opportunities for advancing SP include tailored education and mentoring initiatives, emerging partnerships and networks that advance implementation guidelines and promote best practices, identifying innovative approaches to resource constraints, and designing and executing quality assurance and surveillance programmes. Discussion: Research investigating safe surgery, including SP, in LMICs is increasing. Further research and evidence are needed to confirm the generalisability of study findings and effectiveness of strategies to improve SP practice in LMICs. This review will help researchers and stakeholders identify opportunities to contribute. The burdens of unsafe surgery transcend geopolitical borders, and the global surgery and research communities are called upon to negotiate historical and present-day inequities to achieve safe surgery for all. [ABSTRACT FROM AUTHOR]

Data mining provides the methodology and technology to transform huge amount of data into useful information for decision making. It is a powerful process to extract knowledge and discover new patterns embedded in large data sets. Data mining has been increasingly used in medicine, particularly in cardiology. In fact, data mining applications can greatly benefits all parts involved in cardiology such as patients, cardiologists and nurses. This article aims to perform a systematic mapping study so as to analyze and synthesize empirical studies on the application of data mining techniques in cardiology. A total of 142 articles published between 2000 and 2015 were therefore selected, studied and analyzed according to the four following criteria: year and channel of publication, research type, medical task and empirical type. The results of this mapping study are discussed and a list of recommendations for researchers and cardiologists is provided. [ABSTRACT FROM AUTHOR]

Objectives: While healthcare organizations increasingly aim to address the social determinants of health (SDOH) in the clinic setting, there is little guidance on which staff are best equipped to assume this role. The present study is a scoping review of the peer-reviewed literature to characterize workforce models used to screen for and respond to patients' unmet social needs in ambulatory settings. Methods: Four online databases were used to identify papers published until February 2021. Eligible articles were original research studies or systematic reviews that described the implementation of a standardized assessment for multiple SDOH domains and resulting activities to respond to individual patient needs (eg, referral to community resources) in ambulatory care settings. Results: Of the 1569 articles identified, 65 met study eligibility criteria. Majority of studies had observational study designs (11% were randomized control trials). For screening-related activities, more articles reported using traditional healthcare staff (51%), such as medical providers, medical assistants, and front-desk staff, than social care staff (32%), such as social workers and student volunteers. In contrast, for response-related activities, more articles reported using social care staff (88%) than traditional healthcare staff (60%). While we found wide variations in specific team configurations and training for the roles, social care staff generally provided more intensive forms of assistance than traditional healthcare staff. Conclusion: While this review demonstrates the breadth of models for building or deploying a workforce to integrate health and social care, it also identifies the need for rigorous research on workforce development, implementation, and effectiveness. [ABSTRACT FROM AUTHOR]

Background: Adverse incidents are well studied within acute care settings, less so within aged care homes. The aim of this scoping review was to define the types of adverse incidents studied in aged care homes and highlight strengths, gaps, and challenges of this research. Methods: An expanded definition of adverse incidents including physical, social, and environmental impacts was used in a scoping review based on the PRISMA Extension for Scoping Reviews Checklist. MEDLINE, CINAHL, and EBSCOhost were searched for English language, peer-reviewed studies conducted in aged care home settings between 2000 and 2020. Forty six articles across 12 countries were identified, charted, and analyzed using descriptive statistics and narrative summary methods. Results: Quantitative studies (n = 42, 91%) dominated adverse incidents literature. The majority of studies focused on physical injuries (n = 29, 63%), with fewer examining personal/interpersonal (15%) and environmental factors (22%). Many studies did not describe the country's aged care system (n = 26, 56%). Only five studies (11%) included residents' voices. Discussion: This review highlights a need for greater focus on resident voices, qualitative research, and interpersonal/environmental perspectives in adverse event research in aged care homes. Addressing these gaps, future research may contribute to better understanding of adverse incidents within this setting. [ABSTRACT FROM AUTHOR]

Introduction: Quantification of the social climate of mental health care environments has received considerable attention. Investigations of the resulting measures indicate that social climate is associated with individual outcomes including patient satisfaction and staff burnout. Interest has grown in developing interventions to improve social climate in anticipation of subsequent related benefits. This study aimed to identify and critically review research about the effectiveness of interventions for improving social climate in inpatient adult acute mental health settings. Methods: Systematic review reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Comprehensive terms were used to search multiple electronic databases from inception to July 2019. Information about intervention type(s), complexity was extracted and study quality was assessed. Results: Twenty-three papers met inclusion criteria of which 20 used a pretest–posttest study design and three employed randomized and/or controlled designs. Interventions were environmental/structural, operational/process-oriented and developmental/person-oriented in nature and they ranged in complexity. The Ward Atmosphere Scale was the most common outcome measure used. Following quality assessment, six studies were judged to be sufficiently robust in terms of quality, theory-base, user-inclusion, and outcomes evaluation to contribute credibly to the evidence base. Of these, four complex person- and process-oriented intervention studies and two less complex structural/environmental intervention studies resulted in positive outcomes. Conclusion: There is limited strong evidence that interventions positively influence measures of ward social climate in acute adult mental health settings. Such measures should not be the sole criterion of success when evaluating change. Decisions about implementing change to improve social climate should be informed by meaningful proxy measures including the views and preferences of service users and other stakeholders. Studies using stronger designs are required to establish the ability of interventions to improve social climate. [ABSTRACT FROM AUTHOR]

Dynamic consent is increasingly recommended for longitudinal and biobanking research; however, the value of investing in such systems is unclear. We undertook a rapid review of the benefits and challenges of implementing dynamic consent by searching five databases (Ovid Medline, Ovid Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature – CINAHL) for articles published up to May 2023 that report on participants’ or researchers’ experience of dynamic consent. From 1611 papers screened, 12 met inclusion criteria. Guided by thematic analysis with an inductive approach, we synthesised 31 benefits and 8 challenges. Benefits included: enhanced participant experience through improved consent management and tailoring; greater participant engagement and retention through increased autonomy, trust and communication; reduced costs and burden and increased accessibility and inclusivity. Participants and researchers also valued additional features that dynamic consent platforms facilitate such as two-way communication and return of research updates. The main challenges included the digital divide and consent fatigue. The papers gave recommendations to mitigate these challenges, for example by supplementing with other communication tools and allowing a broad consent approach, respectively. Overall, dynamic consent was described as a valuable consent approach with many benefits and some surmountable challenges. Most included literature was qualitative, so further research is needed to quantify the impact of dynamic consent on recruitment, retention, and participant experience. Further long-term investigations are necessary to explore whether participants want to and do change their consent over time, as well as the impact of dynamic consent on participant privacy. [ABSTRACT FROM AUTHOR]

Background: The use of methamphetamine or amphetamine stimulant drugs has been identified by authoritative public health bodies as a global health issue, with a worrying trend towards production and consumption of a higher purity crystalline form methamphetamine (ice) over the past decade. This trend has been well documented within Australia, resulting in a public perception of there being an 'ice' epidemic in regional/rural areas. Considering the illicit nature of ice, monitoring it is challenging and as such little information is available regarding the actual extent of methamphetamine use, harms and patterns in regional/remote Australia. Aim: To collate the available literature regarding methamphetamine use in regional/rural Australia and identify gaps in the literature. Methods: A literature search was conducted by searching 6 databases (PUBMED, Medline, CINAHL, EMBASE, PsycINFO and SCOPUS) following which exclusion/inclusion criteria were applied. Included papers were appraised with the Joanna Briggs Institute Critical appraisal tools and synthesised in light of the sociocultural, ethnic and geographic differences in methamphetamine use in Australia. Results: Regarding rural/regional Australia there is a significant lack of research into methamphetamine use, patterns and epidemiology since the rise of crystalline methamphetamine in 2013. The existing literature available suggests great variability in methamphetamine harms in rural communities. This can be a double-edged sword however, as the introduction of ice into a remote/rural community may result in greater harms if it becomes ingrained in local customs. Similarly, there is a lack of research into the specific factors within Indigenous communities leading to an increased rate of methamphetamine use amongst members. Recommendation: Future research should address the causes of variance in methamphetamine harms in rural/remote regions. Although the scope of this paper was the Australian context, a wider international approach may yield useful information. [ABSTRACT FROM AUTHOR]

Electronic health record downtimes are any period where the computer systems are unavailable, either for planned or unexpected events. During an unexpected downtime, healthcare workers are rapidly forced to use rarely-practiced, paper-based methods for healthcare delivery. In some instances, patient safety is compromised or data exposed to parties seeking profit. This review provides a foundational perspective of the current state of downtime readiness as organizations prepare to handle downtime events. A search of technical news media related to healthcare informatics and a scoping review of the research literature were conducted. Findings ranged from theoretical exploration of downtime to empirical direct comparison of downtime versus normal operation. Overall, 166 US hospitals experienced a total of 701 days of downtime in 43 events between 2012 and 2018. Almost half (48.8%) of the published downtime events involved some form of cyber-attacks. Downtime contingency planning is still predominantly considered through a top-down organizational focus. We propose that a bottom-up approach, involving the front-line clinical staff responsible for executing the downtime procedure, will be beneficial. Significant new research support for the development of contingency plans will be needed. [ABSTRACT FROM AUTHOR]

Introduction: Midlife climacteric women with metabolic syndrome are at high risk for experiencing a complex array of symptoms. The aim of this scoping review was to identify the prevalence, types, and clustering of symptoms in midlife climacteric women with metabolic syndrome and to compare them to symptoms of midlife climacteric women without metabolic syndrome. Methods: A three-step search method was used according to Joanna Briggs Institute methodology. Eligibility criteria of participants, concept, context, and types of evidence were selected in alignment with the review questions. Seven databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation & Theses, OpenGrey) were searched using search terms with no language or date restrictions. Title and abstract screening, full-text review, data charting, and data synthesis were conducted by two independent researchers based on the eligibility criteria. Results: The search yielded 3813 studies after removing duplicates with 48 full-text papers assessed for eligibility. A total of eight studies were reviewed and analyzed which reported the prevalence and types of symptoms individually or grouped based on each body system. Midlife climacteric women with metabolic syndrome experience a wide prevalence of individual and grouped urogenital, vasomotor, psychological, sleep, and somatic symptoms. Mental exhaustion had the highest prevalence (84.4%) among the individual symptoms, and urogenital symptoms had the highest prevalence (81.3%) among the grouped symptoms. There were mixed findings on symptoms between midlife climacteric women with metabolic syndrome and without metabolic syndrome. No studies focused on symptom clusters. Conclusion: Our findings will serve as a knowledge basis for understanding symptoms experienced by midlife climacteric women with metabolic syndrome. This new knowledge can assist clinicians in effectively assessing and managing their symptoms in clinical settings and inform future development of targeted symptom management interventions. [ABSTRACT FROM AUTHOR]

Background: Older people and people with dementia experience a high prevalence of multiple health conditions. The terms 'comorbidity' and 'multimorbidity' are often used interchangeably to describe this, however there are key conceptual differences between these terms and their definitions. This has led to issues in the validity and comparability of research findings, potentially inappropriate intervention development and differences in quality of health care. Objective: To review how the terms 'comorbidity' and 'multimorbidity' are defined within peer-reviewed dementia research and propose an operational framework. Design: A scoping review of definitions within dementia research was carried out. Searches took place across five databases: Academic Search Premier, CINAHL Complete, MEDLINE, PsycARTICLES and PsycINFO. PRISMA-ScR guidelines were followed. Results: Content analysis revealed five key themes, showing significant overlap and inconsistencies from both within, and between, the comorbidity and multimorbidity definitions; 1. Number of conditions; 2. Type of health conditions; 3. The co-occurrence of conditions; 4. The inclusion of an index disease (or not); 5. Use of medical language. The analysis also revealed gaps in how the underlying concepts of the definitions relate to people with dementia living with multiple health conditions. Conclusion: This scoping review found that current definitions of comorbidity and multimorbidity are heterogeneous, reductionist and disease-focussed. Recommendations are made on the design of research studies including transparency and consistency of any terms and definitions used. A syndemic framework could be a useful tool for researchers, clinicians and policy makers to consider a more holistic picture of a person with dementia's health and wellbeing. [ABSTRACT FROM AUTHOR]

Introduction: A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. Methods: The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing & Allied Health Literature, Midwifery & Infant Care and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources much of the guidance represents good practice based on the consensus view of the Working Group. Key recommendations: Breast pump milk collection kits should not be reused by different mothers unless they have been sterilized in a Sterile Services Department between these different users. When used by the same mother, a detergent wash followed by thorough rinsing and drying after each use gives acceptable decontamination for most circumstances, as long as it is performed correctly. Additional decontamination precautions to washing, rinsing and drying may be used if indicated by local risk assessments and on advice from the departmental clinicians and Infection Prevention and Control Teams. The microbiological quality of the rinse water is an important consideration, particularly for infants on neonatal units. If bottle brushes or breast/nipple shields are used, they should be for use by one mother only. Decontamination should be by the processes used for breast pump milk collection kits. Dummies (soothers, pacifiers or comforters) needed for non-nutritive sucking by infants on neonatal units, should be for single infant use. Manufacturers should provide these dummies ready-to-use and individually packaged. They must be discarded at least every 24 hours or immediately if soiled with anything other than the baby’s saliva. No attempt should be made to decontaminate the dummies, either before or during use. Conclusion: This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers. [ABSTRACT FROM AUTHOR]

Background: This systematic scoping review aimed to describe the content of post-operative rehabilitation programmes, and outcome measures selection following stabilisation surgery for traumatic anterior shoulder dislocation (TASD). Methods: An electronic search of Medline, EMBASE, CINAHL and AMED was conducted (2000–2021). Any cohort or clinical trial of patients receiving post-operative TASD rehabilitation were included. Study selection, data extraction and quality appraisal were undertaken by two independent reviewers. Results: Twelve studies including fourteen treatment programmes were eligible. Period of post-operative immobilisation ranged from 1 day to 6 weeks, with exercise introduced between 1 and 7 weeks. Strengthening exercises were introduced between 1 and 12 weeks. Two studies described "accelerated" rehabilitation programmes, differing in immobilisation period and exercise milestones. No increased recurrence was reported in professional footballers. Two studies compared rehabilitation programmes, one not randomised, the other 18 years old. There was variability in selected outcomes measures, with only 4 studies using a common measure. Discussion: There is minimal evidence to guide post-operative rehabilitation, variability in immobilisation periods and when exercise is introduced. There is no consensus on the definition of accelerated rehabilitation, or outcome measure selection. Clinical consensus of standardised terminology and stages of rehabilitation is required prior to efficacy studies. [ABSTRACT FROM AUTHOR]

Objectives: Colorectal cancer is among the top three most common cancers globally. In order to reduce the health burden, it is important to improve the uptake of colorectal cancer screening by understanding the barriers and facilitators encountered. There are numerous reports in the literature on the views of the general public on cancer screening. However, the experiences of colonoscopy patients are not as well studied. This paper maps their perceptions. Methods: Keyword searches for terms such as 'colorectal', 'colonoscopy' and 'qualitative' were conducted on 3 December 2019 in five databases: Medline, Embase, CINAHL, PsycINFO and Web of Science Core Collection. Qualitative articles that quoted colonoscopy-experienced patients with no prior history of colorectal cancer were included for the thematic analysis. The systematic review was then synthesized according to PRISMA guidelines. Results: The major themes were distilled into three categories: pre-procedure, during and post-procedure. The factors identified in the pre-procedure phase include the troublesome bowel preparation, poor quality of information provided and the dynamics within a support network. Perceptions of pain, emotional discomfort and the role of providers mark the experience during the procedure. The receipt of results, opportunities given for discussion and finances relating to colonoscopy are important post-procedure events. Conclusion: Understanding colorectal cancer screening behaviour is fundamental for healthcare providers and authorities to develop system and personal level changes for the improvement of colorectal cancer screening services. The key areas include patient comfort, the use of clearer instructional aids and graphics, establishing good patient rapport, and the availability of individualized options for sedation and the procedure. [ABSTRACT FROM AUTHOR]

Needleless connectors (NCs) are essential devices which connect to the end of vascular catheters and enable catheter access for infusion and aspiration. There are various different designs which make it difficult for purchasers to identify the features which present the least risk and greatest safety. The NC is the microbial gatekeeper for vascular catheters; how it is disinfected pre access determines if, and how many, organisms enter and how quickly biofilm will form. This paper will consider these design variations and how differences in antiseptic testing methods have made it difficult to determine the best antiseptic practice pre access. One specific design characteristic is considered: the fluid pathway. The NC’s fluid pathway creates a flow which can be either direct to produce a laminar flow or indirect which creates a turbulent flow. At present, the evidence does not support there being an advantage for a specific fluid pathway design in reducing infection risks. [ABSTRACT FROM AUTHOR]

Background: Symptoms of emotional and physical stress near death may be related to previous experiences of trauma. Objective: To investigate current evidence regarding the following: (1) Is previous trauma identified in people who are dying, and if so, how? (2) How is previous trauma associated with the experience of death/dying in people with or without cognitive impairment? and (3) What palliative care interventions are available to people with previous trauma at the end of life? Design: This integrative review was conducted per Whittemore and Knafl's guidelines, which involves a stepped approach, specifically (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Methods: This integrative review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases were searched in August 2021 and updated in August 2023. The articles were quality appraised, and narrative data were analysed using Grounded Theory (GT). Results: Of 1310 studies screened, 11 met the inclusion criteria (four qualitative and seven quantitative) conducted in Australia, Canada, Japan and the United States; and American studies accounted for 7/11 studies. Eight were focused on war veterans. Descriptive studies accounted for the majority, with only two publications testing interventions. Re-living trauma near death has additional features to a diagnosis of post-traumatic stress disorder alone, such as physical symptoms of uncontrolled, unexplained acute pain and this distress was reported in the last weeks of life. Conclusion: This study proposes that re-living trauma near death is a recognisable phenomenon with physical and psychological impacts that can be ameliorated with improved clinical knowledge and appropriate management as a new GT. Further research is needed to enable past trauma identification at the end of life, and trauma-informed safe interventions at the end of life are an urgent need. [ABSTRACT FROM AUTHOR]

Context: Aging and increasing comorbidities in the population are leading to more complex care for patients and primary healthcare providers. Community organizations (COs) may play a role in the services offered to support patients with chronic diseases (PCDs) but there are currently no clear guidelines to support primary healthcare providers in linking patients to COs. Objectives: The aim of this study was to describe the role of primary healthcare providers regarding linking PCDs to COs by: (1) describing linking activities; and (2) identifying the main facilitators and barriers associated with these activities. Methods: This scoping review was based on the Arksey and O'Malley method, completed by Levac, Colquhoun, and O'Brien. Related keywords were used in 7 databases to search relevant studies. After the initial screening, 135 full texts were assessed for eligibility by 2 reviewers using inclusion/exclusion criteria. Empirical studies describing activities performed by primary healthcare providers in linking PCDs to COs or describing facilitators or barriers to linking activities were included. Studies describing activities linking to other services than COs or located in emergency departments were excluded. Results: In total, 28 studies were included. Information reported in the studies was classified into 8 main linking activities: capacity development, patient identification, assessment, information, planning, referral, follow-up, and collaboration. Facilitators and barriers to these activities were related to intrapersonal characteristics of providers and patients, professional practice, work environment, relationships, and external influences. Healthcare providers' involvement was often adapted according to their field of practice. Conclusion: This scoping review details the role of primary healthcare providers when linking PCDs to COs in a collaborative and interdisciplinary context, which can be adapted to clinical practice by providers, experts, or stakeholders to support improvement in chronic care management. [ABSTRACT FROM AUTHOR]

Background: The military is a male-dominated environment and culture in which women veterans can experience significant institutional prejudice. Transition can be confusing and isolating for women veterans. Group programs are an important source of transition support. However, we know little about the specific group program needs of women veterans. Objectives: To examine mental health and well-being support group programs delivered to women veterans, to understand what they value and find most helpful. Eligibility Criteria: Women military veterans (all types); empirical studies using any design; published between 1990 and 2022; group programs focused on transition issues (such as housing, employment, education, physical health, mental health). Sources of Evidence: Peer-reviewed journals and theses. Charting Methods: Six databases searched: Medline (via Ovid SP), PsycINFO (via Ovid SP), EmCare (via Ovid SP), CINAHL, Scopus, and ProQuest. Results: There was significant heterogeneity across 35 included studies in type of groups, program content and structure, length of sessions, measurement of impact, follow-up, and so forth. Most programs were delivered face to face. Physical health and preventative healthcare were important topics for women veterans, particularly reproductive health, mental health, and chronic pain. Groups that included physical activity, creative arts, and alternative therapies were beneficial to women's physical and mental health. Strengths-based women-only groups, facilitated by women, that created safe spaces for women veterans to share their experiences, enhanced self-expression, agency, and self-empowerment. This was particularly important for women who had experience military sexual trauma. Conclusion: This review found a small but diverse range of group programs available for women veterans. Many program evaluations were of moderate or low quality and lacked sufficient information to determine whether benefits were sustained over time. No studies involved Australian women veterans. Despite these concerns, this review highlighted several useful lessons that could help inform improved design, delivery, and evaluation of group programs for women veterans. Plain language summary: Review of women veteran transition mental health and well-being support group programs Women veterans learn to become soldiers, sailors and aviators in a male-dominated environment and culture in which their presence is highly visible, challenged and often subject to institutional prejudice. Transition can be confusing and isolating for women veterans. We know little about the specific needs of women veterans to support them to transition successfully to civilian life. Group programs are an important source of transition and post-transition support for veterans. The aim of this review was to examine the existing literature on mental health and well-being support group programs delivered to women veterans to understand what women veterans value and find most helpful in the design and delivery of such programs. Thirty-five studies were included in this review; 33 of these were conducted in the United States. They were of mixed quality and diverse design. Women only groups were favored. Strengths-based Programs that help to build emotional strengths, agency and empowered women were valued by them. Physical health and preventative healthcare are important topics for group programs for women veterans, as are creative arts and alternative therapies that facilitate self-expression and self-empowerment. [ABSTRACT FROM AUTHOR]

Background: There has been a marked increase in the number of Schenck knee dislocation (KD) I injuries reported in the multiligament knee (MLK) injury (MLKI) and KD literature. Purpose: To examine the heterogeneity of the Schenck KD I classification in the MLKI and KD literature. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature search of PubMed, CINAHL, Scopus, Web of Science, EMBASE, and Cochrane Library was conducted for all studies that investigated KDs and/or MLKIs, utilized the Schenck or an MLKI classification system, and included patients with KD I or MLK 1 injuries. Pooled analysis determined the total number of KD I or MLK 1 injuries and the specific ligamentous tear patterns. Binary meta-analyses of the studies that reported neurovascular injury within each Schenck KD class compared the pooled odds ratio (OR) of vascular and neurological injury in unicruciate (KD I) and bicruciate (KD II-IV) injuries. Results: Included were 50 studies in which 3460 KD I injuries were reported out of 7872 KDs and MLKIs (43.9%). Of the 2912 patients reported to have had a Schenck KD I injury, 26 patients (0.9%) had a clinically and/or radiographically confirmed tibiofemoral KD. The overall prevalence of Schenck KD I injury with documented tibiofemoral KD was 26 of 7872 (0.3%). A total of 22 studies (n = 1702 patients) reported the specific ligamentous tear patterns; the most common patterns were posterior cruciate ligament (PCL)/lateral collateral ligament (LCL) (n = 526; 30.9%), anterior cruciate ligament (ACL)/LCL (n = 488; 28.7%), ACL/medial collateral ligament (MCL) (n = 408; 24.0%), and PCL/MCL (n = 198; 11.6%). Meta-analyses demonstrated that when compared with bicruciate KD or MLKI, unicruciate KD or MLKI was significantly less likely to have concomitant vascular injury (OR, 0.28; 95% CI, 0.15-0.51; P <.0001) and concomitant neurologic injury (OR, 0.49; 95% CI, 0.37-0.65; P <.00001). Conclusion: The number of true, clinically and/or radiographically confirmed unicruciate KDs was extremely rare, representing <1% of all reported Schenck KD I injuries. A misappropriation of these injury patterns as true KDs may be taking place, affecting outcome studies and potentially biasing published clinical results. An MLKI classification system must document whether a confirmed KD has occurred. [ABSTRACT FROM AUTHOR]

Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in critical patients. The negative impacts of VAP on patient outcomes emphasize the importance of effective preventive measures such as oral care and patient positioning. The aim of this review was to investigate the impact of oral care and positioning on the prevention of VAP among patients in the intensive care unit. Methods: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed. The methodological quality of included studies was appraised using Joanna Briggs Institute checklists. Results: In total 13 studies were included, all of them were randomized controlled trials. Six out of nine studies about oral care have significant results on VAP incidence. Regarding the position, Patients positioned at a 45-degree were less likely to develop VAP than those positioned at a 30-degree and those in a supine position. Conclusion: Although patients positioned at 45-degree angle were less likely to develop VAP than those at 30-degree, it is necessary to individualize this practice before recommending it, once there are some contraindications, such as neurocritical patients. Regarding oral care to prevent VAP, considering the current guidelines' recommendation not to use oral chlorexidine, further studies evaluating alternatives are needed. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) have been adopted as a way to measure patient self-rated physical function and health status for patients with anterior cruciate ligament (ACL) injuries. Although multiple PROMs exist and have been translated into various languages, the cross-cultural adaptation and validity of these PROMs for Spanish-speaking patients is unknown. Purpose: To evaluate the adaptation quality and psychometric properties of Spanish-language adaptations of PROMs for patients with ACL injuries. Study Design: Scoping review; Level of evidence, 3. Methods: Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we reviewed published studies related to adaptation quality and psychometric properties of Spanish PROMs in patients with ACL injuries. The methodological quality of the included studies was assessed using the Guidelines for the Process of Cross-Cultural Adaptation of Self-Reported Measures, the Quality Criteria for Psychometric Properties of Health Status Questionnaires, and the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The level of evidence for each PROM was determined based on the number of studies, methodological quality, consistency of results, and sample size. Results: The initial search strategy identified 5687 articles. After removal of duplicates, 1882 titles were screened, and 114 articles were assessed for eligibility. Six articles were selected for final review, comprising 4 PROMs: the Lysholm knee score, the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI), the Lower Extremity Functional Scale, and the Lower Limb Functional Index. Three studies followed all 6 processes for cross-cultural adaptation. None of the studies demonstrated all 14 domains required for cross-cultural validity (eg, description of translator expertise). The ACL-RSI achieved the highest level of evidence, with 3 of 9 domains demonstrating moderate evidence. Conclusion: This review identified 4 instruments that have been translated for Spanish-speaking patients with ACL injuries, none of which demonstrated appropriate adaptation or robust psychometric properties. The study highlights the need for improvement in PROMs for Spanish-speaking patients and the potential for mismeasurement and inappropriate application of PROM results in patients with ACL injuries. [ABSTRACT FROM AUTHOR]

Background: Over 4 million patients acquire a healthcare-associated infection (HCAI) in Europe every year, indicating possible shortcomings in hospitals converting evidence-based infection prevention and control (IPC) strategies into universal adherence. We present a literature review exploring whether insufficient adherence could be culturally based. Aim: To find empirical evidence if and how specific traits of organisational culture improve adherence to IPC strategies utilising HCAI rates as the marker of system failures or successes. Methods: PubMed, CINAHL, PsycINFO and the British Nursing index database were searched from January 2007 to June 2018. Hand-searching, Google Scholar and the snowball effect completed the investigation. The quality of the studies was assessed with the guidance of CASP and Cochrane tools. Results: Twenty papers were eligible for data extraction and thematic analysis. Studies predominantly report positive findings for the association, but none were determined high quality due to multiple methodological concerns. Analysing both quantitative and qualitative research revealed eight major themes: hospital cultures with better HCAI rates foster safety culture; have a generative leadership style; embrace innovation; ensure interventions fit local context; accept long-term orientation; engage and empower health professionals; promote collaboration and communication; and see the benefits of a non-punitive climate. Interpretation: The literature linking organisational culture and HCAI rates is suggestive, but not conclusive, indicating caution about their inferences. Leaving cultural growth to chance or allowing for weak or toxic cultures impedes on our IPC strategies and equivalently our HCAI rates. [ABSTRACT FROM AUTHOR]

Background: Infection prevention and control (IPC) practices performed by healthcare workers are key to the prevention and management of infections. Compliance with IPC practices is often low, they are therefore commonly the focus of improvement interventions. Designing interventions that are based on behaviour change theories may help to improve compliance to practice. The aim of this review is to synthesise the evidence on the application of behaviour change theories to interventions to improve IPC practice in healthcare settings. Methods: A scoping review was conducted following the Joanna Briggs Institute methodological framework. The theories of focus were the Theoretical Domains Framework (TDF), Capability, Opportunity, Motivation, Behaviour (COM-B) and Behaviour Change Wheel (BCW). Studies which applied these theories to any IPC practice were included. Results: Eleven studies were identified which met the inclusion criteria. The IPC behaviours investigated were hand hygiene (7), antimicrobial stewardship (3), and MRSA screening (1). Nine studies explored barriers and facilitators to existing IPC practice; three used their findings to design a behaviour change intervention or tool. Domains of 'beliefs about consequences', 'environmental context/resources', and 'social/professional role and identity' were identified as key across all three IPC behaviours. Discussion: This review has demonstrated the use of behavioural theories to understand determinants of behaviour related to IPC practice. Currently, there are few published examples of interventions to improve IPC practice that have been underpinned by behavioural theory. Practitioners in IPC should consider the use of these methods to enhance the efficacy of strategies to change healthcare worker behaviour. [ABSTRACT FROM AUTHOR]

Introduction: This systematic review attempts to answer the following question – which strategies to improve clinical nursing documentation have been most effective in the acute hospital setting? Methods: A keyword search for relevant studies was conducted in CINAHL and Medline in May 2019 and October 2020. Studies were appraised using the Joanna Briggs Institute (JBI) critical appraisal for quasi-experimental studies. The studies were graded for level of evidence according to GRADE principles. The data collected in each study were added to a Summary of Data (SOD) spreadsheet. Pre intervention and a post intervention percentage compliance scores were calculated for each study where possible i.e. (mean score/possible total score) × (100/1). A percentage change in compliance for each study was calculated by subtracting the pre intervention score from the post intervention score. The change in compliance score and the post intervention compliance score were both added to the SOD and used as a basis for comparison between the studies. Each study was analyzed thematically in terms of the intervention strategies used. Compliance rates and the interventions used were compared to determine if any strategies were effective in achieving a meaningful improvement in compliance. Results: Seventy six full text articles were reviewed for this systematic review. Fifty seven of the studies were before and after studies and 66 were conducted in western countries. Publishing dates for the studies ranged from 1991 to 2020. Eleven studies included documentation audits with personal feedback as one of the strategies used to improve nursing documentation. Ten of these studies achieved a post intervention compliance rate ≥ 70%. Conclusion: Notwithstanding the limitations of this study, it may be that documentation audit with personal feedback, when combined with other context specific strategies, is a reliable method for gaining meaningful improvements in clinical nursing documentation. The level of evidence is very low and further research is required. [ABSTRACT FROM AUTHOR]

The Internet is increasingly being used as a health information resource. This meta-ethnography aimed to synthesize the literature on how parents of children aged below 5 years' experienced using the Internet for health information purposes. We employed an interpretive meta-synthesis approach—meta-ethnography—according to Noblit & Hare's seven phases. A total of 22 articles met the inclusion criteria, representing four continents and with 650 participants, mainly mothers. We analysed and synthesized the primary studies into the following lines-of-argument synthesis representing a novel conceptual understanding of the phenomenon: Parents experience the Internet as "A cyber partner for child caring" being a 24/7 available "go-to" among other confined sources. Parents find ways of "patching together" trustworthy information in solicitude for their child's health while navigating between trust and anxiety. They relate online and share their experiences and secrets without being rejected. Clinicians and parents may benefit from "partnering" with this resource. [ABSTRACT FROM AUTHOR]

Background: Early detection of autism spectrum disorder (ASD) has the potential to significantly reduce the impact of the condition, however previous reviews have found little evidence to support screening programs for ASD in young children. Methods: We conducted a review with the aim of updating evidence on 3 aspects: (a) diagnostic stability of ASD in young children; (b) accuracy of ASD screening tools in young children; and (c) the benefits of early interventions in screen-detected young children with ASD. Results: A total of 33 studies were included in our review. Five studies looking at diagnostic stability reported estimates ranging from 71.9% to 100%, however the majority only included a follow-up of 24 months and all studies raised concerns regarding the risk of bias due particularly to lack of blinding, sample size, and patient flow. A total of 25 studies, reported in 26 articles, were identified that reported accuracy data on 11 screening tools. Most of the reports were concerned with versions of M-CHAT, reporting sensitivity estimates from 0.67 to 1.0; however, many of these were deemed to be of high risk of bias due to lack of blinding and follow-up. Four studies reported on early interventions in screen-detected children; however, the majority did not find significant improvements on the relevant outcomes. Conclusions: Overall, the evidence on screening for ASD in young children captured by this review is not conclusive regarding the 3 aspects of screening in this population. Future studies should attempt to ensure blinded diagnostic assessments, include longer follow-up periods and limit attrition. [ABSTRACT FROM AUTHOR]

As dementia is becoming a great challenge worldwide, modifying its risk factors is a primary preventive approach. However, there is a scarcity of integrated efforts to determine dementia-specific factors that influence preventive behaviors, particularly when considering a theoretical framework. Therefore, this scoping review aimed to map the evidence on factors affecting dementia-preventive behaviors based on the PRECEDE framework. Five electronic databases—PubMed, PsycINFO, CINAHL, EMBASE, and Cochrane CENTRAL—were searched for articles published until May 2022, and only peer-reviewed studies were included to gather robust evidence. During the initial search, 37,331 articles were retrieved. Of these, 22 articles met the inclusion criteria and were included in the evidence synthesis. The scoping review identified 28 specific determinants within the six conceptual categories of the PRECEDE framework, thereby highlighting the multi-dimensional nature of factors influencing dementia-preventive behaviors. Future studies should consider multilevel and multi-dimensional personalized strategies to promote dementia-preventive behavior. Plain Language Summary: Our study focused on understanding the factors that influence dementia-preventive behaviors. We aimed to identify these factors using a theoretical framework called PRECEDE, which could guide future preventive strategies. To gather reliable evidence, we conducted a scoping review by searching five electronic databases for peer-reviewed articles published until May 2022. After a thorough search, we analyzed 22 articles that met our inclusion criteria. Through our review, we identified twenty-eight specific factors within six conceptual categories of the PRECEDE framework that affect dementia-preventive behaviors. This finding emphasizes the complex and multi-dimensional nature of these factors and their impact on dementia preventive efforts. Our study's findings have important implications for promoting dementia prevention. To be effective, future preventive strategies should consider personalized approaches that target multiple levels and dimensions, addressing the diverse factors influencing individuals' behaviors. We acknowledge some limitations in our study. We focused on individual-level factors and did not explore administrative and policy aspects that could also influence dementia prevention. Additionally, the majority of the included studies were conducted in Asian countries, potentially limiting the generalizability of our findings to other cultural contexts. Further research should consider these aspects for a more comprehensive understanding of dementia prevention. In conclusion, our study contributes valuable insights to dementia prevention efforts. By addressing the identified factors, healthcare professionals and policymakers can design more effective interventions to protect cognitive health and enhance the overall well-being of individuals at risk of dementia. [ABSTRACT FROM AUTHOR]

Background and aims: Autistic pupils have the right to be heard in matters concerning their education and to be active agents in shaping their school experiences. Despite this, educational policies and research have rarely included the voices of autistic children, failing to identify what they consider to be beneficial and meaningful in their own education. This study aimed to (i) summarise existing literature exploring autistic pupils' experiences at school from their own perspectives and (ii) identify gaps for future research through a consultation with autistic pupils. Methods: A scoping review was conducted to identify studies exploring first-person accounts of autistic pupils' school experiences (primary and secondary; aged 4–18 years) published between 2005 and 2023. Thematic analysis was conducted to identify overarching thematic categories across the included studies. Review findings were discussed through a consultation with a Child and Youth Advisory Group (CYAG) comprised of autistic pupils in Ireland (N = 3), to seek feedback and inform a future research agenda. Main contribution: Thirty-six studies were included in the review and six themes were identified: Experiences of feeling misunderstood, of bullying and masking, of feeling excluded, of anxiety, of sensory needs in school, and of being overwhelmed during transitions. Consultation with the CYAG highlighted that these six themes were consistent with autistic pupils' experiences but that reports of positive experiences were missing in the literature. Conclusions: This study identified several gaps in the literature on the school experiences of autistic pupils, based on both the scoping review and consultation with the CYAG. While the CYAG validated the themes identified in existing literature, there is a need for greater diversity in the samples included and increased focus on the potential positive aspects of the school experience. Implications. These findings have important research implications. In particular, further studies are needed with autistic pupils at primary school level, including those who are minimally or non-speaking, as well as ensuring pupils with positive school experiences are also represented. Findings also highlight the need for continued collaboration with autistic pupils themselves in matters concerning their education. [ABSTRACT FROM AUTHOR]

Introduction: Stress and pain are high among patients undergoing hemodialysis. Benson's Relaxation technique affected a wide range of physical and psychological signs and symptoms among patients undergoing hemodialysis. Objective: To evaluate the effectiveness of Benson's Relaxation Technique in reducing stress and pain among patients undergoing maintenance hemodialysis. Materials and Methods: A systematic review of randomized controlled trials was conducted. A systematic literature search was carried out from 2000 to 2023. Searched databases included EBSCO-Host "Academic Search, Cochrane, CINAHL, Health Business, MEDLINE, Psychology and Behavioral Sciences, SPORTDiscus", PubMed, Ovid, and Google Scholar. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were conducted. RCTs were critically appraised using the Cochrane's Risk of Bias Tool. Four RCTs met the inclusion criteria and included in this review since they were applicable to practice. Results: Four randomized controlled trials were identified supporting the use of Benson's relaxation technique as a nursing treatment in managing stress and pain among patients undergoing maintenance hemodialysis, as it achieved a significant decrease in stress and pain scores. The overall quality of the randomized controlled trials was judged to be low to relatively moderate. Conclusions: Most of the randomized controlled trials lacked details on intervention adherence. It is recommended to conduct additional longitudinal randomized controlled trials in different countries with bigger sample sizes, to provide more evidence for generalizing outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Immigrant youth face heightened risks of substance use due to the stress associated with immigration and acculturation. While parental intervention can have a preventative impact on substance use, parents need to be well-informed about substance use and effective interventions that can prevent substance use among immigrant youth. Such interventions ought to be culturally sensitive, family-based, and targeted at the specific substances that are prevalent in a given context. Identifying and curating interventions that can empower parents in addressing substance use can help mitigate the risks that immigrant youth may face. Methods: This scoping review aimed to identify the types, characteristics, and effectiveness of family-based substance use intervention programs. Based on Arksay and O'Malley's guidelines, interventions included in the review must have met the following criteria: (a) was a family-based intervention aiming to prevent substance use; (b) targeted immigrant teens aged 12 to 17 years old; (c) was published in English; (d) originated from Australia, Canada, New Zealand, or the United States. The pinch table was used to synthesize included articles, after which studies were compared and categorized, and cross-cutting categories were identified. Results: After screening 4551 searched literature, 13 studies that utilized family-based interventions were included in the review. All interventions were face-to-face programs, and most interventions involved parents and youth as participants. Eco-developmental theory and active learning strategies were used by multiple interventions. Given immigrant families were target stakeholders, both deep structure and surface structure cultural adaptations were utilized. Interventions increased parents' knowledge and skills regarding substance use prevention and delayed substance use initiation among youth. Conclusion: From the review, it was evident that parents are an essential element in any program aiming to prevent or reduce children's substance use. Besides information about substance use prevention, the curriculum also involves parenting and communication skills for parents to understand the protective effects of family. Effective family-based interventions for immigrant youth require attention to parenting and immigration stress, while also considering cultural adaptation. Future directions and limitations are also discussed. [ABSTRACT FROM AUTHOR]

Background: Hand hygiene is considered an effective and potentially modifiable infection control behaviour among healthcare workers (HCW). Several meta-studies have been published that compare quantitatively expressed findings, but limited efforts have been made to synthesise qualitative research. Objectives: This paper provides the first report of integrated findings from qualitative research reports on hand hygiene compliance among HCW worldwide that employs the GRADE-CERQual process of quality assessment. Methods: We conducted database searches and identified 36 reports in which authors conducted qualitative or mixed methods research on hand hygiene compliance among HCW. We used Dedoose analysis software to facilitate extraction of relevant excerpts. We applied the GRADE-CERQual process to describe relative confidence as high, moderate or low for nine aggregate findings. Findings: Highest confidence findings included that HCW believe they have access to adequate training, and that management and resource support are sometimes lacking. Individual, subjective criteria also influence hand hygiene. Discussion: These results suggest the need for further investigation into healthcare cultures that are perceived as supportive for infection control. Surveillance processes have potential, especially if information is perceived by HCW as timely and relevant. [ABSTRACT FROM AUTHOR]

A number of assessment tools exist to evaluate the impact of hearing loss, with little consensus among researchers as to either preference or psychometric adequacy. The item content of hearing loss assessment tools should seek to capture the impact of hearing loss on everyday life, but to date no one has synthesized the range of hearing loss complaints from the perspectives of the person with hearing loss and their communication partner. The current review aims to synthesize the evidence on person with hearing loss- and communication partner-reported complaints of hearing loss. Searches were conducted in Cos Conference Papers Index, the Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica Database, PubMed, Web of Science, and Google Scholar to identify publications from May 1982 to August 2015. A manual search of four relevant journals updated the search to May 2017. Of the 9,516 titles identified, 78 records (comprising 20,306 participants) met inclusion criteria and were taken through to data collection. Data were analyzed using meta-ethnography to form domains representing the person with hearing loss- and communication partner-reported complaints of hearing loss as reported in research. Domains and subdomains mutual to both perspectives are related to ‘‘Auditory’’ (listening, communicating, and speaking), ‘‘Social’’ (relationships, isolation, social life, occupational, and interventions), and ‘‘Self’’ (effort and fatigue, emotions, identity, and stigma). Our framework contributes fundamental new knowledge and a unique resource that enables researchers and clinicians to consider the broader impacts of hearing loss. Our findings can also be used to guide questions during diagnostic assessment and to evaluate existing measures of hearing loss. [ABSTRACT FROM AUTHOR]

The diagnosis of diabetic kidney disease can be delayed by limitations of primary biomarkers, which are microalbuminuria and estimated glomerular filtration rate. A number of Doppler ultrasound studies have associated an increase in intrarenal vascular resistance with the disease, which makes ultrasound a potential adjunct tool for early diagnosis. However, there is inadequate evidence to establish the effectiveness of including Doppler ultrasound in the diagnostic process. This systematic review was therefore conducted to determine the value of using Doppler ultrasound in early detection of diabetic kidney disease. Electronic literature searches were carried out in PubMed, CINAHL, Web of Science and EMBASE. All published prospective studies with records of intrarenal Doppler ultrasound, microalbuminuria and estimated glomerular filtration rate were obtained, and their relationship as parameters for diabetic kidney disease assessed. The meta-analysis of Doppler ultrasound versus albuminuria shows insignificant statistical difference between high resistive index of ≥ 0.7 and albuminuria, with the resistive index being the favoured parameter on the forest plot, making Doppler ultrasound highly comparable with albuminuria for the detection of diabetic kidney disease. Again, there was a significant statistical difference between high intrarenal resistive index of ≥ 0.7 and low estimated glomerular filtration rate of < 60 mL/min/1.73 m2, with the resistive index being the favoured parameter on the forest plot, making Doppler ultrasound a superior parameter compared with estimated glomerular filtration rate for early detection of diabetic kidney disease. [ABSTRACT FROM AUTHOR]

Background: The application of continuous passive motion (CPM) after anterior cruciate ligament reconstruction (ACLR) was popularized in the 1990s, but advancements in the understanding of ACLR rehabilitation have made the application of CPM controversial. Many sports medicine fellowship–trained surgeons report using CPM machines postoperatively. Purpose: To determine the efficacy of CPM use for recovery after ACLR with respect to knee range of motion (ROM), knee swelling, postoperative pain, and postoperative complications. Study Design: Systematic review; Level of evidence, 3. Methods: The PubMed (MEDLINE), EMBASE, Cochrane, Cumulative Index of Nursing, and Allied Health Literature databases were searched from inception to January 1, 2020, for studies with evidence levels 1 to 3 on the use of CPM for ACLR rehabilitation. Included studies were those that comparatively evaluated postoperative outcomes after ACLR between at least 2 groups of patients, with 1 having received CPM rehabilitation and the other not having received CPM. Results: A total of 12 studies from 1989 to 2019 met the inclusion criteria. These studies included 808 patients who underwent ACLR. There was no evidence of CPM improving knee stability, final postoperative ROM, or subjective pain scores. Additionally, CPM did not lead to decreased muscle atrophy or improved International Knee Documentation Committee scores. Regarding pain medication intake during postoperative hospitalization, 2 studies found that the CPM group used less pain medication, 1 study found the CPM group used more pain medication, and 1 study found that there was no difference between the 2 groups. Complications varied widely, with 2 of 12 studies reporting complications that required a return to the operating room. Conclusion: A clinical benefit of postoperative CPM use after ACLR was not identified in this review. While our systematic review identified a number of studies that suggest CPM use may be associated with lower usage of pain medication in hospitalized patients, this cannot be confirmed without further investigation with standardized CPM protocols and larger sample sizes. Routine CPM use after ACLR was not supported by this systematic review. [ABSTRACT FROM AUTHOR]

Background: COVID-19's heavy toll on human health, and its concentration within specific at-risk groups including the socially vulnerable and individuals with comorbidities, has made it the focus of much syndemic discourse. Syndemic theory recognizes that social factors create the conditions that support the clustering of diseases and that these diseases interact in a manner that worsens health outcomes. Syndemics theory has helped to facilitate systems-level approaches to disease as a biosocial phenomenon and guide prevention and treatment efforts. Despite its recognized value, reviews of syndemics literature have noted frequent misuse of the concept limiting its potential in guiding appropriate interventions. Objective: To review how the term 'syndemic' is defined and applied within peer-reviewed literature in relation to COVID-19. Design: A scoping review of definitions within COVID-19 literature published between January 1, 2020 to May 15, 2023 was conducted. Searches took place across six databases: Academic Search Premier, CINAHL, JSTOR, MEDLINE/Pubmed, PsycINFO and Scopus. PRISMA-ScR guidelines were followed. Results: Content analysis revealed that COVID-19 has varied clustered configurations of communicable–non-communicable diseases and novel communicable disease interactions. Spatial analysis was presented as a new strategy to evidence syndemic arrangements. However, syndemics continue to be regarded as universal, with continued misunderstanding and misapplication of the concept. Conclusion: This review found that current applications of syndemics remain problematic. Recommendations are made on the design of syndemic studies. A syndemic framework offers an opportunity for systems-level thinking that considers the full complexity of human-disease interactions and is useful to inform future pandemic preparations and responses. [ABSTRACT FROM AUTHOR]

Background: The need for palliative care is rising globally with 76% of those who are in need living in low- and middle-income countries (LMICs). Digital health interventions (DHIs) have been identified as a means of making palliative care more widely accessible. This review summarizes the range and characteristics of DHIs used to deliver palliative care in LMICs and sought to identify factors that influence their implementation and utilization. Objectives: This review aims to summarize the range and characteristics of DHIs used to deliver palliative care in LMICs and identify factors that influence their implementation and utilization. Design: Mixed-method systematic review incorporating both quantitative and qualitative data. Data sources and methods: All studies focusing on DHIs for patients who need palliative care (adults/children) and their caregivers (patient and caregiver centred) in LMICs and published in English were identified through a systematic search of MEDLINE, EMBASE, PsycINFO and CINAHL databases. Data synthesis and analysis were carried out following the convergent integrated approach based on the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews. Results: Fifteen studies were included (three qualitative, four mixed-methods and eight quantitative studies). Telemedicine/mHealth was the most reported DHI utilized in LMICs in delivering palliative care. Patients and caregivers benefited from using DHIs in many ways including increased access to care with reduced discomfort, travel time and risk of health care-associated infections. Health care providers also reported that using DHI such as telemedicine enables them to provide care in a more effective and efficient way. Four factors were identified as the main barriers to implementation: resource constraints; literacy, training and skills; governance, operational and communication issues and technical issues. Conclusion: DHIs, such as telemedicine, have the potential to enhance accessibility to palliative care in LMICs, particularly in rural areas. Comprehensive strategies for their use are required to address the identified barriers. [ABSTRACT FROM AUTHOR]

Background: The Alanya region on Turkey's southern coast has become an important destination for German retirement migration. Objective: Identify research studies on German retirement migration to Turkey which deal with the life situation, the motives, the handling of critical life situations in the context of retirement migration, and the reasons for return migration. Methods: The researcher conducted a qualitative systematic literature review from January 2021 to May 2021 in MEDLINE, CINAHL Complete, and APA PsychInfo. Results: Eleven studies on German and European retirement migration to Turkey were included after a critical assessment based on defined inclusion and exclusion criteria. Motives for retirement migration are climatic, scenic, cultural advantages and the lower cost of living in Turkey. Conclusion: It has been found that most of the studies are thematically narrowly defined, detailed studies deal with and describe the development of retirement migration in a more general way. [ABSTRACT FROM AUTHOR]

The aim of this qualitative systematic review is to analyze the barriers and facilitators to the uptake of antihypertensive medication in hypertensive patients. The databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, MEDLINE, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical were searched from inception to June 2023. The studies were screened, extracted, and assessed independently by two researchers. Previously, the researchers used the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to assess the quality of the included studies. A total of 27 studies were considered, resulting in two combined findings: a good level of knowledge, belief, and behavior and adequate social support were facilitators of medication adherence in hypertensive patients. In contrast, lack of medication literacy, difficulty adapting to roles, reduced sense of benefit from treatment, limited access to healthcare resources, and unintentional nonadherence were barriers. Medication adherence in hypertensive patients remains a challenge to be addressed. Future research should explore how complex interventions using a combination of evidence-based strategies and targeting multiple adherence behaviors (eg, long-term adherence to medication) are effective in improving medication adherence. [ABSTRACT FROM AUTHOR]

Palliative care in community contexts is undergoing significant change as a result of public policy and new models of care, which link health promotion principles with palliative care practices. These models support the creation of partnerships between formal care structures and the communities in which care is provided. Given the central role of nurses in the institutional delivery of palliative care, particularly in the home, it is important to provide a systematic description of the activities of nurses that fall within the principles of health promotion. The objective was to describe the diverse range of nursing activities for health promotion that are provided in the palliative home care setting. This is an integrative review. Fifty-five studies listed in the MEDLINE, CINAHL and EMBASE databases, and published between 1999 and December 2022, were identified. Data analysis and presentation of the results were guided by Kellehear's Health-Promoting Palliative Care (HPPC) model. Six themes were identified to describe nursing activities for health promotion in the context of palliative home care: creating a meaningful relationship, supplying medical information, promoting self-care throughout the trajectory, providing emotional support, involving professional or community services and supporting change. The findings point to nurses focusing more on the individual context and on direct care. The relationship with communities in which they work remains unidirectional. However, some HPPC principles are relevant to nursing activities through the contextualization of nurses' actions and their moral responsibility to work towards the respect of patient's values. Being poorly described, how nurses can truly engage their practice towards health-promoting principles, such as the enhancement of support and control over their lives for people living with serious illness, still requires further empirical research. [ABSTRACT FROM AUTHOR]