Narrative Synthesis Research Articles

Treatment of Parkinson's Disease Psychosis-A Systematic Review and Multi-Methods Approach.

Parkinson's disease psychosis (PDP) is a prevalent non-motor symptom associated with Parkinson's disease. The treatment options for PDP are limited, and its pharmacological management remains ambiguous. This study aimed to evaluate the existing evidence in relation to clinical practice. This multi-methods study consisted of a systematic review of reviews, adhering to the PRISMA guidelines. The review was registered with PROSPERO. Following data extraction and assessment using the AMSTAR 2 tool, a narrative synthesis was performed. In the second phase of the study, a questionnaire was developed, validated, piloted, and distributed to the heads of specialized PD clinics in Germany and Austria. The search resulted in the inclusion of eleven reviews. The quality of eight of these reviews was rated as high (n = 7) or moderate (n = 1). The reviews indicated that clozapine and pimavanserin demonstrated the highest efficacy and tolerability. Other antipsychotic medications either failed to alleviate PDP symptoms or resulted in distinct motor complications. The survey findings also favored clozapine for its efficacy in managing PDP and improving quality of life, although quetiapine was regarded as effective and pimavanserin was not available. Clinicians reported initiating antipsychotic treatment at various stages of PDP, with a tendency to reduce the dosage or discontinue D2 agonists or anticholinergics. The reviewed literature and the survey results consistently favored clozapine for its efficacy and tolerability in treating PDP. It may be considered the first-line treatment, with pimavanserin as an alternative option.

Outcomes Associated with Arrest for Domestic Violence: A Systematic Review and Meta-Analysis.

This systematic review evaluated outcomes associated with arrest for domestic violence (DV), for both victims and perpetrators, considering both classic and modern research. A systematic search of 5 databases for quantitative reports resulted in 1,379 potentially relevant entries, of which 34 met the inclusion criteria. Studies were screened using prespecified criteria for the population (adults), outcomes (individual-level outcomes), study design (quantitative, including arrest for DV as a focal independent variable and a non-arrest comparator), publication type (peer-reviewed academic journal), study location (United States), language (English), and publication year (in or after 1984). Part I employs narrative synthesis to explore the impact of arrests by race/ethnicity, revealing gaps in reporting and a scarcity of analyses that consider race/ethnicity or its intersections with gender. Part II, a meta-analysis, indicates that arrest does not consistently reduce repeat violence and suggests variability based on the type of comparator used and the proportion of Black victims in a sample. The review finds that much of the research on the impacts of arrest is outdated and lacks diversity in data sources and outcomes, with few studies examining outcomes other than repeat violence. Future research should prioritize an intersectional approach and the perspectives and needs of survivors. Policymakers should consider the potential for disparate impacts and evaluate alternatives to mandatory arrest policies, with funding available for new data sources and related projects. Ultimately, policymakers must consider the context when evaluating the effectiveness and ethics of arrest policies.

Experiences of known bystanders during out-of-hospital cardiac arrest: a scoping review and narrative synthesis

Experiences of known bystanders during out-of-hospital cardiac arrest: a scoping review and narrative synthesis

Botulinum toxin for the management of bruxism: an overview of reviews protocol

IntroductionBruxism is characterised by a repetitive activity in the masticatory muscles that involves teeth clenching or grinding and/or forceful mandibular movements. Its management is typically initiated when individuals start experiencing...

Primary health care as the main guarantor of a healthy population in the country and a global challenge in the world: a systematic review

Background Primary health care (PHC) is a fundamental aspect of healthcare systems globally, playing a crucial role in maintaining the health of the population. Despite its importance, there are still gaps in the delivery of PHC services. This study aims to analyze the healthcare system and the existing gaps to develop strategies for improving PHC services. Methods This study is a mixed method a combination of documentary analysis and narrative synthesis as an alternative to meta-analysis. For our systematic review, we primarily focused on articles published within the last 10 years. However, we also included some older articles (published between 2003 and 2009) that provided valuable insights into the historical context and evolution of primary healthcare systems. Data of each article reviewed during the review - Study, Article, Study setting, Study design, Study assessment, Study suggestions are presented in Table 1. A total of 38 articles were reviewed. The data sources include peer-reviewed articles and other relevant literature on PHC services. With appropriate keywords. Results The study identifies gaps in PHC services, including issues with access to care, affordability, and quality of care. It provides insights into the challenges faced by PHC systems worldwide, highlighting the need for strategies to address these issues. Conclusions The study contributes to a better understanding of the challenges faced by PHC systems worldwide and provides insights for policymakers and healthcare providers to improve healthcare services. The systematic review, which focuses on PHC, was conducted following the PRISMA guidelines. The PRISMA diagram of study selection was used to illustrate the process of article inclusion and exclusion. Table 1 provides a summary of the key information from the selected articles.

Person-centred crisis support services as alternatives to emergency departments: a systematic scoping review.

To identify, critically appraise, and synthesise the published and grey literature on person-centred crisis support services as an alternative to support in emergency departments (EDs) for people experiencing mental health crises. This scoping review explores the characteristics and outcomes of these services. A systematic scoping review was undertaken to identify publications describing person-centred crisis support services and their outcomes. Search strings were applied to multiple databases, and publications were subjected to quality appraisal. The review process was informed by The Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Thirteen publications were included in the narrative synthesis, and these considered eight separate crisis support services. The methodological quality of the publications included was limited. Key findings were positive visitors' experiences, high rates of ED deflection, and overlaps between repeat visits, crises prevention, and hospital avoidance. Key recommendations included increasing opening hours and capacity and improving service awareness and accessibility. The available evidence suggests that person-centred crisis support services are perceived by stakeholders as safe and effective alternatives to EDs for people experiencing mental health crises, providing more timely and appropriate care while reducing ED mental health presentations. Due to the limited quality of the publications included, high-quality research is needed to better understand the model and confirm the findings reported in this review.

The role of the human-canine bond in recovery from substance use disorder: A scoping review and narrative synthesis

Abstract Recovery from substance use disorder (SUD) is a personal journey that includes connection with self and others, including animals – known as the human-animal bond (HAB). Research shows that canines are the most common type of animal integrated into animal-assisted interventions to support people with SUD. Yet, to our knowledge, there has been no review of the evidence on the role of canines in SUD recovery. The scoping review’s objective was to examine the literature on the human-canine bond’s role in recovery from SUD among adolescents and adults, including how the bond may help or hinder recovery. The review considered records that described the human-canine bond with respect to recovery in any recovery- or therapy-related setting globally. Eleven databases were searched, and 32 sources met inclusion criteria that involved companion dogs, therapy dogs, service/assistance, dogs and others. The thematic analysis across records identified three key benefits of the human-canine bond in SUD recovery: (1) a source of social connection and a conduit for human-to-human social connection, (2) a calming and comforting effect on individuals with SUD that can reduce stress and anxiety, and (3) the human-canine bond as a motivating factor for positive change. Through these themes, the bond may help divert substance use-related thoughts and reduce cravings, bolster engagement in treatment and recovery, and help to decrease and prevent substance use. However, a few articles found no role or a limited role of the human-canine bond in recovery, and challenges and considerations were reported, particularly for marginalized populations (e.g., related to obtaining and maintaining housing, employment, and SUD treatment). Most of the records discussed canine welfare in some capacity. Calls were also made for improved policy, public awareness, and animal welfare.

Effectiveness and experience of implementing digital interventions to promote smoking cessation among adults with severe mental illness: A systematic review and meta-analysis.

Digital technology is increasingly used to support interventions targeting smoking cessation in people with severe mental illness (SMI). However, little is known about their implementation and effectiveness in this population. We aimed to determine their effectiveness, stakeholder experiences, factors influencing implementation, and quality of reporting of digital interventions for smoking cessation in adults living with SMI. Five online bibliographic databases were searched for articles published between 31 December 2000 and 31 January 2023. Studies involving adults accessing treatment for alcohol and substance use disorders, neurocognitive disorders and terminal illnesses were excluded. Risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT). A Mantel-Haenszel random-effects meta-analysis of randomized controlled trials (RCTs) was conducted. Participant experience and intervention implementation were explored using a narrative synthesis. Quality of reporting of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. Thirty-one studies enrolling 3,794 participants were included. Meta-analysis of biochemically verified abstinence at longest follow-up (month-1 to month-6) did not find an overall effect in favour of intervention [risk ratio (RR) = 0.66, 95% confidence interval (CI) = -0.005 - 1.37]. Interventions tailored to people with SMI were perceived as acceptable. Implementation strategies concentrated on overcoming practical challenges at the participant/user level. No evidence of the effectiveness of digital interventions to support smoking cessation in people with SMI was found. The importance of tailoring interventions to the needs of people with SMI is highlighted. Robust reporting of implementation is required to enhance future efforts to support smoking cessation in adults with SMI. The findings of this review add to the emerging evidence on digital interventions to support smoking cessation among people with SMI. We highlight the importance of tailoring interventions to the population, particularly considering the role of mental illness and the side effects of psychotropic medication in the accessibility and usability of digital interventions.

Consensus-Building Processes for Implementing Perioperative Care Pathways in Common Elective Surgeries: A Systematic Review.

To identify and understand the different approaches to local consensus discussions that have been used to implement perioperative pathways for common elective surgeries. Systematic review. Five databases (MEDLINE, CINAHL, EMBASE, Web of Science and the Cochrane Library) were searched electronically for literature published between 1 January 2000 and 6 April 2023. Two reviewers independently screened studies for inclusion and assessed quality. Data were extracted using a structured extraction tool. A narrative synthesis was undertaken to identify and categorise the core elements of local consensus discussions reported. Data were synthesised into process models for undertaking local consensus discussions. The initial search returned 1159 articles after duplicates were removed. Following title and abstract screening, 135 articles underwent full-text review. A total of 63 articles met the inclusion criteria. Reporting of local consensus discussions varied substantially across the included studies. Four elements were consistently reported, which together define a structured process for undertaking local consensus discussions. Local consensus discussions are a common implementation strategy used to reduce unwarranted clinical variation in surgical care. Several models for undertaking local consensus discussions and their implementation are presented. Advancing our understanding of consensus building processes in perioperative pathway development could be significantly improved by refining reporting standards to include criteria for achieving consensus and assessing implementation fidelity, alongside advocating for a systematic approach to employing consensus discussions in hospitals. These findings contribute to recognised gaps in the literature, including how decisions are commonly made in the design and implementation of perioperative pathways, furthering our understanding of the meaning of consensus processes that can be used by clinicians undertaking improvement initiatives. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. No patient or public contribution. CRD42023413817.

Efficacy of interventions aimed at reducing explicit and implicit weight bias in healthcare students: A systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to determine the efficacy of interventions aimed at reducing weight bias in healthcare students, and to explore factors that may impact intervention success. A systematic review and random-effects meta-analyses were conducted by including studies that examined the efficacy of weight bias reduction interventions for healthcare students. Of the 3463 journal articles and dissertations screened, 67 studies (within 64 records) met inclusion criteria, with 35 studies included in the meta-analyses (explicit = 35, implicit [and explicit] = 10) and 32 studies included in the narrative synthesis (explicit = 34, implicit [and explicit] = 3). Weight bias interventions had a small but positive impact, g = -0.31 (95% CI = -0.43 to -0.19, p < 0.001), in reducing students' explicit weight bias but there was no intervention effect on implicit weight bias, g = -0.12 (95% CI = -0.26 to 0.02, p = 0.105). There was considerable heterogeneity in the pooled effect for explicit bias (I2 = 74.28, Q = 132.21, df = 34, p < 0.001). All subgroup comparisons were not significant (p > 0.05) and were unable to explain the observed heterogeneity. Narrative synthesis supported meta-analytic findings. The small but significant reduction of explicit weight bias encourages the continued testing of interventions, irrespective of variation in individual intervention components. Contrarily, reductions in implicit weight bias may only be possible from a large societal shift in negative beliefs and attitudes held towards people living in larger bodies.

Assessment of Employees' Ergonomic Issues in The Workplace in Terms of Occupational Health and Safety Practices: A Meta-Analysis Study

Purpose: This study is a meta-analysis aimed at evaluating ergonomic issues in workplaces in terms of occupational health and safety practices. Materials and Methods: This study is of a meta-analytic nature. Data used in the meta-analysis were obtained through searches on databases such as Google Scholar, YÖK Thesis, EBSCO, and Web Of Science without any time restrictions between January and March 2024. A total of 15 research studies were included in the search results. The data obtained were synthesized using narrative synthesis and meta-analysis methods. The total sample size of the studies used in this study is 65,160. Results: In this meta-analysis study, it was found that the practices implemented for addressing ergonomic issues faced by employees in the workplace were effective (SMD: 0.367, 95% CI: 0.055-0.679; Z = 2.305, p = 0.021, I2 = 97.761%, Q = 625.169). The variance among studies is statistically significant according to the analysis results (p &lt; 0.05). It is believed that challenges related to the structure of work in workplaces lead to various discomforts in employees, and therefore, ergonomic practices can minimize physical strains on employees, contribute to work efficiency, and enhance employee health and safety.

Relationships of post-stroke fatigue with mobility, recovery, performance, and participation-related outcomes: a systematic review and meta-analysis.

Effective post-stroke mobility, recovery, performance, and participation are key goals for stroke survivors. However, these outcomes may be hindered by post-stroke fatigue (PSF), which can affect numerous aspects of post-stroke mobility, recovery, performance, functioning, community participation, and return to work. This review aimed to assess the scientific evidence on the relationship between PSF and mobility function, functional recovery, functional performance, and participation-related outcomes among stroke survivors. A comprehensive search of Cochrane Central, PubMed, Embase, and Web of Science (WoS) databases was conducted from inception to December 2023. Observational, cross-sectional, and longitudinal studies were included. The methodological quality of the included studies was assessed using the National Institute of Health's quality assessment tool, while the risk of bias was assessed using the Quality in Prognostic Studies tool. A total of 28 studies (n = 2,495 participants, 1,626 men, mean age ranging from 52.5 ± 9.5 to 71.1 ± 9.9 years) were included. The data analysis was conducted using narrative and quantitative synthesis. Fixed and random effects meta-analyses were conducted to explore the relationships between PSF and relevant outcomes. Chronic PSF was found to have significant negative correlations with mobility (meta r = -0.106, p < 0.001), balance performance (meta r = -0.172; 95%; p = 0.004), and quality of life (meta r = -0.647; p < 0.001). It also showed significant positive correlations with stroke impairment (meta r = 0.144, p < 0.001) and disability (meta r = 0.480, p < 0.001). Additionally, exertion/acute PSF had significantly negative correlations with walking economy (meta r = -0.627, p < 0.001) and walking endurance (meta r = -0.421, p = 0.022). The certainty of evidence was deemed moderate for these relationships. Our findings indicate that higher levels of PSF are associated with poorer mobility, balance, and participation, as well as greater disability and stroke impairment. Future studies, especially prospective longitudinal and randomized controlled trials, are warranted to substantiate our findings. PROSPERO, identifier: CRD42023492045.

Characteristics of advanced practice nurses’ clinical competence in primary healthcare settings: a scoping review protocol

Objective: This scoping review aims to identify the clinical competency characteristics, in terms of knowledge, skills, and attitudes, of advanced practice nurses in primary care settings. Introduction: Although much has been written about the competencies of advanced practice nurses, more detail about the skills, knowledge, and attitudes that inform their clinical competency in primary health care needs to be ascertained. This will promote the development, implementation, and evaluation of advanced nursing practice in contexts where it is unavailable. Inclusion criteria: Studies that address the clinical competency characteristics of advanced practice nurses in primary health care settings will be considered for inclusion. Methods: This review will be conducted according to JBI methodology for scoping reviews. A comprehensive search will be conducted in PubMed, CINAHL (EBSCOhost), Web of Science, Scopus, Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), Embase (Elsevier), Science Direct (Elsevier), Cochrane Library, and Google Scholar for primary and secondary qualitative, quantitative, and mixed methods studies on the topic of relevance. Gray literature will be searched in DART-E, TESES CAPES, CAUL (Australian Digital Theses), and Theses Canada Editorials. Letters, editorials, commentaries, conference abstracts, and documents published by advanced practice nurses’ associations will also be considered for inclusion. Two independent reviewers will screen the studies at title and abstract and full text. The same reviewers will extract relevant data using an instrument developed by the reviewers. These data will be presented in a narrative synthesis to facilitate the analysis of the evidence found. Review registration: Open Science Framework https://osf.io/tnrjz/

Collaborative approaches with stakeholders in speech-language pathology: Narrative literature review.

Collaborative approaches in speech-language pathology (SLP) aim to integrate the experience of clients and people important to them by including these stakeholders actively in decision making. This inclusion can lead to more effective, engaging, and safer SLP practice. A variety of collaborative approaches have evolved in response to sociocultural contexts, and as a result, there are many different approaches currently in use such as co-design, co-production, and co-creation. However, despite widening acceptance and utilisation of collaborative approaches, the use and evidence for these in SLP literature have not been considered collectively. The current study aims to explore how collaborative approaches, used to develop products or services in SLP, are reported in literature. Using narrative review methodology, a systematic search of three databases and hand searching were conducted to explore how collaborative approaches, used to develop products or services, are reported in SLP. Search terms reflected the breadth of collaborative approaches and the diverse nature of SLP across clinical practice. Following screening of initial data, 59 articles were identified for data extraction and narrative synthesis. An internationally recognised reporting checklist for stakeholder involvement called the Guidance for Reporting Involvement of Patients and the Public, Version 2 (GRIPP2), informed the reviewing process in addition to qualitative description. Collaborative approaches across SLP practice were found to be diverse as were the terminology and tools used for collaboration. Two-thirds of the studies were published after 2020. The timing and involvement of stakeholders in collaborative approaches varied greatly; however, most stakeholder involvement was found in the conducting of research activities, compared to other areas such as planning, analysis, and reporting. The GRIPP2 review indicated strengths and opportunities in reporting of stakeholder involvement. When stakeholder involvement was rigorously reported it could include reflection on how stakeholders contributed within their communication abilities and how this contribution benefited the study. Collaborative approaches reported in SLP focused on valuing and respecting people with living experience of communication and swallowing difficulties. This narrative review contributes to the resources available to support decision-making and working together with stakeholders, encouraging SLPs to reflect, consider the context and respond. Future research could continue to strengthen consistency in terminology for collaborative approaches, use frameworks to plan and report stakeholder involvement and carefully consider involvement across the research continuum. What is already known on this subject There is an expectation that health services include stakeholders in development and evaluation of services. Collaborative approaches in speech-language pathology (SLP) aim to integrate the lived experience of people with communication and swallowing difficulties and those important to them. These approaches, including but not limited to, co-design, co-production and participatory action research, have shared philosophies of being community-driven, strengths based and inclusive (Loeffler & Bovaird, 2021). What this paper adds to existing knowledge This study contributes information about current SLP practice when collaborative approaches have been employed to develop a product or service. The study maps diverse collaborative approaches and their frequency in the literature, as well as the various stakeholders involved, using the Guidance for Reporting Involvement of Patients and the Public, Version 2 (GRIPP2) checklists to guide the review of reporting stakeholder involvement. What are the potential or actual clinical implications of this work? This synthesis of literature supports researchers and clinicians in making intentional decisions in implementation and reporting of collaborative approaches. This decision-making can strengthen the implementation of collaborative approaches, which has implications for person-centred care in SLP.

The emerging role of a Stroke Clinical Nurse Specialist (CNS) in Early Supported Discharged: Developing a pathway for stroke nursing for secondary prevention in the community. A scoping review protocol.

Background Stroke represents a major source of mortality and morbidity globally. The role of a stroke Clinical Nurse Specialist (CNS) as an expert team member in early supported discharge (ESD) for stroke, is not well defined or described although it is well established in other models of after-hospital and out-reach specialist care in the community. A greater focus has been on patients receiving rehabilitation post-stroke, however there is a need for a more holistic approach to care which clinical nurse specialists can offer to patients as part of ESD. Nurses are often the cohesive point of contact for other after-hospital services, managing many aspects of secondary prevention. Objective The aim of this scoping review is to explore the evidence in relation to the role of the stroke nurse providing secondary prevention interventions to stroke patients in a community setting. Methods We will conduct a scoping review in accordance with the Arksey and O’Malley, 2005 1 scoping review framework and the PRISMA-ScR guidelines to map available literature on the role of the stroke nurse in post-stroke care of patients in the community. The Cochrane Central Register of Controlled Trials and Systematic literature searches including databases MEDLINE, EMBASE, CINAHL, google scholar and grey literature will be searched using keyword searches. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions This scoping review will be used to identify gaps in the current literature and identify areas for future research in the role of the stroke nurse in ESD in relation to secondary prevention for stroke patients and inform the development of a pathway for stroke nursing in ESD.

Psychological well-being of travellers on long-distance shipping voyages: A systematic review protocol

The psychosocial well-being of every individual is as important as the well-being of long-distance voyages, especially that they have to spend longer hours and days travelling to their destinations with all the experiences of adventure and adversities characterizing the journey. The aim of this systematic review is to explore the psychosocial well-being of long-distance travellers on board shipping vessels to gain an understanding of their psychological and social well-being with the objective of ameliorating the adversities associated with these travels. A systematic review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020) statement. The databases to be searched for the data will be limited to Scopus, Web of Science, and Advanced Google Scholar using keywords selected by the reviewers. Meta-analysis, narrative synthesis, or both will be used depending on the extent of heterogeneity across eligible observational studies included in the review. Some specific countries will be selected for data extraction, and only data published in English will be included. It is expected that the findings from this review will bring to bear if these categories of travellers are prone to risks that affect their psychosocial wellbeing and if so discovered. This protocol was registered with the PROSPERO. PROSPERO registration number: CRD42024517277(08/03/2024)

A protocol for the systematic review and meta-analysis of clinical trials of interventions to improve sleep in people with mild cognitive impairment or dementia.

Background While sleep disturbance is common in advanced dementia, leading to negative outcomes, there is growing evidence that sleep disturbance begins early in prodromal dementia and may contribute to cognitive decline. Sleep is therefore an important treatment target throughout the natural history of dementia. The existing literature regarding interventions for sleep in people with cognitive impairment is beset by wide heterogeneity in the sleep measurement tools used and outcome measures reported, which limits data synthesis and impedes the development of a robust evidence base for these interventions. Aim We propose to undertake a systematic review and meta-analysis to assess the evidence base from clinical trials for both pharmacological and non-pharmacological interventions to improve sleep in people with cognitive impairment. We will also extract data regarding the sleep measurement tools and outcome measures used in these studies to underpin the development of a core outcome set for future clinical trials in the area. Methods This systematic review and meta-analysis will include randomised and non-randomised controlled clinical trials that assess interventions to improve sleep in participants with mild cognitive impairment or dementia. Medline, CINAHL, PsycINFO, and the Cochrane CENTRAL database will be searched from inception to present. A flow chart will illustrate the study selection process in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The methodological quality and risk of bias of included studies will be assessed. Heterogeneity will be tested. A narrative synthesis will be undertaken where meta-analysis is not feasible. Conclusion This systematic review and meta-analysis will help inform clinical practice by evaluating the available evidence for interventions to improve sleep in people with mild cognitive impairment or dementia. It will also facilitate the development of a core outcome set that will improve the coherence and utility of data emerging from future clinical trials.

The effectiveness of simulation-based learning (SBL) on students’ knowledge and skills in nursing programs: a systematic review

BackgroundSimulation-Based Learning (SBL) serves as a valuable pedagogical approach in nursing education, encompassing varying levels of fidelity. While previous reviews have highlighted the potential effectiveness of SBL in enhancing nursing students’ competencies, a gap persists in the evidence-base addressing the long-term retention of these competencies. This systematic review aimed to evaluate the impact of SBL on nursing students’ knowledge and skill acquisition and retention.MethodA comprehensive search of electronic databases, including CINAHL, PubMed, Embase, Scopus, and Eric, was conducted from 2017 to 2023 to identify relevant studies. The Joanna Briggs critical appraisal tools were used to assess the methodological quality of the included studies. A total of 33 studies (15 RCTs and 18 quasi-experimental) met the inclusion criteria and were included in the review. A descriptive narrative synthesis method was used to extract relevant data.ResultsThe cumulative sample size of participants across the included studies was 3,670. Most of the studies focused on the impact of SBL on life-saving skills like cardiopulmonary resuscitation (CPR) or other life-support skills. The remaining studies examined the impact of SBL on critical care skills or clinical decision-making skills. The analysis highlighted consistent and significant improvements in knowledge and skills. However, the evidence base had several limitations, including the heterogeneity of study designs, risk of bias, and lack of long-term follow-up.ConclusionThis systematic review supports the use of SBL as a potent teaching strategy within nursing education and highlights the importance of the ongoing evaluation and refinement of this approach. While current evidence indicates enhancing knowledge and skill acquisition, limited studies evaluated the retention beyond five months, constraining generalisable claims regarding durability. Further research is essential to build on the current evidence and address gaps in knowledge related to the retention, optimal design, implementation, and evaluation of SBL interventions in nursing education.

Effective community-based interventions to prevent and control infectious diseases in urban informal settlements in low- and middle-income countries: a systematic review

BackgroundThe impact of rapid urbanization taking place across the world is posing variegated challenges. Especially in terms of communicable disease, the risk is more concentrated in urban poor areas where basic amenities are inadequate. This systematic review synthesizes evidence on the effective community-based interventions (CBIs) aimed at preventing and controlling infectious diseases among the urban poor in low- and middle-income countries (LMICs).MethodsThis systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A comprehensive search across five major databases was conducted to capture literature on CBIs published between 2011 and 2021. Scientific articles of any design that reported any type of CBIs effective in preventing and controlling infectious diseases (tuberculosis, diarrhea, typhoid, dengue, hepatitis B and C, influenza, and COVID-19) were included. Screening and selection of studies were done by two pairs of independent researchers using the predefined eligibility criteria. The risk of bias in included studies was assessed using the modified checklist outlined in the Cochrane Handbook for Systematic Reviews of Interventions and Effective Public Health Practice Project (EPHPP). Analysis of effective CBIs was guided by the conceptual framework for integrated CBIs for neglected tropical diseases (NTDs), and narrative synthesis was carried out. Geographical restrictions were limited to LMICs and papers published in English.ResultsOut of 18,260 identified papers, 20 studies met the eligibility criteria and were included in this review. Community-based screening and socio-economic support, community-based vector control, behavior change communication, capacity building of the community health workers (CHWs), health education, and e- and m-health interventions were found as effective CBIs. Diversified CBIs were found to be effective for specific diseases, including tuberculosis (TB), diarrhea, dengue, influenza and ARI, and hepatitis B and C. Bundling of interventions were found to be effective against specific diseases. However, it was difficult to isolate the effectiveness of individual interventions within the bundle. The socio-cultural context was considered while designing and implementing these CBIs.ConclusionThe effectiveness of an intervention is inextricably linked to social context, stakeholder dimensions, and broader societal issues. System approach is recommended, emphasizing context-specific, multi-component interventions that address social determinants of health. Integrating these interventions with public health strategies and community involvement is crucial for sustainable outcomes. These findings can guide the design of future interventions for better prevention and control of communicable diseases in urban poor areas.Systematic review registrationPROSPERO CRD42021278689.

Halotherapy as Adjuvant Therapy for Respiratory Diseases: A Literature Review

Halotherapy (HT) is part of salt therapy derived from speleotherapy/speleoclimate, which comes from using a micro size of dry salt in aerosol form (such as sodium, potassium, magnesium, calcium, and sodium chloride) with stable air temperature (18–24ºC) and moderate to high humidity (40–60%) for inhalation inside a cave/imitation cave since the nineteenth century. The benefits of HT as an adjuvant may help patients with many medical conditions, especially respiratory and dermatology diseases. This therapy is believed to alleviate inflammation and the immune response and improve respiratory function, etc. The clinical benefits of HT are advocated, but the mechanisms still need to be explicitly elucidated. This study’s main objective is to critically review and evaluate the evidence from existing literature of HT efficacy as an adjuvant therapy for respiratory disease in a narrative review. This review used a systematic approach and narrative synthesis. PubMed, Google Scholar, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Based on preset selection criteria, two reviewers separately looked over abstracts and chose relevant papers. HT improves mucociliary elimination, diminishes airway inflammation, and improves pulmonary function. This adjuvant therapy is safe and does not cause serious adverse events. Therefore, this therapy should be considered an adjuvant therapy for respiratory diseases because of its potential effects. However, scientific evidence of the effectiveness of HT is limited. High-quality further research is required to ascertain the effectiveness of this treatment for respiratory conditions. Keywords: adjuvant, halotherapy, respiratory diseases, salt therapy, therapy