Mixed Methods Appraisal Tool Version Research Articles

Mobile-linked point-of-care diagnostics in community-based healthcare: a scoping review of user experiences

BackgroundWhile mobile-linked point-of-care diagnostics may circumvent geographical and temporal barriers to efficient communication, the use of such technology in community settings will depend on user experience. We conducted a scoping review to systematically map evidence on user experiences of mobile-linked point-of-care diagnostics in community healthcare settings published from the year 2016 up to the year 2022.MethodologyWe conducted a comprehensive search of the following electronic databases: Scopus, Web of Science, and EBSCOhost (Medline, CINAHL, Africa-wide, Academic Search Complete). The inter-reviewer agreement was determined using Cohen’s kappa statistic. Data quality was appraised using the mixed method appraisal tool version 2018, and the results were reported according to the preferred reporting items for systematic reviews and meta-analyses for scoping reviews (PRISMA-ScR).ResultsFollowing the abstract and full article screening, nine articles were found eligible for inclusion in data extraction. Following the quality appraisal, one study scored 72.5%, one study scored 95%, and the remaining seven studies scored 100%. Inter-rater agreement was 83.54% (Kappa statistic = 0.51, p < 0.05). Three themes emerged from the articles: approaches to implementing mobile-linked point-of-care diagnostics, user engagement in community-based healthcare settings, and limited user experiences in mobile-linked point-of-care diagnostics. User experiences are key to the sustainable implementation of mobile-linked point-of-care diagnostics. User experiences have been evaluated in small community healthcare settings. There is limited evidence of research aimed at evaluating the usability of mobile-linked diagnostics at the community level.ConclusionMore studies are needed to assess the user experience of mobile-linked diagnostics in larger communities. This scoping review revealed gaps that need to be addressed to improve user experiences of mobile-linked diagnostics, including language barriers, privacy issues, and clear instructions.

Barriers to mental health service utilization among African immigrants in the United Kingdom: A systematic review

AbstractBackgroundAfrican immigrants in the United Kingdom (UK) face unique challenges in accessing mental health services (MHSs), in contrast to their peers born in the UK, contributing to their worsening mental and physical health outcomes. This study aims to uncover barriers to MHS utilization and proffer evidence‐based recommendations toward addressing the mental health needs of African immigrants residing in the UK.MethodsA systematic literature search was conducted across six databases: Medline, PsycINFO, Web of Science, CIHNAL, Scopus, and Embase published up to September 2022. To assess methodological quality of the included studies, the Critical Appraisal Skills Program qualitative checklist and the Mixed Methods Appraisal Tool Version 2018 were used. Consecutively, a deductive thematic analysis was employed to group related barriers within overarching themes.ResultsThe study selection process yielded eight studies conducted in the UK, encompassing African populations identifying as African/Afro‐Caribbean origin, Somali refugees, and ethnic minorities of Black/British descent. The findings highlight the complex interplay of key barriers such as stigma, residential instability, cultural influences, discrimination, and accessibility issues, among others, that continue to hinder African populations from accessing and utilizing MHSs. These barriers were categorized into predisposing,enabling and need factors (themes), aligning with Anderson's model of health service utilization, reflecting a comprehensive range of challenges affecting this population.ConclusionThis systematic review illuminates the myriad barriers faced by African immigrants in utilizing MHSs in the UK, underlining the urgent need for targeted interventions. The findings advocate for the development of culturally sensitive, affordable, and accessible MHSs and policies that address the personal, sociocultural, and structural barriers identified. Collaboration across key stakeholders is highly recommended for advancing equitable and inclusive MHSs for all.

Key factors for effective implementation of healthcare workers support interventions after patient safety incidents in health organisations: a scoping review

ObjectivesThis study aims to map and frame the main factors present in support interventions successfully implemented in health organisations in order to provide timely and adequate response to healthcare workers...

Mapping evidence on cryptococcal antigen infection among HIV-infected persons in sub-Saharan Africa- A scoping review protocol.

Infections of the central nervous system are a considerable basis of mortality in people living with HIV, with progression to cryptococcal meningitis documented at around 15% of HIV-associated mortality globally, with nearly three-quarters occurring in the sub-Saharan Africa. Discoveries from previous studies prelude to the mortality of cryptococcal antigen positive, which persisted to be elevated than in cryptococcal antigen negative persons. One feasible interpretation of this could be due to undiagnosed cryptococcus. Laboratory investigations identify cryptococcal disease prior to cryptococcal meningitis progression. Point-of-care testing has high sensitivity and specificity as seen with the cryptococcal antigen lateral flow assay screening to expedite treatment. The aim of the study is to map and translate evidence on cryptococcal antigen infection among HIV-infected persons in sub-Saharan Africa. The proposed scoping review will be conducted using guidelines proposed by Arksey and O'Malley methodological framework and Levac et al. advanced method. It will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. A comprehensive literature search of studies published from the first relevant publication to 2022 will be conducted on multiple electronic databases. Additional sources (grey literature) will also be searched. The search strategy will be generated and implemented by the principal investigator with assistance from a subject specialist, and an information specialist. Two reviewers will screen eligible studies. The screening will be guided by an inclusion and exclusion criteria. The mixed methods appraisal tool version 2018 will be used to appraise the quality of the empirical studies. The proposed scoping review will map and translate evidence on cryptococcal antigen infection among HIV-infected persons in sub-Saharan Africa. Synthesising and sharing recent evidence in this area has potential to help guide future research and interventions aimed at improving the management of cryptococcal antigen infection among HIV-infected persons in sub-Saharan Africa and other high HIV- burdened settings.

Experiences with Cling Film and Dental Dam Use in Oral Sex: A Mixed-Methods Systematic Review

This study aimed to conduct a mixed-methods SR of the literature investigating the experiences (knowledge, attitudes, practices, and effects of use) concerning dental dam and cling film use. The SR methodology was informed by the Preferred Reporting Items for SRs and Meta-analysis framework, the Cochrane Handbook for SR of Interventions, the Joanna Briggs Institute guideline for conducting mixed-methods SRs, and the PICO (population, intervention (or exposure), comparison, and outcome) framework. Using a set of inclusion criteria, relevant studies in the literature were obtained for the review from 11 electronic databases, Teesside University Library, websites of multilateral health organisations, and reference lists of eligible literature. The included literature was appraised for quality using the Mixed Methods Appraisal Tool version 2018 and the AAOCDS Tool. Only those studies in the literature with sufficient quality were finally included for data extraction (using an adapted version of the JBI Quality Assessment and Review Instruments) and synthesis. Best evidence synthesis was performed for the quantitative data, while meta-aggregation was performed for the qualitative data. The synthesised data were then configured using the segregated approach. A total of 529 studies from the literature were obtained from the searched databases, while only four were obtained from the other sources. After de-duplication, screening, and quality appraisal, a total of 17 studies were found eligible and included in this review. Sixteen studies were non-grey literature while, one was grey literature, and only a few reported a finding on cling film and heterosexual populations. A total of 5516 adolescents and adults were investigated in the analysed literature. Overall, the reported knowledge of dental dams was generally poor, while no study reported knowledge of cling film. The attitudes towards dental dams/cling film were complex and predominantly negative, with very few participants using dental dams/cling film for oral sex. No study reported any finding on the effect(s) of dental dam/cling film use. In conclusion, there is a need for robust and strategic public health interventions for sexual health and safer oral sex practices.

Promoting sleep in hospitals: An integrative review of nurses' attitudes, knowledge and practices.

To explore nurses' knowledge, attitudes and practices related to improving hospitalized patients' sleep. Integrative review. We searched CINAHL, PubMed and PsycInfo electronically including a manual search of references listed within the relevant studies. Original, peer-reviewed studies published in English between 2000 and 2022 evaluating nurses' sleep knowledge, attitudes, or practices to improve inpatients' sleep were reviewed. This review was guided by Whittemore and Knafl method and followed PRISMA guidelines to search the literature. Fifteen articles reporting nurses' sleep knowledge, attitudes or practices to improve inpatients' sleep were included. The quality appraisal was done using the Mixed Methods Appraisal Tool version 2018. Inadequate training of nurses regarding sleep hygiene and insufficiency in sleep-promoting practices were apparent. Most studies reported that nurses hold positive attitudes about sleep. The acuity of patients' health conditions affected their perception of sleep priorities. Lack of organizational sleep policies/protocols and coworkers' attitudes negatively impacted nurses' motivation to implement sleep hygiene interventions. Interventions reported in the studies were reducing noise and nursing interventions at night, using a clock for time orientation, earplugs, reducing light, keeping patients awake during the daytime, maintaining comfortable room temperature and managing patients' stress. These practices were hindered by poor knowledge, negative attitudes, patients' acuity and lack of sleep assessment tools. It is essential to support nursing practice to improve patients' sleep in hospitals through interventions that target nurses' knowledge, attitudes and confidence towards implementing sleep hygiene interventions to improve patients' sleep and, consequently, their health outcomes during hospitalization. This integrative review explored nurses' knowledge, attitudes and practices to improve patients' sleep during hospitalization. It revealed that expanding nurses' sleep knowledge and empowering them to implement sleep promotion practices are needed. Nursing educators and leaders need to be involved. This paper is an integrative review and does not include patient or public contribution.

When People With Chronic Conditions Turn to Peers on Social Media to Obtain and Share Information: Systematic Review of the Implications for Relationships With Health Care Professionals.

People living with chronic conditions such as diabetes turn to peers on social media to obtain and share information. Although social media use has grown dramatically in the past decade, little is known about its implications for the relationships between people with chronic conditions and health care professionals (HCPs). We aimed to systematically review the content and quality of studies examining what the retrieval and sharing of information by people with chronic conditions on social media implies for their relationships with HCPs. We conducted a search of studies in MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO). Eligible studies were primary studies; examined social media use; included adults with any type of diabetes, cardiovascular diseases that are closely linked with diabetes, obesity, hypertension, or dyslipidemia; and reported on the implications for people with chronic conditions-HCP relationships when people with chronic conditions access and share information on social media. We used the Mixed Methods Appraisal Tool version 2018 to assess the quality of the studies, and the included studies were narratively synthesized. Of the 3111 screened studies, 17 (0.55%) were included. Most studies (13/17, 76%) were of low quality. The narrative synthesis identified implications for people with chronic conditions-HCP relationships when people with chronic conditions access and share information on social media, divided into 3 main categories with 7 subcategories. These categories of implications address how the peer interactions of people with chronic conditions on social media can influence their communication with HCPs, how people with chronic conditions discuss advice and medical information from HCPs on social media, and how relationships with HCPs are discussed by people with chronic conditions on social media. The implications are illustrated collectively in a conceptual model. More evidence is needed to draw conclusions, but the findings indicate that the peer interactions of people with chronic conditions on social media are implicated in the ways in which people with chronic conditions equip themselves for clinical consultations, evaluate the information and advice provided by HCPs, and manage their relationships with HCPs. Future populations with chronic conditions will be raised in a digital world, and social media will likely remain a strategy for obtaining support and information. However, the generally low quality of the studies included in this review points to the relatively immature state of research exploring social media and its implications for people with chronic conditions-HCP relationships. Better study designs and methods for conducting research on social media are needed to generate robust evidence.

Occupational Health Hazards Among Traffic Police in South Asian Countries: Protocol for a Scoping Review

Occupational health hazards and injuries are an alarming concern among traffic police. Occupational injuries affect the physical, social, and mental well-being of police personnel, which has various public health implications. The evaluation of occupational health and safety policies and regulations for the traffic police relies on their occupational exposure and health hazard statistics and assessments. The purpose of this scoping review is to systematically explore, analyze, and describe relevant findings from all studies conducted on occupational exposure and associated health hazards among traffic police in South Asia. The scoping review will include studies that assessed occupational exposure prevalence, types, knowledge, predisposing factors, and prevention strategies. Databases like PubMed, Springer Link, EBSCOhost, the Cochrane library, and Google Scholar will be used to obtain both published and unpublished works in the English language. Relevant gray literature, including governmental and international organization reports, will be examined. After removing duplicates and screening titles and abstracts, the full-text analysis will begin. Arksey and O'Malley's methodology framework for scoping reviews will be followed. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, the scoping review will be reported. Two qualified reviewers will independently conduct article screening and data extraction. The extracted data will then be tabulated and accompanied by an explanation to facilitate comprehension. We will extract relevant article results using NVivo (version 10; QSR International) and thematic content analysis. The included articles will be evaluated using the mixed methods appraisal tool (version 2018). The scoping review will provide insight into how occupational health hazards affect traffic police physically and psychologically in South Asia. The theoretical conceptualization of different aspects of the occupational health of traffic police will emphasize future studies in this region, which will inform policy makers to revise their occupational health and safety policies and principles. It will have implications for taking necessary preventive measures in the future to reduce occupational injuries and fatalities resulting from different types of occupational hazards. This scoping review will describe the overview of occupational hazards among South Asian traffic police and will provide insights for policy makers to implement changes and to adapt new strategies. PRR1-10.2196/42239.

A scoping review protocol on integration of mobile-linked POC diagnostics in community-based healthcare: User experience.

Mobile-linked point-of-care diagnostics forms an integral part of diagnostic health services for efficient communication between patients and healthcare professionals despite geographical location and time of diagnosis. The efficiency of this technology lies in the user experience which means that the interaction of the user with the implemented technology needs to be simple, convenient, and consistent. Having a well-structured user experience of these devices in community-based healthcare will aid in sustainable implementation. Herein, we propose to conduct a literature search to systematically map out evidence based on mobile-linked POC diagnostics user experience at a community level in resource-limited settings. The proposed scoping review will be guided by the advanced Arksey and O'Malley methodological framework and further advanced by Levac et al. A comprehensive search will be conducted to find relevant published literature from the following electronic databases: Scopus, Web of Science, EBSCOhost (Medline, CINAHL, Africa-wide, Academic Search Complete). Grey literature will also be searched, including reports from government and international organizations such as World Health Organization (WHO), Foundation for Innovative New Diagnostics (FIND), and the Food and Drug Administration (FDA). Two independent reviewers will screen the relevant studies and the degree of the agreement will be determined by calculating Cohen's kappa statistic. The quality of eligible data will also be appraised using the mixed method appraisal tool version 2018. We anticipate that the planned scoping review will present useful evidence to inform stakeholders on the integration of mobile-linked diagnostic devices in community-based healthcare which will guide further research on the subject.

What improves access to primary healthcare services in rural communities? A systematic review

BackgroundTo compile key strategies from the international experiences to improve access to primary healthcare (PHC) services in rural communities. Different innovative approaches have been practiced in different parts of the world to improve access to essential healthcare services in rural communities. Systematically collecting and combining best experiences all over the world is important to suggest effective strategies to improve access to healthcare in developing countries. Accordingly, this systematic review of literature was undertaken to identify key approaches from international experiences to enhance access to PHC services in rural communities.MethodsAll published and unpublished qualitative and/or mixed method studies conducted to improvement access to PHC services were searched from MEDLINE, Scopus, Web of Science, WHO Global Health Library, and Google Scholar. Articles published other than English language, citations with no abstracts and/or full texts, and duplicate studies were excluded. We included all articles available in different electronic databases regardless of their publication years. We assessed the methodological quality of the included studies using mixed methods appraisal tool (MMAT) version 2018 to minimize the risk of bias. Data were extracted using JBI mixed methods data extraction form. Data were qualitatively analyzed using emergent thematic analysis approach to identify key concepts and coded them into related non-mutually exclusive themes.ResultsOur analysis of 110 full-text articles resulted in ten key strategies to improve access to PHC services. Community health programs or community-directed interventions, school-based healthcare services, student-led healthcare services, outreach services or mobile clinics, family health program, empanelment, community health funding schemes, telemedicine, working with traditional healers, working with non-profit private sectors and non-governmental organizations including faith-based organizations are the key strategies identified from international experiences.ConclusionThis review identified key strategies from international experiences to improve access to PHC services in rural communities. These strategies can play roles in achieving universal health coverage and reducing disparities in health outcomes among rural communities and enabling them to get healthcare when and where they want.

Mapping research evidence on perinatal asphyxia within the sustainable development era in sub-Saharan Africa: a scoping review protocol

BackgroundApproximately 45% of all under-five child deaths are among newborn infants, babies in their first 28 days of life, or the neonatal period every year in the World Health Organization (WHO) Africa Region. To facilitate the achievement of Sustainable Development Goal (SDG) 3.2, innovative interventions are needed to address this challenge. Thus, this scoping review aims to map research evidence on perinatal asphyxia among neonates in the WHO Africa Region.MethodsThis scoping review will be guided by the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute checklist for scoping reviews. Relevant published literature will be searched using a combination of keywords, Boolean terms, and Medical Subject Headings in the following databases: PubMed, SCOPUS, CINAHL, and Web of Science from January 2016 onwards. We will further search the World Health Organization and government websites, as well as the reference list of included studies for potentially eligible studies. This scoping review will include research evidence involving countries in the WHO Africa Region, with a focus on the burden of perinatal asphyxia, contributory/associated factors of perinatal asphyxia, clinical interventions for perinatal asphyxia, and interventions/strategies for the prevention of perinatal asphyxia in the SDGs era. Two reviewers will independently sort the studies to include and exclude, guided by the eligibility criteria. Also, the data from the included studies will be extracted and any discrepancies resolved using a third reviewer. Thematic analysis will be conducted, and the findings reported using both qualitative tables and figures. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) will be followed to report this study’s results. Quality appraisal of the included studies will be done utilising the mixed methods appraisal tool version 2018.ConclusionThis scoping review results may reveal research evidence gaps to inform future primary studies, systematic reviews and meta-analyses; and possibly contribute towards the realisation of the SDG 3.2 by countries in the WHO Africa Region. The finding of this review will be disseminated using multiple channels such as workshops, peer review publications, conferences, and social media.

Leveraging breast cancer screening to promote timely detection, diagnosis and treatment among women in sub-Saharan Africa: a scoping review protocol

IntroductionFemale breast cancer is now the most often diagnosed cancer in the world. Breast cancer screening aims to reduce mortalities related to cancer, and morbidity associated with advanced stages of...

Mapping evidence of community health workers delivering physical rehabilitation services in sub-Saharan Africa: a scoping review protocol

IntroductionSub-Saharan Africa (SSA) is one of the low-income regions in the world which is affected by the critical shortage of human resources for health amid a high disease burden, including...

A protocol for a scoping review to map the assessment approaches in optometry education programmes globally

BackgroundThe training of optometrists aims to prepare practitioners with critical thinking skills who utilise their education and experience to solve clinical problems in real-life practice. Professional competencies should inform assessment, and as such, assessment methods for learning should encompass a wide range of approaches. The objective of this scoping review is therefore to map assessment approaches utilised within optometry education programmes globally.MethodsThis study is a scoping review based on the PRISMA methodology. The review will be guided by the following research question, “What are the assessment approaches that inform optometry training globally?”. This was validated by the Population-Concept-Context framework according to the methodology for Joanna Briggs Institution Scoping Reviews. Relevant peer-reviewed studies and grey literature conducted during the last 10 years will be identified from electronic databases including CINAHL, PubMed, PROquest and ERIC. The search strings using keywords such as “Optometry students and staff”, “Assessments” and “Optometry education” will be conducted using Boolean logic. An independent reviewer will conduct all title screening, two independent reviewers will conduct abstract and full article screening, followed by data extraction. Thereafter, a thematic analysis will be conducted. The Mixed Method Appraisal Tool version 2018 will be used for quality appraisal of mapped studies.DiscussionThe review will document evidence of assessment approaches utilised in optometry training globally. Considering the exit level competencies required in the basic job function of an optometrist, a coherence in assessment approaches and relevant rationale for these would be expected, if the accredited (regulated) training programmes follow a competency-based model.

Integrating social support into interventions among the elderly in nursing homes: a scoping review protocol

IntroductionThe instituted elderly in nursing home need professional support targeting to maintain their daily activities and quality of life. Social support affects the health of elderly through its influence as...

A Scoping Review of Supply Chain Management Systems for Point of Care Diagnostic Services: Optimising COVID-19 Testing Capacity in Resource-Limited Settings.

Background: Point of care (POC) testing has enabled rapid coronavirus disease 2019 (COVID-19) diagnosis in resource-limited settings with limited laboratory infrastructure and high disease burden. However, the accessibility of the tests is not optimal in these settings. This scoping review mapped evidence on supply chain management (SCM) systems for POC diagnostic services to reveal evidence that can help guide future research and inform the improved implementation of SARS-CoV-2 POC diagnostics in resource-limited settings. Methodology: This scoping review was guided by an adapted version of the Arksey and O’Malley methodological framework. We searched the following electronic databases: Medline Ovid, Medline EBSCO, Scopus, PubMed, PsychInfo, Web of Science and EBSCOHost. We also searched grey literature in the form of dissertations/theses, conference proceedings, websites of international organisations such as the World Health Organisation and government reports. A search summary table was used to test the efficacy of the search strategy. The quality of the included studies was appraised using the mixed method appraisal tool (MMAT) version 2018. Results: We retrieved 1206 articles (databases n = 1192, grey literature n = 14). Of these, 31 articles were included following abstract and full-text screening. Fifteen were primary studies conducted in LMICs, and 16 were reviews. The following themes emerged from the included articles: availability and accessibility of POC diagnostic services; reasons for stockouts of POC diagnostic tests (procurement, storage, distribution, inventory management and quality assurance) and human resources capacity in POC diagnostic services. Of the 31 eligible articles, 15 underwent methodological quality appraisal with scores between 90% and 100%. Conclusions: Our findings revealed limited published research on SCM systems for POC diagnostic services globally. We recommend primary studies aimed at investigating the barriers and enablers of SCM systems for POC diagnostic services for highly infectious pathogens such SARS-CoV-2 in high disease-burdened settings with limited laboratory infrastructures.

Public health implications of heavy metals in foods and drinking water in Ethiopia (2016 to 2020): systematic review

BackgroundBesides their benefits, heavy metals are toxic, persistent, and hazardous to human health, even at their lower concentrations. Consumption of unsafe concentrations of food contaminated with heavy metals may lead to the disruption of numerous biological and biochemical processes in the human body. In developing country including Ethiopia, where untreated or partially treated wastewater is used for agricultural purposes, the problems related to the consumption foods contaminated with heavy metals may poses highest risk to human health. Therefore, this review was aimed to determine the public health implications of heavy metals in foods and drinking water in Ethiopia.MethodsThe articles published from 2016 to 2020 were identified through systematic searches of electronic databases that include MEDLINE/PubMed, EMBASE, CINAH, Google Scholar, WHO, and FAO Libraries. The data was extracted using a predetermined data extraction form using Microsoft Excel, 2016. The methodological quality of the included studies was assessed using mixed methods appraisal tool (MMAT) version 2018 and Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the studies. Finally, the results were evaluated based on the FAO/WHO guidelines for foods and drinking water.ResultsA total of 1019 articles published from 2016 to 2020 were searched from various electronic databases and by manual searching on Google. Following the initial screening, 317 articles were retrieved for evaluation and 49 articles were assessed for eligibility, of which 21 studies were included in the systematic review. The mean concentration of Cr, Cd, Pb, As, Hg, Zn, Cu, Ni, Co, Fe and Mn in fruits and vegetables ranged from 2.068–4.29, 0.86–1.37, 1.90–4.70, 1.01–3.56, 3.43–4.23, 19.18–98.15, 4.39–9.42, 1.037–5.27, 0.19–1.0, 199.5–370.4, 0.26–869 mg/kg, respectively. The mean concentration Cr, Cd, Pb, As, Zn, and Fe in meat and milk ranged from 1.032–2.72, 0.233–0.72, 1.32–3.15, 0.79–2.96, 78.37–467.7, and 505.61–3549.9 mg/kg, respectively. The mean concentration of Cr, Cd, Pb, Zn, and Cu in drinking water ranged 0.0089–0.054, 0.02–0.0237, 0.005–0.369, 0.625–2.137, and 0.176–1.176 ml/L, respectively. The mean concentration of Cr, Cd, Pb, Zn, Cu, Ni, Co, Fe, and Mn in other edible cereals ranged from 0.973–2.165, 0.424–0.55, 0.65–1.70, 70.51–81.58, 14.123–15.98, 1.89–13.8, 1.06–1.59, 67.866–110.3, and 13.686–15.4 mg/kg, respectively.ConclusionThis systematic review identified heavy metals in foods and drinking water and determined their public health implications. The results of this finding imply that the majority of the studies reported high concentrations of toxic heavy metals in foods and drinking water that are hazardous to human health. Therefore, effective food safety and risk-based food quality assessment are essential to protect the public health.

The Effect of Nursing Simulation on the Clinical Judgment of Nursing Care for Patients with Increased Intracranial Pressure (IICP).

Background:Nursing educators commonly adopt simulations to educate nursing students and evaluate their clinical thinking, clinical reasoning, and clinical judgment. We aimed to determine the effectiveness of established nursing care simulations by evaluating, through video, a select number of nursing students in scenarios that simulate nursing care for Increased Intracranial Pressure (IICP) patients.Methods:The participants were students in their senior year at a nursing college in South Korea in 2018. We adopted a mixed-method design by first conducting a nonequivalent control group pre-test/post-test research design, then analyzing the experimental group’s simulation videos. The participants consisted of 38 students in the experimental group and 39 students in the control group, and each group consisted of 9 teams. This study measured the level of anxiety (Cronbach’s α=0.780), critical thinking (Cronbach’s α=0.895), performance (Cronbach’s α=0.927), theoretical knowledge (Cronbach’s α=0.970), and analyzed clinical judgments by directly reviewing video from the experimental group. We used a mixed methods appraisal tool (MMAT) version 2018 as its research checklist.Results:Confidence (P=0.000), theoretical knowledge (P=0.000), clinical performance (P=0.017) indicated statistically significant increases in the experimental group. We subsequently identified 10 clinical judgment processes, including “Identify the patient’s condition” to “Reassess the condition after symptoms improve” by analyzing the simulation videos.Conclusion:Developing a simulation for nursing care is effective in honing students’ clinical judgment and enhancing their theoretical knowledge, confidence, and clinical performance.

Decision-Making Experience Related to Mastectomy Among Women With Breast Cancer: An Integrative Review.

Deciding to have a mastectomy can be challenging for women. An understanding of the decision-making experience related to mastectomy would contribute to improving the support of women making this decision. The aim of this study was to understand women's decision-making experience related to mastectomy. Studies published from 2000 to 2020 were identified by searching databases (CINAHL, MEDLINE, EMBASE, PsycINFO, PubMed, Web of Science, and China National Knowledge Infrastructure) and reference lists of previous reviews. Methodological quality of these studies was assessed using the Mixed Methods Appraisal Tool version 2018. Data were analyzed using content comparison analysis. Twenty-three quantitative and 6 qualitative studies were included in this review. Four themes emerged from the included studies: participation in decision-making, seeking information about treatment choices, postoperative perceptions of mastectomy decision-making, and factors related to mastectomy choice. Several negative experiences related to decision-making were identified. A number of clinical, sociodemographic, and psychosocial factors that influenced women to choose a mastectomy were identified. This review provides in-depth information about decision-making experiences and factors that influence the choice of mastectomy. Research is required about women who have had a mastectomy using standardized instruments to investigate their decision-making experiences. Studies are also necessary in non-Western countries. The factors and experiences identified in this review may help nurses to assist in the treatment decision-making process. Further research is required regarding breast care and other nurses' involvement in the decision-making process related to mastectomy.

What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities?

This scoping literature review aimed to answer the question: What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities? Shared decision-making has been an important patient-centred approach to nursing care since the 1990s, yet it is becoming increasingly evident that it is still not the reality in aged care facilities fifty years on. Currently, it is not well understood how adult children participate in shared decision-making and the types of decisions they are required to make. A review of original research papers using Kable, Pich and Maslin-Prothero 12-step systematic approach to documenting a search strategy. The researcher screened 597 articles from four databases, published in the English language, during the period 1985-2019. The researcher used the Mixed Methods Appraisal Tool version 2011 to determine the methodological quality of the included studies. The Joanna Briggs Institute QARI data tool was used to appraise the seven selected articles and thematically analyse findings, respectively. Four themes were highlighted: communication; staffing; being involved; and staff-family relationships. Despite these themes being apparent, families have limited opportunities to participate in shared health decision-making in regard to their parents' care. The findings from this literature show how shared decision-making is affected by the RACF environment. There is a need to find out and understand what is important from a family member's point of view to optimise shared decision-making and nursing care of the family member in residential aged care settings. The limited findings specific to the SDM experiences of adult children of parents in RACFs in this review could help staff and RACFs to develop strategies and staff training to encourage and facilitate the implementation of shared health decision-making with staff and families on older people's care.