Use Of Educational Interventions Research Articles

The Impact of Pain Education Interventions for Cancer Survivors and Caregivers: A Systematic Review with Meta-Analysis.

Cancer-related pain is a global health-related problem associated with functional impairment, anxiety, depression, and reduced quality of life. The use of educational interventions for patients and their caregivers has been proposed as a promising tool for overcoming pain in cancer. The aim of this study was to summarize by means of a standardized methodological systematic revision the actual pain education intervention used in cancer patients and their caregivers and to analyze its effects on pain. A search was conducted through PubMed, Web of Science, Scopus and Cinhal from their inception to September 2022. Randomized controlled trials which included pain education interventions were identified. Two reviewers performed independent data extraction and methodologic quality assessments of these studies. A total of seven studies was included in the study. The meta-analysis showed that pain education interventions have a significant effect on the worst pain; however, there was no effect on average pain. Pain education interventions addressed to patients and their caregivers could have positive effects on cancer-related pain. It is recommended that a minimum of three sessions of about one hour's duration be held once a week. Further research needs to be carried out and analyzed on the effects over the long term. Pain education interventions show positive results in improving pain in cancer patients regardless of etiology or extent of the cancer. Studies with better methodological quality should be carried out to address specific components related to education interventions.

The Impact of Pain Education Interventions for Cancer Survivors and Caregivers: A Systematic Review with Meta-Analysis

Introduction: Cancer-related pain is a global health-related problem associated with functional impairment, anxiety, depression, and reduced quality of life. The use of educational interventions for patients and their caregivers has been proposed as a promising tool for overcoming pain in cancer. The aim of this study was to summarize by means of a standardized methodological systematic revision the actual pain education intervention used in cancer patients and their caregivers and to analyze its effects on pain. Methods: A search was conducted through PubMed, Web of Science, Scopus and Cinhal from their inception to September 2022. Randomized controlled trials which included pain education interventions were identified. Two reviewers performed independent data extraction and methodologic quality assessments of these studies. Results: A total of seven studies was included in the study. The meta-analysis showed that pain education interventions have a significant effect on the worst pain; however, there was no effect on average pain. Conclusions: Pain education interventions addressed to patients and their caregivers could have positive effects on cancer-related pain. It is recommended that a minimum of three sessions of about one hour’s duration be held once a week. Further research needs to be carried out and analyzed on the effects over the long term. Pain education interventions show positive results in improving pain in cancer patients regardless of etiology or extent of the cancer. Studies with better methodological quality should be carried out to address specific components related to education interventions.

Diagnostic Accuracy of Posterior Circulation Stroke by Paramedics: A Systematic Review

Objective This systematic review aims to identify the diagnostic accuracy of posterior circulation stroke (PCS) by paramedics and the causes and duration of delay in its recognition. Methods A systematic search using CINAHL Plus, MEDLINE, Scopus, and PubMed was performed. All databases were searched up to May 25, 2022. Studies were included where patients were adults, assessed by paramedics, and PCS was the primary diagnosis. Bias was assessed using the Newcastle-Ottawa Scale and the Effective Practice and Organization of Care tool. Results have been described by proportions, and both sensitivity calculations and subgroup analysis were performed utilizing MedCalc. Results A total of 797 titles/abstracts and a subsequent 87 full texts were screened, of which 15 were included. There were 5395 patients who were assessed by paramedics and had a confirmed diagnosis of PCS. Among five studies containing both true positive and false negative data, there were 98 (45.8%) true positives. PCS patients lost an average of 27 min (p < 0.001) compared to anterior stroke patients in the prehospital setting. One study revealed that educational intervention, including implementing the finger-to-nose test, increased the sensitivity for diagnosis from 45.8 to 74.1% (p = 0.039) and decreased the time from door to computed tomography from 62 to 41 min (p = 0.037). Conclusion There is a substantial lack of evidence regarding the diagnosis of PCS by paramedics. Despite the low quality of evidence available, overall, the sensitivity for paramedic PCS diagnosis appears to be poor. Further investigation is required into paramedics’ diagnosis of PCS and the use of educational interventions. Prospective Register of Systematic Reviews Registration Number: CRD42022324675.

Factors associated with the evaluation of geriatric assessment (GA) domains by oncology specialists in Mexico.

The use of geriatric assessment (GA) by oncology specialists in Mexico is low. We aimed to explore factors associated with the evaluation of individual GA domains by Mexican oncology specialists. We performed an exploratory analysis of a sequential explanatory mixed-methods study consisting of an online cross-sectional survey of Mexican oncology specialists and follow-up interviews on the use of GA in cancer care. For each GA domain, we performed multivariable logistic regression analyses with the frequency of evaluation of the domains as the dependent variable (dichotomised as never/rarely/sometimes versus most of the time/always). A p-value <0.05 was considered significant. Qualitative data from the interviews were analysed inductively. Of 196 respondents, 62% were male, 50% were surgical oncologists, 51% took care of >10 patients per day and 61.7% had access to a geriatrician. Self-perceived confidence in managing common geriatric conditions was associated with the evaluation of specific GA domains. For instance, self-perceived confidence in managing dementia (OR 2.72; 95% CI 1.42-5.51, p = 0.008) was associated with cognition evaluation, while for evaluation of falls, self-perceived confidence in evaluation of falls (OR 6.31; 95% CI 3.19-12.46, p < 0.001) was significantly associated. Follow-up interviews showed quality and appropriateness of evaluations may not be ideal: in many cases, physicians do not use guideline-recommended tools. For example, evaluation of cognition is commonly performed through non-validated methods which may miss the detection of patients with an impairment in this domain, partly due to limitations in knowledge and time to use recommended tools. In conclusion, self-perceived confidence in evaluating and managing common situations in older adults was associated with the evaluation of GA domains as part of everyday practice in a sample of oncology specialists in Mexico. This analysis supports the use of educational interventions to boost knowledge and confidence regarding the proper use of validated GA tools among oncology specialists.

Irrational prescription and its costs in neonatal surfactant therapy: public and private hospitals of Iran in 2018

BackgroundIrrational prescription and its subsequent costs are a major challenge worldwide. Health systems must provide appropriate conditions for the implementation of national and international strategies to prevent irrational prescription. The aim of the present study was to determine the irrational surfactant prescription among neonates with respiratory distress and the resulting direct medical costs for private and public hospitals in Iran.MethodsThis was a cross-sectional descriptive study performed retrospectively using data belonged to 846 patients. Initially, the data were extracted from the patients’ medical records and the information system of the Ministry of Health. The obtained data were then compared with the surfactant prescription guideline. Afterward, each neonatal surfactant prescription was evaluated based on the three filters listed in the guideline (including right drug, right dose, and right time). Finally, chi-square and ANOVA tests were used to investigate the inter-variable relationships.ResultsThe results showed that 37.47% of the prescriptions were irrational and the average costs of each irrational prescription was calculated as 274.37 dollars. It was estimated that irrational prescriptions account for about 53% of the total surfactant prescription cost. Among the selected provinces, Tehran and Ahvaz had the worst and the best performance, respectively. As well, public hospitals outperformed private hospitals in terms of the in drug selection, but they underperformed them in terms of the right dose determination.ConclusionThe results of the present study are considered as a warning to insurance organizations, in order to reduce unnecessary costs caused by these irrational prescriptions by developing new service purchase protocols. Our suggestion is the use of educational interventions to reduce irrational prescriptions due to drug selection as well as using computer alert approaches to reduce irrational prescriptions caused by wrong dose administration.

Educational interventions for deaf and hard-of-hearing children in preschool: a systematic review

ABSTRACT Educational intervention is known to enhance learners in general, including deaf and hard-of-hearing (DHH) learners in particular. This study is a systematic review to identify educational interventions in Arab experimental studies published from 2008 to 2019 concerning deaf and hard-of-hearing children in preschool. The study used Google Scholar and Academic Research Library to identify 30 studies that were examined in terms of their objectives, characteristics of the participants, types of interventions, findings and the country in which they were conducted. A positive effect of the educational interventions was observed in all targeted studies. However, there was an absence of interventions in the first 4 years of the period (2008–2011). Subsequently, in the last 4 years of the study period, there was a considerable increase in interventions. Fifty-seven percent of these studies were conducted in Egypt, followed by the Kingdom of Saudi Arabia (23%), Kuwait (10%) and finally Sudan (3%). This review indicates that the use of educational interventions for deaf and hard-of-hearing children in the preschool period is promising. Educators and professionals should carefully consider these children’s preferences, characteristics and actual abilities when making decisions about the design of appropriate educational interventions.

Implementation of the Hand Hygiene Eczema Education Program to Improve Patient Knowledge and Symptoms

Background: COVID-19 hand hygiene recommendation had resulted in a hand eczema -exacerbation. The guidelines of care for the management of hand eczema recommend the use of educational interventions for patients. Objective: An educational intervention was designed to increase the patient's knowledge of appropriate hand hygiene and improve the patient's symptoms. Methods: The validated self-assessment patient-oriented eczema measure tool and pre- and post-tests were used to measure outcomes prior to educational intervention and again in 1-2 months postintervention. Of the 26 participants enrolled, 21 completed the study. The study included newly diagnosed or established patients with eczema, and the education material was available for all patients. Results: The difference between the average pretest and initial posttest was statistically significant (df = 20, P (T ≤ t) = 0.000663535, p < .05). Similarly, the difference between the average pretest and follow-up posttest was also statistically significant (df = 20, P (T ≤ t) < 0.001, p < .05). Participants also had a 2.04 mean point decrease in symptoms severity. Conclusions: The results demonstrated an improvement in patient's knowledge and reduction in symptoms. Implications for Nursing: The program can serve as a new guideline for managing hand eczema symptoms due to COVID-19 in the adult population in the private office setting.

The Use of Educational Interventions to Reduce Unnecessary Lipase Measurement in Patients with Acute Pancreatitis: A Quality Improvement Project

The Use of Educational Interventions to Reduce Unnecessary Lipase Measurement in Patients with Acute Pancreatitis: A Quality Improvement Project

Prehabilitation. An Interdisciplinary Patient-Centric Conceptual Framework

To review the recent literature around patient-centric prehabilitation in oncology patients and propose a conceptual framework to inform development of interdisciplinary prehabilitation services leading to focused, individualized prehabilitation interventions. A review of recent peer-reviewed literature, national guidance, and government strategy on prehabilitation in oncology patients. Patient- centric prehabilitation is key to improving patient's experiences of cancer throughout the cancer journey while improving population health and reducing financial costs. Successful personalized prehabilitation interventions are comprised of an interplay between individual interdisciplinary roles, as illustrated in the conceptual framework. The role of the nurse underpins this whole process in patient screening, assessment, implementation of the intervention, and patient reassessment, ensuring care is dynamic and tailored to patient need. The review has discussed the key role that nurses play in the process but warrants more research in the area. The conceptual framework provides a basis to develop interdisciplinary prehabilitation services underpinned by the nurse's role. The review advocates the use of educational interventions to equip all health professionals with prehabilitation knowledge to enable interdisciplinary prehabilitation services to be developed.

Irrational prescription of surfactant replacement therapy in neonatal respiratory distress.

PurposeRespiratory distress is known as one of the leading causes of neonatal death. In recent decades, surfactant therapy has revolutionized respiratory failure. Since the implementation of the health system reform plan as well as the allocation of new financial resources for health system in Iran, the rate of irrational prescription has increased and prescription of surfactant for neonates, has raised unexpectedly, which is thought to be due to irrational prescriptions partly. The present study aimed to determine the rate of irrational prescription of surfactant for neonates with respiratory distress.MethodsThis research was a cross-sectional descriptive study, which was conducted retrospectively. In the current study, determining the rate of irrational prescription was done in terms of the surfactant prescription guideline. Finally, the medical data of 846 neonates who underwent surfactant therapy in Iran in 2018, were extracted from the information system of the Ministry of Health and the neonatal medical records.ResultsThe results show that drug selection index, dose index, and time index were irrational for 14.30%, 27.42%, and 1.06% of neonates, respectively. Moreover, the total index of drug prescription, which is a combination of the above-mentioned three components, was found to be irrational for 31.47% of neonates.ConclusionsThe results of the present study are considered as a warning to providers and decision makers in the field of neonatal health to reduce irrational prescriptions of surfactant for neonates. This study suggests the use of educational interventions in order to reduce irrational prescriptions due to drug selection as well as the use of computer alert approaches in order to reduce irrational prescriptions due to wrong dose.

Factors associated with the evaluation of geriatric assessment (GA) domains by oncology specialists in Mexico.

12050 Background: Use of GA by oncology specialists is low in Mexico, with some of the domains of the GA more frequently assessed than others in everyday practice. We aimed to explore factors associated to the evaluation of individual GA domains by Mexican cancer care providers. Methods: Secondary analysis of a mixed-methods study which consisted of an online cross-sectional survey of Mexican oncology specialists and follow-up interviews on the use of GA in cancer care. We performed multiple logistic regression analyses with frequency of evaluation of specific GA domains as the dependent variable (dichotomized as never/sometimes vs most of the time/always). Independent variables included age, gender, medical specialty, and practice size of the survey respondent, presence of a geriatrician in main practice site, and perceived confidence in managing common situations in older adults relevant for each GA domain (dichotomized as not at all/mildly vs very/completely). A p-value of &lt; 0.05 was considered significant in each model. Results: Of 196 survey respondents, 62% were male, 50% surgical oncologists, 51% took care of &gt; 10 patients per day, and 61.7% had access to a geriatrician at their main practice site. Frequently (most of the time/always) evaluated domains included: comorbidities (94.4%), daily function (72.9%), nutrition (67.3%), cognition (54.1%), depression (42.9%) and falls (42.3%). Self-perceived confidence in managing dementia (OR 2.72; 95% CI 1.42-5.51, p = 0.008) and being a surgical oncologist (OR 2.80; 95% CI 1.29-5.72, p = 0.003) were associated with increased evaluation of cognition. For nutrition, only self-perceived confidence in nutritional evaluation was associated (OR 3.86; 95% CI 2.0-7.46, p &lt; 0.001). For comorbidities, self-perceived confidence in managing osteoporosis (OR 5.61; 95% CI 1.03-30.4, p = 0.046). For falls, significant factors included age (OR 1.04; 95% CI 1.01-1.07, p = 0.004), practice size (OR 0.46; 95% CI 0.23-0.91, p = 0.026), and self-perceived confidence in evaluation and prevention of falls (OR 6.31; 95% CI 3.19-12.46, p &lt; 0.001). Age (OR 1.03; 95% CI 1.01-1.06, p = 0.011) and self-perceived confidence in managing depression (OR 2.52; 95% CI 1.33-4.78, p = 0.005) were associated with evaluation of depression. For daily function, no variables were significantly associated. Follow-up interviews showed quality and appropriateness of evaluations may not be ideal, such as asking only about orientation and level of consciousness when evaluating cognition. Conclusions: Self-perceived confidence in evaluating and managing common situations in older adults is associated with the evaluation of GA domains as part of everyday practice among cancer care providers in Mexico. This analysis supports the use of educational interventions to boost knowledge and confidence regarding the proper use of validated GA tools among oncology specialists.

Effect of educational interventions on level of epilepsy knowledge in children with epilepsy and parents: Systematic review and meta-analysis.

The aim of the study was to synthesise the effect of educational interventions on the level of epilepsy knowledge in children with epilepsy and parents. Educational interventions are commonly used to provide knowledge about epilepsy management. One of the most important responsibilities of nurses is to inform children with epilepsy and parents in a skilful way. Systematic review and meta-analysis based on PRISMA 2020. We searched CINAHL, Cochrane Library, Science Direct, Web of Science, Ovid, PubMed, Scopus, Springer Link, ProQuest, TR Index ending March 2021. The review followed the PRISMA guidelines. This meta-analysis was analysed in Comprehensive Meta-Analysis version 3software. The risk of bias of included studies was assessed with the Cochrane handbook. The results were the level of epilepsy knowledge of children and parents. Ten studies meeting the inclusion criteria were included in this meta-analysis, including four randomised studies and six non-randomised studies. Educational interventions had large effect on improving the level of epilepsy knowledge in children with epilepsy (p<.001, Hedge's g=1.19) and parents (p<.001, Hedge's g=1.41). As a result of the subgroup analyses, significant differences were found only in the type of educational intervention. It was found that traditional education is more effective than technology-based education in improving the level of epilepsy knowledge in parents (p=.005, Hedge's g=1.77). Educational interventions have high and beneficial effect on the level of epilepsy knowledge in the children with epilepsy and parents; can be used as effective interventions in the epilepsy management. However, due to low number of randomised controlled studies, further high-quality randomised controlled studies are needed about this topic. The findings will contribute to the use of educational interventions in the epilepsy management for health professionals, especially nurses. Thus these interventions will contribute to improving epilepsy management of children with epilepsy and parents.

Factors related to cervical cancer screening among Asian women.

Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by approximately 90% in developing countries, the gynecologist is still confronted with women in advanced stages of the disease. The eradication of cervical cancer depends on identifying the disease early and removing barriers to its timely detection. Given the significant burden of cervical cancer in Asian countries, we investigated factors related to its screening in Asia. A comprehensive search was carried out in databases such as Medline, Web of Science and Scopus for articles published until September 2020. The following keywords were used: vaginal smear, Pap smear, cervical cancer screening, barriers, obstacles, challenge, early detection, the name of each Asian country, and a combination of these words. Seventy-five articles were included in the study. The investigation revealed various factors related to cervical cancer screening in Asian women, including sociodemographic factors, awareness, attitudes and beliefs, perceived risk, psychological factors, self-efficacy, previous experiences, time, household, culture, fatalism, social support, access, cost, safety, insurance and health system-related factors. Several barriers hinder the efficacy of a screening program. Its success requires the use of educational interventions, professional and inter-professional cooperation, allocation of sufficient resources, and policymakers focusing on the elimination of barriers.

Reducing the number of unnecessary laboratory tests within hospital through the use of educational interventions.

The growing number of laboratory investigation requests is placing an increased burden upon NHS resources. Around a quarter of all tests are unnecessary repeats, and almost a third have no impact on patient management. Doctors recognise that tests should only be performed when clinically indicated, but a culture persists of undertaking unnecessary repeat investigations. A cohort study was undertaken at a district general hospital to observe the impact of introducing educational interventions in the form of a poster and a series of educational lectures, encouraging clinicians to consider whether an investigation was clinically indicated. Data was collected from nine different sites across the hospital run by different medical teams regarding the number of tests undertaken and the impact on patient care. Data from over 13,000 tests and over 2000 patients was analysed from nine different sites across the hospital. There was a significant reduction (33%, p = 0.0001) in the number of blood tests performed. This reduction in testing saved £7006 over the course of 1month, in addition to other benefits. There was a reduction in testing in eight out of the nine sites in which the study was undertaken, demonstrating good generalisability of results. There was no significant increase in length of admission or mortality. Educational interventions to doctors have a significant and safe impact in reducing the number of unnecessary investigations, providing cost saving benefits to the NHS.

Validation of the eHealthResp online course for pharmacists and physicians: A Delphi method approach

FrameworkThe inappropriate use of antibiotics for respiratory tract infections is dispersed worldwide, thus being a strong contributor to antibiotic resistances. As the use of educational interventions among health practitioners is shown to have an impact on judicious antibiotic use, an online course (eHealthResp) has been developed, especially targeted to pharmacists and physicians. Thus, the main goal of this study is to validate the contents of the online course eHealthResp. MethodsThis two-round Delphi study involved the recruitment of a multidisciplinary panel (n = 19), to which the questionnaires of the first round were sent. After the first round, a report summing up the results has been forwarded to the panel, along with a new, reformulated version of the questionnaire. ResultsAfter the two rounds of the Delphi process, consensus was evaluated. Six clinical cases and fifty-one treatments obtained minor consensus [60–75%] or full consensus (≥75%). The question on antibiotic practice has obtained a consensus >90% on both rounds. ConclusionsThe validation of the contents based on experts’ consensus has been an essential approach to improve eHealthResp’s online course, as valuable feedback has been provided by the panel on both rounds.

Impact of educational intervention on cervical cancer screening uptake among reproductive age women

The objective of this review is to examine the efficacy of educational approaches in increasing women's adoption of cervical screening. A search was conducted through PubMed, Medline and Google Scholar. Articles that met the eligibility criteria were reviewed. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guided the data synthesis and reporting. We conducted a qualitative synthesis of evidence and pooled individual research results in meta-analyses using RevMan 5.3 review manager, where applicable. Heterogeneity has been estimated for total summary results of studies pooled together. Quality analysis of the papers was done using JADAD scale. This meta-analysis included a total of nine articles (n=2316). Statistical research findings indicate that the use of cervical cancer educational approaches substantially improved cervical cancer screening rates and screening acceptability by double folds 2.88. The results of this study support the use of educational intervention for cervical cancer to increase the acceptance of cervical cancer screening by women. We also recommend more research to assess the efficacy of various teaching approaches and the effect of intervention length on the rise in women's cervical cancer screening services utilization.

An An assessment of the impact of educational interventions on hand hygiene compliance

PICO question&#x0D; In small animal veterinary professions, does implementation of an educational intervention, when compared to no intervention, improve hand hygiene compliance?&#x0D; &#x0D; Clinical bottom line&#x0D; Category of research question&#x0D; Treatment&#x0D; The number and type of study designs reviewed&#x0D; Three papers were critically appraised. They were all prospective observational cohort studies&#x0D; Strength of evidence&#x0D; Weak&#x0D; Outcomes reported&#x0D; Two out of the three papers did not find educational implementation to have a statistically significant positive effect on hand hygiene compliance (HHC) in small animal veterinary professionals&#x0D; Conclusion&#x0D; The veterinary evidence reviewed does not provide strong justification for the use of education in the improvement of HHC in small animal practice. This contrasts with extensive human evidence which supports the use of educational interventions (Helder et al., 2010). However, a limited veterinary knowledge base in the field of HH, combined with the flawed methodologies of the appraised literature, suggests that this finding is not representative of the effect education could have on HHC.&#x0D; The conclusion drawn from the evidence assessed within this Knowledge Summary is that educational interventions are not significantly linked to an improvement in HHC within a small animal veterinary setting. When considering the volume of human evidence which supports education as a tool to improve HHC, the authors suggest this Knowledge Summary should be repeated in the future when additional veterinary evidence is available to reassess the conclusion drawn&#x0D; &#x0D; How to apply this evidence in practice&#x0D; The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.&#x0D; Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.&#x0D; &#x0D;

Opioid Consumption Following Breast Surgery Decreases with a Brief Educational Intervention: A Randomized, Controlled Trial.

Current rates of opioid prescribing and consumption in the United States have resulted in deleterious consequences for both patients and society. There has been a focus on opioid consumption and overprescribing, but the utility of patient education in reducing opioid consumption has only recently been explored. This randomized trial aimed to evaluate the effectiveness of a brief patient educational intervention in reducing pain and opioid consumption in patients undergoing mastectomy and breast reconstruction. A parallel, randomized, single-center trial of women undergoing mastectomy with immediate, implant-based breast reconstruction was completed to evaluate the utility of a patient educational instrument with information on multi-modal pain control. A questionnaire was administered postoperatively to collect data on pain control and opioid consumption. Fifty participants were randomized to each group preoperatively; 46 control (92%) and 39 intervention (78%) participants completed the postoperative questionnaire. Active tobacco use was more common in the control group (p = 0.04). There was a trend towards lower pain scores in the intervention group (3.0/10, SD 1.8 vs 3.6/10, SD 1.6, p = 0.06). Both groups were prescribed a median of 32.0 5-mg oxycodone tablets postoperatively. Participants in the intervention group consumed 33% fewer opioids than the control group (16.2 tablets, SD 16.4 vs 24.3 tablets, SD 21.8, p = 0.05). The use of a brief educational intervention provided at a preoperative appointment can reduce opioid consumption. We recommend the use of an educational intervention to decrease opioid consumption among breast surgery patients.

Reducing Student Nurse Stigmatization of the Patient Who Misuses Opioids: A Scoping Review.

The United States is in the midst of an opioid epidemic. The numbers of opioid-related deaths have been steadily climbing, magnifying the need for innovative intervention. Stigma is a set of preconceived, negative assumptions about a patient population or group. Stigma is a known deterrent to communication and the delivery of healthcare. Nurses serve as a primary contact for many marginalized patients within the healthcare system. The purpose of this scoping review is to gather known data on the use of educational interventions with nursing students to reduce stigmatizing tendencies. Inclusion criteria constituted an educational intervention involving student nurses and an effort to reduce stigmatizing attitudes toward patients who misuse opioids. The intervention must have taken place in an institute of higher learning between the years of 2003 and 2018. Exclusion criteria included community-wide studies. A single study was identified addressing nursing student reduction of stigmatization of the individual who uses opioids, and so, the search was expanded to include any student nursing intervention developed to reduce stigma toward any marginalized population. The following electronic databases were utilized in the search process: Cumulative Index of Nursing and Allied Health Literature, Google Scholar, Journal Storage, Microsoft Academic, and ScienceDirect. Reference pages of selected or related articles were reviewed in an attempt to identify additional pertinent literature through citation mapping. Fifteen studies were identified, each of which utilized a variable methodology for stigma reduction with varying levels of success.

Impact of Institutional Quality on Educational Attainment: The Case of Low-Income SSA Countries

Education produces many social, political and economic outcomes including improved cognitive competences, higher wages, better health and enhanced economic status. Nations ensure the development of their population by the use of educational intervention. Despite the documented empirical correlations of education attained, there have been scanty researches exploring the impact of institutional quality in low-income SSA countries. The problem facing SSA can be ascertained in the area of weak institutions which leads to poor level of educational attainment and low level of life expectancy which have become the focus of the development agenda in the world as a whole and developing countries in general. The objective of this study is to evaluate the relationship between institutional quality and educational attainment in low-income SSA countries from 2005 to 2013. The research used secondary data sourced from World Bank governance indicators, Transparency International and Heritage Foundation. The analysis was divided into panel data using the fixed effects method (FEM) and generalized method of moments (GMM). Both the panel data analysis and the generalized method of moments of institutional quality and educational attainment indicated that most of the countries investigated exhibits mixed performance in institutional quality. The study recommends policies to reduce corruption in all levels of economic activities. In addition, rule of law need to be strengthened and the educational sector should be refined to train manpower in all aspect of human activities in the region especially the low-income countries in SSA countries.