Cumulative Index To Nursing And Allied Health Research Articles

Nursing student caring behaviours: a systematic review

Caring is central to nursing and requires scientific professional skills and knowledge. Numerous definitions highlight the fact that there is a range of perspectives regarding the caring behaviors. The purpose of this study was to provide a summary of caring behaviors among nursing students in order to depict a more comprehensive view, which could be used as foundational data for the argument that cultivating caring behaviors should be an early focus of the nursing curriculum. Article selection was guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) Statements. Literature searches were conducted in June 21, 2022 in PubMed, cumulative index to nursing and allied health (CINAHL), and (OVID). The following search blocks were generated: nursing students, caring behavior, and education. About 318 were found using primary search descriptors and 19 studies were included in the review. All research was published between 2016 and 2020. The majority of studies were conducted using a cross-sectional design, two studies used prospective, and one study used a retrospective design. The caring behavior of nursing students varies depending on the country and instrument used, ranging from a moderate score to a high score, and varies from one study year to the next. The most dominant caring behavior domains reported are the domains of instrumental caring/physical caring and expressive caring/emotional caring. This study adds to the existing literature on nursing care and explains the universality of the concept of care from multiple theoretical perspectives. Caring interventions should be used to help students develop clinically-relevant caring behaviors.

The Role of the School Nurse in E-Cigarette Prevention and Cessation: A Scoping Review.

E-cigarettes have rapidly gained popularity among youth in recent years. This scoping review identifies opportunities for school nurses to incorporate e-cigarette prevention strategies into their practice and identifies gaps for future research in school nursing evidence-based practice. Using the methodological framework developed by Arksey and O'Malley and advanced by Levac et al., a literature review was conducted using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), and Education Resources Information Center (ERIC) databases. A total of 15 articles were included in the final review. Articles for inclusion addressed interventions aimed at reducing e-cigarette use in K-12 schools. The results highlight two general types of school-based interventions: (1) universal e-cigarette prevention education and (2) targeted e-cigarette use-cessation programs. Each of these types of interventions presents a leadership opportunity for school nurses to engage within all domains of their scope of practice.

Social Media as an Effective Provider of Quality-Assured and Accurate Information to Increase Vaccine Rates: Systematic Review.

Vaccination programs are instrumental in prolonging and improving people's lives by preventing diseases such as measles, diphtheria, tetanus, pertussis, and influenza from escalating into fatal epidemics. Despite the significant impact of these programs, a substantial number of individuals, including 20 million infants annually, lack sufficient access to vaccines. Therefore, it is imperative to raise awareness about vaccination programs. This study aims to investigate the potential utilization of social media, assessing its scalability and robustness in delivering accurate and reliable information to individuals who are contemplating vaccination decisions for themselves or on behalf of their children. The protocol for this review is registered in PROSPERO (identifier CRD42022304229) and is being carried out in compliance with the Cochrane Handbook for Systematic Reviews of Interventions. Comprehensive searches have been conducted in databases including MEDLINE, Embase, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar. Only randomized controlled trials (RCTs) were deemed eligible for inclusion in this study. The target population encompasses the general public, including adults, children, and adolescents. The defined interventions comprise platforms facilitating 2-way communication for sharing information. These interventions were compared against traditional interventions and teaching methods, referred to as the control group. The outcomes assessed in the included studies encompassed days unvaccinated, vaccine acceptance, and the uptake of vaccines compared with baseline. The studies underwent a risk-of-bias assessment utilizing the Cochrane Risk-of-Bias tool for RCTs, and the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment. This review included 10 studies, detailed in 12 articles published between 2012 and 2022, conducted in the United States, China, Jordan, Australia, and Israel. The studies involved platforms such as Facebook, Twitter, WhatsApp, and non-general-purpose social media. The outcomes examined in these studies focused on the uptake of vaccines compared with baseline, vaccine acceptance, and the number of days individuals remained unvaccinated. The overall sample size for this review was 26,286, with individual studies ranging from 58 to 21,592 participants. The effect direction plot derived from articles of good and fair quality indicated a nonsignificant outcome (P=.12). The findings suggest that, in a real-world scenario, an equal number of positive and negative results may be expected due to the interventions' impact on the acceptance and uptake of vaccines. Nevertheless, there is a rationale for accumulating experience to optimize the use of social media with the aim of enhancing vaccination rates. Social media can serve as a tool with the potential to disseminate information and boost vaccination rates within a population. However, relying solely on social media is not sufficient, given the complex structures at play in vaccine acceptance. Effectiveness hinges on various factors working in tandem. It is crucial that authorized personnel closely monitor and moderate discussions on social media to ensure responsible and accurate information dissemination.

Supporting the resilience of healthcare workers in the Gulf Cooperation Council countries: An integrative review

Background: A wide range of evidence has shown that there is a crisis in the mental health of healthcare workers (HCWs) due to the nature of their work. Resilience has been recognized as an essential component in supporting mental health. No synthesized literature concretely defines the concept of resilience or outlines the factors that affect the resilience of HCWs in the Gulf Cooperation Countries (GCC).Aim: To explore the definition of resilience and to provide a synthesis of the factors that affect the resilience of HCWs in the GCC.Method: Whittemore and Knafl’s framework guided this integrative review. Cumulative Index to Nursing and Allied Health (CINHAL), Medical Literature Analysis and Retrieval System (MEDLINE), and Excerpta Medica Database (Embase) were searched systematically for peer-reviewed primary studies published between 2011 and 2022. Considering inclusion and exclusion criteria, a total of nine articles were included. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the quality of the studies. The socio-ecological model was used for data extraction, analysis, and presentation of findings.Results: The definition of resilience varies across the included studies. The factors that affect the resilience of HCWs fall within three main themes: intrapersonal factors (individual characteristics and internal influences), interpersonal factors (teamwork and camaraderie), and organizational factors (work setting, availability of resources, shift length, and leadership style).Conclusions: The resilience of HCWs can be affected by multiple factors. As a result, the interventions targeting the improvement of resilience should be multi-dimensional. Organizational policies should be developed in a way that supports a culture that fosters the resilience of HCWs in the GCC.

Suicides by pesticide ingestion in Pakistan and the impact of pesticide regulation

IntroductionSuicide is a major public health problem in Pakistan, accounting to approximately 19,331 deaths every year. Many are due to consumption of acutely toxic pesticides; however, there is a lack of national suicide data, limiting knowledge and potential for intervention. In this paper, we aimed to review the literature on pesticide self-poisoning in Pakistan to identify the most problematic pesticides in relation to national pesticide regulations.MethodsInformation on the currently registered and banned pesticides was obtained from Ministry of National Food Security and Research while data on pesticide import and use was extracted from FAOSTAT. We searched the following sources for articles and research papers on poisoning in Pakistan: Cumulative Index to Nursing and Allied Health (CINAHL), Google Scholar, Applied Social Sciences Index and s (ASSIA), Excerpta Medica (EMBASE), National Library of Medicine’s MEDLINE (PUBMED), PS102YCHINFO and Pakmedinet.com using the search terms ‘self-poisoning’, ‘deliberate self-harm’, ‘suicide’, ‘methods and means of suicide’, ‘organophosphate’, ‘wheat pill’, ‘aluminium phosphide’, ‘acute poisoning’, OR ‘pesticides’, AND ‘Pakistan’.ResultsAs of May 2021, 382 pesticide active ingredients (substances) were registered in Pakistan, of which five were WHO hazard class Ia (extremely hazardous) and 17 WHO hazard class Ib (highly hazardous). Twenty-six pesticides, four formulations, and seven non-registered pesticides had been banned, of which two were WHO class Ia and five Ib. We identified 106 hospital-level studies of poisoning conducted in Pakistan, of which 23 did not mention self-poisoning cases and one reported no suicidal poisoning cases. We found no community or forensic medicine studies. Of 52,323 poisoning cases identified in these papers, 24,546 [47%] were due to pesticides. The most commonly identified pesticide classes were organophosphorus (OP) insecticides (13,816 cases, 56%) and the fumigant aluminium phosphide (3 g 56% tablets, often termed ‘wheat pills’; 686 cases, 2.7%). Few studies identified the particular pesticides involved or the resulting case fatality.ConclusionWe found pesticide poisoning to be a major cause of poisoning in Pakistan, with OP insecticides and the fumigant aluminium phosphide the main pesticides identified. Withdrawal of Class I pesticides (as proposed to occur nationally in 2022) and high concentration aluminium phosphide tablets should rapidly reduce suicidal deaths by reducing the case fatality for low-intention poisoning cases. National cause of death data and forensic toxicology laboratory data identifying the pesticides responsible for deaths will be important to assess impacts of the proposed national ban.

Nurse manager support of graduate nurse development of work readiness: An integrative review.

To systematically review relevant literature to identify how Nurse Managers support graduate nurse work readiness. Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. A five-step, systematic integrative review reported in accordance with the PRISMA 2020 Checklist. The steps of the review method included (1) problem identification, (2) literature search, (3) data evaluation and quality appraisal, (4) data extraction and analysis and (5) presentation. Analysis used the Framework method and was guided by theory of graduate nurse work readiness and the Theoretical Domains Framework. MEDLINE COMPLETE, Cumulative Index to Nursing and Allied Health (CINAHL) Complete, ERIC and PSYCINFO searched in December 2020. Studies eligible for inclusion (N= 40) represented research from 15 countries; most (67.5%, n= 27) used a qualitative design, 22.5% (n= 9) were quantitative and 10% (n= 4) used mixed methods. Three themes related to the social constructs and local area work environments influenced by nurse managers emerged: supporting people, supportive environment and supporting learning. The review identified a lack of robust evidence about the effectiveness of specific nurse manager-led strategies to support development of graduate work readiness. However, the findings provide a framework to guide nurse managers in supporting graduate nurses and provide a foundation for further research about nurse manager roles in developing graduate work readiness. Previous research has described poor transition of graduate nurses as responsible for increased workplace errors, decreased job satisfaction and high rates of attrition. Exploring the role of nurse managers in graduate nurse transition is essential to ensure quality patient care and a sustainable workforce. What Problem Did the Study Address? Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. What Were the Main Findings? High rates of attrition are attributed to poor support during the initial transition phase of graduate nurses. Nurse managers can impact transition by providing a supportive environment, support learning and by providing a team of supportive people. Where and on whom will the research have an impact? The research will have an impact on graduate nurses and nurse managers. No patient or public contribution (integrative review exploring existing literature). This integrative review was registered with PROSPERO (CRD42021213142).

Neonatal Intensive Care Unit Interventions to Improve Breastfeeding Rates at Discharge Among Preterm and Low Birth Weight Infants: A Systematic Review and Meta-Analysis.

Background: While breast milk is widely accepted as the best source of nutrients for almost all newborns, breastfeeding can be especially challenging for preterm and low birth weight (LBW) infants. With increased risk of admission to neonatal intensive care units (NICUs) and separation from parents, this population experiences significant barriers to successful breastfeeding. Thus, it is crucial to identify interventions that can optimize breastfeeding for preterm and LBW infants that is continued from birth and admission, through to hospital discharge and beyond. Objectives: To identify and analyze evidence-based interventions that promote any and exclusive breastfeeding among preterm and LBW neonates at discharge and/or postdischarge from hospital. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Searches were performed in the following databases: MEDLINE Ovid, EMBASE, Web of Science, and Cumulative Index to Nursing and Allied Health (CINAHL). Results: From the 42 studies included, 6 groups of intervention types were identified: educational and breastfeeding support programs, early discharge, oral stimulation, artificial teats and cups, kangaroo mother care (KMC), and supportive policies within NICUs. All groupings of interventions were associated with significantly increased rates of any breastfeeding at discharge. All types of interventions except artificial teats/cups and oral stimulation showed statistically significant increases in exclusive breastfeeding at discharge. KMC demonstrated the highest increased odds of breastfeeding at discharge among preterm and LBW infants. Conclusions: A variety of effective interventions exist to promote breastfeeding among hospitalized preterm and LBW infants. Hospital settings hold unique opportunities for successful breastfeeding promotion. PROSPERO registration: CRD42021252610.

Identifying the Optimal Exercise Prescription for Patients with Coronary Artery Disease Undergoing Cardiac Rehabilitation: Protocol for a Systematic Review and Network Meta-Analysis of Randomized Control Trials.

Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity. Exercise-based cardiac rehabilitation (EBCR) has been shown to improve clinical outcomes in these patients, and yet clinicians are often challenged to prescribe the most effective type of exercise training. Therefore, this systematic review and network meta-analysis (NMA) aims to formally quantify the optimal dose of exercise training interventions to improve exercise capacity and quality of life by undertaking direct and indirect pooled comparisons of randomized controlled trials. A detailed search will be conducted on PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), EMBASE and Web of Science. Two reviewers will screen the existing literature and assess the quality of the studies. Disagreements will be resolved through consensus. We anticipate that the analysis will include pairwise and Bayesian network meta-analyses. Most of the trials have studied the impact of exercise training comparing one or two modalities. As a result, little evidence exists to support which interventions will be most effective. The current NMA will address this gap in the literature and assist clinicians and cardiac rehabilitation specialists in making an informed decision. Results will be disseminated through peer-reviewed journals. Ethical approval is not applicable, as no research participants will be involved. PROSPERO Registration number: CRD42022262644.

The Use of Guided Reflection in Simulation-Based Education With Prelicensure Nursing Students: An Integrative Review.

This integrative review synthesized the findings of studies to determine the uses and outcomes of guided reflection in simulation-based education (SBE) with prelicensure nursing students. A search of Cumulative Index to Nursing and Allied Health (CINAHL) Plus, Education Resources Information Center (ERIC), Education Research Complete (ERC), and PsychINFO using the key words reflection, guided reflection, simulation (nursing education or nursing student), traditional, and baccalaureate identified 18 articles. Findings suggest facilitation of guided reflection in SBE has a positive effect on leadership development, clinical judgment, student satisfaction, and critical thought. Development of a tool to accurately measure guided reflection is warranted. Current evidence on the use of guided reflection in SBE calls for a major paradigm shift in higher education. Guided SBE experiences enhance participant knowledge, and guided reflection should be used as an innovative teaching strategy in SBE. [J Nurs Educ. 2022;61(2):73-79.].

Factors associated with viral suppression among cisgender women living with human immunodeficiency virus in the United States: An integrative review.

Introduction:Women account for 23% of new human immunodeficiency virus diagnoses in the United States, yet remain understudied. Adherence to antiretroviral therapy and consequent viral suppression are keys to preventing human immunodeficiency virus transmission, reducing risk of drug resistance, and improving health outcomes.Objectives:This review identified and synthesized peer-reviewed studies in the United States describing factors associated with viral suppression among cisgender women living with human immunodeficiency virus.Methods:We searched five databases: Cumulative Index to Nursing and Allied Health (CINAHL), PubMed, Embase, Scopus, and PsycINFO, and reported the findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Eligible studies included: (1) peer-reviewed English-language articles published since 2010; (2) includes only cisgender women; (3) participants were at least 18 years of age; (4) reported metrics on viral loads; and (5) conducted in the United States.Results:Fourteen studies in total were reviewed. Eight studies had adult women living with human immunodeficiency virus, four recruited only pregnant women, and two included only racial minority women. The most commonly reported factors negatively associated with viral suppression were substance use (n = 4), followed by availability of health insurance, financial constraint, complexity of human immunodeficiency virus treatment regimen (n = 3), and intimate partner violence (n = 2). Other factors were depression, race, and age. In addition, all four studies that included only pregnant women reported early human immunodeficiency virus care engagement as a significant predictor of low viral loads pre- and post-partum.Conclusion:Substance use, financial constraint, lack of health insurance, human immunodeficiency virus treatment regimen type, intimate partner violence, and late human immunodeficiency virus care pre–post pregnancy were the most common factors negatively associated with viral suppression. There is a paucity of data on viral suppression factors related to transgender and rural populations. More human immunodeficiency virus research is needed to explore factors associated with human immunodeficiency virus treatment outcomes in transgender women and cisgender women in rural U.S. regions.

What can we learn from retracted studies in the nursing field in the last 20 years? Findings from a scoping review.

Background and aim of the work:Literature reviews have summarised the number of retracted studies and guidelines have been developed to prevent this issue. However, available data are scarce in the nursing field. Learning from other experiences may be able to increase awareness of the issue and prevent avoidable errors. Therefore, the intent of this study was to map retracted articles in the nursing field by investigating the reasons for retractions in order to elicit strategies to prevent their occurrence.Methods:A scoping review was performed by searching PubMed and Cumulative Index to Nursing and Allied Health (CINAHL) for articles published from 2001 to 2021. Quantitative primary and secondary studies related to the nursing field and written in English, with a “retracted article” message and/or presenting a retraction notice, have been included. The main reasons for retraction have been recorded, as well as the main features of the studies retracted.Results:Out of 274 studies, we detected 26 retractions, of which eight were literature reviews and seven were experimental studies. Editors were the most frequent party requiring retraction. The retracted studies originated from 11 countries and were mostly published (n = 19) in general nursing journals. Scientific misconduct was the main cause of retraction (n = 18), while the remaining retractions were due to other types of errors.Conclusions:Most of the study retractions were issued by editors and originated mostly from high-scientific output countries. Scientific misconduct represented the principal cause of retraction; from these failures, educational strategies have been identified in order to prevent issues and to increase awareness among researchers and healthcare professionals. (www.actabiomedica.it)

Techniques and Technologies to Improve Peripheral Intravenous Catheter Outcomes in Pediatric Patients: Systematic Review and Meta-Analysis.

Insertion and function of pediatric peripheral intravenous catheters (PIVCs) present challenges. We systematically reviewed techniques and technologies to improve PIVC outcomes (first-time insertion success, overall insertion success, time to insertion, dwell time, failure, and complications). Cochrane Central Register of Controlled Trials (CONTROL), Cumulative Index to Nursing and Allied Health (CINAHL), US National Library of Medicine, and Embase. English-language pediatric trials published post 2010 reporting PIVC outcomes. Following Cochrane standards, two authors screened, extracted, and critiqued study quality (Grading of Recommendations Assessment, Development and Evaluation approach) data, random effects analysis, results expressed as risk ratios (RR), mean differences (MD) and 95% CIs. Twenty-one studies (3237 children; 3098 PIVCs) were included. First-time insertion success significantly increased with ultrasound guidance (compared with landmark insertion; RR, 1.60; 95% CI, 1.02-2.50). Use of ultrasound guidance (compared with landmark insertion) did not improve overall PIVC insertion success (RR, 1.10; 95% CI, 0.94-1.28). There was no evidence of an effect of near-infrared (compared with landmark) on first-time insertion success (RR, 1.21; 95% CI, 0.91-1.59) or number of attempts (MD, -0.65; 95% CI, -1.59 to 0.29); however, it significantly reduced PIVC insertion time (MD, -132.47; 95% CI, -166.68 to -98.26) and increased first-time insertion success in subgroup analysis of patients with difficult intravenous access (RR, 2.72; 95% CI, 1.02-7.24). Few studies per intervention, small sample sizes, and inconsistent outcome measures precluded definitive conclusions. Ultrasound and near-infrared appear to improve pediatric PIVC insertion. High-quality studies examining the full extent of techniques and technologies are needed. Registration: CRD42020175314.

A scoping review of the school-aged stuttering intervention literature

We explore school-aged (6–14 years old) stuttering interventions for children who stutter (CWS) using a scoping review. Database searches were conducted (EBSCO host, PubMed, PsycINFO, Academic Search Premier, MEDLINE, Education Resources Information Center (ERIC), Health Source (consumer edition), Africa-wide Information, Cumulative Index to Nursing and Allied Health (CINAHL), Dissertation abstracts International, the Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), 15 Cochrane Methodology Register, Education Resource Information Center, Google Scholar, manual searching using reference lists and gray literature) from the inception of the databases until June 2018. Ten school-aged stuttering intervention studies met the inclusion criteria of this study, which were conducted between 1982 and 2016. The 10 studies used quantitative pretest posttest designs with low to moderate quality, according to GRADE. ICF showed a dominance of interventions targeted and measured within the domain of body structures and function with treatment effects focused predominantly on traditional individualized speech fluency measures. Studies were conducted in Australia (n = 3), United States of America (n = 3), Canada (n = 2), Islamic Republic of Iran (n = 1) and South Africa (n = 1). The findings lead to the authors questioning knowledge production and its influence on evidence-based literature and practices.

Gait Pattern in People with Multiple Sclerosis: A Systematic Review.

The aim of the present systematic review was to describe the gait pattern in people with multiple sclerosis (MS) by compiling the main findings obtained from studies using three-dimensional capture systems of human movement. The search was carried out in PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cumulative Index to Nursing and Allied Health (CINAHL) databases. Studies that used three-dimensional gait analysis systems and that analyzed spatiotemporal, kinematic, kinetic, or electromyographic parameters, were included. The quality of the studies was assessed using the Critical Review Form–Quantitative Studies scale. 12 articles were included with 523 (342 women and 181 men) people with a diagnosis of MS. The present work suggests that people with MS have a decrease in speed and stride length, as well as an increase in double-stance intervals during gait. Likewise, it is common to observe a decrease in hip extension during the stance period, a decrease in knee flexion in the swing period, a decrease in ankle dorsiflexion in the initial contact and a decrease in ankle plantar flexion during the pre-swing phase. The subjects with MS decrease the hip extensor moment and the ankle power during the stance period of walking.

Experiences of Front-Line Medical Staffs Fighting Against Coronavirus Disease 2019: A Meta-Synthesis of Qualitative Studies

Background: To explore the experiences of front-line medical staffs fighting against Coronavirus Disease 2019 (COVID-19) by synthesizing evidence from a meta-synthesis of qualitative studies.Methods: We conducted a meta-synthesis to integrate qualitative studies on experiences of front-line medical staffs fighting against COVID-19. Six databases were searched from inception to 1 November 2020, including PubMed, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, and Scopus. The Critical Appraisal Skills Programme (CASP) qualitative research appraisal tool was used to appraise the quality of included studies. Thematic synthesis was used to synthesize the data from included studies.Findings: A total of 26 studies were included and six themes were identified: (1) psychological and emotional experience in different stages; (2) social experience; (3) challenges and difficulties; (4) coping styles; (5) demands; (6) growth and transcendence.Interpretation: This meta-synthesis reflects diverse experiences of front-line medical staffs fighting against COVID-19. Appropriate psychological support and social support should be provided to front-line medical staffs. Managers should pay attention to needs of front-line medical staffs for improving professional capability and ensure sufficient supplies to respond to similar crisis.Funding Statement: This study received no specific grant from any funding agency in the public,commercial, or not-for-profit sectors.Declaration of Interests: We declare no competing interests.

A systematic review of ankle fracture treatment modalities in diabetic patients

AimThis systematic review evaluated the surgical outcomes of various ankle fracture treatment modalities in patients with Diabetes Mellitus as well as the methodological quality of the studies. MethodsFor our review, four online databases were searched: PubMed, MEDLINE (Clarivate Analytics), CINAHL (Cumulative Index to Nursing and Allied Health) and Web of Science (Clarivate Analytics). The overall methodological quality of the studies was assessed with the Coleman Methodology Score. Data regarding diabetic ankle fractures were pooled into three outcomes groups for comparison: (1) the standard fixation cohort with management of diabetic ankle fractures using ORIF with small or mini fragment internal fixation techniques following AO principles, (2) the minimally invasive cohort with diabetic ankle fracture management utilizing percutaneous cannulated screws or intramedullary fixation, and (3) the combined construct cohort treated with a combination of ORIF and another construct (transarticular or external fixation). ResultsThe search strategy identified 2228 potential studies from the four databases and 11 were included in the final review. Compared to the standard fixation cohort, the minimally invasive cohort had increased risk of hardware breakage or migration and the combined constructs cohort had increased risk of hardware breakage or migration, surgical site infection and nonunion. Limb salvage rates were similar for the standard fixation and minimally invasive cohorts; however, the combined constructs cohort had a significantly lower limb salvage rate compared to that of the standard fixation cohort. The mean Coleman Methodology Score indicated the quality of the studies in the review was poor and consistent with its limitations. DiscussionThe overall quality of published studies on operative treatment of diabetic ankle fractures is low. Treating diabetic ankle fractures operatively results in a high number of complications regardless of fixation method. However, limb salvage rates remain high overall at 97.9% at a mean follow-up of 21.7 months. To achieve improved limb salvage rates and decrease complications, it is critical is to follow basic AO principles, respect the soft tissue envelope or utilize minimally invasive techniques, and be wary that certain combined constructs may be associated with higher complication rates. Level of evidence2.

African American Adolescents and Young Adults, New Media, and Sexual Health: Scoping Review.

BackgroundRates of sexually transmitted infections and unintended pregnancies are disproportionately high among African American adolescents and young adults (AYA). New media platforms such as social networking sites, microblogs, online video sites, and mobile phone applications may be a promising approach in promoting safe sex and preventing sexually transmitted infections.ObjectiveThe purpose of this scoping review was to address promising approaches in new media that may serve as valuable tools in health promotion, prevention, education, and intervention development aimed at African American AYA.MethodsAn electronic search was conducted using Google Scholar, Scopus, Cumulative Index to Nursing and Allied Health (CINHAL), and PubMed online databases. Concept blocks and MeSH terminology were used to identify articles around African American youth and new media.ResultsThe search yielded 1169 articles, and 16 publications met the criteria. Studies from the review found themes in new media that included feasibility, changing attitudes, and improving knowledge related to sexual health behavior among youth of color.ConclusionsNew media is a promising and feasible platform for improving the sexual health of African American AYA. Further research is suggested to better understand the benefits of new media as a sexual health promotion tool among this specific population.

Accuracy of Physicians’ Electrocardiogram Interpretations

The electrocardiogram (ECG) is the most common cardiovascular diagnostic test. Physicians' skill in ECG interpretation is incompletely understood. To identify and summarize published research on the accuracy of physicians' ECG interpretations. A search of PubMed/MEDLINE, Embase, Cochrane CENTRAL (Central Register of Controlled Trials), PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), ERIC (Education Resources Information Center), and Web of Science was conducted for articles published from database inception to February 21, 2020. Of 1138 articles initially identified, 78 studies that assessed the accuracy of physicians' or medical students' ECG interpretations in a test setting were selected. Data on study purpose, participants, assessment features, and outcomes were abstracted, and methodological quality was appraised with the Medical Education Research Study Quality Instrument. Results were pooled using random-effects meta-analysis. Accuracy of ECG interpretation. Of 1138 studies initially identified, 78 assessed the accuracy of ECG interpretation. Across all training levels, the median accuracy was 54% (interquartile range [IQR], 40%-66%; n = 62 studies) on pretraining assessments and 67% (IQR, 55%-77%; n = 47 studies) on posttraining assessments. Accuracy varied widely across studies. The pooled accuracy for pretraining assessments was 42.0% (95% CI, 34.3%-49.6%; n = 24 studies; I2 = 99%) for medical students, 55.8% (95% CI, 48.1%-63.6%; n = 37 studies; I2 = 96%) for residents, 68.5% (95% CI, 57.6%-79.5%; n = 10 studies; I2 = 86%) for practicing physicians, and 74.9% (95% CI, 63.2%-86.7%; n = 8 studies; I2 = 22%) for cardiologists. Physicians at all training levels had deficiencies in ECG interpretation, even after educational interventions. Improved education across the practice continuum appears warranted. Wide variation in outcomes could reflect real differences in training or skill or differences in assessment design.

Advanced Nursing Practice in Austria under consideration of outcome measurement

BackgroundInternationally, Advanced Practice Nurses (APN) are associated with improvements when measuring results in health care. Advanced Nursing Practice (ANP) refers to an extended nursing care with the aim of meeting the changing conditions in health care systems by providing evidence-based practice. APN outcomes are the endpoints of nursing interventions based on clinical experience, scientific knowledge, and practical skills. Due to the challenges in health care systems, Advanced Practice Nurses have become well established internationally in various fields. ProblemIn Austria, the first nurses are currently trained in Advanced Nursing Practice on a master's level according to the International Council of Nurses core curriculum (ICN). However, national implementation and evaluation strategies are still missing. ObjectiveThe aim of this short report is (i) to show the current situation of APNs in Austria, and (ii) to underline the importance of measuring APN outcomes in implementing this role for future developments in health care. MethodA literature search was conducted in CINAHL (Cumulative Index to Nursing and Allied Health), PubMed, and the Cochrane Library in the period 09/2019 to 01/2020. ResultsWith the help of APNs and coordinated, holistic, patient-centered care, a higher quality of care for different patient groups is clearly evident. The cost-effectiveness and the positive experience of both patients and nursing staff have been demonstrated in international studies. In particular, the guidance and educational skills of APNs have been shown to improve health outcomes in vulnerable population groups. ConclusionWith regard to the implementation of APNs in the health care system, more focus is needed on the measurement of outcomes in nursing research. Outcome research has been shown to help identify the unique effect of APNs in patient care and to highlight the health-related improvements through Advanced Nursing Practice for health policy and further developments in the health care system.

Association of Childhood Maltreatment With Suicide Behaviors Among Young People

Children and young people's reports of experiences of adverse childhood events have increased in recent years, and this trend has been associated with an elevated risk for suicide behaviors. However, a systematic review and meta-analysis is needed to confirm the significance of this association in young people. To quantify the association between core types of childhood maltreatment, including sexual, physical, and emotional abuse and/or neglect and suicide behaviors in children and young adults. Medline, PsychInfo, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health) databases were searched from January 1, 1980, until December 31, 2019. The reference lists of all the included studies were also checked. Quantitative studies that focused on the association between core types of childhood abuse and/or neglect and suicide ideation, plans, and attempts. Data were extracted by 2 independent raters. Publication bias and risk of bias across studies were assessed. Meta-analyses using random-effect models were applied, and heterogeneity was quantified using the I2 statistic. Data were analyzed from January to May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. The association between core types of childhood maltreatment and suicide behaviors. Seventy-nine studies with 337 185 young individuals (mean [SD] age, 15.67 [2.11] years; 63.19% female) were included. The findings demonstrated that sexual abuse (odds ratio [OR], 3.41; 95% CI, 2.90-4.00), physical abuse (OR, 2.18; 95% CI, 1.75-2.71), emotional abuse (OR, 2.21; 95% CI, 1.37-3.57), emotional neglect (OR, 1.93; 95% CI, 1.36-2.74), physical neglect (OR, 1.79; 95% CI, 1.27-2.53), and combined abuse (OR, 3.38; 95% CI, 2.09-5.47) were significantly associated with higher rates of suicide attempts. Core types of childhood maltreatment were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4.0-fold increase for suicide plans. Studies based on community samples (β [SE] = -1.68 [0.79]; P = .04) or with lower methodological quality (β [SE] = -2.86 [1.30]; P = .03) were associated more strongly with suicide attempts in those reporting experiences of sexual abuse, whereas young age was associated with both suicide attempts (β [SE] = -0.59 [0.27]; P = .03) and ideation (β [SE] = -0.41 [0.18]; P = .03). These findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect.