Cumulative Index To Nursing And Allied Health Literature Research Articles

Predictive factors and quality of life assessment among patients with spinal cord injury in the Middle East: a systematic review.

Spinal cord injury (SCI) is impairment of the spinal cord that adversely affects patients' health and quality of life (QoL). The aim of the study was to assess the quality of life (QoL) and related factors in patients with traumatic spinal cord injury in Middle Eastern countries. PubMed, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, psycINFO, and Google Scholar were systematically searched for eligible studies published in peer-reviewed journals up till October 2023. Out of 1060 papers found in the literature, only 18 studies from Iran, Lebanon, and Turkey met the inclusion criteria. The majority of the studies employed the SF-36 scale to assess for QoL. In general, all SCI patients had reduced QoL scores when compared to the healthy population. Some of the factors such as age, education level, the level of injury, time since injury onset, marriage, and job opportunities were correlated with SCI subjects QoL. Our papers were assessed and found to be of both good and high quality. This review emphasizes the significant shortage of QoL studies among SCI patients in the Middle East countries and highlights the importance of improving the QoL of this marginalized population. This work should enhance the governments to establish rehabilitation centers, social and economic support systems, and mental health services to diminish complications arising from SCI.

Artificial intelligence informing clinical decision making on the risk of hospital readmissions in multi-morbid patients: a systematic review

Abstract Introduction Multi-morbid patients have complex care needs and are more likely to utilise healthcare services, which represents a financial burden on healthcare organisations. 30-day readmission of patients is a method of measuring the quality of the services provided within healthcare.[1] Artificial intelligence (AI) models can flag multi-morbidity patients at increased risk of readmission.[2] However, it is unclear which common predictors have been used to develop these models. Aim To systematically review the medical literature to identify predictors that have been used to develop AI models that predicted unplanned 30-day hospital readmissions of multi-morbid patients, and whether these predictors were modifiable or non-modifiable. Methods Four large databases: Medline, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched on 15th November 2022. Only publications that developed a machine learning algorithm to predict unplanned 30-day hospital readmission for patients with multi-morbidity were included. Articles published in English language were eligible for inclusion. A narrative synthesis of all eligible studies was undertaken. Key findings were identified through inductive strategy, which includes simplifying raw data in the included articles into a comprehensive format. This systematic review was registered with the PROSPRO database (CRD42022373937) and followed PRISMA guidelines. Results There were 1,906 articles extracted from all databases, 18 of which met our inclusion criteria. A total of 669 predictors of hospital readmission were found, and were divided into 103 modifiable (i.e., action could be taken to change the outcome) and 566 non-modifiable (i.e. age, gender, number of previous emergency admissions. The average number of modifiable predictors per prediction model was six, with the most common being length of hospital stay, multi-morbidity, obesity, hypertension, diabetes, depression, and anaemia. The most commonly used AI algorithm was the gradient boosting algorithm. This algorithm generally showed a better performance than other models reported. The performance of all models in the included studies was compared; 13 studies showed an average sensitivity of 72%. The average specificity was calculated at 73% from 11 studies. The highest AUC reported was above 0.9, which demonstrates an excellent performing model, while five models did not report a value for the AUC. Conclusion We identified modifiable and non-modifiable predictors used in previously developed AI algorithms that predict 30-day hospital readmissions of multi-morbid patients. Modifiable predictors in particular can help guide clinical decision-making by allowing early actions to be taken in primary care to potentially reduce the risk of readmission. However, one limitation of this review is that some included studies used balanced (i.e. synthetic) data which could have introduced a level of bias.

Breast cancer screening motivation and behaviours of women aged over 75 years: a scoping review

BackgroundThis scoping review aimed to identify and present the evidence describing key motivations for breast cancer screening among women aged ≥ 75 years. Few of the internationally available guidelines recommend continued biennial screening for this age group. Some suggest ongoing screening is unnecessary or should be determined on individual health status and life expectancy. Recent research has shown that despite recommendations regarding screening, older women continue to hold positive attitudes to breast screening and participate when the opportunity is available.MethodsAll original research articles that address motivation, intention and/or participation in screening for breast cancer among women aged ≥ 75 years were considered for inclusion. These included articles reporting on women who use public and private breast cancer screening services and those who do not use screening services (i.e., non-screeners).The Joanna Briggs Institute (JBI) methodology for scoping reviews was used to guide this review. A comprehensive search strategy was developed with the assistance of a specialist librarian to access selected databases including: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Web of Science and PsychInfo. The review was restricted to original research studies published since 2009, available in English and focusing on high-income countries (as defined by the World Bank). Title and abstract screening, followed by an assessment of full-text studies against the inclusion criteria was completed by at least two reviewers. Data relating to key motivations, screening intention and behaviour were extracted, and a thematic analysis of study findings undertaken.ResultsA total of fourteen (14) studies were included in the review. Thematic analysis resulted in identification of three themes from included studies highlighting that decisions about screening were influenced by: knowledge of the benefits and harms of screening and their relationship to age; underlying attitudes to the importance of cancer screening in women's lives; and use of decision aids to improve knowledge and guide decision-making.ConclusionThe results of this review provide a comprehensive overview of current knowledge regarding the motivations and screening behaviour of older women about breast cancer screening which may inform policy development.

The effectiveness of savouring interventions on well-being in adult clinical populations: A protocol for a systematic review.

Savouring interventions aim to amplify the intensity and duration of positive feelings and positive affect. Research has shown that the potential benefits of savouring include the promotion of psychological well-being and diminution of negative affective states. Savouring strategies may be particularly useful amongst clinical populations in changing biobehavioural processes which can strengthen an individual's propensity to exert control over how to develop, intensify and promote psychological well-being, while simultaneously mitigating negative affective states. This paper outlines a protocol for a systematic review that will be used to identify, critically appraise and synthesise findings of studies examining the effectiveness of savouring interventions in adult clinical populations. Savouring interventions will be defined broadly, operationalised as any savouring strategy focusing on past, present or future events or experiences whereby participants are instructed to attend to and amplify positive affect relating to same. The goal of our review is to include the extent of the literature on this topic and contribute to the overall evidence to support savouring interventions. This protocol is carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols Guidelines. The protocol has been registered with PROSPERO (CRD42023404857). The databases PsycINFO, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Scopus will be searched alongside a search of grey literature. An examination of the first 200 papers on Google Scholar will also be done to identify relevant papers. Studies describing randomised controlled trials evaluating the effects of savouring interventions as described within this article on adult clinical populations will be included in the review. Outcomes will include well-being, quality of life, depression, anxiety or stress. Study selection and data extraction will be completed by three independent reviewers to reduce risk of bias. Interrater percentage agreement and interrater reliability will be reported on same. The quality of studies will be assessed using criteria based on the Cochrane Collaboration's tool for assessing risk of bias and the Jadad scale. A narrative synthesis with tables of study characteristics will be provided. Separate considerations of the three time perspectives of savouring interventions (past-focused, present-focused, and future-focused) will also be described. This systematic review will provide important clinical insights into the potential efficacy of savouring interventions when working with adult clinical samples.

Data science techniques to gain novel insights into quality of care: a scoping review of long-term care for older adults

Background: The increase in powerful computers and technological devices as well as new forms of data analysis such as machine learning have resulted in the widespread availability of data science in healthcare. However, its role in organizations providing long-term care (LTC) for older people LTC for older adults has yet to be systematically synthesized. This analysis provides a state-of-the-art overview of 1) data science techniques that are used with data accumulated in LTC and for what specific purposes and, 2) the results of these techniques in researching the study objectives at hand. Methods: A scoping review based on guidelines of the Joanna Briggs Institute. PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using keywords related to data science techniques and LTC. The screening and selection process was carried out by two authors and was not limited by any research design or publication date. A narrative synthesis was conducted based on the two aims. Results: The search strategy yielded 1,488 studies: 27 studies were included of which the majority were conducted in the US and in a nursing home setting. Text-mining/natural language processing (NLP) and support vector machines (SVMs) were the most deployed methods; accuracy was the most used metric. These techniques were primarily utilized for researching specific adverse outcomes including the identification of risk factors for falls and the prediction of frailty. All studies concluded that these techniques are valuable for their specific purposes. Discussion: This review reveals the limited use of data science techniques on data accumulated in or by LTC facilities. The low number of included articles in this review indicate the need for strategies aimed at the effective utilization of data with data science techniques and evidence of their practical benefits. There is a need for a wider adoption of these techniques in order to exploit data to their full potential and, consequently, improve the quality of care in LTC by making data-informed decisions.

Effect of digital technology interventions for cognitive function improvement in mild cognitive impairment and dementia: A systematic review and meta-analysis.

The development and commercialization of digital therapeutics are increasing. The aim of this study was to determine the effects of digital technology interventions on cognitive function, thereby providing evidence for the development and practical application of interventions to manage cognitive function in patients with mild cognitive impairment and dementia. We conducted a systematic review and meta-analysis of randomized controlled trials according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Randomized controlled trials on digital technology interventions published until April 2023 were searched in PubMed, Embase, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases without a period limit. Articles that identified the effects of digital technology interventions on cognitive function improvement in dementia and mild cognitive impairment were integrated and analyzed. RevMan software 5.4 was used for quality assessment and meta-analysis. Twelve out of 708 studies were included in the review and meta-analysis. Digital technology interventions had significant effects on global cognitive function (standardized mean difference [SMD] = 0.31; 95% confidence interval [CI] = 0.04-0.57; p = 0.02; I² = 60%). In addition, these interventions had significant effects on neuropsychological characteristics, including attention (SMD = 1.17; 95% CI = 0.36-1.97; p = 0.004; I² = 84%), visuospatial perception (SMD = 0.68; 95% CI = 0.19-1.17; p = 0.006; I² = 57%), and memory (SMD = 0.45; 95% CI = 0.19-0.71; p = 0.0007; I² = 22%). The results suggest that digital technology interventions help improve cognitive function in patients with dementia and mild cognitive impairment.

Health-related quality of life in patients with conditions affecting the hand: meta-analysis.

Health state utility values provide the quality component of quality-adjusted life years and are essential for health economic analyses, such as the National Institute for Health and Care Excellence Technology Appraisal. The aims of this systematic review were to: catalogue utility values for health states experienced by patients with hand conditions; provide pooled utility estimates for common hand conditions; and determine how utilities have been estimated. A PRISMA-compliant systematic review and meta-analysis was conducted (registered in PROSPERO, the international prospective register of systematic reviews (CRD42021226098)). Five databases were searched from inception until April 2023 (Embase, MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials (CENTRAL)). All studies that reported primary utility values for hand health states in adult patients were eligible for inclusion. Pooled utility estimates were determined across conditions and intervention status using random-effects meta-analysis. A total of 10 254 articles were identified; 57 studies met the full inclusion criteria and reported 363 distinct health state utility values. Health state utility values were estimated using a range of methods; the most common measure was the EQ-5D. Pooled utility estimates for carpal tunnel syndrome and hand osteoarthritis before surgical intervention were 0.69 (95% c.i. 0.66 to 0.73) and 0.63 (95% c.i. 0.60 to 0.67) respectively. Pooled utility estimates for patients with untreated carpal tunnel syndrome and hand osteoarthritis are 11% and 18% lower than age-matched population norms respectively. Hand conditions have a significant detrimental impact on health-related quality of life and this study provides catalogued utility values for use in future economic analyses to support the delivery of value-based hand surgery.

Investigating the retention and attrition of emergency care advanced clinical practitioners in the UK

Background: Advanced clinical practitioners (ACPs) are an integral part of the healthcare workforce, and recognising growth in these roles is a priority for the future. ACPs within emergency care (EC) are often senior clinical decision-makers that work within the multidisciplinary team to provide high-quality care to a variety of patients, presentations and acuity. Reflection upon clinical practice over the last 7 years has revealed an issue with the retention of experienced ACPs. Losing ACPs in a service that is already stretched due to increasing attendance and subsequently longer waiting times places further burden on strained departments. While there is research that examines the retention and attrition of emergency medicine trainees and consultants, there is a dearth of literature on the retention of ACPs. Aims: The aim of this scoping review is to investigate what is already known about retention of ACPs in EC and examine why ACPs leave EC for other areas of practice. Methods: A database search was conducted using keywords, from 2–21 November 2022, across five databases (the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the British Nursing Index (BNI), MEDLINE, PsycINFO and the Cochrane Library). This search identified 892 studies that were examined using a two-stage process against inclusion and exclusion criteria, which resulted in seven articles being selected for inclusion in the review. Findings: Three themes were identified: the importance of a clear career pathway; a structured training programme and education; and concerns regarding working conditions in EC. Conclusion: The review identifies a gap in the literature on the reasons for attrition rates of ACPs in EC. Future research is required to identify the reasons why some ACPs leave EC and what aspects make others stay.

Impacts of pro-inflammatory cytokines variant on cardiometabolic profile and premature coronary artery disease: A systematic review and meta-analysis.

Interleukin-6 (IL-6), a pivotal pro-inflammatory cytokine, is closely linked to vascular wall thickening and atherosclerotic lesion. Since serum IL-6 levels are largely determined by the genetic variant in IL-6, this study was conducted to investigate whether the IL-6 variant impacts cardiometabolic profile and the risk of premature coronary artery disease (PCAD). PubMed, Cochrane Library, Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ClinicalTrials.gov were searched from May 13, 2022 to June 28, 2023. In total, 40 studies (26,543 individuals) were included for the analysis. The rs1800795 (a function variant in the IL-6 gene) C allele was linked to higher levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), fasting plasma glucose (FPG), body mass index (BMI), and waist circumference (WC), and a lower levels of high-density lipoprotein cholesterol (HDL-C). However, no significant association was observed of rs1800795 with triglycerides (TG), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Interestingly, a significant association was detected between rs1800795 and PCAD. Subgroup analyses indicted that the impacts of rs1800795 on cardiometabolic risk factors were significant in Caucasians but stronger in obese patients. In contrast, the impact of rs1800795 on PCAD was significant in brown race population. In summary, rs1800795 had a slight but significant impact on cardiometabolic risk factors and PCAD. IL-6 inhibition with ziltivekimab or canakinumab may benefit high-risk populations (e.g. brown race population, Caucasians, obese patients, etc.) with rs1800795 to prevent PCAD.

How Reproducible Are Manual Therapy Interventions in Trials for Low Back Pain? A Scoping Review.

OBJECTIVES: To assess the reproducibility of manual therapy interventions used in clinical trials for low back pain (LBP), and summarize knowledge gaps in assessing the reproducibility of manual therapy interventions for LBP. DESIGN: Scoping review. LITERATURE SEARCH: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Embase were searched for trials from inception through April 2023. STUDY SELECTION CRITERIA: Randomized controlled trials were included if they described the use of manual therapy to treat LBP in adults 18 to 65 years old and were accessible in English. DATA SYNTHESIS: The Consensus on Exercise Reporting Template (CERT) checklist, used for exercise reporting, was previously modified for manual therapy reporting. This 11-item modified CERT was used to extract details of manual therapy reporting in the included trials. Frequency counts were calculated to identify items most and least commonly reported. RESULTS: Of 128 trials, none reported all 11 items of the modified CERT. The most commonly reported items were the description of how the application of manual therapy was decided (n = 113, 88.3%) and a description of adjunct interventions provided (n = 82, 64.1%). The least reported items were the description of an associated home program (n = 27, 21.1%) and a detailed description of the application of manual therapy (n = 22, 17.2%). CONCLUSION: Reporting of manual therapy interventions in trials investigating LBP was poor overall, limiting the reproducibility of these treatments. Using a checklist designed explicitly for manual therapy intervention reporting may improve reproducibility of these interventions and help align clinical outcomes with experimental findings. J Orthop Sports Phys Ther 2024;54(4):1-10. Epub 29 January 2024. doi:10.2519/jospt.2024.12201.

The Reasons for Unfinished Nursing Care during the COVID-19 Pandemic: An Integrative Review.

Background: The concept of unfinished nursing care (UNC) describes nursing interventions required by patients and families that nurses postpone or omit. UNC reasons have been documented; however, no studies have summarised the underlying factors triggering the UNC during the pandemic. Therefore, the aim was to synthesise the available studies exploring factors affecting UNC during a pandemic. Methods: We conducted an integrative review following Whittemore and Knafl's framework according to the Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Scopus databases were searched for primary studies that collected data from 1 January 2020 to 1 May 2023. Both qualitative and quantitative studies assessing the reasons for UNC were eligible and evaluated in their quality using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Results: Four studies were included-three qualitative and one cross-sectional. The reasons for UNC have been documented at the following levels: (a) system (e.g., new healthcare system priorities); (b) unit (e.g., ineffective work processes); (c) nurse management (e.g., inadequate nurse manager's leadership); (d) nurse (e.g., nurses' attitudes, competences, performances); and (e) patient (increased demand for care). Conclusion: The reasons for UNC during the COVID-19 pandemic are different to those documented in the pre-pandemic times and reflect a pre-existing frailty of the National Health Service towards nursing care.

Hospital nurses perceived challenges and opportunities in the care of people with dementia: A mixed-methods systematic review.

To synthesise evidence from the literature on hospital nurses' perceived challenges and opportunities in the care of people with dementia. People with dementia often have longer lengths of hospital stay and poorer health outcomes compared to those without dementia. Nurses play a pivotal role in the care of people with dementia. However, there is a scarcity of systematic reviews that synthesise the challenges and opportunities they perceive. A mixed-methods systematic review was conducted with a database search covering Ageline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, Embase, Medline, PsycINFO, ProQuest, Scopus and Web of Science in April 2022. In total, 27 articles that met the selection criteria were critically reviewed and included in this systematic review. Data from the selected articles were extracted and synthesised using a convergent segregated approach. Three main themes and eight subthemes were identified. Theme 1 described nurse-related factors consisting of the lack of capability in dementia care, experiencing multiple sources of stress and opportunities for nurses to improve dementia care. Theme 2 revealed people living with dementia-related factors including complex care needs and the need to engage family carers in care. Theme 3 explained organisation-related factors comprising the lack of organisational support for nurses and people with dementia and opportunities for quality dementia care. Hospital nurses experience multidimensional challenges in the care of people with dementia. Opportunities to overcome those challenges include organisational support for nurses to develop dementia care capability, reduce their stress and partner with the family caregivers. Hospitals will need to build an enabling environment for nurses to develop their capabilities in the care of people with dementia. Further research in empowering nurses and facilitating quality dementia care in acute care hospitals is needed. The review followed the PRISMA 2020 checklist. No.

Evaluating the Efficacy and Safety of CyberKnife for Meningiomas: A Systematic Review.

This systematic review aims to evaluate CyberKnife (Accuray, Madison, WI, USA) radiosurgery's efficacy, safety, and outcomes in treating meningiomas, focusing on tumour control rates, symptom relief, survival rates, quality of life, and adverse events. A comprehensive literature search was conducted across PubMed, EMBASE, Web of Science, Google Scholar, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), covering studies published in the last 20 years and available in English. The inclusion criteria targeted studies involving patients with meningioma treated with CyberKnife radiosurgery, reporting on specific outcomes of interest. Quality assessment was performed using the Newcastle-Ottawa Scale for observational studies, and a narrative synthesis approach was adopted for data analysis. Twenty-one studies met the inclusion criteria, encompassing various design types and patient demographics. The review highlights CyberKnife's effectiveness in managing benign and atypical meningiomas and specific challenging cases like perioptic lesions and large cranial base tumours. Key findings include high tumour control rates, preservation or improvement of visual functions in perioptic lesions, and promising results in benign spinal tumours and supratentorial meningiomas. Comparative analyses suggest better radiographic tumour control and a lower incidence of post-treatment complications with stereotactic radiotherapy over stereotactic radiosurgery. Long-term outcomes and safety profiles underline the viability of CyberKnife as a treatment option, with minimal permanent side effects reported. CyberKnife radiosurgery is a highly effective and safe treatment modality for meningiomas. It offers significant benefits in tumour control, symptom relief, and maintaining the quality of life with minimal adverse effects. The precision and adaptability of CyberKnife technology make it a valuable addition to the treatment arsenal for meningiomas. It necessitates further research and adoption in clinical practice, especially in regions like the United Arab Emirates, where its use is emerging.

The Efficacy of Metformin as a Therapeutic Agent in the Treatment of Acne Vulgaris: A Systematic Review.

A large portion of the world's population is affected by acne vulgaris (AV), with many of these individuals being adolescents. The underlying mechanism of AV is hyperkeratinization and Cutibacterium acnes infection of the pilosebaceous follicle secondary to excessive stimulation of sebaceous glands by androgens. Metformin is a biguanide medication primarily used in efforts to lower patients' sugar levels in the management of type 2 diabetes. It has been proven to reduce levels of circulating androgens in patients with insulin resistance, indicating its potential for treating AV. A search strategy was developed and performed using the databases Ovid Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Controlled Register of Trials (CENTRAL), and Web of Science. The keywords "metformin" and "acne" were searched, along with related Medical Subject Headings (MeSH) and other subject headings. Studies that met the inclusion criteria were controlled trials, published after 2010, and in the English language. Participants with and without comorbidities such as polycystic ovary syndrome (PCOS) were considered. Two independent reviewers screened studies based on predefined criteria and extracted data from each study, which were quantitatively combined. A total of 15 studies were included in this systematic review. Across the 15 studies, there were 1,046 participants, with 13 studies looking exclusively at women with PCOS. Of the remaining two studies, one examined males with altered metabolic profiles, while the other included men and women with moderate AV. Notable risks of bias included studies that did not exclusively state the blindness of the study. Of the studies that were examined, 13 showed that metformin reduces AV, with seven studies showing statistical significance. Acne vulgaris is an inflammatory condition that has plagued patients for years due to the limited treatment options available. The hyperglycemic medication metformin, used in the management of type 2 diabetes, is being explored as a novel therapeutic that can possibly be repurposed for the treatment of AV. The use of metformin in AV is hypothesized to disrupt the proposed linkage between insulin resistance and AV proliferation. This proposed research could offer physicians a new option for the treatment of AV as well as render an alternative AV treatment for patients.

Use of contraceptives, empowerment and agency of adolescent girls and young women: a systematic review and meta-analysis

IntroductionThe evidence on adolescent empowerment, which involves access to personal and material resources for reproductive autonomy and economic equity, is limited. This systematic review assesses the use of contraceptives in...

A systematic review of the experience of treatment burden of digital health for military personnel in primary healthcare.

Background Digital Health (DH) integrates digital technologies into healthcare to increase efficiency and improve patient experiences, benefiting both primary care and military healthcare systems. However, it raises concerns about the potential shift of healthcare responsibilities onto patients, creating workloads or treatment burdens that affect care, adherence, equity, and resource allocation. It is critical to assess this in the military context to enhance patient-centred care and outcomes. Objective To understand military personnel’s experience of treatment burden of DH in primary care, to understand the barriers and facilitators of the use of DH, and to map barriers identified to the Burden of Treatment Theory (BOTT). Design A systematic literature review. MEDLINE, Psych INFO, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar will be searched. Two independent reviewers will screen papers using inclusion and exclusion criteria, with conflicts decided by a third reviewer. Any retrieved study that meets the inclusion and exclusion criteria will be quality appraised using the appropriate Critical Appraisal Skills Programme (CASP) checklist. The findings will be analysed using thematic synthesis and evaluated in the context of the Burden of Treatment Theory. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA) guidelines have been adhered to in the production of this protocol. Conclusions Understanding the experience of treatment burden whilst using DH in the military has the potential to influence health policy, the commissioning of services and interventions, and most importantly, improve patient experience and health outcomes. PROSPERO registration number: CRD42023494297.

Non-violent communication as a technology in interpersonal relationships in health work: a scoping review

BackgroundWorking in healthcare environments is highly stressful for most professionals and can trigger problems in interpersonal relationships that can result in horizontal violence. In order to prevent violence and improve the working environment, some strategies can be implemented to provide well-being for all those involved, whether directly or indirectly in health care, such as non-violent communication. The aim of this study was to map and synthesize the available scientific evidence on the use of Nonviolent Communication as a technology for a culture of peace in interpersonal relationships in healthcare.MethodsThis is a scoping review carried out in the National Library of Medicine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Excerpa Medica DataBASE (Embase), PsycINFO - APA/ PsycNET (American Psychological Association) and Latin American and Caribbean Health Sciences Literature (LILACS) databases between March and August 2023. The eligibility criteria used were studies that addressed the topic of NVC in the area of health, published in Portuguese, Spanish or English, with no time restrictions.Results53 studies were found in the databases. Two additional studies were extracted from of primary research. In the first exclusion phase, 16 texts were removed due to being duplicated. 39 articles were potentially relevant, and full-texts were reviewed for eligibility along with the inclusion and exclusion criteria Thus, seven studies were included in this review, published in English (five) and Portuguese (two), two of which were carried out in Brazil, one in the United States of America, one in South Korea, one in France, one in Canada and one in Thailand. In terms of the type of study/publication, two studies were reflections, one was a review, one was a mixed study, one was an experience report and two were experimental. The studies were predominantly of high and moderate methodological quality (85.7%). The total number of participants in the studies was 185. The studies showed that NVC is a technology that has made it possible to improve interpersonal relationships between health professionals. Training programs or educational intervention projects on the subject are useful for familiarizing professionals with the subject and demonstrating situations in which the technique can be included.ConclusionThe global scientific literature indicates that Nonviolent Communication is a significant resource for improving interpersonal relationships in healthcare work. This approach can be adopted as a strategy by managers and decision-makers, both to resolve conflicts and to prevent aggressive situations between health professionals, especially when it comes to moral or psychological aspects.

Nursing strategies in antimicrobial stewardship in the hospital environment: a qualitative systematic review

BackgroundAntimicrobial resistance has become one of the world’s most important public health problems. Accordingly, nursing strategies to manage antimicrobials in hospital environments are fundamental to promoting patient health. The aim of this study was to summarise the best evidence available on nursing strategies for the safe management of antimicrobials in hospital environments.MethodsThis qualitative systematic review used meta-aggregation in accordance with the recommendations of the Joanna Briggs Institute. The protocol was registered in the data base of the Prospective Register of Systematic Reviews under No. CRD42021224804. The literature search was conducted, in April and May 2021, in the following data bases and journal repositories: Latin American and Caribbean Health Sciences Literature (LILACS) via the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System on-line (Medline) via PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scientific Electronic Library Online (SciELO) and Excerpta Medica Database (EMBASE). The findings of each study were summarized and the results were meta-aggregated in JBI SUMARI software.ResultsThe search resulted in a total of 447 studies and, after selection, the review included 26 studies, in which 42 nursing strategies were identified. The strategies were first categorised as care- or stewardship-related and then into the subcategories: Screening, Administration, Monitoring and Discharge, Nursing Team, Multi-professional Teams, Patients and Institutional Leadership. The 42 strategies were meta-aggregated and represented in flow diagrams. The best evidence was synthesized related to nursing strategies in the safe management of antimicrobials in the hospital environment.ConclusionsNurses play an indispensable function in antimicrobial stewardship in the hospital environment, because they work directly at the core of safe patient care. Significant contributions by nursing towards reducing antimicrobial resistance were found in care-related practice, education activities, research and policy.

Protocol for the diagnostic performance of C reactive protein, procalcitonin and interleukin-6 for serious bacterial infections among children ≤36 months old presenting with fever without source: a systematic review and meta-analysis

IntroductionThe management of fever without source in children ≤36 months old remains a diagnostic challenge as the underlying aetiologies can vary from self-limiting viral infections to serious bacterial infections (SBIs)....

Effects of Behavioral, Clinical, and Policy Interventions in Reducing Human Exposure to Bisphenols and Phthalates: A Scoping Review.

There is growing interest in evidence-based interventions, programs, and policies to mitigate exposures to bisphenols and phthalates and in using implementation science frameworks to evaluate hypotheses regarding the importance of specific approaches to individual or household behavior change or institutions adopting interventions. This scoping review aimed to identify, categorize, and summarize the effects of behavioral, clinical, and policy interventions focused on exposure to the most widely used and studied bisphenols [bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF)] and phthalates with an implementation science lens. A comprehensive search of all individual behavior, clinical, and policy interventions to reduce exposure to bisphenols and phthalates was conducted using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. We included studies published between January 2000 and November 2022. Two reviewers screened references in CADIMA, then extracted data (population characteristics, intervention design, chemicals assessed, and outcomes) for studies meeting inclusion criteria for the present review. A total of 58 interventions met the inclusion criteria. We classified interventions as dietary (), clinical (), policy (), and those falling outside of these three categories as "other" (). Most interventions (81%, 47/58) demonstrated a decrease in exposure to bisphenols and/or phthalates, with policy level interventions having the largest magnitude of effect. Studies evaluating policy interventions that targeted the reduction of phthalates and BPA in goods and packaging showed widespread, long-term impact on decreasing exposure to bisphenols and phthalates. Clinical interventions removing bisphenol and phthalate materials from medical devices and equipment showed overall reductions in exposure biomarkers. Dietary interventions tended to lower exposure with the greatest magnitude of effect in trials where fresh foods were provided to participants. The lower exposure reductions observed in pragmatic nutrition education trials and the lack of diversity (sociodemographic backgrounds) present limitations for generalizability to all populations. https://doi.org/10.1289/EHP11760.