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Unplanned hospital readmission rate is up to 43 % in mental health settings, which is higher than in general health settings. Unplanned readmissions delay the recovery of patients with mental illness and add financial burden on families and healthcare services. There have been efforts to reduce readmissions with a particular interest in identifying patients at higher readmission risk after index admission; however, the results have been inconsistent. This systematic review synthesized risk factors associated with 30-day unplanned hospital readmissions for patients with mental illness. Eleven electronic databases were searched from 2010 to 30 September 2021 using key terms of 'mental illness', 'readmission' and 'risk factors'. Sixteen studies met the selection criteria for this review. Data were synthesized using content analysis and presented in narrative and tabular form because the extracted risk factors could not be pooled statistically due to methodological heterogeneity of the included studies. Consistently cited readmission predictors were patients with lower educational background, unemployment, previous mental illness hospital admission and more than 7 days of the index hospitalization. Results revealed the complexity of identifying unplanned hospital readmission predictors for people with mental illness. Policymakers need to specify the expected standards that written discharge summary must reach general practitioners concurrently at discharge. Hospital clinicians should ensure that discharge summary summaries are distributed to general practitioners for effective ongoing patient care and management. Having an advanced mental health nurse for patients during their transition period needs to be explored to understand how this role could ensure referrals to the general practitioner are eventuated.

Objective The objective of the study was to comprehensively synthesise the components of integrated clinical pathways (ICPs) and post-operative outcomes of patients undergone total hip and knee arthroplasty (THA & TKA) and hip fracture surgeries. Background Previous systematic reviews examined components and effectiveness of ICPs for lower limb joint replacement and hip fracture surgeries. Design and Methods An updated systematic review guided by the Whittemore and Knafl (2005) framework. Electronic databases, Ovid MEDLINE, EBSCOhost-CINAHL, the Cochrane Reviews and Trails, EMBASE and PubMed, were searched from 2007 to 31 January 2021. Due to the heterogeneity of the methods and data collection tools of included studies, pooling of the quantitative data was not possible. Therefore, the included studies were synthesised and presented narratively under subthemes of arthroplasty and hip fracture surgeries. The PRISMA checklist for systematic reviews was used. Results Twenty-four studies met selection criteria with 11 examined ICPs for hip fracture and 13 for the THA and TKA. Twenty-one ICPs were reviewed, and 33 components were extracted. The most frequently included components for hip fracture subgroup were ‘discharge disposition arrangement’ and ‘dedicated personnel and resources’. ‘Exercise plan’ and ‘pain management’ were for the arthroplasty subgroup. A significant reduction in the length of stay and post-operative complications were associated with the ICPs. Results were mixed for the effectiveness of ICPs in reducing unplanned hospital admissions, mortality rates, post-operative complications and hospital costs. Conclusion The number of ICP components varied across studies. This review could not recommend a one size-fits-all ICP that could be adapted for use for patients undergoing hip fracture and joint replacement surgeries. Relevance for clinical practice This review identified research evidence-based components considered as essential for the inclusion in IC

Objective The objective of the study was to comprehensively synthesise the components of integrated clinical pathways (ICPs) and post-operative outcomes of patients undergone total hip and knee arthroplasty (THA & TKA) and hip fracture surgeries. Background Previous systematic reviews examined components and effectiveness of ICPs for lower limb joint replacement and hip fracture surgeries. Design and Methods An updated systematic review guided by the Whittemore and Knafl (2005) framework. Electronic databases, Ovid MEDLINE, EBSCOhost-CINAHL, the Cochrane Reviews and Trails, EMBASE and PubMed, were searched from 2007 to 31 January 2021. Due to the heterogeneity of the methods and data collection tools of included studies, pooling of the quantitative data was not possible. Therefore, the included studies were synthesised and presented narratively under subthemes of arthroplasty and hip fracture surgeries. The PRISMA checklist for systematic reviews was used. Results Twenty-four studies met selection criteria with 11 examined ICPs for hip fracture and 13 for the THA and TKA. Twenty-one ICPs were reviewed, and 33 components were extracted. The most frequently included components for hip fracture subgroup were ‘discharge disposition arrangement’ and ‘dedicated personnel and resources’. ‘Exercise plan’ and ‘pain management’ were for the arthroplasty subgroup. A significant reduction in the length of stay and post-operative complications were associated with the ICPs. Results were mixed for the effectiveness of ICPs in reducing unplanned hospital admissions, mortality rates, post-operative complications and hospital costs. Conclusion The number of ICP components varied across studies. This review could not recommend a one size-fits-all ICP that could be adapted for use for patients undergoing hip fracture and joint replacement surgeries. Relevance for clinical practice This review identified research evidence-based components considered as essential for the inclusion in IC

A mixed-methods sequential explanatory research design, collecting quantitative and qualitative data, examined paediatric unplanned hospital readmissions and nurse-caregiver communication of hospital-to-home transition information at a tertiary children’s hospital in Western Australia. The thesis is presented as seven peer-reviewed journal publications, including three comprehensive literature analyses and four primary studies. Research outcomes confirmed the complexities associated with developing predictive models, inconsistent content and delivery of transition information and the need to implement a comprehensive transition framework.

Aim and objective: To present a comprehensive review of current evidence on the factors which impact on nurse-physician communication and interventions developed to improve nurse-physician communication. Background: The challenges in nurse-physician communication persist since the term 'nurse-doctor game' was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse-physician communication. Design: An integrative review was conducted following a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Methods: Five electronic databases were searched from 2005 to April 2016 using key search terms: "improve*," "nurse-physician," "nurse," "physician" and "communication" in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus. Results: A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse-physician communication; barriers to effective nurse-physician communication; and interventions to improve nurse-physician communication. Conclusion: This integrative review suggests that nurse-physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies. Relevance to clinical practice: Cross-training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of n

Objective: To update previous systematic review of predictive models for 28-day or 30-day unplanned hospital readmissions. Design: Systematic review. Setting/data source: CINAHL, Embase, MEDLINE from 2011 to 2015. Participants: All studies of 28-day and 30-day readmission predictive model. Outcome measures Characteristics of the included studies, performance of the identified predictive models and key predictive variables included in the models. Results: Of 7310 records, a total of 60 studies with 73 unique predictive models met the inclusion criteria. The utilisation outcome of the models included all-cause readmissions, cardiovascular disease including pneumonia, medical conditions, surgical conditions and mental health condition-related readmissions. Overall, a wide-range C-statistic was reported in 56/60 studies (0.21–0.88). 11 of 13 predictive models for medical condition-related readmissions were found to have consistent moderate discrimination ability (C-statistic ≥0.7). Only two models were designed for the potentially preventable/avoidable readmissions and had C-statistic >0.8. The variables ‘comorbidities’, ‘length of stay’ and ‘previous admissions’ were frequently cited across 73 models. The variables ‘laboratory tests’ and ‘medication’ had more weight in the models for cardiovascular disease and medical condition-related readmissions.Conclusions: The predictive models which focused on general medical condition-related unplanned hospital readmissions reported moderate discriminative ability. Two models for potentially preventable/avoidable readmissions showed high discriminative ability. This updated systematic review, however, found inconsistent performance across the included unique 73 risk predictive models. It is critical to define clearly the utilisation outcomes and the type of accessible data source before the selection of the predictive model. Rigorous validation of the predictive models with moderate-to-high discriminative ability is essential, e

Background. The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate the influence of demographic factors and personal characteristics on the burnout syndrome. Methods. A cross-sectional survey design was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire eliciting data on demographics, burnout (measured using the Maslach Burnout Inventory, MBI), and personality profile (measured using the NEO Five-Factor Inventory, NEO-FFI) was used. Results. 1830 nurses out of 3588 responded (response rate: 51%). Results from 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score of > 27), 40% having high depersonalization (DP, cut-off score of > 10), and 59% having low personal accomplishment (PA, cut-off score of < 33). In multivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components of the MBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and low PA. Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in the experience of burnout. © 2016 Shin Yuh Ang et al.

The foundation for a family-centered approach to pediatric health care is the belief that a child'semotional and developmental needs, and overall family wellbeing are best achieved when the service system supports the ability of the family to meet the needs of their child by involving families in their child’s care. There are a range of potential benefits and difficulties associated with the provision of family centred care, e.g. role negotiation, parental expectations in regard to participation in their child’s care, and issues relating to power and control. Currently, however, there is limited systematic information on how the principles of family-centered care are implemented in the delivery of care to the hospitalized child and their family, and the impact on the family and the health care providers.

(Equation presentation) (Table presentation) Source of material Syringic acid (4-hydroxy-3,5-dimethoxy benzoic acid, 50 g, 250 mmol) was added to acetic anhydride (350 mL) for hydroxyl protecting. The acetylation compound (10.0 g, 38.66 mmol) of syringic acid was poured into SOCl2 (60 mL) and stirred for 6-7 hours at 80 °C. Then the excess of SOCl2 was evaporated. The intermediate 3,5-dimethoxy-4-acetoxy-benzoyl chloride was obtained. Then, sulfadiazine (4.23 g, 16.91 mmol), tetrahydrofuran (THF, 43.7mL) and pyridine (8 mL)were added to the intermediate (4.37 g, 16.90 mmol) and stirred for 24 hours in an ice bath. Among them, pyridine was the catalyst for the reaction [6].When the reaction was completed, the solvent was evaporated under vacuum, and the residue was washed with water. Recrystallized from methanol and THF for more than 10 days, the title product was obtained. The m. p. was determined as 588-590 K using a XT-4 melting point instrument (Beijing Taike Instrument Co., Ltd, Beijing, China). NMR spectra were recorded on an AVANCE III 300 NMR instrument (Bruker, Germany). 1HNMR (300 MHz, DMSO-d6) d: 2.295 (3H, s, H-9), 3.863 (6H, s, H-10,11), 7.044 (1H, t, J=5.0 Hz, H-20), 7.315 (1H, s, H-N2), 7.963 (2H, d, J=9.0Hz, H-13,17), 8.034 (2H, d, J=9.0Hz,H- 14,16), 8.517 (2H, d, J=5.0 Hz, H-19,21), 10.565 (H, s, H-N1), 11.77 (2H, s, H-2,6); 13C-NMR (75 MHz, DMSO-d6) d: 168.38(C-18), 165.89 (C-8), 158.81 (C-7), 157.40 (C-3,5), 152.11 (C-19,20), 143.45 (C-12), 135.08 (C-15), 133.13 (C-4), 131.21 (C-1), 129.22 (C-14,16), 120.25 (C-13,17), 116.26 (C- 21), 105.27 (C-2,6), 56.71 (C-10,11), 20.57 (C-9). IR spectra (potassium bromide) were recorded on a NEXUS 470 Fourier Transform IR spectrophotometer (Thermo Nicolet Corporation, USA). IR (Vmax, cm-1): 3505, 3461 (VN-H); 3191, 3041 (V=C-H); 1772, 1749 (VC=O); 1685, 1670, 1655, 1648, 163, 1532, 1505, 1436 (VC=C); 1339, 1174, 1162, 1134, 949, 668, 595, 570, 563, 547, 530, 522, 509, 488, 478, 467, 459, 454, 440,430, 415, 407.

Background: Family-centred care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. It is a widely used model in paediatrics, and is felt instinctively to be the best way to provide care to children in hospital. However, its effectiveness has not been established. Objectives: The objective of this review was to identify the effectiveness of family-centred models of care for children (excluding premature neonates) when compared to standard models of care. Inclusion criteria: The review considered quasi-experimental studies of children aged 0-12 years, their families and/or attending health professionals. Interventions for inclusion were family-centred polices, family support, communication, educational and environmental. Outcomes of interest covered three categories: the child, parent and staff. These included psychological, behavioural, physical, developmental, knowledge, satisfaction and attitudinal outcomes. The degree of family-centredness for eligible studies was scored using a modified rating scale based on that developed by Trivette. Types of participants: This review considered studies that included hospitalised children aged 0-12 years (excluding premature neonates), their family and/or health care professionals. Types of intervention(s)/phenomena of interest: The review considered studies that evaluated the effectiveness of family-centred models of care for hospitalised children when compared to standard models of care.Types of studies: The review considered quasi-experimental studies for inclusion to enable the identification of current best evidence regarding the effectiveness of family-centred models of care on child, family and health service outcomes. Quasi-experimental design includes experimental studies in which participants are not randomly assigned to treatment conditions. Types of outcomes: This review considered studies t

Exhumation processes of ultrahigh-pressure (UHP) metamorphic rocks, by which these deep-seated rocks were rapidly returned from mantle depths of more than 100 km within deep subduction zones into the upper crust and to the surface, are of paramount importance for the understanding of the kinematics and dynamics of convergent plate margins and continental collision belts. At least four large successive stages of the exhumation process of UHP metamorphic rocks in the Dabie-Sulu area, east-central China, mainly based on structural, petrological, geochemical data and available geochronological data, combined with previously regional polyphased deformation analyses, can be distinguished. Massive eclogites recorded the deep continental subduction/collision between the Sino-Korean and Yangtze cratons during the Triassic (~250-230 Ma). The early exhumation occurred after the peak of UHP metamorphism at conditions of up to >3.1-4.0 GPa and 800±50°C, which may correspond to the D 2 regional deformation phase and took place at mantle depths, displaying the model of vertical ductile extrusion, within the coesite stability field. The subsequent exhumation stages, corresponding with D 3, D 4 and D 5 regional deformation phase, respectively, and two intermediate tectono-thermal events, i.e., the formation of the granulite/amphibolite facies symplectite or corona and the generation of extensive partial melting, occurred in crustal levels. Shear zones of an anastomosing rheological type were developed at diffterent stages and depths, indicating that the partitioning of deformation and metamorphism within the UHP metamorphic belt repeated. These imply that the exhumation of the UHP rocks is a complex tectonic process, in response to subduction/collision or extension of the continental crust, and is strongly constrained by a number of internal and external factors of the belt. In particular, fluids play important roles in the exhumation process of UHP rocks in the Dabie-Sulu area

Background: This is an update of the Cochrane systematic review of family-centred care published in 2007 (Shields 2007). Family-centred care (FCC) is a widely used model in paediatrics, is thought to be the best way to provide care to children in hospital and is ubiquitous as a way of delivering care. When a child is admitted, the whole family is affected. In giving care, nurses, doctors and others must consider the impact of the child’s admission on all family members. However, the effectiveness of family-centred care as a model of care has not been measured systematically. Objectives: To assess the effects of family-centred models of care for hospitalised children aged from birth (unlike the previous version of the review, this update excludes premature neonates) to 12 years, when compared to standard models of care, on child, family and health service outcomes. Search methods: In the original review, we searched up until 2004. For this update, we searched: the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library, Issue 12 2011); MEDLINE (Ovid SP); EMBASE (Ovid SP); PsycINFO (Ovid SP); CINAHL(EBSCO Host); and Sociological Abstracts (CSA). We did not search three that were included in the original review: Social Work Abstracts, the Australian Medical Index and ERIC. We searched EMBASE in this update only and searched from 2004 onwards. There was no limitation by language. We performed literature searches in May and June 2009 and updated them again in December 2011.Selection criteria: We searched for randomised controlled trials (RCTs) including cluster randomised trials in which family-centred care models are compared with standard models of care for hospitalised children (0 to 12 years, but excluding premature neonates). Studies had to meet criteria for family-centredness. In order to assess the degree of family-centredness, we used a modified rating scale based on a validated instrument, (same instrument used in the initial review), howeve

Watts, R., Zhou, H., Shields, L., Taylor, M., Munns, A., & Ngune, I. M. (2014). Family-centered care for hospitalized children aged 0-12 years: a systematic review of qualitative studies. The JBI Database of Systematic Reviews and Implementation Reports, 12(7), 204-283. Available here