Critical Appraisal Tool Research Articles

Botulinum Toxin Injections for Psychiatric Disorders: A Systematic Review of the Clinical Trial Landscape.

Botulinum toxin type A (BONT-A) has shown promise in improving the mood-related symptoms of psychiatric disorders by targeting muscles linked to the expression of negative emotions. We conducted a systematic review of past and ongoing efficacy trials of BONT-A therapy for psychiatric disorders to identify relevant trends in the field and discuss the refinement of therapeutic techniques. A comprehensive search for published clinical trials using BONT-A injections for psychiatric disorders was performed on 4 May 2023 through OVID databases (MEDLINE, Embase, APA PsycINFO). Unpublished clinical trials were searched through the ClinicalTrials.gov and International Clinical Trial Registry Platform public registries. The risk of bias was assessed using the JBI Critical Appraisal tools for use in systematic reviews. We identified 21 studies (17 published, 4 unpublished clinical trials) involving 471 patients. The studies focused on evaluating the efficacy of BONT-A for major depressive, borderline personality, social anxiety, and bipolar disorders. BONT-A was most commonly injected into the glabellar area, with an average dose ranging between 37.75 U and 44.5 U in published studies and between 32.7 U and 41.3 U in unpublished trials. The results indicated significant symptom reductions across all the studied psychiatric conditions, with mild adverse effects. Thus, BONT-A appears to be safe and well-tolerated for psychiatric disorders of negative affectivity. However, despite the clinical focus, there was a noted shortage of biomarker-related assessments. Future studies should focus on pursuing mechanistic explorations of BONT-A effects at the neurobiological level.

Relationship Between Psychological Empowerment and Nurses' Job Satisfaction: A Systematic Review and Correlational Meta-Analysis.

Psychological empowerment is a motivational concept that encompasses a person's thoughts and perceptions that give a sense of behavior and commitment to the work. Psychological empowerment is widely acknowledged to be associated with nurses' job satisfaction. However, this relationship has been found to be controversial. Therefore, this systematic review and meta-analysis aimed to investigate the relationship between psychological empowerment and nurses' job satisfaction. The electronic databases CINAHL, PubMed, Web of Science, and Google Scholar were utilized to search for relevant studies published from 2001 to 2024. The correlation coefficients were extracted for each eligible study and transformed into Fisher's Z. Then, the pooled effect size (r coefficient) was computed using Fisher's Z and the corresponding standard error. Moreover, I2 was used to assess the heterogeneity of studies. Begg's rank and Egger's test were employed to assess the publication bias. Sensitivity analysis was utilized to measure the robustness of study findings using the one-leave-out approach, and a critical appraisal tool for cross-sectional studies was adopted to assess the quality of included studies. A total of 18 studies were selected for analysis with a total sample of 6,353 nurses from different countries. The included studies ranged from moderate to high quality based on the quality assessment checklist. The pooled effect size for the correlation between psychological empowerment and nurses' job satisfaction was 0.512 (95% confidence interval = 0.406-0.604) with mild-to-moderate heterogeneity. Moreover, the majority of the studies confirmed a positive relationship between the two measured concepts. This study presents evidence indicating that psychological empowerment has a sensible relationship with nurses' job satisfaction. Therefore, nurse administrators should implement tailored strategies to trigger nurses' psychological empowerment, aiming to boost job satisfaction and reduce turnover and burnout. However, additional studies are essential to establish a causal relationship.

Facilitators and barriers to asylum seeker and refugee oral health care access: a qualitative systematic review.

Objectives Asylum seekers and refugees (ASRs) encounter barriers when accessing oral health care (OHC). A qualitative systematic review was conducted to understand the perceptions, attitudes, behaviours and experiences of ASRs regarding their OHC. Themes were extracted to identify the barriers and facilitators ASRs face when accessing OHC.Data sources PubMed, APA PsycInfo, Cochrane Database, Web of Science and CINAHL were searched on 4 and 5 October 2022.Data selection Primary studies including ASRs of any age or nationality were included. Qualitative data of ASRs' lived experiences of oral health (OH) and accessing OHC were extracted. The Critical Appraisal Skills Programme quality appraisal tool was applied.Data synthesis Data findings were extracted and meta-aggregation performed using inductive reasoning. A total of 13 primary qualitative studies were included. Three barriers were identified, including difficulty accessing treatments and appointments, cultural and language changes, and ASRs' lack of OHC knowledge or incongruous beliefs surrounding OH. Two facilitators were identified as good OH education and support from care providers or government.Conclusions Decision-makers should adapt policy to facilitate access to OHC and educate ASRs on OH. More research is needed to understand the barriers and facilitators to OHC for other people groups who experience health inequalities.

Nurse leaders' interpersonal communication competence: A mixed-method systematic review.

To identify and synthesize evidence available on nurse leaders' interpersonal communication competence. Systematic mixed-methods review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed-methods appraisal tool. The data-based convergent synthesis design and narrative synthesis were used. CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022. A total of 26 studies-15 quantitative, 9 qualitative and 1 of both mixed-method and multi-method-met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert. This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication. This is the first mixed-methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence. CRD42023385058. No patient or public contribution.

Genotype-phenotype associations in microtia: a systematic review

BackgroundMicrotia is a congenital ear malformation that can occur as isolated microtia or as part of a syndrome. The etiology is currently poorly understood, although there is strong evidence that genetics has a role in the occurrence of microtia. This systematic review aimed to determine the genes involved and the abnormalities in microtia patients' head and neck regions.MethodsWe used seven search engines to search all known literature on the genetic and phenotypic variables associated with the development or outcome of microtia. The identified publications were screened and selected based on inclusion and exclusion criteria and assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tools. We found 40 papers in this systematic review with phenotypic data in microtia involving 1459 patients and 30 articles containing genetic data involved in microtia.ResultThe most common accompanying phenotype of all microtia patients was external ear canal atresia, while the most common head and neck abnormalities were the auricular, mental, and oral regions. The most common syndrome found was craniofacial microsomia syndrome. In the syndromic microtia group, the most common genes were TCOF1 (43.75%), SIX2 (4.69%), and HSPA9 (4.69%), while in the non-syndromic microtia group, the most frequently found gene was GSC exon 2 (25%), FANCB (16.67%), HOXA2 (8.33%), GSC exon 3 (8.33%), MARS1 (8.33%), and CDT1 (8.33%).ConclusionsOur systematic review shows some genes involved in the microtia development, including TCOF1, SIX2, HSPA9, GSC exon 2, FANCB, HOXA2, GSC exon 3, MARS1, and CDT1 genes. We also reveal a genotype-phenotype association in microtia. In addition, further studies with more complete and comprehensive data are needed, including patients with complete data on syndromes, phenotypes, and genotypes.

Unveiling the hidden struggle of healthcare students as second victims through a systematic review

BackgroundWhen healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training.MethodsThis systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies.ResultsA total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered.ConclusionEnsuring healthcare students’ resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review.

This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. Five databases were searched on 23 May 2023. To be included in the review, studies had to be published in peer-reviewed journals or as grey literature containing relevant statistical data. The Joanna Briggs Institute critical appraisal tool was employed to assess the methodological quality of each article included in this study. Of 2137 citations identified after exclusions, 99 records met the inclusion criteria. The predominant individual, organizational, and environmental factors that were most frequently found associated with the COVID-19 outbreak comprised older age, higher dependency level; lower staffing levels and lower star and subset domain ratings for the facility; and occupancy metrics and co-occurrences of outbreaks in counties and communities where the LTCFs were located, respectively. The primary individual, organizational, and environmental factors frequently linked to COVID-19-related deaths comprised age, and male sex; higher percentages of racial and ethnic minorities in LTCFs, as well as ownership types (including private, for-profit, and chain membership); and higher occupancy metrics and LTCF's size and bed capacity, respectively. Unfolding the risk factors collectively may mitigate the risk of outbreaks and pandemic-related mortality in LTCFs during future endemic and pandemics through developing and improving interventions that address those significant factors.

Group-based trajectory modeling for fear of cancer recurrence in cancer survivors: a systematic review.

We aimed to systematically review studies that used a group-based trajectory modeling approach to explore the categories of fear of cancer recurrence (FCR) trajectories and their predictors in cancer survivors. MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science were searched. Three authors independently reviewed the literature for predefined eligibility criteria. The Joanna Briggs Institute critical appraisal tools for Cohort Studies and the Guidelines for Reporting on Latent Trajectory Studies were used to assess the quality of included studies. A qualitative synthesis of the included studies was performed. Ninety-eight studies were retrieved after removing duplicates, and 11 studies met the criteria for inclusion. There are four types of FCR trajectories: stable, decreasing, increasing, and stable-then-decreasing-then-increasing. The following factors were considered significant predictors of FCR trajectory category in at least one of the included studies: age, race, income, education, employment, cancer stage, physical symptoms, depression, anxiety, satisfaction with medical care, and selected cognitive and behavioral factors. There was considerable heterogeneity among the studies included in study design and FCR trajectory results. Factors that significantly predicted FCR trajectory categories mostly focused on psychological characteristics. The correlation of sociodemographic and disease-related predictors with FCR trajectory categories was not consistent among the included studies. We suggest that future scholars should incorporate more psychological factors when identifying cancer survivors who persistently maintain a high level of FCR and developing FCR mitigation measures.

Effectiveness of Ayurveda Intervention in the Management of Infertility: A Systematic Review.

Infertility is encountered as a stressful condition by couples worldwide, impacting not just their physical and mental well-being but also placing financial strain on them. Ayurvedic management provides a promising, cost-effective avenue for addressing infertility disorders and enhances the success rates of in vitro fertilization (IVF), especially after previous unsuccessful attempts. This study aims to enhance clinical evidence and expand the scope of Ayurvedic approaches for managing infertility. A systematic literature search was conducted in PubMed and Scopus search engines for studies evaluating Ayurveda treatment modalities in infertility. Articles were searched using a combination of Medical Subject Heading (MeSH) terms, and the risk of bias was assessed using Robvis and the Joanna Briggs Institute (JBI) Critical Appraisal Tool. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.A total of 14 studies were considered in this systematic review, involving 248 patients. Among them, 84 were males and 164 were females. Of the 14 included studies, six were original studies, whereas eight were case reports. Our research contributes to addressing a notable research gap by conducting a comprehensive analysis of Ayurvedic treatments for infertility or medical conditions that lead to infertility. However, the limited sample size and lack of standardized protocols highlight the need for rigorous experimental research to establish the efficacy and safety of Ayurvedic treatments for infertility.

Factors impeding physical activity in older hospitalised patients: A qualitative meta-synthesis.

Older hospitalised patients have low levels of physical activity and multiple impairing factors. To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs. Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results. In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level. Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older. This study is a meta-synthesis and does not require relevant contributions from patients or the public. Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity. Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.

Landscape of NRXN1 Gene Variants in Phenotypic Manifestations of Autism Spectrum Disorder: A Systematic Review.

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication challenges and repetitive behaviors. Recent research has increasingly focused on the genetic underpinnings of ASD, with the Neurexin 1 (NRXN1) gene emerging as a key player. This comprehensive systematic review elucidates the contribution of NRXN1 gene variants in the pathophysiology of ASD. Methods: The protocol for this systematic review was designed a priori and was registered in the PROSPERO database (CRD42023450418). A risk of bias analysis was conducted using the Joanna Briggs Institute (JBI) critical appraisal tool. We examined various studies that link NRXN1 gene disruptions with ASD, discussing both the genotypic variability and the resulting phenotypic expressions. Results: Within this review, there was marked heterogeneity observed in ASD genotypic and phenotypic manifestations among individuals with NRXN1 mutations. The presence of NRXN1 mutations in this population emphasizes the gene's role in synaptic function and neural connectivity. Conclusion: This review not only highlights the role of NRXN1 in the pathophysiology of ASD but also highlights the need for further research to unravel the complex genetic underpinnings of the disorder. A better knowledge about the multifaceted role of NRXN1 in ASD can provide crucial insights into the neurobiological foundations of autism and pave the way for novel therapeutic strategies.

Oral Microbiota of Infants in Maternal Gestational Diabetes: A Systematic Review.

Gestational diabetes mellitus (GDM) affects approximately 5-20% of pregnant women and is associated with adverse pregnancy outcomes. This review aimed to assess whether the oral microbiota of infants and their mothers with GDM had a different composition from that found in unaffected women and offspring. PubMed, Embase, Scopus, and Google Scholar were searched in December 2023 after protocol registration in the International Prospective Register of Systematic Reviews (CRD42023406505). Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tools. Overall, 1113 articles were identified; after evaluating the full texts, 12 papers were included in the qualitative analysis. In six studies of the eight included, significant differences in microbiota between M-GDM and M-nGDM were found. In four studies, a depletion of Firmicutes and an enrichment of Proteobacteria was found in the microbiota of infants. Since all included studies were judged to have high risk of bias, a quantitative synthesis of the results was not carried out. In conclusion, although the oral microbiota of infants from mothers with GDM could be different from that of infants from mothers without GDM, there is insufficient evidence to clarify this aspect so far.

A guide to critical appraisal of quality improvement reports

Quality improvement (QI) has become an integral part of healthcare. Despite efforts to improve the reporting of QI through frameworks such as the SQUIRE 2.0 guidelines, there is no standard or well-accepted guide to evaluate published QI for rigor, validity, generalizability, and applicability. User's Guides for evaluation of published clinical research have been employed routinely for over 25 years; however, similar tools for critical appraisal of QI are limited and uncommonly used. In this article we propose an approach to guide the critical review of QI reports focused on evaluating the methodology, improvement results, and applicability and feasibility for implementation in other settings. The resulting Quality Improvement Critical Knowledge (QUICK) Tool can be used by those reviewing manuscripts submitted for publication, as well as healthcare providers seeking to understand how to apply published QI to their local context.

Effectiveness of coma arousal therapy on patients with disorders of consciousness - A systematic review and meta-analysis.

Disorders of consciousness (DOC) incorporate stages of awareness and arousal. Through coma arousal therapy sensory deprivation experienced by patients with DOC can be mitigated. Nevertheless, consensus concerning its effectiveness on these patients is still fractional. This review aims to investigate the effectiveness of coma arousal therapies on patients with DOC. A meta-analysis was performed by searching electronic databases using search terms, the studies investigating the effect of coma arousal therapy in patients with DOC using the Coma Recovery Scale-Revised and Glasgow Coma Scale as outcome measures were included. The risk of bias was assessed, using Cochrane and Joanna Briggs Institute critical appraisal tools. Further, analysis was conducted for the included studies. Out of 260 studies, 45 trials were reviewed and assessed for bias, with 31 studies included for analysis. The analysis demonstrates a significant difference in pre- and post - sensory stimulation, vagus nerve stimulation, transcranial magnetic stimulation, and transcranial direct current stimulation. Sensory stimulation showed the greatest mean difference of -4.96; 95% CI = -5.76 to - 4.15. The patients who underwent intervention after 3 months of illness showed significant improvement. The result shows that sensory stimulation, transcranial magnetic stimulation, and transcranial direct stimulation can improve behavioral outcomes of patients with DOC, wherein sensory stimulation is found to be more effective.

Systematic review of servant leadership and burnout

PurposeEmployee burnout is increasingly coming under attention due to its negative impact on employee well-being and organisational effectiveness. This study, a systematic review, aims to evaluate the role of servant leadership and its mediators in preventing and mitigating against burnout experiences in organisations.Design/methodology/approachA preferred reporting items for systematic review and meta-analyses (PRISMA) was conducted using three databases, Academic search Complete, Embase and Scopus, in addition to bibliography searches. Articles were included if they reported on primary data, in English from inception to 2023. The mixed methods critical appraisal tool was used to assess the quality of articles, and a narrative synthesis was used to report results.FindingsThe search strategy yielded 4,045 articles, of which (N = 17), with total sample size of (N = 10,444) are included. Findings suggest that servant leadership is predictive of burnout, and that several mediators impact this relationship. Most studies were conducted in health care (n = 8) and banking (n = 3), and while the quality of the studies was mostly high (64%), the methods used were mainly descriptive and cross-sectional, which limits the extent to which causality can be inferred. A theory of change is provided based on the findings from this review and integrated with the extant literature on servant leadership theory, and can be used by organisations to support the policy, training and practice of servant leadership to reduce burnout.Originality/valueServant leadership is predictive of burnout; however, further research needs to be undertaken in this important emerging area.

Non-cardiac comorbid health outcomes and prevalence after myocardial infarction: an umbrella review.

There exists limited comprehensive evidence on the potential association between non-cardiac comorbidities and myocardial infarction (MI). Thus, we conducted an umbrella review of existing meta-analyses to provide a broad understanding of non-cardiac health outcomes associated with MI. The primary focus on the prevalence of related health outcomes in patients with MI was systemically searched. Each original meta-analysis that was included had its methodological quality evaluated by a Measurement Tool Assessment Systematic Reviews 2 (AMSTAR2). To evaluate the certainty in the evidence for each outcome, we employed GRADE and the Joanna Briggs Institute Prevalence Critical Appraisal Tool. The protocol was registered in PROSPERO (CRD42023458642). We identified seven meta-analyses comprising 126 studies with 336,581 participants from 22 countries and five continents. The pooled prevalence of comorbidities in patients with MI was 39% anxiety [95% confidence interval (CI), 30-48; GRADE, very low certainty], 29% depression (95% CI, 23-36; very low certainty), 39% frailty (95% CI, 24-55; very low certainty), and 23% failure of returning to work (95% CI, 16-29; very low certainty). The diagnosis of MI was associated with an increased risk of cognitive impairment (odds ratio, 1.45; 95% CI, 1.10-1.92; moderate certainty). Among frail patients, MI was associated with an increased risk of major bleeding (relative risk, 1.93; 95% CI, 1.08-3.45; low certainty) and mortality (relative risk, 2.29; 95% CI, 1.48-3.53; moderate certainty). However, we did not find any evidence of cancer risk associated with the development of MI. Our umbrella meta-analysis provided comprehensive evidence of the association between MI and several non-cardiac health conditions. The robustness of our study is attributed to the integration of evidence across several studies, thus, these insights offer valuable treatment options for policymakers and physicians to develop personalized health strategies.

Non-operative management of high-grade splenic injury: a systematic review protocol.

The objective of this review is to establish whether embolization is more effective than clinical observation for adult patients with grade III-V splenic injuries. The findings will be used to guide future practice and, if necessary, inform future research design and conduct. The spleen is one of the most frequently injured intra-abdominal organs, with a reported adult mortality of 7% to 18% following trauma. Non-operative management has become a standard of care for hemodynamically stable patients. In clinical practice, the decision whether to prophylactically embolize or manage high-grade injuries with observation alone remains controversial. Sources including adult patients with grade III-V splenic injuries secondary to blunt trauma will be included in this review. Eligible studies must include comparisons between 2 cohorts of patients undergoing either prophylactic embolization or clinical observation only. Outcomes will include mortality rate, failure of treatment, intensive care unit admission, length of hospital stay, blood transfusion requirements, and patient satisfaction. A systematic review with meta-analysis will be conducted. PubMed, Embase, and CINAHL will be searched for eligible studies, as will trial registries and sources of gray literature. Study selection, quality appraisal, and data extraction of outcomes will be performed in duplicate. Methodological quality will be evaluated using JBI critical appraisal tools. Studies will, where possible, be pooled in statistical meta-analysis. A random effects model will be used and statistical analysis will be performed. The certainty of the findings will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. PROSPERO CRD42023420220.

EFEKTIVITAS EDUKASI ANTENATAL TERHADAP KETAKUTAN DAN EFIKASI DIRI PERSALINAN PADA PRIMIPARA: SYSTEMATIC REVIEW

Fear of giving birth due to lack of knowledge causes a decrease in primigravida mothers' confidence in their ability to undergo childbirth. Decreased self-efficacy in childbirth can cause birth complications such as prolonged labor, fatigue and weakness in the mother, which results in the mother's failure to undergo a natural birth. Antenatal education is an appropriate alternative to increase mothers' knowledge of the birth process. The aim of the research was to examine the effectiveness of antenatal education in reducing fear of childbirth and increasing childbirth self-efficacy in primiparous mothers. The structure of this research is a detailed analysis using the PRISMA flow diagram. Researchers applied the PICO method and searched for articles in English published between 2018 and 2023. Some of the databases used included Proquest, PUBMED, Sage Journal, Springer Link, Science Direct, EBSCO, Plos One and Taylor & Francis. Article quality assessment using JBI Critical Appraisal Tools for RCT. Seven articles were identified and analyzed, all articles used a Randomized Controlled Trial design. The research sample numbered 56 to 182, consisting of primiparas in the age range 18-32 years with a gestational age of <34 weeks and was conducted in Saudi Arabia, Turkey, Iran and China. From the literature search, in general it can be concluded that antenatal education provided to primiparous mothers is effective in reducing fear of childbirth and increasing self-efficacy in childbirth.

Interprofessional Education: Learning Method and Core Competencies in Medical Students in Asia

Background: Interprofessional collaboration is a partnership among health professionals that supports more comprehensive, confident, and safe healthcare. Collaboration competence in Indonesian health worker still needs to be improved. Interprofessional education is an effort to realize interprofessional collaboration. Aims: This study aims to describe the implementation of interprofessional education learning for preclinical medical students in Asia by identifying learning methods, learning outcomes and challenges.Methods: Scoping reviews were conducted in this study. Articles were sourced from Proquest, PubMed, and Taylor & FrancisOnline using Population, Intervention, Comparison and Outcomes (PICO Framework). In the identification process, 737 articles were found and screened according to inclusion criteria. Nine articles were assessed for eligibility using the Joanna Briggs Institute Critical Appraisal Tools Checklist for Quasi-Experimental Studies and seven articles were obtained.Results: Learning methods such as simulation-based learning, problem-based learning, didactic learning, community-based learning, team-based learning, and shadowing were found. Learning outcomes vary in each article because objectives, measuring instruments, and selection of activities are also varied.Conclusion: Interprofessional education improves students' ability to collaborate. Learning methods and outcomes varied according to the objectives and design of the program in each institution. The challenges encountered were logistical, student diversity, facilitator skills, and cultural barriers.

Risk factors for scabies in hospital: a systematic review

BackgroundAnnually, 175.4 million people are infected with scabies worldwide. Although parasitic infections are important nosocomial infections, they are unrecognized compared to bacterial, fungal, and viral infections. In particular, nonspecific cutaneous manifestations of scabies lead to delayed diagnosis and frequent nosocomial transmission. Hospital-based studies on the risk factors for scabies have yet to be systematically reviewed.MethodsThe study followed the PRISMA guidelines and was prospectively registered in PROSPERO (CRD42023363278). Literature searches were conducted in three international (PubMed, Embase, and CINAHL) and four Korean (DBpia, KISS, RISS, and Science ON) databases. We included hospital-based studies with risk estimates calculated with 95% confidence intervals for risk factors for scabies infection. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tools. Two authors independently performed the screening and assessed the quality of the studies.ResultsA total of 12 studies were included. Personal characteristics were categorized into demographic, economic, residential, and behavioral factors. The identified risk factors were low economic status and unhygienic behavioral practices. Being a patient in a long-term care facility or institution was an important factor. Frequent patient contact and lack of personal protective equipment were identified as risk factors. For clinical characteristics, factors were categorized as personal health and hospital environment. People who had contact with itchy others were at higher risk of developing scabies. Patients with higher severity and those with a large number of catheters are also at increased risk for scabies infection.ConclusionsFactors contributing to scabies in hospitals range from personal to clinical. We emphasize the importance of performing a full skin examination when patients present with scabies symptoms and are transferred from settings such as nursing homes and assisted-living facilities, to reduce the transmission of scabies. In addition, patient education to prevent scabies and infection control systems for healthcare workers, such as wearing personal protective equipment, are needed.