JBI Critical Appraisal Checklist Research Articles

Prevalence of Anxiety and Depression among Nurses during the early phase of COVID-19: A meta-analysis

Background & Objective: The COVID-19 pandemic exposed significant mental health challenges among healthcare workers, particularly nurses, who are key frontline responders and are the largest segment of the global health workforce. Given the ongoing threat of Mpox and potential new COVID-19 variants, understanding these challenges is vital. This review estimates the prevalence of anxiety and depression among nurses during the early phase of the pandemic to inform future pandemic responses. Methods: A systematic review was conducted to identify studies published from January 1st to November 9, 2020. The quality of the included studies was assessed using the JBI Critical Appraisal Checklist. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was performed using a random-effects model to estimate the pooled prevalence of anxiety and depression. Findings: Twenty-seven studies, involving 39,386 nurses from ten countries, were included in the meta-analysis. The pooled prevalence of anxiety across 24 studies was 38.54% (95% CI: 33.99, 43.10) (I2 = 97.89%). The pooled prevalence of depression in 22 studies was found to be 35.52% (95% CI: 26.61, 44.43) (I2 = 99.72%). Interpretation: The pooled prevalence of anxiety and depression in nurses caring for patients with COVID-19 during the early phase of the pandemic was higher than that in other healthcare workers. With the ongoing Mpox outbreak and the potential for future pandemics, these findings necessitate timely screening and robust mental health strategies to support nurses and enhance healthcare resilience. doi: https://doi.org/10.12669/pjms.41.2.10828 How to cite this: Jatt KA, Froelicher ES, Pienaar AJ, Dhamani KA. Prevalence of Anxiety and Depression among Nurses during the early phase of COVID-19: A meta-analysis. Pak J Med Sci. 2025;41(2):622-629. doi: https://doi.org/10.12669/pjms.41.2.10828 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

What are family caregivers' experiences of coordinating end-of-life care at home? A narrative review.

People with life-limiting diseases, who are no longer receiving active or curable treatment, often state their preferred place of care and death as the home. This requires coordinating a multidisciplinary approach, using available health and social care services to synchronize care. Family caregivers are key to enabling home-based end-of-life support; however, the 2 elements that facilitate success - coordination and family caregiver - are not necessarily associated as being intertwined or one and the same. This narrative review explores family caregiver experiences of coordinating end-of-life care in the home setting. Studies were identified systematically following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A search of 5 databases (CINAHL, AMED, MEDLINE, Joanna Briggs Institute for Systematic Reviews, and the Cochrane Database) was conducted using Medical Subject Headings search terms and Boolean operators. Seven hundred and eighty papers were screened. Quality assessment was conducted using the JBI Critical Appraisal Checklist for Qualitative Research. Characteristics of included studies were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) extraction tool. Ten qualitative studies were included. A meta-aggregative approach was used to assemble findings and categories extracted from the included papers, which led to identification of 3 overall themes: (1) family caregiver identity, (2) strategies for care, and (3) practicalities of care. Research suggests there should be a designated care coordinator to support people nearing the end of life at home. However, this review shows that family caregivers intrinsically take on this role. Their experiences, frequently share commonalities across different cultures and regions, highlighting the universal nature of their challenges. Difficulties associated with providing home-based care are evident, but the undertaking of care coordination by relatives highlights a need for a change in approach. Future studies could explore the impact of having a designated "facilitator" or single point of contact for families, as well as the development of tailored communication strategies.

Prevalence of metabolic syndrome among pregnant women: a systematic review and meta-analysis.

Metabolic syndrome (MetS) is a cluster of risk factors that increase the risk of cardiometabolic diseases. The prevalence of MetS and individual components across pregnancy has not been reviewed in the literature. This research was conducted to identify the prevalence of MetS and its components among pregnant women. The PubMed, EMBASE, CINAHL, Web of Science and Scopus databases were searched. The review protocol is registered in PROSPERO (CRD42023460729). Quality assessment was performed using the JBI critical appraisal checklist. The study selection, data extraction and data analyses were performed in accordance with the MOOSE guidelines. The prevalence of MetS among pregnant women was 16.3%, (n = 3946). The prevalences for individual MetS components were: low HDL, 12.3% (n = 1108); high fasting glucose, 16.2% (n = 2333); high triglycerides, 48.5% (n = 2880); obesity, 42.7% (n = 5162) and high blood pressure 37.7% (n = 828). According to the definitions used to diagnose MetS, the prevalences were 18.2% according to the World Health Organization, 15.0% according to the International Diabetes Federation and 17.2% according to the National Cholesterol Education Program Adult Treatment Panel III. When stratified by gestational age at assessment, the prevalence of MetS was 9.9% before 16 weeks' and 24.1% after 20 weeks' of gestation. This review demonstrates that MetS is detected in approximately one-fifth of pregnant women. Screening for MetS and its components during pregnancy may help identify young women at risk for future cardiovascular disease.

Maternal Birth Satisfaction Relating to Intraoperative and Early Postpartum Skin-to-Skin Contact with the Neonate During Caesarean Birth: An Integrative Review.

Background: Mothers and their newborns experiencing caesarean birth often receive delayed or interrupted skin-to-skin care (SSC) despite the intervention being well recognised as beneficial to both mother and baby, with no associated risk for increased morbidity or mortality. Maternal birth satisfaction is recognised as an indicator of quality maternity care; however, most of the research has focused on early intraoperative SSC initiation and breastfeeding outcomes. Objectives: To collate and synthesise evidence for maternal satisfaction of intraoperative and early postpartum SSC during and immediately following caesarean birth. To identify timelines of implementation, barriers, and facilitators of SSC. Methods: An integrative review was conducted guided by the 5-stage Wittemore and Knalf's framework. Four electronic databases (CINAHL, Medline, PsycINFO, Web of Science) were searched. Key terms were 'Caesarean birth', 'skin-to-skin care', 'maternal satisfaction'. Studies published from 2014 to 5 September 2024 in English language were included. A hand search of potential inclusion articles was also searched to undertake a comprehensive review. The JBI critical appraisal checklist was used to assess the quality of inclusion studies. Results: 17 studies met the selection criteria and were included in this review. Intraoperative and early SSC during caesarean birth is associated with positive maternal birth satisfaction and contributes to improved birth experience for mothers with no negative implications. Conclusions: Increased access to intraoperative SSC will likely contribute to increased maternal satisfaction and positive birthing experience. Compliance with policy recommendations regarding SSC may improve with access to a flow chart tool identifying expectations of women's intraoperative and postoperative care for caesarean birth.

Effectiveness of school-based oral health education interventions on oral health status and oral hygiene behaviors among schoolchildren: an umbrella review.

To summarize evidence of the effectiveness of school-based oral health education interventions on oral health status and oral hygiene behaviors among schoolchildren. A comprehensive search was conducted across seven databases MEDLINE Ovid, Google Scholar, Web of Science, Scopus, EBSCO-APA PsycInfo, ProQuest, and CINAHL, with two independent reviewers screening titles and abstracts including full texts. Data extraction procedure and quality appraisal of this umbrella review adhered to the JBI critical appraisal checklist. Systematic reviews of RCTs in which schoolchildren of 5 to 18 years of age received oral health education in a classroom-based school setting from dentists, schoolteachers, or caregivers were included. Key outcome measures included distinct oral health indices, as well as knowledge, attitudes, and practices. A total of 27 relevant systematic reviews were included for the umbrella review. Methodological quality was substantial among most systematic reviews, thus enhancing the strength of reliability of findings. Nineteen were graded excellent (scores 30 to 33), four were classified as good quality (scores 26 to 29), four rated as fair quality (scores 21 to 25) and none rated as poor-quality (scores 20 or below). Numerous studies from various nations were identified, with reviews peaking in 2019 and 2021. The overlap assessment reveals slight degree of overlap (3.73% overlap, -0.45% CCA-corrected covered area). Meta-analyses show that oral health education interventions had a favorable impact on a number of outcomes, such as reduced plaque and gingivitis, enhanced knowledge, attitude, and behavior, and improved oral cleanliness. This umbrella review provides a comprehensive synthesis of the effectiveness of oral health education interventions in school settings. Positive outcomes in plaque reduction and gingivitis prevention affirm the benefits of these programs, though the evidence for caries prevention remains inconclusive. The findings highlight the broader impact of these interventions on students' knowledge, attitudes, and behaviors, emphasizing the need for tailored approaches and further research to optimize oral health education. This review serves as a valuable resource for educators, healthcare professionals, and policymakers dedicated to improving pediatric oral health. CRD42023401903.

External quality assessment in African clinical laboratories: A systematic review and meta-analysis.

External quality assessment (EQA) helps evaluate and improve the quality of laboratory testing by providing unbiased reviews. The study aimed to synthesize pooled EQA performance of clinical laboratories across the African region. The review was registered in PROSPERO (CRD42024562987) and reported based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An extensive search was employed using the PubMed, Scopus, Cochrane, and Embase databases as well as gray literature. After duplicates were removed, the remaining articles were evaluated based on title, abstract, and full text. Methodologic quality was assessed using the JBI critical appraisal checklist. Random effects meta-analysis was used to estimate the pooled performance of EQA at 95% CIs. In addition, the I2 statistic was used to assess heterogeneity, and a funnel plot along with Egger regression were employed to evaluate publication bias. Trim and fill analysis was also performed to adjust the publication bias. From an electronic database search, a total of 622 articles were retrieved. Of these, 17 articles met the inclusion criteria, encompassing a total sample size of 4509 participating laboratories. In this study, the overall pooled performance of EQA in the African region was 71.25% (95% CI, 63.12-79.39). The result indicated statisticallysignificant heterogeneity (I2 = 96.36). The funnel plot displayed an asymmetrical distribution of the studies, and Egger regression revealed significant publication bias (P = .002). The findings revealed that the pooled EQA performance of laboratories in Africa did not meet the typical standard of 80%, indicating a need for continuous improvement. We suggest conducting further studies to gain better insights.

A Systematic Review Exploring the Relationship Between Family Factors and Symptom Severity, Relapse and Social or Occupational Functioning in First-Episode Psychosis.

Research on family functioning in psychosis has typically focused on specific family-related factors and their impact on symptomatology, finding strong associations between high expressed emotion and poor outcomes, especially in those with long-term illness. The objective of this review is to examine the impact of a broad range of family-related factors and their relationship with clinical, social, occupational and relational outcomes in first-episode psychosis (FEP). A systematic search of databases PsycInfo, Pubmed, Embase and CINHAL between 1990 and August 2023 was completed. In total, 1408 articles were screened, and study quality was assessed using the JBI critical appraisal checklists for analytical cross-sectional studies and cohort studies. A narrative synthesis approach was used to analyse the data. Of the 1408 identified articles, 80 full-text articles were screened. Fifteen studies were included for data extraction. The objectives and scope of the selected studies varied considerably. Studies consisted of cross-sectional and prospective cohort designs. Participants consisted of FEP patients and family members, with the patient age range varying from 15.9 to 30.8 (MD = 24.5). Significant associations were identified between family factors (high EE, family environment and carer burden) and symptom and social outcomes. While findings emphasised the significant impact of family factors on symptomatic and social outcomes, the literature had significant limitations due to the absence of underlying theoretical models and understanding of the dynamics of distress in families within FEP. Future research should seek to develop a model accounting for such processes.

Antarctic Expeditions: A Systematic Review of the Physiological, Nutritional, Body Composition and Psychological Responses to Treks Across the Continental Ice.

Antarctic expeditions, although supported by scientific knowledge, face various challenges, with little research conducted to explore the physical demands that explorers experience. To summarise physiological, psychological, body composition and nutritional changes faced during trek expeditions in the Antarctic's continental portion. Systematic review. We used PubMed, SPORTDiscus, PsycINFO, Scopus, Cochrane databases, CINAHL and Medline Ovid to search for studies published up to January 2023. We included original articles or case reports published in English and in peer-reviewed journals, involving both sexes, using both quantitative and qualitative approaches, that considered Antarctic continent expedition, as well as solo exploration/group exploration. Animal studies, in vitro studies, explorers <18 years of age, overwintering at research stations, tourist/organized visits to Antarctica or the South Pole, not sleeping on the ice, and ultraendurance events were excluded. The JBI critical appraisal checklist for case studies was used for quality assessment. A total of 12 studies met the eligibility criteria. The main findings are reversible changes in bone density and mineral content. Despite high-calorie intake (5000kcal/day or more), participants experienced body weight loss and a decrease in appetite-regulating hormones. Motivation and goal orientation, positive interpersonal communication and support are important skills during polar expeditions. Multidisciplinary research revealed various physiological and cognitive responses, disrupted sleep patterns and mood changes. Prolonged hypobaric hypoxia reduces aerobic capacity and increases anaerobic metabolism, while bone density changes are reversible and weight loss occurs despite high-calorie intake. Effective decision-making, teamwork and personal growth are crucial for Antarctic explorers. Future studies need to investigate strategies on how to improve physiological functions while maintaining homeostasis. PROSPERO-CRD42022382609.

Reliability of ameloglyphics in forensic identification: a systematic review.

Teeth are considered as hard tissue analogue to fingerprints, being unique to an individual. The enamel which forms the outer layer of the tooth is formed through a highly dynamic process in which ameloblasts lay down enamel rods in an undulating and intertwining path, which is reflected as a series of enamel rod pattern. The study of these patterns is termed as "Ameloglyphics". These patterns formed on the surface of enamel are called tooth prints each of which comprises the combination of different sub patterns, and are unique for every single tooth of an individual. This characteristic of uniqueness of the tooth print can serve as a significant biometric tool in forensic identification. To assess if ameloglyphics is an accurate and reliable method for forensic identification of individuals. Registration number- CRD42022338138. Data sources- Google Scholar, PubMed, Proquest, Europe PMC, Scopus. Study appraisal and synthesis methods- Studies were assessed for quality with the help of predetermined criteria which categorized the studies into high, medium and low quality with the help of JBI critical appraisal checklist for analytical cross-sectional studies using the key words such as Ameloglyphics, tooth prints and enamel rod end patterns. A total of 475 articles were obtained in the primary search from PubMed, Scopus, Europe PMC, ProQuest, and Google Scholar including gray literature for thorough search of related publications on Ameloglyphics. Following initial search of titles, 433 articles were excluded because they were not related to the objectives of the systematic review and 42 articles were further excluded after abstract reading and removal of duplicates. Finally,18 out of 22 articles which were fulfilling the inclusion criteria of the study were selected for qualitative synthesis after full-text screening and exclusion of review articles. The data obtained from the eighteen included studies were systematically reviewed but a meta-analysis could not be performed due to heterogeneity of the data. Ameloglyphics is a relatively newer technique and a fair number of research are done on its application in identification of individuals. The results of the eighteen studies included in this review suggest that Ameloglyphicsis an useful adjunct for forensic identification. The study protocol can be accessed through the International Prospective Register of Systematic Reviews, the PROSPERO database with the following register number: CRD42022338138.

Family Experience of Detention for Migratory Reasons: Findings From a Qualitative Systematic Review

ABSTRACTIn response to growing international migration, several states have adopted controversial measures, including detaining migrants, which have detrimental impacts on migrants' physical, mental and social health. Although family is often at the heart of migratory decisions, few studies have used a family lens to examine this phenomenon. This paper reports on the findings of a qualitative systematic review that aims to describe the experience of migrant families dealing with detention. Articles were searched in relevant databases, and the quality of studies was assessed independently by two reviewers using the JBI Critical Appraisal Checklists. Twenty‐two out of 897 articles met the inclusion criteria and were subsequently included. Three themes emerged from the thematic synthesis that capture the experience of migrant families affected by detention: (1) alterations of the family structure, (2) disruptions in instrumental and emotional functioning and (3) weakening of the family identity. Results robustly evidenced the detrimental effects of detention on families and the urge to stop this practice. Limitations included the difficulty of distinguishing between the experience of detention and deportation in some studies, as well as limited information about the long‐term effect of detention on family health and integration in the host society.

Effectiveness of Peer-Assisted Learning in health professional education: a scoping review of systematic reviews

BackgroundPeer-assisted learning (PAL) has been widely implemented for many years worldwide. To further enhance the understanding of available data, a scoping review of systematic reviews was conducted to synthesize existing evidence on the effectiveness of PAL in health professional education, aiming to provide more comprehensive outcomes.MethodsNine databases were systematically searched. The review process was guided by the five-stage scoping review framework proposed by Arksey and O’Malley. The JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was used to assess the methodological quality. The results were narratively synthesized and reported following the Context, Input, Process, and Product (CIPP) evaluation model.Results24 systematic reviews (including nine meta-analyses) were included. The majority of these reviews were synthesized using narrative analysis. The application of PAL in health professional education was developed. In the context of evaluation, support for the theory, problem-based drivers, and the need to develop teaching and assessment skills for students were the main reasons for the development of PAL. Inputs for PAL predominantly centered on tutor recruitment and tutor training. Common activities within the PAL process encompassed peer teaching, peer tutoring, peer feedback, peer simulation, peer discussion, peer-led debriefing, peer supervision, and curriculum design. Outcomes of PAL were categorized across peer tutees, peer tutors, health professional educators, and challenges of PAL.ConclusionsDespite certain challenges, the reciprocal benefits of PAL for peer tutees and tutors are evident. It is recommended that relevant institutions should consider incorporating PAL into the curriculum for health professional students. Future research should aim to develop a more rigorous framework to determine the short- and long-term effects, cost-effectiveness, and generalizability of PAL in health professional education.

Community-dwelling older people's experiences of advance care planning with health care professionals: a qualitative systematic review.

The objective of this review is to examine community-dwelling older people's experiences of advance care planning with health care professionals. The importance of health care professionals initiating advance care planning for patients has been reported; however, because of the shift from institutionalized to community care, community-dwelling older people have fewer opportunities to discuss these plans with health care professionals compared with those living in other settings. The timely initiation of advance care planning and sustainable discussions among older people, their families, and community health care professionals is necessary and may improve palliative and end-of-life care. Studies with participants aged 60 years and older who have experience with advance care planning and live in their own homes in the community were included. We considered qualitative studies and the qualitative component of mixed methods studies published between January 1999 and April 2023 in English or Japanese. MEDLINE, CINAHL, Embase, PsycINFO, JSTORE, Scopus, Japan Medical Abstract Society, and CiNii were searched for published papers, and Google Scholar, ProQuest Dissertations and Theses Global, and MedNar were searched for unpublished papers and gray literature. Study selection, critical appraisal, data extraction, and data synthesis were conducted by 2 independent reviewers using the JBI approach and JBI standardized tools. Findings were pooled using a meta-aggregation approach. The synthesized findings were graded using the ConQual approach for establishing confidence in the output of qualitative research syntheses and presented in a Summary of Findings. Five studies published between 2017 and 2022 were included in the review. Each study's total score was between 6 and 8 out of 10 on the JBI critical appraisal checklist for qualitative research. We extracted 28 findings and aggregated them into 7 categories, generating 3 synthesized findings: i) A trusting relationship with health professionals is essential for older people's decision-making. Health professionals' attitudes, knowledge, and skills play a role in this, influencing the perceived quality of care; ii) Shared decision-making and patient-centered communication are essential. Older people feel ambiguity toward end-of-life decision and advance care planning and they want their wishes to be heard in any situation to maintain their autonomy and quality of life; iii) Older people need the appropriate forms and accessible and coordinated care to begin advance care planning. Qualitative studies on community-dwelling older people's experiences of advance care planning with health care professionals are scarce. The experiences have illustrated that trusting relationships influence people's perception of the quality of care they receive; there is uncertainty about their future; and they have varying feelings or attitudes toward their impending death, including denial and avoidance. This review highlighted the need for appropriate forms, and accessible and coordinated care to begin advance care planning; thus, an approach that meets the individual's health and psychosocial status should be selected carefully. Further research is recommended to include older populations from broader geographical and cultural backgrounds and to assess and evaluate the different advance care planning approaches and their implementation processes among groups of community-dwelling older people with different health and psychosocial statuses. PROSPERO CRD42020122803.

JBI critical appraisal checklist for systematic reviews and research syntheses (product review)

The purpose of this product review is to highlight the Joanna Briggs Institute’s (JBI) Critical appraisal checklist for systematic reviews and research syntheses. This review will elucidate the strengths and weaknesses of the checklist, and indicate scenarios where use of the checklist may be warranted.

A comparative analysis of antimicrobial agents in artificial saliva: Scoping review

Background: Artificial saliva should be formulated to mimic the physical properties and composition of the natural saliva. In addition to its moisturizing effects, artificial saliva should also include buffering and antimicrobial properties to adequately substitute the physiological functions of natural saliva. Most artificial saliva products focus on lubrication and moisture retention, with limited exploration of antimicrobial components. The optimal antimicrobial agents in artificial saliva have yet to be determined. Purpose: To identify antimicrobial agents used in artificial saliva. Methods: Article searches were conducted using the PRISMA flow chart in October 2024 using three databases: Scopus, Pubmed, and ScienceDirect. Selected articles were then evaluated for risk of bias using the JBI critical appraisal checklist. Results: Six quasi-experimental studies met the inclusion criteria and included in this review. Conclusion: Antimicrobial agents used in artificial saliva are xylitol, sorbitol, lysozyme, lactoferrin, lactoperoxidase with potassium thiocyanate, hinokitiol, protamine, whey protein, dried egg yolk, system of enzymes, fluoride ions, hydroxyethylcellulose, and core-shell magnetic nanoparticles. Various other active ingredients may also serve as antimicrobial agents.

Efficiency of Bacteriophage-Based Detection Methods for Non-Typhoidal Salmonella in Foods: A Systematic Review.

Food contamination with non-typhoidal Salmonella (NTS) presents a significant public health risk, underscoring the critical need for rigorous food safety measures throughout the production, distribution, preparation, and consumption stages. Conventional diagnostic strategies are time-consuming and labor-intensive and are thus sub-optimal for throughput NTS detection. Bacteriophages (phages) are highly specialized bacterial viruses and exhibit extreme specificity for their hosts. This organic phage/bacterial interaction provides an invaluable tool that can potentially replace or complement existing S. enterica detection methods. Here, we explored work in this area and reviewed data from PubMed/MEDLINE, Embase, and ScienceDirect up to 4 November 2024. Thirty-five studies were selected from 607 retrieved articles using the JBI Critical Appraisal Checklist to ensure quality. Salmonella enrichment, rapid detection, and effective recovery in diverse food sources for various NTS serovars were targeted. Utilizing phages as bio-probes alongside lateral flow immunoassays, surface-enhanced Raman spectroscopy, fluorescence, and electrochemistry assays enabled rapid and highly sensitive detection of NTS, achieving limits as low as 7 to 8 CFU/mL within 30 min. Balancing detection sensitivity with rapid analysis time is essential. Further research and development will be pivotal to overcoming challenges and maximizing the efficiency of NTS phage-based detection to ensure optimal food safety.

TRANSFORMATIONAL LEADERSHIP ON JOB SATISFACTION AMONG REGISTERED NURSES CARING PERSPECTIVE: A SYSTEMATIC REVIEW

Background: The healthcare profession face scarcity due to increased global demand for registered nurses. The inadequacy of the healthcare workforce is a critical concern in an organization, as it is difficult to retain and recruit qualified staff to deliver safe and quality outcomes in the provision of care. Numerous studies identify transformational leadership style as an effective style to foster job satisfaction among licensed nurses. Objective: The study aimed to review transformational leadership in relation to job satisfaction according to Registered Nurses perspective. Design: This systematic review utilized the Cochrane Collaboration procedures and PRISMA statement. Data source: A comprehensive search of Pubmed, CINAHL, ScienceDirect, Cochrane Library, Wiley Online, and Google Scholar published from 2018 to 2023. Ten articles of cross-sectional studies met the inclusion criteria. Review Methods: The method utilized is the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Results: All articles demonstrated that a transformational leadership style was reported to have a positive correlation among registered nurses' job satisfaction. In addition, four main themes emerged to determine job satisfaction variables on organizational commitment, work environment, competencies in evidence-based practices, and resilience of skilled nurses to minimize the repercussions of the inadequacy of nurses in the healthcare setting. Conclusion: Transformational leadership contributes to improving job satisfaction and instituting the identified themes that could support the development of caring strategies that would close the gap of registered nurses’ shortage in healthcare.

Prevalence of paucibacillary cases of leprosy in Brazil: a 20-year systematic review and meta-analysis.

Leprosy is a chronic infectious disease caused by the agent Mycobacterium leprae, characterized by its high disabling power. Data points to Brazil being the second country with the highest number of cases in the world, behind only India, representing a major challenge for public health. This work aims to determine the prevalence of paucibacillary (PB) cases in relation to leprosy cases in Brazil, using data published in the literature. This is a systematic review and meta-analysis carried out with studies from the last 20 years, being developed based on the Preferred Reporting Items for Systematic Review and Meta-analyzes (PRISMA).The search was carried out in the databases: PUBMED, SciELO, LILACS (via VHL)and Science Direct in October 2023, using the following descriptors ((("Brazil" [Mesh]) AND ("Leprosy, paucibacillary" [Mesh])) AND "Epidemiology" [Mesh]), in English, Portuguese and Spanish. Original studies of the analytical case-control, cohort, cross-sectional, epidemiological types were selected, as well as articles with satisfactory information for numerical extraction with separate data on the paucibacillary and multibacillary clinical forms. The methodological quality assessment followed the JBI critical appraisal checklist. Statistical analysis was performed using the Comprehensive Meta-Analyses-CMA software, version 3.0 (Biostat, Engewood, NJ, United States). The meta-analysis of the 48 studies obtained a paucibacillary prevalence rate in Brazil of 50.5% or 0.505 (95% CI = 0.502-0.509).The differences in the analyzes were statistically significant (Q-value 4302.681;df 47; I 98.905), with a high heterogeneity value evidenced by I2 (98.905). This analysis demonstrated that the frequency in the Midwest region was the highest and the South region was the lowest (21.4%). Begg's (Kendall Tau p = 0.35) and Egger's tests (p = 0.20) were performed, in which no high publication bias was noted. Subgroup analysis indicated that paucibacillary cases varied from region to region, with the Midwest region having the highest prevalence and the South region having the lowest. The results stand out significantly for the research gaps that investigate PB cases, requiring more research aimed at investigating the paucibacillary clinical form that can contribute to the early diagnosis of leprosy. PROSPERO code: CRD42024514106.

Efficacy of plantar foot temperature monitoring in preventing ulcers in individuals with diabetes: An umbrella review protocol

Diabetes mellitus often leads to foot ulcers, which can result in amputations and significantly affect quality of life. Monitoring plantar foot temperature has emerged as a promising intervention for preventing these ulcers. This study aims to examine the potential benefits of plantar foot temperature monitoring in preventing ulcers in individuals with diabetes mellitus. The umbrella review protocol will follow the guidelines set forth by the Joanna Briggs Institute. Participants aged 18 years and older with a diagnosis of type 1 or type 2 diabetes mellitus, and without any active ulcers at the commencement of the study, will be included. We will consider studies that monitor plantar foot temperature using thermometry and thermography. Two independent reviewers will carry out the study location selection and data extraction, employing a modified and validated JBI extraction tool. The methodological quality of the studies included will be evaluated using both the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, as well as the AMSTAR-2 tool. This systematic review is registered under PROSPERO number CRD42024509838. Data on the effectiveness of interventions for monitoring plantar foot temperature to prevent ulcers in individuals with diabetes will be collected and summarized. A citation matrix will analyze the overlap of primary studies, and meta-analysis will be performed if feasible. The certainty of evidence will be assessed using the GRADE system. This protocol ensures rigorous execution by researchers and may aid in implementing evidence-based nursing interventions for ulcer prevention in diabetes.

Interventions for improving health literacy among older people: a systematic review

BackgroundHealth literacy(HL) is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions. Effective interventions to improve older people’s HL have become increasingly important. The purpose of this study is to conduct a review of interventions aimed at enhancing the HL of older people.MethodologyRelevant information was gathered from various databases including PubMed, Scopus, Cochrane Library, Science Direct, and Web of Science. Additionally, a manual search of related journals and Google Scholar, a search of the reference lists of selected articles, and a search of unpublished sources were also conducted up to 30 August 2024. Reporting quality assessment was performed using CONSORT: 2010, JBI Critical Appraisal Checklist for Quasi-Experimental Studies, and “Quality Assessment Criteria for Survey Research Reports”.ResultsA total of 21 articles were included in this study. The interventions conducted in high-income countries were found to be more effective compared to those conducted in middle and low-income countries. Furthermore, interventions carried out at the community level were more effective than those performed in nursing homes. Educational interventions were more effective than lifestyle modification interventions, and interventions carried out in a single dimension were more effective than multidimensional interventions. Additionally, interventions that utilized technology were found to be more effective.ConclusionBased on the findings, community-based interventions that encompass a one-dimensional approach, incorporating the use of technology and considering the duration of the intervention, are more recommended.

Experiences of Nurses Speaking Up in Healthcare Settings: A Qualitative Metasynthesis.

To systematically review and synthesise qualitative research on nurses' experiences of speaking up in various contexts and to identify factors facilitating or impeding such a behaviour. This review was conducted as a qualitative metasynthesis, utilising the qualitative meta-ethnography approach. A total of 6250 articles were screened. Two reviewers screened titles, abstracts and full texts. A total of 15 studies were included in this review. Researchers conducted a quality appraisal using the JBI critical appraisal checklist for qualitative research. An a priori protocol was created and registered on the Open Science Framework. Literature searches were conducted in five international bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global) and five Korean databases (RISS, KISS, DBpia, KCI and NDSL). Three main themes were identified from the 15 studies used in the metasynthesis: (1) decisional complexity of speaking up, (2) motivators for speaking up and (3) barriers to speaking up. Nurses experienced challenges in speaking up. They were, and continue to be, concerned about negative responses. Hierarchy structure and poor work environment were identified as barriers to speaking up; professional responsibility and a supportive atmosphere were identified as facilitators for speaking up. This review synthesised nurses' experiences of speaking up and influencing factors. Speaking up is crucial for nurses to improve patient safety, as frontline nurses are ideally positioned to observe early indicators of unsafe conditions in healthcare delivery. Identified motivators and barriers of nurses' speaking-up behaviour offer considerations and opportunities for healthcare leaders and managers. This could lead to improvement in patient safety through the establishment of a safety culture that facilitates nurses' speaking-up behaviour. The review adhered to the ENTREQ guideline. No patient or public contribution has been made in this review.