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Background: Caring for individuals and their families with a life-limiting, symptomatic illness and those who are dying has long been an integral role of palliative care nurses. Yet, over the last two decades, the specialty of palliative care has undergone significant changes in technology and medical treatments which have altered both the disease trajectory and the delivery of palliative care. To date, there is little evidence as to the impact of these medical and nursing advancements on the role of nurses working in palliative care and how in clinical practice these nurses continue to uphold their nursing values and the philosophy of palliative care. Methods: An integrative review was conducted searching seven academic databases from the time period of January 2010 – December 2019 for studies identifying research relating to the role of the palliative care nurse working in specialist palliative care units and hospices. Research articles identified were screened against the inclusion criteria. Data extraction was completed on all included studies and the Crowe Critical Appraisal Tool was utilized to appraise the methodological quality and thematic analysis was performed guided by Braun and Clarke's framework. The review was conducted and reported in lines with PRISMA guidelines. Results: The search yielded 22,828 articles of which 7 were included for appraisal and review. Four themes were identified: (1) enhancing patient-centred care (2) being there (3) exposure to suffering and death (4) nursing values seen but not heard. The findings highlight that while palliative care nurses do not articulate their nurse values, their actions and behaviors evident within the literature demonstrate care, compassion, and commitment. Conclusion: These findings suggest that there is a need for nurses working in specialist palliative care units to articulate, document, and audit how they incorporate the values of nursing into their practice. This is pivotal not only for the future of palliative nursing within hospice and specialist palliative care units but also to the future of palliative care itself. To make visible the values of nursing further practice-based education and research is required. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of non‐pharmacological non‐invasive supportive interventions for impacts on women's comfort and well‐being during induction of labour. Design: A quantitative systematic review without meta‐analysis. Data Sources: Databases were searched for primary research published in English between 2000–2019: AMED, CINAHL, Medline, Maternity and Infant Care database, PsycINFO, and ProQuest. The quality of studies was evaluated using JBI levels of evidence and established critical appraisal tools. Studies describing measures of comfort, coping, and well‐being for women during induction of labour were included. Results: Two articles met the criteria for inclusion. There is limited evidence to suggest that women having outpatient cervical priming were more satisfied with their experience than women having inpatient cervical priming and that outpatient cervical priming did not increase women's anxiety. A specifically designed information brochure explaining the induction process improved women's knowledge and understanding. Review Methods: The quantitative systematic review followed the Centre for Reviews and Dissemination guidelines and Cochrane Effective Practice and Organisation of Care guidance. Quality appraisal was conducted using JBI levels of evidence, Cochrane Risk of Bias, and other established tools. A narrative description of the quantitative data was undertaken. There was insufficient evidence to perform a narrative synthesis or meta‐analysis due to the nature of the study designs and insufficient outcome data. Conclusions: Globally, the number of women having an induction of labour is increasing and there is a lack of evidence on the effectiveness of supportive interventions. Components of supportive care for women having induction of labour require urgent evaluation. Measurement tools which capture the complexity of supportive care for women having induction of labour need to be developed and validated. Impact: This is the first review to evaluate non‐pharmacological, non‐invasive supportive interventions for women having induction of labour. The findings of this review identify the urgent need to develop an evidence base for effective supportive. [ABSTRACT FROM AUTHOR]

Dual sensory impairment (DSI) is prevalent in the older population, but due to exposure to military-related risk factors, it is a particular problem for veterans, older and younger. This rapid review aimed to critically review and summarise the prevalence of DSI in military veteran populations, as well as any associative factors and outcomes that were assessed. This was done in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Several databases (Scopus, Web of Science, AMED, CINAHL Plus, Ultimate, and MEDLINE via EBSCOHost) were searched and five studies were selected for final review. All studies provided a prevalence rate for DSI in a veteran sample. One study also looked at functional independence as an outcome. Three of the studies considered blast injuries and traumatic brain injury (TBI) by using samples from TBI patient populations. Overall, results of this review suggest that age and presence of TBI and/or exposure to blast may increase prevalence of DSI in veterans. Prevalence rates ranged from 5.0-34.6% but there are caveats. There is a lack of universal or standardised definition for DSI, making it difficult to determine true prevalence. Future research should also include veterans who may not be receiving support from Veterans Affairs, consider factors such as TBI aetiology and severity based on clinical measures, and utilise a more standardised definition for DSI based on clinical measures. [ABSTRACT FROM AUTHOR]

Kicking strikes are fundamental in combat sports such as Taekwondo, karate, kickboxing, Muay Thai, and mixed martial arts. This review aimed to explore the measurement methods, kinematics such as velocities, kinetics such as impact force, determinants, and injury potential of kicking strikes in combat sports. Searches of Academic Search Premier, The Allied and Complementary Medicine Database, CINAHL Plus, MEDLINE, SPORTDiscus, Scopus, and Web of Science databases were conducted for studies that measured kicking velocity and impact force. A total of 88 studies were included in the review. Studies most frequently involved only male participants (49%) aged between 18 and 30 years of age (68%). Studies measuring velocity predominantly implemented camera-based motion capture systems (96%), whereas studies measuring impact force displayed considerable heterogeneity in their measurement methods. Five primary strikes were identified for which foot velocities ranged from 5.2 to 18.3 m/s and mean impact force ranged from 122.6 to 9015 N. Among the techniques analysed, the roundhouse kick exhibited the highest kicking velocity at 18.3 m/s, whilst the side kick produced the highest impact force at 9015 N. Diverse investigation methodologies contributed to a wide value range for kicking velocities and impact forces being reported, making direct comparisons difficult. Kicking strikes can be categorised into throw-style or push-style kicks, which modulate impact through different mechanisms. Kicking velocity and impact force are determined by several factors, including technical proficiency, lower body strength and flexibility, effective mass, and target factors. The impact force generated by kicking strikes is sufficient to cause injury, including fracture. Protective equipment can partially attenuate these forces, although more research is required in this area. Athletes and coaches are advised to carefully consider the properties and potential limitations of measurement devices used to assess impact force. [ABSTRACT FROM AUTHOR]

Background: Children and young people with life-limiting conditions and their families need physical and emotional support to manage the challenges of their lives. There is a lack of synthesised qualitative research about how music therapy is experienced by children, young people and their families supported by paediatric palliative care services. Aim: To systematically identify and synthesise qualitative research on experiences of music therapy in paediatric palliative care from stakeholder perspectives. Design: A Qualitative Evidence Synthesis was conducted using Thematic Synthesis. The review protocol was registered in PROSPERO (registration number: CRD42021251025). Data sources: Searches were conducted with no dates imposed via the electronic databases PsycINFO, MEDLINE, EMBASE, AMED and CINAHL in April 2021 and updated in April 2022. Studies were appraised for quality using the Critical Appraisal Skills Programme tool (CASP). Results: A total of 148 studies were found, 5 studies met the eligibility criteria reporting the experiences of 14 mothers, 24 family members and 4 staff members in paediatric palliative care. There were five overarching themes: emotional and physical reprieve, opportunity for normalised experiences, thriving despite life limited condition, enhance family wellbeing and therapeutic relationship central to outcomes. Conclusion: Music therapy provides unique benefits for this paediatric population particularly in supporting child and family wellbeing. The therapeutic relationship, interpersonal skills of the therapist and experience in paediatric palliative care are perceived as central to these positive outcomes. [ABSTRACT FROM AUTHOR]

Objective Technology-based interventions offer many opportunities to enhance neurorehabilitation, with associated research activity gathering pace. Despite this fact, translation for use in clinical practice has lagged research innovation. An overview of the current "state of play" regarding the extent of clinical uptake and factors that might influence use of technologies is required. This scoping review explored the uptake of technologies as neurorehabilitation interventions in clinical practice and factors that are reported to influence their uptake. Methods This systematic scoping review was conducted with narrative synthesis and evidence mapping. Studies of any design reporting uptake or implementation of technology (wearable devices, virtual reality, robotics, and exergaming) for movement neurorehabilitation after stroke and other neurological conditions were sought via a formal search strategy in MEDLINE (Ovid), CINAHL, AMED, and Embase. Full-text screening and data extraction were completed independently by 2 reviewers. Results Of 609 studies returned, 25 studies were included after title, abstract, and full-text screening. Studies investigated a range of technologies at various stages of development. Only 4 of the included studies explored the sustained use of technology in practice. The following 5 themes representing experiences of technology use emerged: perceived usefulness, technology design, social interaction, integration with services, and suggested improvements to enhance uptake. Conclusion Reporting of uptake and use of neurorehabilitation technologies in clinical practice is limited. The synthesis provided comprehensive knowledge of barriers to and facilitators of uptake to be considered in future protocols, including a steep learning curve required to engage with technology, a need for a supportive organizational culture, and a need for user involvement in both design and development. Impact This scoping review has provided indicators from current evidence of important factors to consider in the planning of research into and clinical implementation of technologies for neurorehabilitation. It serves to support an evidence-based, user-centered platform for improved research on and translation of technologies in neurorehabilitation clinical practice. [ABSTRACT FROM AUTHOR]

Upper limb (UL) impairment-related functional limitation is a frequent post-stroke consequence, potentially negatively impacting health-related quality of life (HRQoL). Significant debate surrounds optimal approach to UL stroke rehabilitation. Task-oriented rehabilitation is recommended to improve UL performance, however despite the motor relearning program (MRP) being a task-oriented approach widely utilized in stroke rehabilitation, there has been insufficient appraisal on its specific effectiveness. This review therefore aimed to review evidence pertaining to the effectiveness of MRP on UL function post-stroke. A systematized review on MRP effectiveness on post-stroke UL function in adults aged 18 years and above, also considering UL impairment and HRQoL. A search of AMED, CINAHL, MEDLINE, CENTRAL and PEDro was conducted, accompanied by examination of individual study citations. Only full text English language randomized controlled trials (RCTs) were included. The methodological quality of each included study was rated using PEDro. Of 721 articles identified, 10 met analysis criteria. There was moderate evidence that MRP, as an individual approach, improved UL function post-stroke. Limited evidence was obtained for positive effect of MRP combined with adjunctive therapies on UL function and impairment. Evidence was lacking regarding the relationship of MRP and HRQoL. There is inadequate evidence on the supremacy of the MRP in comparison to other interventions in improving UL function post-stroke. The inclusion of the MRP into rehabilitation shows some evidence for UL function and impairment improvements. Methodological flaws have been identified within the RCTs reviewed, warranting further high-quality RCTs. [ABSTRACT FROM AUTHOR]

Background: Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. Methods: Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. Results: Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. Conclusion: The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with conventional treatment in cancer care. Health care providers who care for cancer patients should be aware of these risks. [ABSTRACT FROM AUTHOR]

Objectives To explore the safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings. Design Seven-stage framework from the PRISMA statement for research question, eligibility (definition), search, identification of relevant papers from title and abstract, selection and retrieval of papers, appraisal and synthesis. Data sources British Nursing Index (BNI), Allied and Complementary Medicine Database (AMED), Applied Social Sciences Index and Abstracts (ASSIA), Cinahl, Cochrane Library, Embase, Ergonomics Abstracts, Health Business Elite, Health Management Information Consortium (HMIC), Medline, PsycInfo, Scopus, Social Care online, Social Science Citation Index. Review methods The included references ( n = 42) were critically appraised using a modified version of Downs and Black checklist and the Mixed Methods Appraisal Tool. Results The risk factors are reported using the modified model of human factors of health care in the home to represent the roles of both patients and caregivers in the system. The results are grouped as environment (health policy, physical and social), artefacts (equipment and technology), tasks (procedures and work schedules) and care recipient/provider. These include permanent and temporary building design and access, communication and lone working, provision of equipment and consumables, and clinical tasks. The topics with strong evidence from at least 2 papers relate to risks associated with awkward working positions, social environment issues (additional tasks and distractions), abuse and violence, inadequate team (peer) support, problems with workload planning, needle stick injuries and physical workload (moving and handling patients). Conclusions As home care increases, there is a need to ensure the safety of both patients and caregivers with an understanding of the physical interactions and tasks to manage safety risks and plan safer care delivery systems. [ABSTRACT FROM AUTHOR]

The consideration of patient preferences in decision-making has become more important, especially for life-threatening diseases such as lung cancer. This paper aims to identify the preferences of lung cancer patients with regard to their treatment and involvement in the decision-making process. We conducted a systematic literature review from 12 electronic databases and included studies published between 2000 and 2012. A total of 20 studies were included in this review. These revealed that lung cancer patients do have preferences that should be considered in treatment decisions; however, these preferences are not homogenous. We found that patients often consider life extension to be more important than the health-related quality of life or undesirable side effects. This preference seems to depend on patient age. Nausea and vomiting are the most important side effects to be avoided; the relevance of other side effects differs highly between subgroups. The majority of lung cancer patients, nevertheless, seem to prefer a passive rather than an active role in decision-making, although the self-reported preferences differed partly from the physicians' perceptions. Overall, we identified an urgent need for larger studies that are suitable for subgroup analyses and incorporate multi-attributive measurement techniques. [ABSTRACT FROM AUTHOR]

Background: Tendon pathology and tendinopathy have been reported in children and adolescents; however, the age at onset and prevalence of the conditions have not been examined systematically. Objective: To examine the prevalence of lower limb tendon pathology and tendinopathy in children and adolescents, and the factors associated with these conditions in this population. Methods: Six databases were searched (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Scopus, the Web of Science and the Allied and Complementary Medicine Database). Studies were included if the prevalence of lower limb tendon pathology and/or tendinopathy were reported in humans under the age of 18 years. Studies were divided according to the method of diagnosis (physical examination, ultrasound or a questionnaire) and further divided into studies that reported prevalence data by tendon [reported two data points (right and left) for each participant] and those that reported prevalence data for each participant [reporting one data point (right or left) per participant]. Results: Seventeen studies met the inclusion criteria. Lower limb tendinopathy prevalence (presence of pain and dysfunction) ranged between 8.2 and 33.3 %, and increased in prevalence as age increased up to 18 years. The odds ratio for studies reporting tendinopathy by tendon was 0.37 (95 % confidence interval 0.20-0.69) in favour of boys presenting with tendinopathy. Study aims and reporting methods were heterogeneous. Conclusions: The age at onset of lower limb tendinopathy in children and adolescents has not been widely studied. This systematic review found that tendinopathy is present in children and adolescents, and increases in prevalence with age up to 18 years. Male sex is significantly associated with tendinopathy in studies that report tendinopathy by tendon. [ABSTRACT FROM AUTHOR]

Introduction Promoting the wellbeing of people with dementia is central to current social policies. To address the psychological impact of dementia, sensory stimulation is one approach practised by occupational therapists. This article will critically review the primary research that tests the link between sensory interventions and wellbeing for people with dementia. This research is inspired by theory relating to person-centred care and sensory processing. Method A literature search was conducted using electronic databases for health and social care. Nine papers were identified that met the inclusion criteria. These were critically appraised to identify the quality of the evidence available, and to collate emerging themes from their results.Results Although the studies appraised varied widely in the quality of their methodologies, some significant results and themes were found that do link sensory stimulation with emotional wellbeing and occupational engagement. Two distinctly different methods of intervention were documented in the evidence base. Most studies tested the impact of session based interventions in specific environments. One large scale randomised controlled trial implemented sensory care plans that were embedded in the lived environment of participants. This approach is more congruent with sensory processing theory and occupational science theories than time-bound sessions of sensory stimulation. Conclusion Attending to the sensory needs of people with dementia can positively affect their emotional wellbeing and their ability to engage in occupations. This can be incorporated into the reasoning and interventions of occupational therapists when supporting this client group. [ABSTRACT FROM AUTHOR]

The Innovative Medicines Initiative (IMI) is making great strides in promoting patient and public involvement (PPI) in health research across Europe, supporting patient organisations to be involved in the projects that it funds. Despite this, the literature around PPI in health services and research originating from European countries appears less than from the United Kingdom (UK), where PPI is well established. Therefore, we conducted a systematic review to explore the attitudes and approaches to PPI across Europe. Eight scientific databases were systematically searched and data extracted. Data quality was assessed using a checklist based on the Guidance for Reporting Involvement of Patients and the Public (GRIPP2) (Staniszewska et al., Research, Involvement and Engagement, 3, 13, 2017) and the critical appraisal guidelines developed by Wright et al. (Health Expectations, 13, 359, 2010). We included all studies reporting PPI activity in both public and private health services and research institutions in the World Health Organization European region, excluding the UK, published in the English language from 1996 to 2018. Forty studies in total were included in the analysis. The studies imply a growing interest and support for the idea of PPI in health services and, to a lesser extent, in health research. There seems to be a convergence of conceptualisations of PPI across Europe, with internationally significant areas of innovative work taking place in countries such as the Netherlands and the Scandinavian countries. However, the implementation of PPI is highly uneven, and PPI is not yet firmly embedded or adequately formalised in European healthcare systems and research, possibly due to a lack of infrastructure, guidance and support. In order to try to get a better understanding of what is happening on the ground, we are carrying out a survey with potential follow‐up interviews as the next part of this research project. This work is currently on hold due to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Using push notifications, companies can address their smartphone app users with advertising messages. Each of these notifications can mean added value for smartphone users in terms of content, but also disruption and interruption. It is therefore important for advertisers to understand how the frequency of message delivery influences consumer acceptance. The systematic review is based on the PRISMA method and initially identifies a total of 18,725 potentially relevant scientific papers. The 17 research articles included in the qualitative synthesis show that push notifications are suitable for encouraging users to use an app and establish new habits. App usage increases with frequency, with particularly active users tolerating higher frequencies. At the same time it is also shown that too high a frequency can be perceived as disturbing and users should therefore be given the opportunity to determine the frequency with which they receive notifications. A gap in research has been identified in particular in studies that look at real observed behaviour of app users instead of behaviour reported via questionnaires and examine the interaction of frequency, content and presentation of notifications. [ABSTRACT FROM AUTHOR]

Diabetes is one of the typical chronic diseases, and its incidence is related to many environmental factors. At present, there is no radical cure for diabetes, so the prevention of diabetes is particularly important. In order to effectively prevent the occurrence of diabetes, it is necessary to understand the conditions leading to the occurrence of diabetes. Current studies have shown that long-term exposure to noise will increase the risk of diabetes. Literature was retrieved from Pubmed and Web of Science. The relationship between noise exposure and diabetes published in the past 10 years was retrieved from the literature. Two researchers screened the literatures and extracted the data according to the inclusion and exclusion criteria. Endnote software was used to manage the literature, and NOS (Newcastle-Ottawa Scale) scale was used to evaluate the quality of the included literatures. Random effects meta-analysis was used to comprehensively evaluate the noise exposure of diabetic patients, and stata13.1 was used for data analysis. After adherence to strict inclusion and exclusion criteria, eight studies on the association between noise and diabetes were selected, including five cohort studies and three cross-sectional studies, with a total of 514,570 participants and 23,708 diabetics. The results showed that exposure to noise increased the risk of developing diabetes (OR = 1.08; 95% CI = 1.03 ~ 1.12). From the analysis of these selected articles, it can be seen that there is a positive correlation between noise and the occurrence of diabetes. As a result, it is necessary to strengthen routine blood tests for people who have been exposed to noise for a long time, especially those who have to be exposed to noise due to their occupations. [ABSTRACT FROM AUTHOR]

Background: Cancer patients' disclosure rate of their complementary and alternative medicine (CAM) use to health professionals is low, mainly attributed to health professionals' attitude toward CAM. Thus, we aimed to identify and compare the knowledge, attitudes and practices of doctors, nurses and pharmacists regarding CAM use in cancer patients. Method: The databases AMED, CINAHL, Embase, Emcare, Medline, PubMed, Scopus and Web of Science were searched for surveys of health professionals published between 2008 and 2020. Results: The knowledge of CAM in cancer care was generally poor for all three professions in the included studies, although how knowledge was assessed showed large variability. Doctors were found to dismiss or discourage CAM use out of concerns for side-effects and interactions. Nurses were generally positive and supportive toward CAM use by cancer patients. Pharmacists were neutral toward CAM, but believed they should be a reliable source of information for patients. All professions felt a major barrier to discussions with patients about CAMs was a lack of evidence of their safety and efficacy. Studies of all three professions also showed a general desire for more education regarding CAM. Conclusions: The review suggests that doctors, nurses and pharmacists may lack appropriate knowledge to inform CAM use in a cancer care setting, which determines their attitude, influences practice and potentially impacts patient outcomes. Our findings indicate that increased access to research-based education on CAM would strengthen health practitioners' confidence in discussing CAM with cancer patients, which would lead to more disclosure and safer therapeutic decision making. [ABSTRACT FROM AUTHOR]

Aim: To identify relevant and pertinent themes and interventions within the literature relating to childhood traumatic grief, in order to provide a sound background of evidence for further research and service development. Background: Childhood traumatic grief is caused when a significant person in a child's life dies under circumstances that they perceive to be traumatic. This can leave a child unable to return to the same level of physical and emotional functioning that he or she had prior to the death occurring. In Sub-Saharan Africa, there is an increased risk for childhood traumatic grief due to a high prevalence of orphanhood, environmental stressors, stigma, and abuse. This can have detrimental effects upon mental health. Methods: The review followed the York methodology: identifying the purpose and agreeing on the strategy beforehand; identifying relevant sources/studies; selecting the studies; charting the data; and collating, summarizing, and reporting results. Results and discussion: Interventions identified to prevent and/or manage traumatic grief included narrative exposure therapy, psychotherapy, mentoring, peer-group support, psychosocial support, a grief and loss therapy session, and memory boxes. Mental health remains neglected within service and policy development as well as in global health spending. The average amount expended on mental health services per person per year in low-income countries is less than $0.25. Only 36% of people in low income countries are covered by a mental health policy, compared with 92% in high income countries. Limitations: The sixth stage of the York methodology was omitted. Only papers written in English were included in the review. Conclusion: Childhood traumatic grief in young people is an important issue within Sub- Saharan Africa and has relevance to the global mental health agenda. Implications for nursing and health policy: With the HIV/AIDS pandemic continuing to threaten and the number of orphans estimated to rise, a number of recommendations developed from the literature are suggested. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to gain a greater understanding of the development of safer walking technology for people with dementia through contemporary literature. Design/methodology/approach – A two stage systematic approach to searching the literature was adopted. Initially this involved searching the literature to gain a broad overview of the development of safer walking technology and the context in which it has been developed. Then, this literature was examined in detail to look at published evidence surrounding the use of safer walking technology by people with dementia. These articles were quality appraised and a meta ethnographic approach taken to synthesis of the findings. Findings – There is a small but growing body of literature within this field. Whilst there is only limited evidence to support the use of safer walking technologies for people with dementia, the evidence to date indicates great potential for its use. If provided with the right support and guidance, safer walking technology has the potential to increase freedoms and independence for people with dementia; gaining them improved access to outdoor spaces and environments to support their health and wellbeing. However, if the safer walking technology continues to be associated with only risk management it will not achieve this potential. Research limitations/implications – The published literature within this field is small and has limited generalisability as much of it was generated in recent years has been by the same small research teams, often reusing data sets. There is also very little research that examines the experience of actually using safer walking technology and even less which explores the views of people with dementia. It is evident that a greater breadth and depth of knowledge is needed within this field to develop a clearer understanding of how this technology is used and perceived by all stakeholders concerned. In particular the literature would benefit from greater consideration of the views and experiences of people with dementia themselves. Practical implications – For many people with dementia, health and social care professionals can play an important role in ensuring appropriate assessment and support in the decision-making process when using safer walking technology. However, greater support is needed in decision making for all people with dementia, especially those people not currently engaged with specialist services. Therefore greater awareness of the benefits and limitations of this technology is needed by all health and social care professionals as well as the general public. Originality/value – At the time of conducting this review the author is unaware of any other systematic search of literature or overview of research on the use of safer walking technology and its use by people with dementia. Despite this safer walking technology is growing in popularity, commonly recommended by health and social care practitioners and often marketed and purchased directly by people with dementia and their families. This review offers an insight into the development of the technology and the current evidence base for its use. [ABSTRACT FROM AUTHOR]

Background/Aim: Phantom limb pain (PLP) is a debilitating condition that affects 50-85% of patients following an amputation and significantly diminishes their quality of life. Mirror therapy has been reported to have potential success for the alleviation of PLP. However, due to a lack of understanding of the mechanisms underlying PLP and the fact that no current consensus as to the effectiveness of mirror therapy exists, guidelines for treatment protocols are lacking. This review aimed to assess the current best evidence for using mirror therapy to treat PLP in patients with amputation. Methods: The authors conducted a systematic review of original research papers specifically investigating the use of mirror therapy in populations of patients experiencing PLP after unilateral limb amputation. Literature was sourced from PubMed, AMED, CINAHL and Google Scholar. The following search terms were used in combination: ‘phantom pain’; ‘PLP’; ‘phantom limb’; ‘phantom limb pain’; ‘mirror’; ‘mirror treatment’; ‘mirror therapy’; and ‘virtual limb’. All available studies were marked against predetermined inclusion and exclusion criteria. Results: Seven primary articles met the inclusion criteria, all of which reported significant PLP alleviation after using mirror therapy, with a trend for achieving phantom limb movement prior to pain relief. Conclusions: Mirror therapy is a promising intervention for PLP. Regular sessions of mirror therapy are required to maintain treatment effects. Causes of PLP and treatment pathways may be multifactorial; therefore, further well-conducted randomised controlled trials are required to identify best practice. [ABSTRACT FROM AUTHOR]

Objectives: To provide a comprehensive scoping review of evidence of the impact and effectiveness of 12 h shifts in the international nursing literature, supplemented by a review of evidence in other, non-nursing related industries. Data sources: A search of the academic literature was undertaken in electronic databases (AMED, MEDLINE, CINAHL, PsychInfo, Scopus, HMIC, the Cochrane Library, Business Source Premier, Econ Lit, ASSIA and Social Policy and Practice). Review methods: A total of 158 potentially relevant nursing research papers and reviews were published between 1973 and 2014. Two reviewers independently reviewed the articles, leaving 85 primary research studies and 10 review papers in the nursing field to be included in the scoping review. Thirty-one relevant primary research papers and reviews were also identified in the non-nursing related industries literature. Results: Research into 12 h nursing shifts fell within five broad themes: 'risks to patients', 'patient experience', 'risks to staff', 'staff experience' and 'impact on the organisation of work'. There was inconclusive evidence of the effects of 12 h shift patterns in all five themes, with some studies demonstrating positive impacts and others negative or no impacts. This also mirrors the evidence in other, non-nursing related industries. The quality of research reviewed is generally weak and most studies focus on the risks, experience and work/life balance for staff, with few addressing the impact on patient outcomes and experience of care or work productivity. Conclusions: There is insufficient evidence to justify the widespread implementation or withdrawal of 12 h shifts in nursing. It is not clearly understood where there are real benefits and where there are real and unacceptable risks to patients and staff. More research focusing on the impact of 12 h nursing shifts on patient safety and experience of care and on the long term impact on staff and work organisation is required. [ABSTRACT FROM AUTHOR]

Objective: It is common to study and understand how various illness and disorders result in negative consequences. However, positive experiences have been reported in a range of disabling conditions including multiple sclerosis, heart disease, physical and sensory disabilities. This paper presents a literature review of studies that have explored positive experiences associated with acquired hearing loss, Ménière's disease, and tinnitus. Design: A review of the peer reviewed scientific literature. Study sample: A comprehensive search strategy identified 15 articles after applying inclusion criteria. Results: A range of positive experiences have been reported by patients with hearing and balance disorders and by their significant others. Associations between demographic variables (e.g. age, gender), audiological variables (e.g. severity of the condition, duration) and the reported positive experiences are low. In Ménière's disease, self-reported positive experiences can predict the impact of the condition. However, this phenomenon has not yet been demonstrated in relation to hearing loss and tinnitus. Conclusions: Positive experiences associated with audio-vestibular disorders have been demonstrated. Further research is needed on the long-term benefits of the encouragement of such experiences and positive attitudes in persons with hearing loss, tinnitus, and imbalance. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) is highly prevalent within both sporting and recreationally active populations. Multiple treatment approaches have been advocated for the management of PFP, attempting to address both intrinsic and extrinsic factors thought to contribute to the development and persistence of pain. A number of predictors of treatment success have been proposed, and evaluated, for directing intervention choice. Objective: Our aim was to systematically review the literature that identifies outcome predictors of specific conservative interventions in the management of PFP, including quality of the current evidence, to guide clinical practice and future studies investigating outcome predictors within this population. Data Sources: The AMED, CINAHL, EMBASE, MEDLINE and Web of Science databases were searched from inception to April 2013. Study Selection: Randomized controlled trials (RCTs) and cohort studies. Study Appraisal and Synthesis Methods: Following initial searching, all potential papers were assessed by two independent reviewers for inclusion using a checklist developed from the inclusion criteria. Cited, and citing, references were also searched in Google Scholar, but unpublished work was not sought. Methodological quality was assessed using a previously designed quality assessment scale. Definitions for levels of evidence were guided by recommendations made by van Tulder et al. Results: Fifteen low-quality (LQ) cohort studies were included. No RCTs were found. This systematic review identified the evaluation of 205 conservative management outcome predictor variables. Of this large number of variables that have been assessed, 19 (9 %) were found to significantly predict a successful outcome. Where two or more outcome predictors and success determinants were consistent between studies, data were pooled. Within these studies, the low number of participants per output variable, and absence of controls, is likely to compromise the validity of the predictor's accuracy. Very limited evidence identified higher functional index questionnaire scores (mean 0.82, 95 % confidence interval [CI] 0.18-1.46), greater forefoot valgus (mean 0.67, 95 % CI 0.05-1.28) and greater rearfoot eversion magnitude peak (mean −0.93, 95 % CI −1.84 to −0.01) to significantly predict improved outcomes with orthoses interventions. Shorter symptom duration ( p = 0.019), lower frequency of pain ( p = 0.012), younger age, faster vastus medialis oblique reflex response time ( p = 0.026), negative patella apprehension, absence of chondromalacia patella, tibial tubercle deviation of <14.6 mm and greater total quadriceps cross-sectional area on magnetic resonance imaging ( p = 0.01), and reduced eccentric average quadriceps peak torque ( p = 0.015) significantly predicted exercise intervention success following multivariate statistical analysis. Limited evidence identified increased Q-angle (mean 0.38, 95 % CI 0.05-0.72) and very limited evidence identified greater usual pain (mean 0.43, 95 % CI 0.01-0.85) to predict taping intervention success. Conclusions: This systematic review provides a comprehensive summary of current derivation level studies identifying indicators of prediction for conservative PFP management. The overall strength of evidence was low. With appropriate caution, clinicians should consider taping for those with greater usual pain, orthoses for older individuals and exercise for younger individuals, and orthoses intervention for patients with greater forefoot valgus and rearfoot eversion magnitude peak. RCTs with evaluation of outcome prediction as a primary aim are clearly warranted to provide clinicians with robust evidence and facilitate evidence-informed, tailored intervention to this heterogeneous patient population. [ABSTRACT FROM AUTHOR]

Aging is associated with a progressive decline in health, resulting in increased medical care and costs. Mobile technology may facilitate health self-management, thus increasing the quality of care and reducing costs. Although the development of technology offers opportunities in monitoring the health of older adults, it is not clear whether these technologies allow older adults to manage their health data themselves. This paper presents a review of the literature on mobile health technologies for older adults, focusing on whether these technologies enable the visualization of monitored data and the self-reporting of additional information by the older adults. The systematic search considered studies published between 2009 and 2019 in five online databases. We screened 609 articles and identified 95 that met our inclusion and exclusion criteria. Smartphones and tablets are the most frequently reported technology for older adults to enter additional data to the one that is monitored automatically. The recorded information is displayed on the monitoring device and screens of external devices such as computers. Future designs of mobile health technology should allow older users to enter additional information and visualize data; this could enable them to understand their own data as well as improve their experience with technology. [ABSTRACT FROM AUTHOR]

The number of older adults is increasing worldwide, and it is expected that by 2050 over 2 billion individuals will be more than 60 years old. Older adults are exposed to numerous pathological problems such as Parkinson's disease, amyotrophic lateral sclerosis, post-stroke, and orthopedic disturbances. Several physiotherapy methods that involve measurement of movements, such as the Timed-Up and Go test, can be done to support efficient and effective evaluation of pathological symptoms and promotion of health and well-being. In this systematic review, the authors aim to determine how the inertial sensors embedded in mobile devices are employed for the measurement of the different parameters involved in the Timed-Up and Go test. The main contribution of this paper consists of the identification of the different studies that utilize the sensors available in mobile devices for the measurement of the results of the Timed-Up and Go test. The results show that mobile devices embedded motion sensors can be used for these types of studies and the most commonly used sensors are the magnetometer, accelerometer, and gyroscope available in off-the-shelf smartphones. The features analyzed in this paper are categorized as quantitative, quantitative + statistic, dynamic balance, gait properties, state transitions, and raw statistics. These features utilize the accelerometer and gyroscope sensors and facilitate recognition of daily activities, accidents such as falling, some diseases, as well as the measurement of the subject's performance during the test execution. [ABSTRACT FROM AUTHOR]

Future intelligent transportation systems (ITS) hold the promise of supporting the operation of safety-critical applications, such as cooperative self-driving cars. For that purpose, the communications among vehicles and with the road-side infrastructure will need to fulfil the strict real-time guarantees and challenging dependability requirements. These safety requisites are particularly important in wireless vehicular networks, where road traffic presents several threats to human life. This paper presents a systematic survey on fault tolerance techniques in the area of vehicular communications. The work provides a literature review of publications in journals and conferences proceedings, available through a set of different search databases (IEEE Xplore, Web of Science, Scopus and ScienceDirect). A systematic method, based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) Statement was conducted in order to identify the relevant papers for this survey. After that, the selected articles were analysed and categorised according to the type of redundancy, corresponding to three main groups (temporal, spatial and information redundancy). Finally, a comparison of the core features among the different solutions is presented, together with a brief discussion regarding the main drawbacks of the existing solutions, as well as the necessary steps to provide an integrated fault-tolerant approach to the future vehicular communications systems. [ABSTRACT FROM AUTHOR]

Background the number of older people living in residential and nursing care homes is rising. Loneliness is a major problem for older people, but little is known about the prevalence of loneliness amongst older people living in care homes. Aim to undertake a systematic review of literature on the prevalence of moderate and severe loneliness amongst older people living in residential and nursing care homes. Design we systematically reviewed the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase, Scopus, Cochrane and Allied and Complementary Medicine Database (AMED) from inception to January 2019. We included all studies reporting data on the prevalence of loneliness amongst older people living in care homes. A random-effects meta-analysis was conducted on all eligible data. Results a total of 13 articles were included, representing 5,115 participants (age range of 55–102 years, mean age 83.5 years, 68% female). There was a significant variation between studies in estimates of prevalence. The prevalence of moderate loneliness ranged from 31 to 100%, and the prevalence of severe loneliness ranged from 9 to 81%. The estimated mean prevalence of 'moderate loneliness' was 61% (95% confidence interval (CI): 0.41, 0.80). The estimated mean prevalence of 'severe loneliness' was 35% (95% CI: 0.14, 0.60). Conclusion the prevalence of both moderate loneliness and severe loneliness amongst care home residents is high enough to warrant concern. However, the significant variation in prevalence estimates warrants further research. Future studies should identify which interventions can address loneliness and promote meaningful social engagement to enhance quality of life in care homes. [ABSTRACT FROM AUTHOR]

Purpose: Yoga practice has become increasingly popular around the world for the benefits it can bring for physical and mental health. However, little research has been done regarding the use of yoga as a therapy for elderly people with mental health problems. This literature review will therefore attempt to answer the questions: what research has been done to look into the use of yoga as therapy for elderly people with a diagnosis of mental health problems, what does this research show and what future directions may this work take in the future. Design/methodology/approach: The review describes four research studies that have been done looking at the use of yoga as an intervention in older people with diagnosed mental health problems and one upcoming larger study. Findings: Therefore, it is shown that the research in this area is so far still in its infancy, but that yoga has potential to be a useful potential treatment for older people with mental health problems. Originality/value: As with all research into treatments for mental health problems, involvement of patients and their carers will be vital to ensure that the direction of the research is one that will be valuable, and that the traditions of yoga that have been of so much benefit to so many can be used to help a group of people who are often vulnerable and who sometimes do not receive all the treatment that they deserve. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is a major risk factor for non-communicable disease and premature mortality. People who live in rural settings are usually regarded as more physically active than those living in urban areas, however, direct comparisons between these populations are scarce. We aimed to summarise the prevalence of physical inactivity and sedentary behaviour in rural settings in Australia, compared to urban counterparts.Methods: We searched six databases (AMED, Embase, Medline; CINAHL, SPORTDiscus; and RURAL) and identified 28 observational studies that investigated the levels of physical inactivity and/or sedentary behaviour in adults aged 18 years and over in rural Australia. Random effects meta-analysis was used to generate pooled prevalence estimates.Results: Physical inactivity was four percentage points (95% confidence interval (CI) = 0.4 to 8) higher in rural populations compared to urban populations. There was a one percentage point (95% CI = -3 to 5) prevalence difference of physical activity in the rural populations. Rural populations reported on average 7.8 hours of sedentary time per day (95% CI = 5 to 10) and the prevalence of high levels of sedentary behaviour (≥to 8 hours per day) was 7% (95% CI = -8 to -7) greater in urban areas compared to rural areas.Conclusions: People living in rural areas are just as physically inactive as people who live in urban areas. Our findings challenge the popular views that rural lifestyles result in people engaging more frequently in physical activity. Public health campaigns promoting physical activity in rural settings are just as necessary as in urban settings. [ABSTRACT FROM AUTHOR]

Do web surveys still yield lower response rates compared with other survey modes? To answer this question, we replicated and extended a meta-analysis done in 2008 which found that, based on 45 experimental comparisons, web surveys had an 11 percentage points lower response rate compared with other survey modes. Fundamental changes in internet accessibility and use since the publication of the original meta-analysis would suggest that people's propensity to participate in web surveys has changed considerably in the meantime. However, in our replication and extension study, which comprised 114 experimental comparisons between web and other survey modes, we found almost no change: web surveys still yielded lower response rates than other modes (a difference of 12 percentage points in response rates). Furthermore, we found that prenotifications, the sample recruitment strategy, the survey's solicitation mode, the type of target population, the number of contact attempts, and the country in which the survey was conducted moderated the magnitude of the response rate differences. These findings have substantial implications for web survey methodology and operations. [ABSTRACT FROM AUTHOR]

Introduction/Background: The depth and breadth of research on dry needling (DN) has not been evaluated specifically for symptomatic spine related disorders (SRD) from myofascial trigger points (TrP), disc, nerve and articular structures not due to serious pathologies. Current literature appears to support DN for treatment of TrP. Goals of this review include identifying research published on DN treatment for SRD, sites of treatment and outcomes studied. Methods: A scoping review was conducted following Levac et al.'s five part methodological framework to determine the current state of the literature regarding DN for patients with SRD. Results: Initial and secondary search strategies yielded 55 studies in the cervical (C) region (71.43%) and 22 in the thoracolumbar-pelvic (TLP) region (28.57%). Most were randomized controlled trials (60% in C, 45.45% in TLP) and clinical trials (18.18% in C, 22.78% in TLP). The most commonly treated condition was TrP for both the C and TLP regions. In the C region, DN was provided to 23 different muscles, with the trapezius as treatment site in 41.88% of studies. DN was applied to 31 different structures in the TLP region. In the C region, there was one treatment session in 23 studies (41.82%) and 2–6 treatments in 25 (45.45%%). For the TLP region, one DN treatment was provided in 8 of the 22 total studies (36.36%) and 2–6 in 9 (40.9%). The majority of experimental designs had DN as the sole intervention. For both C and TLP regions, visual analogue scale, pressure pain threshold and range of motion were the most common outcomes. Conclusion: For SRD, DN was primarily applied to myofascial structures for pain or TrP diagnoses. Many outcomes were improved regardless of diagnosis or treatment parameters. Most studies applied just one treatment which may not reflect common clinical practice. Further research is warranted to determine optimal treatment duration and frequency. Most studies looked at DN as the sole intervention. It is unclear whether DN alone or in addition to other treatment procedures would provide superior outcomes. Functional outcome tools best suited to tracking the outcomes of DN for SRD should be explored. [ABSTRACT FROM AUTHOR]

Background: The development of trustworthy guidelines requires substantial investment of resources and time. This highlights the need to prioritize topics for guideline development and update. Objective: To systematically identify and describe prioritization exercises that have been conducted for the purpose of the de novo development, update or adaptation of health practice guidelines. Methods: We searched Medline and CINAHL electronic databases from inception to July 2019, supplemented by hand-searching Google Scholar and the reference lists of relevant studies. We included studies describing prioritization exercises that have been conducted during the de novo development, update or adaptation of guidelines addressing clinical, public health or health systems topics. Two reviewers worked independently and in duplicate to complete study selection and data extraction. We consolidated findings in a semi-quantitative and narrative way. Results: Out of 33,339 identified citations, twelve studies met the eligibility criteria. All included studies focused on prioritizing topics; none on questions or outcomes. While three exercises focused on updating guidelines, nine were on de novo development. All included studies addressed clinical topics. We adopted a framework that categorizes prioritization into 11 steps clustered in three phases (pre-prioritization, prioritization and post-prioritization). Four studies covered more than half of the 11 prioritization steps across the three phases. The most frequently reported steps for generating initial list of topics were stakeholders' input (n = 8) and literature review (n = 7). The application of criteria to determine research priorities was used in eight studies. We used and updated a common framework of 22 prioritization criteria, clustered in 6 domains. The most frequently reported criteria related to the health burden of disease (n = 9) and potential impact of the intervention on health outcomes (n = 5). All the studies involved health care providers in the prioritization exercises. Only one study involved patients. There was a variation in the number and type of the prioritization exercises' outputs. Conclusions: This review included 12 prioritization exercises that addressed different aspects of priority setting for guideline development and update that can guide the work of researchers, funders, and other stakeholders seeking to prioritize guideline topics. [ABSTRACT FROM AUTHOR]

Background: Journal clubs are an educational activity in which individuals meet to critique and discuss research articles. They are an established part of the medical education system and are considered to be a practical way to improve the content knowledge of health professionals. Aims: To determine the effectiveness of journal clubs for increasing health professionals' competency in EBM. Methods: A systematic review of randomized controlled trials (RCTs) was performed. Electronic searches were conducted in October 2019 across MEDLINE, ERIC and Scopus databases. Two authors independently reviewed articles, and extracted data. A risk‐of‐bias tool, based on the Cochrane Collaboration's tool for assessing risk of bias in RCTs, was used to assess internal validity. Results: A total of 151 citations were returned, from which five studies (n = 378 individuals) were included in the final review. No overall statistical difference in knowledge scores was observed between health professionals participating in journal clubs compared to other professional education modes (SMD 0.15, 95% CI –0.09, 0.39). Similarly, no significant difference in attitudes or implementation of evidence‐based medicine practices was observed across studies. Conclusions: There is insufficient evidence to support the effectiveness of journal clubs in improving the knowledge, attitudes, and implementation of evidence‐based skills by health professionals in clinical practice. Further research is needed to test the effectiveness of other interventions to increase uptake of EBM in real world settings. Such interventions may include interactive components with auditing and feedback to facilitate more effective learning. [ABSTRACT FROM AUTHOR]

Objective: Immune checkpoint inhibitors (ICIs) have recently shown tremendous promise in the treatment of diverse cancers. The available data suggests that ICIs are well tolerated in terms of health-related quality of life (HRQOL) compared to other anticancer therapies. However, it appears that instruments currently used to evaluate HRQOL in this context may fail to capture important symptomatology unique to ICIs. This systematic review was designed to assess the adequacy of methods used to report HRQOL in cancer patients treated with ICIs and to identify the quality of life scales used. Method: A systematic review was performed (systematic registration number: PROSPERO: CRD42019121427). A search of the PubMed, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences collection, and SocINDEX databases was carried out for publications in English and in French. Relevant databases were searched from the earliest records through to March 2019. Publications were selected if they reported on HRQOL in patients with cancer treated by ICIs. Risk of bias was scored using the Cochrane Collaboration bias assessment tool. Results: Our search identified 144 publications between 2012 and 2019, of which 15 RCTs met the inclusion criteria. The results suggest that even though the overall reporting of HRQOL was deemed to be of good quality, the data available was marred by methodological aspects such as the lack of HRQOL research hypotheses and the lack of questionnaires validated for cancer patients treated with immunotherapy. Conclusion: This study provides a comprehensive analysis of the current state of the art and identifies gaps in knowledge on HRQOL analysis with respect to ICIs. It also suggests avenues for further research. [ABSTRACT FROM AUTHOR]

Medical practitioners' (MP) role is pivotal in primary prevention, early diagnosis, prompt referral and effective management of oral and oropharyngeal carcinomas (OC/OPC), which raises the importance of their effective OC/OPC education at all levels of medical education. The purpose of this systematic review was to summarise the available scientific evidence about their educational competence in dealing with OC/OPC. We made a systematic search of papers in the English language in MEDLINE, Scopus, Cochrane Library CENTRAL and CINAHL databases from their inception until December 2018. Overall, 23 cross-sectional and three interventional studies have been selected for the systematic review and 18 of these were included in the meta-analyses. Excluding tobacco use (synthesised estimate of 95% of respondents identified tobacco as an OC/OPC risk factor, 95% CI of synthesised estimate 92% to 97%) and alcohol consumption (65%, 95%CI 52% to 77%), less than half of MP (approximately) were knowledgeable about important OC/OPC risk factors including human papilloma virus (42%, 95% CI 30% to 54%), poor diet (34%, 95% CI 17% to 54%), and advancing age (45%, 95% CI 21% to 70%). There was a low to moderate level of awareness among MP regarding common precancerous oral lesions involving leukoplakia (56%, 95% CI 32% to 79%), erythroplakia (30%, 95% CI 8% to 58%), and oral lichen planus (13%, 95% CI 0 to 41%). Moderate knowledge was also recorded about frequent sites of OC development involving the tongue (48%, 95% CI 33% to 64%) and floor of the mouth (37%, 95% CI 19% to 57%). Most MP enquired about tobacco use (86%, 95% CI 74% to 96%), and alcohol consumption (73%, 95% CI 47% to 94%) during history taking, and expressed willingness to be given supplementary OC/OPC education (78%, 95% CI 54% to 96%), as well. With regard to the incidence of intraoral screening, 27% of MP (95% CI 12% to 46%) make an intraoral examination as a routine. Interestingly, studies from each continent yielded significantly different outcomes to some research questions in the review. From the MP's perspective, clinical time restrictions and deficiencies in organised training were recognised as the main barriers towards their OC/OPC educational competence. The findings of this systematic review indicated the existence of deficiencies in knowledge and misconceptions, neglected preventive responsibilities, and associated barriers towards OC/OPC. A need for improved OC/OPC training at all levels of medical education is required to increase competence worldwide. [ABSTRACT FROM AUTHOR]

Background: The long-term usage of electronic devices produces negative effects on the growth and development of the child. Frequent and regular usage of electronics without the supervision of caregivers may be associated with delayed growth and development among young children. A plethora of studies has demonstrated heavy usage of electronic gadgets that affects the child's psychological, mental and behavioral aspects of the development, although the findings from the literature are not synthesized. Hence, the objective of this review was to appraise and synthesize the existing literature on the effects of electronics on the growth and development of young children. Methods: We searched for different databases such as Google Scholar, PubMed, CINAHL and Science Direct to search and retrieve articles. All English articles published in developed and developing countries from 2000 to 2018 were included in this study. Primary and review articles were examined for information pertinent to the objective. Findings from both quantitative and qualitative studies were reviewed and included. After doing a comprehensive search of all eligible studies, we included 15 fulltext articles in this review. Findings: The existing review of the literature demonstrated that children spend most of their time on different gadgets like telephone, mobile phone, radio, TV, games, Xbox, iPod, and stereo system. Children use gadgets for various purposes like playing games, watching videos, listening to songs, chatting with their friends, browsing different websites. The findings of the study regarding the effect of electronic gadgets on the child's growth and development are mixed. Some studies show that children might be benefited from gadgets, however, studies also reveal that usage of gadgets might have negative effects on the growth and development of children. Conclusion: It is concluded that as the gadgets are increasing day by day, it is making children more addicted to technology. The usage of gadgets might be beneficial to some extent, however, excessive usage may lead to adverse outcomes among young children. Thus, it is important to take action to prevent children from watching excessive electronic gadgets under the proper supervision of caregivers. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the diagnostic criteria used in randomized controlled trials to define trial participants as having cervicogenic headache (CeH). Background: While animal and human studies suggest a biological basis for "cervicogenic" headaches the diagnostic criteria necessary to evidence CeH are debated. Methods: A systematic review was undertaken guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. An electronic search of MEDLINE, Cochrane, CINHAL, Pedro, AMED, and EMBASE online databases of randomized controlled trials published between January 1983 and October 2018 found 39 randomized controlled trials which met the study inclusion criteria. Results: Two independent reviewers found most trials cited 1 (31/39; 79.5%) or more (3/39; 7.6%) references to define the criteria used to identify CeH in their study participants. In spite of updated publications concerning the characteristics and definition of CeH, many (27/39; 69.2%) used diagnostic criteria published between 5 and 24 years prior to the randomized controlled trial. The most commonly cited diagnostic criteria included unilateral headache (18/39; 46.2%), cervical movement or sustained posture that either provoked (18/39; 46.2%) or precipitated (17/39; 43.6%) the headache. Fifteen trials did not exclude participants with signs or symptoms of other forms of headache. Although anesthetic blockade of cervical tissue or nerves is considered necessary for a "definitive" diagnosis, only 7.6% (3/39) of trials used anesthetic blockade at recruitment. Conclusions: This systematic review evidences the heterogeneity in the clinical characteristics used to diagnose CeH in participants recruited in randomized controlled trials. It raises a significant concern about the usefulness of currently available randomized controlled trials to determine the clinical merits of the treatment and management of people with CeHs. Our systematic review suggests that most randomized controlled trials published to date have investigated headaches with a clinical presentation involving the neck that maybe better defined as "possible," "probable," or "definitive" CeH depending on how well the diagnostic criteria used align with the most recent edition (3rd) of the International Classification of Headache Disorders. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the overall effectiveness of the flipped classroom on students' learning achievement and motivation. Data were collected from three databases, which include Web of Science, Scopus, and Eric. The present meta-analysis synthesized the findings of 95 studies with 15386 participants published from 2013 to 2019. The results revealed that the flipped classroom approach had a moderate effect size for learning achievement and learning motivation. The effect sizes of 12 moderators, including sample level, sample size, learning domain, the flip classroom model, research design, intervention duration, teaching method in the class, sample region, interactions in a pre-class and face-to-face class, tools in pre-class, and resources in pre-class were also analyzed. The results indicated that sample size, intervention durations, and sample regions significantly moderated the effect sizes. The findings of this study are discussed in-depth, together with the implications for practices on the use of the flipped classroom approach. [ABSTRACT FROM AUTHOR]

Systematic reviews and meta-analyses are used to summarize and interpret evidence for clinical decision-making in human health. The extent of the application of these methods in veterinary medicine and animal agriculture is unknown. The goal of this scoping study was to ascertain trends in the publication of systematic reviews and meta-analyses examining animal health, animal performance, and on-farm food safety. Online databases were searched for reviews published between 1993 and 2018 that focused on relevant outcomes in domestic livestock, companion animals, or wildlife species. In total 1787 titles and abstracts underwent data characterization. Dairy cattle, fish, and pigs were the most common target commodity groups. Few articles investigated both health and performance outcomes (only health: n = 418; only performance: n = 701; both health and performance: n = 103). Most of the reviews (67.6%, n = 1208/1787) described a meta-analysis but did not state in the title or abstract that a systematic review was also conducted, which is potentially problematic. Adherence to reporting guidelines is recommended for all systematic reviews and meta-analyses. For research areas with many reviews, an evidence repository is recommended. For less well-reviewed areas, additional investigation may be necessary to identify the reasons for the lack of synthesis research. [ABSTRACT FROM AUTHOR]

Background: Inactive physical activity among university students remains public health concern due to significant adverse effects and its high prevalence. Transmission from adolescence to adulthood considered as a critical period for lowered their physical activity. Evidences suggested that either self-efficacy-driven intervention or applied exercise App could promote the level of physical activity. However, have examined the effect of exercise App with self-efficacy intervention to promote recommended level of physical activity among university students. Objective: It was recognized the effects of exercise App with self-efficacy to achieve recommended levels of physical activity among university students by systematic review. Methods: A systematic review was conducted to search the English publications in the databases of PubMed, Cochrane Library, MEDLINE, and CINAHL, in a period of during 2008 to 2018. Inclusive criteria were the publications using exercise App with self-efficacy programs and the participants in the age from 18 to 64 years old and healthy people. Excluded criteria were if research recruited participants with chronic diseases, mental diseases, pregnant women, and disability in the study. Finally, 319 articles were searched. After two reviewers used CASP checklist to evaluate study quality, the findings were extracted from 4 qualified articles. Results: The results of systematic review show that most of the studies were conducted in the USA and using Apps as strategies to design basing on SE to increase physical activity. Regarding as how using App for self-monitoring that combine with SE to design in the interventions, the strategies included merging in class sessions to implement the program, goal setting, advice and counseling from health care provider and telephone, problem solving training, using website, self-efficacy coaching, and health provider visit plus telephone. All studies results show that a significant effectiveness using Apps combine SE to applying in program could promote participants achieving recommended levels of PA. Conclusions: This systematic review provides an evidence base if the program with exercise App and self-efficacy to design it has higher effectiveness on achieving recommended levels of PA. SE is valuable to use in PA programs for adults in future studies. [ABSTRACT FROM AUTHOR]

• A review of the functionalities of interlinking converters and the aspects in their integration. • A review of the most employed topologies for interlinking converters. • A review of the primary level control techniques for interlinking converters. • A general classification of primary control techniques for interlinking converters. Classical power systems, which are typically structured in top-down topologies, are gradually evolving towards more decentralized systems comprised by clusters of smart subgrids to cope with the increasing penetration of distributed generation, energy storage systems and controllable loads. These clusters will increase the overall reliability, optimize resource usage and reduce investments in back-up systems. However, tying subgrids via passive devices (tie lines or power transformers) poses certain problems from the point of view of modularity and controllability. They also limit the connection capability of subgrids, as it is expected that systems with different voltage natures (ac and dc) will coexist in the future network. In this context, interlinking converters (IC) have emerged as a universal approach for the interconnection of such subgrids regardless of their characteristics. These power converters not only provide power flow control, but they also improve the power quality of networks through different ancillary services. Therefore, ICs are expected to be the energy routers of the future, smartly connecting and managing the interaction among grids. In the literature several topologies and control techniques have been proposed for this type of converters to transfer power between grids and provide support under contingencies. However, there are no classifications from the point of view of the participation of ICs in the primary regulation of the power system. The aim of this paper is to 1) identify the main characteristics of ICs compared to conventional interconnections based on passive devices, 2) review the most usual IC topologies depending on the nature of the grids they are interconnecting (ac-ac, ac-dc or dc-dc) and 3) analyse and compare the different control approaches for the primary regulation via ICs and propose a general classification based on this analysis regardless of the number of conversion power stages of the IC and the nature and characteristics of tied grids. [ABSTRACT FROM AUTHOR]

This metasynthesis contributes to an understanding of the experiences, perceptions, and attitudes of employees on managing chronic musculoskeletal disorders (CMSDs) at work. Many studies in this field are concerned with prevention or return-to-work (RTW) programmes. However, the purpose of this review was to synthesise evidence that only focuses on the employees' management of their CMSDs at work. The SPIDER framework was used to structure the question "How do employees with CMSDs experience the management of their condition in the workplace"? The literature search focused on articles published between 2011 and 2021, and the search was conducted using the following databases: MEDLINE, SCOPUS, CINAHL, AMED, PsycINFO. The review identified nine articles that explored employees' experiences of managing CMSDs at work. Thematic synthesis was used to create analytic themes which provided a more in-depth discussion of these experiences. The identified themes were: 'employees actively seek ways to manage their conditions', 'influence of work environment on employees with CMSDs' and 'optimising the relationship between employees and managers. This metasynthesis suggests that the ability to negotiate workplace support and manage CMSDs at work is influenced by the cultural and social environment of the organisation. Effective communication, care and trust between the employee is needed. The review also illustrated the need for healthcare professionals to provide support to employees at work. [ABSTRACT FROM AUTHOR]

Background. The concentration of pharmacologically active tetrahydrocannabinol (THC) in cannabis products has been increasing over the past decade. Concerns about potential harmful health effects of using these increasingly higher-concentration products have led some states to consider regulation of cannabis product THC concentration. We conducted a scoping review of health effects of high-concentration cannabis products to inform policy on whether the THC concentrations of cannabis product should be regulated or limited. Objectives. We conducted a scoping review to (1) identify and describe human studies that explore the relationship of high-concentration cannabis products with any health outcomes in the literature and (2) create an interactive evidence map of the included studies to facilitate further analyses. Search Methods. An experienced medical information specialist designed a comprehensive search strategy of 7 electronic databases. Selection Criteria. We included human studies of any epidemiological design with no restrictions by age, sex, health status, country, or outcome measured that reported THC concentration or included a known high-concentration cannabis product. Data Collection and Analysis. We imported search results into Distiller SR, and trained coders conducted artificial intelligence‒assisted screening. We developed, piloted, and revised data abstraction forms. One person performed data abstraction, and a senior reviewer verified a subset. We provide a tabular description of study characteristics, including exposures and outcomes measured, for each included study. We interrogated the evidence map published in Tableau to answer specific questions and provide the results as text and visual displays. Main Results. We included 452 studies in the scoping review and evidence map. There was incomplete reporting of exposure characteristics including THC concentration, duration and frequency of use, and products used. The evidence map shows considerable heterogeneity among studies in exposures, outcomes, and populations studied. A limited number of reports provided data that would facilitate further quantitative synthesis of the results across studies. Conclusions. This scoping review and evidence map support strong conclusions concerning the utility of the literature for characterizing risks and benefits of the current cannabis marketplace and the research approaches followed in the studies identified. Relevance of the studies to today's products is limited. Public Health Implications. High-quality evidence to address the policy question of whether the THC concentration of cannabis products should be regulated is scarce. The publicly available interactive evidence map is a timely resource for other entities concerned with burgeoning access to high-concentration cannabis. (Am J Public Health. 2023;113(12):1332–1342. https://doi.org/10.2105/AJPH.2023.307414) [ABSTRACT FROM AUTHOR]

Background: Measuring outcomes facilitates evaluation of palliative services for children, adolescents, and young adults (CAYAs) with life-limiting and/or life-threatening (LL/LT) conditions. Implementation of patient-reported, proxy-reported, or patient-centered outcome measures (hereafter PROMs) is recommended to ensure palliative services. The purpose of this scoping review was to provide an overview of PROMs relevant for CAYAs living with LL/LT conditions eligible for pediatric palliative care (PPC). Methods: Arksey and O'Malley's 6-stage scoping review framework was used to guide the review. The identified citations had to report on PROMs in any context including CAYAs with LL/LT conditions up to 25 years of age. A systematic search of Medline, EMBASE, CINAHL, APA PsycInfo, Health and Psychosocial Instruments, and AMED took place in January 2021 and was updated in June 2022. Citations were screened independently by pairs of researchers. The scoping review protocol was registered, and peer-review published. Results: Of 3690 identified citations, 98 reports were included, of which the majority were from Western countries and about PROMs in CAYAs living with cancer or organ failure. A total of 80 PROMs were identified, assessing a range of phenomena, where quality of life and symptoms (especially pain) during the stage of ongoing care were the most frequent. There were only a few reports about outcome measures at time of diagnosis or in end-of-life care. CAYAs self-reported on the PROMs or collaborated with their parents in about half of the reports, while the remaining had proxies answering on behalf of the CAYAs. In the identified reports, PROMs were used to characterize a sample through cross-sectional or longitudinal research, and less often to assess effects of interventions. Conclusion: The identified PROMs in the CAYA population eligible for PPC is characterized by studies in high-income countries during ongoing care, primarily in patients with cancer or organ failure. More research is needed in patients living with other LL/LT conditions, and during different stages of the disease course, especially at time of diagnosis, during transition to adulthood, and in end-of-life care. This scoping review of PROMs relevant for young patients eligible for PPC may inform future research about patient-/proxy-reported or patient-centered outcome measures in PPC. Trial registration: Review registration: (https://osf.io/yfch2/) and published protocol (Holmen et al. Syst Rev. 10:237, 2021). [ABSTRACT FROM AUTHOR]

Background: Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients. Methods: A systematic review was conducted using the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle–Ottawa Scale. Results: In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL. Conclusions: The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL. [ABSTRACT FROM AUTHOR]

The homecare sector's high turnover rate is linked to poor working conditions and a lack of person-centered practice. Limited research exists on the training and psychosocial needs of homecare workers caring for people living with dementia (PLWD). This systematic review explored these needs and identified 285 studies, of which seven studies met the inclusion criteria. A narrative synthesis identified four themes: "training and education challenges and facilitators;" "social isolation and the importance of peer support;" "emotional attachments and distress experienced by homecare workers;" and "working with families and its emotional impact on homecare workers." This review highlights the unmet educational and psychosocial needs of homecare workers and the negative impacts these unmet needs have. To improve person-centered practice in homecare, workers require dementia-specific training, and concurrent emotional and peer support, alongside support managing relationships with clients' families. Future research is required to implement an intervention to meet these needs. [ABSTRACT FROM AUTHOR]

Background Extensive research has been conducted into the effects of feedback interventions within many areas of healthcare, but prehospital emergency care has been relatively neglected. Exploratory work suggests that enhancing feedback and follow-up to emergency medical service (EMS) staff might provide staff with closure and improve clinical performance. Our aim was to summarise the literature on the types of feedback received by EMS professionals and its effects on the quality and safety of patient care, staff well- being and professional development. Methods A systematic review and meta-analysis, including primary research studies of any method published in peer-reviewed journals. Studies were included if they contained information on systematic feedback to emergency ambulance staff regarding their performance. Databases searched from inception were MEDLINE, Embase, AMED, PsycINFO, HMIC, CINAHL and Web of Science, with searches last updated on 2 August 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Data analysis followed a convergent integrated design involving simultaneous narrative synthesis and random effects multilevel meta-analyses. Results The search strategy yielded 3183 articles, with 48 studies meeting inclusion criteria after title/abstract screening and full-text review. Interventions were categorised as audit and feedback (n=31), peer-to-peer feedback (n=3), postevent debriefing (n=2), incident-prompted feedback (n=1), patient outcome feedback (n=1) or a combination thereof (n=4). Feedback was found to have a moderate positive effect on quality of care and professional development with a pooled effect of d=0.50 (95% CI 0.34, 0.67). Feedback to EMS professionals had large effects in improving documentation (d=0.73 (0.00, 1.45)) and protocol adherence (d=0.68 (0.12, 1.24)), as well as small effects in enhancing cardiac arrest performance (d=0.46 (0.06, 0.86)), clinical decision-making (d=0.47 (0.23, 0.72)), ambulance times (d=0.43 (0.12, 0.74)) and survival rates (d=0.22 (0.1 1, 0.33)). The between-study heterogeneity variance was estimated at σ²=0.32 (95% CI 0.22, 0.50), with an I² value of 99% (95% CI 98%, 99%), indicating substantial statistical heterogeneity. Conclusion This review demonstrated that the evidence base currently does not support a clear single point estimate of the pooled effect of feedback to EMS staff as a single intervention type due to study heterogeneity. Further research is needed to provide guidance and frameworks supporting better design and evaluation of feedback interventions within EMS. PROSPERO registration number CRD42020162600. [ABSTRACT FROM AUTHOR]

Background: Access to housing for people with intellectual disabilities is often constrained by lack of choice, control and can often be inappropriate or unsafe. To enable people to remain at home and participate in their occupations, a collation and review of theories and models supporting good home environment design offers a view from which practice could be advanced. Method: A scoping review was used to map the literature on theories and models on home environmental designing, which can have influence on the occupational performance and participation of people with intellectual disabilities. The theories and models found were analysed using the lens of the Person-Environment-Occupation-Performance model. Results: Four themes supporting the understanding of environmental home design that can influence participation and well-being were found. These were offering safety and comfort; providing control and choice to manage stress; offering skill acquisition for continued learning and interest; and the person–environment interaction for function and participation. The themes are discussed in relation to participation in occupation and well-being for people with intellectual disabilities. Conclusion: The study contributes knowledge to practitioners and stakeholders on theories and models of home environment design which could support the occupational performance, participation and well-being of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Many test case generation algorithms have been proposed to test Android apps through their graphical user interfaces. However, no systematic study on the impact of the core design elements in these algorithms on effectiveness and efficiency has been reported. This paper presents the first controlled experiment to examine three key design factors, each of which is popularly used in GUI traversal-based test case generation techniques. These three major factors are definition of GUI state equivalence, state search strategy, and waiting time strategy in between input events. The empirical results on 33 Android apps with real faults revealed interesting results. First, different choices of GUI state equivalence led to significant difference on failure detection rate and extent of code coverage. Second, searching the GUI state hierarchy randomly is as effective as searching it systematically. Last but not the least, the choices on when to fire the next input event to the app under test is immaterial so long as the length of the test session is practically long enough such as 1 h. We also found two new GUI state equivalence definitions that are statistically as effective as the existing best strategy for GUI state equivalence. [ABSTRACT FROM AUTHOR]

Current developments in information and electronic technologies have pushed a tremendous amount of applications to meet the demands of personal computing services. Various kinds of smart devices have been launched and applied in our daily lives to provide services for individuals; however, the existing computing frameworks including local silo-based and cloud-based architectures, are not quite fit for personal computing services. Meanwhile, personal computing applications exhibit special features, they are latency-sensitive, energy efficient, highly reliable, mobile, etc, which further indicates that a new computing architecture is urgently needed to support such services. Thanks to the emerging edge computing paradigm, we were inspired to apply the distributed cooperative computing idea at the data source, which perfectly solves issues occurring among existing computing paradigms while meeting the requirements of personal computing services. Therefore, we explore personal computing services utilizing the edge computing paradigm, discuss the overall edge-based system architecture for personal computing services, and design the conceptual framework for an edge-based personal computing system. We analyze the functionalities in detail. To validate the feasibility of the proposed architecture, a fall detection application is simulated in our preliminary evaluation as an example service in which three Support Vector Machine based fall detection algorithms with different kernel functions are implemented. Experimental results show edge computing architecture can improve the performance of the system in terms of total latency, with about 22.75% reduction on average in the case of applying 4G at the second hop even when the data and computing stream of the application is small. [ABSTRACT FROM AUTHOR]

Background: Individuals diagnosed with severe mental illness have higher rates of obesity than the general population due to a range of factors, including: medication side effects, poor nutrition and reduced physical activity. Obesity is associated with increased mortality and reduced quality of life. Evidence suggests that lifestyle interventions can be effective in addressing this issue. While such interventions would appear to fit within the scope of practice of occupational therapy, there is no publication synthesising the existing literature regarding occupational therapy interventions addressing lifestyle factors associated with obesity. Aim: To determine what is known from the existing literature about occupational therapy interventions addressing weight gain and obesity in adults diagnosed with severe mental illness. Methods: A scoping review was conducted. Searches were performed in online databases, occupational therapy journals and grey literature databases. Thematic analysis occurred across all articles included in the review. Results: A total of 14 articles were included in the review. Analysis revealed a central theme of supporting occupational performance and participation in health promoting occupations. This central theme consisted of four categories; facilitating client‐centred practice, addressing personal performance issues, addressing environmental barriers and providing the 'just right' challenge. Conclusion/Significance: These findings suggest occupational therapists are providing occupation focused interventions that are aligned with current clinical guidelines. However, more research is required to strengthen evidence‐based occupational therapy practice in this important area. [ABSTRACT FROM AUTHOR]