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Introduction: In recent decades, an increase in the incidence of type 2 diabetes mellitus (T2DM) in children and adolescents has been observed. Pediatric‐onset T2DM differs from the adult‐onset form, particularly regarding the durability of glycemic control and earlier appearance of complications. However, the scarcity of approved treatments and comprehensive studies on T2DM management in youth persists. Ongoing clinical trials seek to ascertain the efficacy and safety of sodium‐glucose cotransporter 2 inhibitors (SGLT2i) in patients aged between 10 and 24 years with T2DM. Therefore, we aimed to perform a meta‐analysis exploring the efficacy and safety of SGLT2i in pediatric patients and young adults with T2DM. Methods: We searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled clinical trials on the efficacy and safety of SGLT2i in children, adolescents, and young adults with T2DM compared with placebo. Statistical analysis was performed using RevMan 5.4 and R statistical software 4.2.1. Heterogeneity was assessed with I2 statistics. Results: We included three studies totaling 334 patients followed for 37.79 weeks. Reduction in HbA1C (MD = −0.93; 95% CI = −1.36 to −0.49; p < 0.0001; I2 = 0%) was significantly higher in SGLT2i group compared with placebo. The proportion of patients requiring rescue or discontinuation of study medication due to lack of efficacy was statistically lower in SGLT2i group compared with placebo (RR = 0.64; 95% CI = 0.43–0.94; p = 0.02; I2 = 0%). SGLT2i and placebo were similar in terms of any adverse event (RR = 1.10; 95% CI = 0.96–1.27; p = 0.17; I2 = 0%), serious side effects (RR = 1.06; 95% CI = 0.44–2.57; p = 0.90; I2 = 0%), and individual adverse effects. Conclusion: In children, adolescents, and young adults with T2DM, SGLT2i appears to be effective and safe for glycemic control. [ABSTRACT FROM AUTHOR]

Background: Pneumatosis intestinalis (PI) and pneumoperitoneum are some of the complications after lung transplantation (LT). But only limited reports are published. The purpose of this study is to review our experience and perform a systematic review to discuss the possible causes, risk factors, and management. Methods: We reviewed the characteristics, management, and outcome of the patients who developed PI or pneumoperitoneum after LT in our institution from 2013 to 2022. We also performed a systematic review to discuss the management and outcome. Results: PI and pneumoperitoneum were found in 15 out of 729 patients (2.06%) in our institution. We also found 50 patients in the systematic review. Tracheostomy was performed in 40% and gastrointestinal procedures were performed in 55.6%. Laparotomy was performed in 23.4%. A total of 44.6% of patients had benign physical exams or no symptoms. Rejection was seen in 42.9%. A total of 28.6% of patients died during follow‐up periods. Conclusions: This report has the largest number of patients so far with PI and pneumoperitoneum after LT. These conditions have a high rejection and high mortality rate. Mechanical ventilation, tracheostomy, gastrointestinal procedure, CMV infection, Clostridium difficile (C. difficile) infection, and immunosuppression can be the risk factors, and the management includes laparotomy or conservative management. It is generally recommended to proceed with laparotomy if patients have portal venous gas, elevated white blood cell count, elevated lactic acid level, decreased bicarbonate level, elevated amylase level, metabolic acidosis, abdominal tenderness, or abdominal distension. Otherwise, most of the patients recover with conservative management with nil per os (NPO), metronidazole, ganciclovir, antibiotics, high‐flow oxygen, and holding mycophenolate mofetil (MMF). [ABSTRACT FROM AUTHOR]

Background: Curcumin is a polyphenol compound with anticancer effects. We aimed to review the anti‐neoplastic effects of curcumin on urogenital cancers, by regulating different microRNA expressions. Methods: A systematic search was conducted in Medline (PubMed), Embase, Scopus, and Web of Science up to the end of August 2024. All English, in vitro, and observational studies that evaluated the effect of curcumin on preventing or treating urogenital cancers through its impact on microRNA expression were included. In vivo or silico studies were excluded. Result: A total of 2549 records were found. Finally, 25 studies were included. Twelve studies assessed the effect of curcumin on prostate cancer, six studies on ovarian cancer, three studies on cervical cancer, three studies on bladder cancer, and one study on renal cancer. MicroRNAs are small noncoding RNAs that regulate the post‐transcriptional pathways. They possess pivotal roles in different fundamental mechanisms in cells such as differentiation, migration, apoptosis, and proliferation. Curcumin exerts its anticancer effects on urogenital neoplasms by upregulating tumor suppressor microRNAs (miR‐143, miR‐145, miR‐Let‐7, miR‐101, miR‐3127, miR‐3178, miR‐1275, miR‐3198, miR‐1908, miR‐770, miR‐1247, miR‐411, miR‐34a, miR‐383, miR‐708, miR‐483, miR‐199a, miR‐335, miR‐503, miR‐10b, miR‐551a, miR‐9, miR‐203, miR‐7110, miR‐29b, and miR‐126) and downregulating oncogenic microRNAs (miR‐21, miR‐210, miR‐382, miR‐654, miR‐494, miR‐193b, miR‐671, miR‐222, miR‐23b, miR‐664, miR‐183, miR‐214, miR‐320a, miR‐23a, miR‐30a, miR‐320d, miR‐1285, miR‐32, miR‐181a, miR‐205, miR‐216a, miR‐1246, and miR‐106b). Conclusion: Cell proliferation is inhibited, and cell apoptosis is induced by curcumin in different urogenital cancers through suppressing oncogenic microRNAs or provoking tumor suppressor microRNAs. [ABSTRACT FROM AUTHOR]

A biomarker is defined as a characteristic that is measured as an indicator of a normal biological or pathological process, a response to an exposure or intervention. Biomarkers with a diagnostic approach must identify not only the presence but also the absence of the disease with high precision, so having the biological source of the said marker is of vital importance to ensure precision and accuracy; the aim was to carry out a review of its diagnostic potential. The search strategy was carried out in three databases: PubMed, ScienceDirect, and Scopus. The keywords that were used were as follows: "gingival crevicular fluid", "Biomarker", and "Diagnosis", using the Boolean operator "AND". The filter was used at 10 years. Within the type of molecules most studied, the cytokine family was the most abundant with 25.42% of the studies, followed by metalloproteinases and proteins with 16.9% each one. Studies that included RNA‐type genetic material were less frequently found. As has been demonstrated, the use of GCF as a source of biomolecules for diagnostic use has been increasing, both for oral diseases, which reflects the local conditions of the disease; it also has the ability to reflect the development of distant diseases; and this is because GCF is a blood ultrafiltrate. [ABSTRACT FROM AUTHOR]

Aims: This scoping review aims to examine the level and outcomes of emotional labor in nurses. Background: Nursing is a highly emotional profession that requires nurses to experience a wide range of emotions and control their emotional expressions in nursing practice. Chronic emotional labor and emotional burden not only impact nurses' individual well‐being and professional performance but also their job satisfaction and turnover intention. Evaluation: This scoping review was guided by a five‐stage scoping review framework and the PRISMA‐ScR checklist. Eight databases were searched and 41 studies were reviewed. Key Issues: The Emotional Labor Scale and the Emotional Labor Scale for Nurses were the most commonly used instruments. Significant associations were found between emotional labor and 52 outcomes, which were categorized into two main themes: nurses' personal well‐being and organizational well‐being. There were 19 mediators and 12 moderators between nurses' emotional labor and 26 different outcomes. Conclusions: While the level of emotional labor among nurses remains uncertain, its consequences are plentiful and intricate. Studies have shown an important relationship between nurses' emotional labor and individual and organizational well‐being, which is crucial for nurse managers. There is a need to explore the positive effects of nurses' emotional labor and its impact on patients. Additionally, validation studies of the instruments used to measure nurses' emotional labor are necessary. Implications for Nursing Management: The insights gained from this scoping review provided a more comprehensive understanding of emotional labor for nurse managers. This knowledge can be utilized to design training programs on emotional management and to explore different interventions aimed at alleviating the adverse impacts of nurses' emotional labor. [ABSTRACT FROM AUTHOR]

Aim: To describe the use of artificial intelligence (AI) by nurse managers to enhance management, leadership, and healthcare outcomes. Background: AI represents a significant transformation in healthcare management by enhancing decision‐making, communication, and resource optimization. However, the integration and strategic application of AI in nursing management are underexplored, particularly regarding its impact on leadership roles and healthcare delivery. Methods: Methodological guidelines described by PRISMA were followed, and quality was assessed using the Joanna Briggs Institute (JBI) methodology. The databases searched included the Web of Science, Scopus, CINAHLi, and PubMed. The review included quantitative, qualitative, and mixed‐method studies published between January 2015 and April 2024. Results: Fourteen studies were selected for the review. The key findings indicate that AI technologies facilitate better resource management, risk assessment, and decision‐making. AI also supports nurse managers in leading changes, enhancing communication, and optimizing administrative tasks. Conclusion: AI has been progressively integrated into nursing management, demonstrating significant benefits in operational efficiency, decision support, and leadership enhancement. However, challenges, such as resistance to technological change and ethical complexities, need to be addressed. Implications for Nursing Management: Specific training programs for nurse managers are essential to optimize the integration of AI. Such programs should focus on the management of AI applications and data analyses. In addition, creating interdisciplinary groups involving nurse managers, AI developers, and nursing staff is crucial for tailoring AI solutions to meet the unique needs of healthcare settings. [ABSTRACT FROM AUTHOR]

Introduction. Social prescribing (SP) is an integrated care program aimed to improve individuals' health and wellbeing. Understanding the influence of SP and determining best practices and processes are challenging due to variability in its delivery, implementation, and intervention characteristics between different studies and countries. This study aimed to identify the intervention characteristics, mechanisms, and outcomes associated with SP research and explore how these factors relate to the influence of SP on health and wellbeing, healthcare utilization, and care experiences. Method. A comprehensive search was conducted in twelve databases, Google Scholar, and reference lists of relevant studies published from January 2010 up to April 2023. Searches were limited to literature written in English or Dutch. We utilized ASReview, an open‐source machine learning tool, to conduct title and abstract screening. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool, and the risk of bias was evaluated using the Cochrane RoB2 and the ROBINS‐I. We coded all intervention characteristics, mechanisms, and relevant outcomes. Quantitative data were visually presented using Harvest Plots, and qualitative data were narratively summarized. Results and Discussion. In total, 49 papers were included, of which seven qualitative, seventeen quantitative, and 25 mixed method studies. The findings highlight the importance of social‐related mechanisms, including loneliness and social connectedness, in contributing to the observed positive influence of SP on mental health and wellbeing. The observed outcomes seem to be influenced by various characteristics, including gender, age, the presence of a link worker, and the use of behavior change techniques. However, we should be cautious when interpreting these results due to limitations in study designs, such as the lack of controlled trials and statistical considerations. Further rigorous research is needed to comprehensively understand the impact and potential benefits of SP. [ABSTRACT FROM AUTHOR]

Health and social needs exist along a dynamic continuum. Recognising that health status is inextricably impacted by social determinants of health, community paramedicine has opportunities and a responsibility to reduce inequities. The objective of this scoping review was to investigate the peer‐reviewed and grey literature to explore how community paramedicine supports community needs along a health and social continuum. We conducted a scoping review of the English language literature using the JBI Scoping Review methodology. We searched CINAHL, EMBASE, MEDLINE, Google Scholar, and organisational websites. 30 peer‐reviewed and 13 grey literature articles met the inclusion criteria. The findings describe the ways community paramedicine models evolved from minimising system pressures on emergency health services to addressing health and social needs. A key recommendation across the literature was the need to meaningfully engage communities early in the program development to understand how best to implement and codesign integrated service models addressing specific community needs although there was a lack of evidence to guide this approach. There is a notable lack of evidence pertaining to optimising technologies in the program design and implementation. The results highlight opportunities to determine the best practices for conducting holistic community needs assessments that include equitable stakeholder engagement and enhancing education to prepare paramedics for expanded roles. Community paramedicine provides opportunities to better meet the needs of structurally marginalised communities. There is a social responsibility and opportunity to engage communities to codesign service delivery, advance paramedic education, and enhance interprofessional collaboration to better support community needs and generate upstream solutions for individuals and communities. [ABSTRACT FROM AUTHOR]

A pervasive barrier to preventing, reducing, and ending homelessness is the stigmatization of and discrimination towards persons experiencing homelessness (PEH), termed "homeism." To date, there has been no systematic review of the experiences and outcomes of stigmatization and discrimination among PEH or interventions to reduce this discrimination. To fill this gap in the literature, we conducted a scoping review to identify the ways in which PEH have been stigmatized and discriminated against, the results of these experiences, and interventions that have been used to reduce stigma and discrimination. We reviewed results from 12 databases with no date restrictions; 205 studies met our inclusion criteria. Thematic data analyses resulted in the identification of 12 categories. Using community consultation, the scoping review themes were reviewed and validated with 25 PEH or service providers in the homelessness sector and their feedback integrated into our results. Thematic categories included discrimination and stigmatization in healthcare, social services, workplaces and employment, and public spaces by the general public; discrimination and stigmatization from landlords, police and security guards, informal social networks, and by PEH toward PEH; discrimination and stigmatization linked to intersectional domains; PEH feelings about discrimination and stigmatization; outcomes of discrimination and stigmatization for PEH; and interventions to reduce stigma, discrimination, and prejudice towards PEH. Based on findings from this review, we argue that homeism serves as a social determinant of health as PEH confront multiple barriers to housing, income security, and healthcare due to interpersonal, institutional, structural, and intrapersonal stigmatization and discrimination. [ABSTRACT FROM AUTHOR]

Young people with type 1 diabetes mellitus (T1DM) transition from paediatric to adult services when they reach late adolescence. This can be a risky period for young people, and it has been associated with a deterioration in glycaemic control and disengagement from diabetes services. This review aimed to identify current interventions addressing the following questions: What adolescents with T1DM healthcare transition interventions have been evaluated? What are the underlying theories and components of these interventions? What outcomes have been considered in these evaluations? Databases, trial registries and other sources were searched using the population and intervention keywords. Studies were included if they explicitly reported a transition intervention targeting young people aged 10–25 years. Studies were critically apprised, and data were extracted. Both tabular and narrative data synthesis were used. The review included 22 studies. Most interventions were service‐oriented, with little use of theory. The interventions included transition planning, service coordination, pre‐transition education, transition clinics, prompting strategies and other less frequent components. Most studies reported metabolic outcomes, with limited data on psychological outcomes such as diabetes adaptation, acceptance and self‐management activation. It is inconsistent how each outcome was defined, measured or reported. Consequently, effective theory‐based interventional transition models are yet to be identified. [ABSTRACT FROM AUTHOR]

Background. Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) are an intriguing class of antihyperglycemic drugs for type 2 diabetes mellitus (T2DM). Such drugs not only play a primary role in regulating blood glucose levels but also exhibit additional pleiotropic effects, including potential impacts on bone metabolism and fracture risk. However, the mechanism of such drugs is unclear. The purpose of this study was to evaluate the effect of GLP‐1 RAs on bone metabolism in T2DM. Methods. From database inception to May 1, 2023, the searches were conducted on multiple databases such as Web of Science, Embase, PubMed, CNKI, the Cochrane Library, Wanfang, and VIP. We systematically collected all randomized controlled trials of bone metabolism in patients with T2DM treated with GLP‐1 RAs. The quality evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was analyzed using Review Manager 5.4 software, and funnel plots were drawn to evaluate publication bias. Results. Twenty‐six randomized controlled trials that met the inclusion criteria were included, involving a total of 2268 participants. In this study, compared to other antidiabetic drugs or placebo, GLP‐1 RAs were found to significantly increase serum calcium (mean difference (MD) = 0.05, 95% confidence interval (CI) (0.01, 0.09), P = 0.002], bone alkaline phosphatase [standardized MD (SMD) = 0.76, 95% CI (0.29, 1.24), and P = 0.001), and osteocalcin (SMD = 2.04, 95% CI (0.99, 3.08), and P = 0.0001) in T2DM. Specifically, liraglutide increased procollagen type 1 N‐terminal propeptide (SMD = 0.45, 95% CI (0.01, 0.89), and P = 0.04). GLP‐1 RAs were also associated with a reduction in cross‐linked C‐terminal telopeptides of type I collagen (SMD = −0.36, 95% CI (−0.70, −0.03), and P = 0.03). In additionally, GLP‐1 RAs increased lumbar spine bone mineral density (BMD) (SMD = 1.04, 95% CI (0.60, 1.48), and P < 0.00001) and femoral neck BMD (SMD = 1.29, 95% CI (0.36, 2.23), and P = 0.007). Conclusions. GLP‐1 RAs can not only improve BMD in the lumbar spine and femoral neck of patients with T2DM but also protect bone health by inhibiting bone resorption and promoting bone formation. Systematic Review Registration. PROSPERO, identifier CRD42023418166. [ABSTRACT FROM AUTHOR]

If properly used, condoms can serve as an effective family planning method and preventive tool towards sexually transmitted diseases (STDs). Despite its anticipated effectiveness, there are different myths and misconceptions which have been observed as hindrances to both its use and effectiveness. This review examines the myths and misconceptions of condom use among youths and explores challenges in condom usage in sub‐Saharan Africa (SSA). A narrative review was employed of which different journal articles were reviewed. The search words/phrases were "condom use in SSA, condom use among youths in SSA, myths and misconceptions on condom use among youths in SSA." A total of 1074 studies were identified, 93 were relevant to the topic, and only 71 suited the review. The identified myths and misconceptions of condom use include that males were the ones to decide on the use of condoms during sexual intercourse, economic power determines the use of condoms, condom use reduces sexual pleasure, condom use relates to the spread of HIV/AIDS, and condom use is against God's will. Other identified myths and misconceptions of condom use include that the use of condoms is a sign of lack of trust associated with fornication and adultery, also the use of condoms is only for family planning purposes. The challenges identified were breakage of condom during sexual intercourse, condom slippage, condom leakage, incorrect storage, and reuse of condoms. The identified myths and misconceptions lead to low knowledge of condom use within communities. There is a need for collaboration between governments, researchers, and NGOs to provide education on condom use to communities, particularly youths. [ABSTRACT FROM AUTHOR]

Objective: To describe the profile of Streptococcus pneumoniae, identify research gaps, and provide in‐depth insights into various aspects related to the pathogen. Methods: Google Scholar, PubMed, and ScienceDirect were searched for all studies on the pneumococcus in Ghana that reported on specimen collected, population and sample size, carriage prevalence, incidence of pneumococcal diseases, age of the study population, types of test performed, serotypes identified, antimicrobial susceptibilities, or molecular analysis on the pneumococci for data extraction. Results: Overall, a total of 7954 results were obtained from the three‐database search, and of this, 24 articles were selected after screening. A total of 924 isolates were accounted for by serotyping/serogrouping. The prevalence of pneumococcal carriage in Ghana ranges from 11.0% to 51.4% in the population depending on the age (≤ 24–80 years), sickle cell disease (SCD), human immunodeficiency virus (HIV) status, or health of the study population, and penicillin (Pen)‐nonsusceptible isolates ranged from 17% to 63%. The prevalence of pneumococci found as the etiologic agent of diseases among Ghanaians ranges from 3.4% for otitis media to 77.7% for meningitis. Overall, the 13‐valent pneumococcal conjugate vaccine (PCV) (PCV‐13) carriage serotypes accounted for 28.4% of the reported pneumococcal isolates. PCV‐13 invasive serotypes accounted for 22.4% of the reported isolates. The non‐PCV‐13 carriage serotypes accounted for most (43.9%) of the reported isolates. In the pre‐PCV‐13 era, the nontypeable (NT) (5.5%) and other nonvaccine types (NVTs) (6.4%) were reported as being predominant. The non‐PCV‐13 serotypes accounted for 4.4% of the reported isolates in invasive pneumococcal disease (IPD) cases. Multidrug resistance (MDR) ranged from 7.8% to 100%. Conclusion: Predicting the invasiveness of pneumococci using molecular typing is the way to go in the future as this will provide answers to the extent to which capsular switching is contributing to the pneumococcal disease burden in Ghana almost a decade after introducing PCV‐13. Continuous monitoring of antibiotic resistance patterns at both phenotypic and genotypic levels, along with serotyping and molecular typing, should be a standard practice in the surveillance of pneumococcal disease burden in Ghana. [ABSTRACT FROM AUTHOR]

Background. Paediatric patients in Australia experience lengthy wait times for Primary and Allied Healthcare Service (PAHCS) appointments. This results in a lack of satisfaction and adverse health outcomes. However, very few studies have explored wait times for appointments with PAHCSs in Australia. This study explored the length of wait time and associated barriers to timely access to paediatric PAHCSs in Australia. Methods. The scoping review followed PRISMA‐ScR guidelines for Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. We comprehensively searched for relevant studies from five databases, including Scopus, Emcare, Medline (via Ovid), CINAHL, and Google Scholar in August 2023 without any time limitations. Studies that reported qualitative findings on the wait times and associated barriers to timely accessing to PAHCSs were selected in this scoping review. We performed a reflexive thematic analysis using NVivo software in this review. Results. A total of seven studies out of ninety‐one retrieved records were eligible to be included in this review. Studies show that Australian children, in general, had to wait more than one year for health assessments and interventions in PAHCSs. The long waiting times were perceived as frustrating and worrying by caregivers of children. Several overarching themes related to the barriers of timely accessing to paediatric PAHCSs in Australia were identified, such as strict appointment criteria for children, disparity between demand and provision, parental unawareness, and inadequate public funding in rural PAHCSs. Conclusion. Australian paediatric patients are severely burdened with long wait times for appointments with PAHCSs, primarily, due to the poor government initiatives in rural PAHCSs. This study suggested that the criteria for booking an appointment in PAHCSs need to be simplified. Besides, adequate public health funding and the provision of resources are required in rural PAHCSs. [ABSTRACT FROM AUTHOR]

Aims. To synthesize the evidence on nurses' experiences of their caring role during the COVID‐19 pandemic and identify emerging concepts that have affected nurses within the caring role in relation to (a) their professional lives and (b) their personal lives. Background. The concept of caring is central to the science and art of nursing practice, and fulfilment of the caring role is fundamental to the profession. The COVID‐19 pandemic imposed unprecedented change globally transforming the caring role of the nurse. The WHO highlights that a well‐supported workforce is paramount to emergency preparedness; therefore, understanding the experiences of the nurse's caring role during the COVID‐19 crisis is paramount to practice in future healthcare crises. Methods. A scoping review. Data Sources. Studies published between January 2020 and November 2023 were identified from the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Coronavirus Database, PUBMED, PsycINFO, PsycArticles, Scopus, Web of Science, and SocINDEX. Reporting Method. The scoping review adhered to the Joanna Briggs Institute (JBI) Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Extension for Scoping Review (PRISMA‐ScR) checklist. Results. The search identified 1,347 studies, subsequent review of title and abstract, resulted in 117 full‐text papers for further eligibility screening, with a total of 52 studies being included in the scoping review. Findings were grouped thematically using the Braun and Clarke (2006) approach. The five distinctive themes that emerged were (a) emotional turmoil, (b) erosion of care, (c) relationships and solidarity, (d) expansion of role, and (e) professional growth. Conclusion. During the COVID‐19 pandemic, there was an evolutionary shift in the caring role of the nurse, on a trajectory from emotional turmoil to professional growth. The process followed a theoretical framework of transformative learning that could support nurses' capability and preparedness in their caring role for future inevitable extreme events and crisis in healthcare. Implications for Nursing Management. Mapping current knowledge of the unprecedented COVID‐19 crisis from a nurse's professional and personal perspective purposefully aims to highlight gaps for future research, education, and policy and is paramount to emergency preparedness and a well‐supported workforce in future healthcare crisis. [ABSTRACT FROM AUTHOR]

Purpose of the study: We aim to examine the association between liver function‐related indicators and gallstone disease (GSD) risk. Study design: The subjects who participated in the China Multicenter Physical Examination Cohort (CMPEC) were enrolled. Relative odds ratios (ORs) with 95% CIs and standardized mean differences (SMDs) were applied to investigate the effect of liver function‐related indicators and GSD risk. Moreover, a systematic review and meta‐analysis were conducted until July 2021. Additionally, the results in the CMPEC and the systematic review and meta‐analysis were combined by meta‐analysis. Finally, the results were validated by a cohort study of the UK Biobank (UKB). Results and conclusions: Totally, 369,931 subjects in CMPEC were included in the study. A total of 28 publications were incorporated into the systematic review and meta‐analysis. The pooled analysis suggested that aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total protein (TP), and low albumin (ALB) were positively associated with the risk of GSD. Meanwhile, GSD present to have higher AST, ALT, gamma‐glutamyl transferase (GGT), total bilirubin (TBil), globulin (G), and ALP levels and relatively lower TP and ALB levels than the healthy participants. These results were consistent when stratified by the study design, geographic background, and study quality. Only the association between ALP and GSD risk was validated in the UKB cohort. This study suggests liver function indicators were associated with GSD risk. The results may provide the basis for exploring the etiology of GSD and may help clinicians identify high‐risk subjects. Trial Registration: PROSPERO (CRD42020179076). [ABSTRACT FROM AUTHOR]

What is Known and Objective. Omalizumab is a humanized anti‐IgE antibody, which is used in the treatment of chronic spontaneous urticaria (CSU). This study aims to investigate the trends in the efficacy of omalizumab for CSU, focusing on temporal aspects, drug dosages, and sample sizes. Methods. Cochrane, OVID MEDLINE, Embase, Web of Science, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) from 1900 to January 2023. The primary outcome was the percentage of complete responders (defined as the weekly urticaria activity score as 0, UAS7 = 0). Secondary outcomes included the percentage of patients with UAS7 ≤ 6, the percentage of patients achieving a minimally necessary difference in weekly itch severity score (defined as a reduction from baseline in ISS7 of ≥5 points, ISS7 MID), and adverse events (AEs). A cumulative meta‐analysis was performed with pooled risk ratio (RR) and 95% confidence intervals (CI). Publication bias was assessed by the contour‐enhanced funnel plots with the trim‐and‐fill method, alongside Begg's and Egger's tests. Results and Discussion. Twelve randomized, placebo‐controlled studies encompassing 2166 patients were analyzed. Compared with the placebo group, the omalizumab group exhibited significant increases in the proportion of patients achieving UAS7 = 0 [RR 5.18, 95% CI (3.97, 6.75), I2 = 14%], UAS7 ≤ 6 [RR 3.21, 95% CI (2.69, 3.83), I2 = 30%], and ISS7 MID responders [RR 1.50, 95% CI (1.39, 1.63), I2 = 33%]. AEs were similar between the omalizumab group and placebo group [RR 0.96, 95% CI (0.89, 1.03), I2 = 4%]. What is New and Conclusion. The cumulative meta‐analysis confirmed that the efficacy outcomes for omalizumab have remained consistent over time, across different drug doses and sample sizes, with improved precision from newer studies. Omalizumab is confirmed to be safe and effective for CSU. It is also suggested to minimize redundant RCTs to conserve scientific and medical resources efficiently. [ABSTRACT FROM AUTHOR]

Purpose. This systematic review aims to consolidate key findings regarding the efficacy of pain relief medications administered prior to pan‐retinal photocoagulation (PRP) for diabetic retinopathy (DR). Methods. A comprehensive search of major databases from 1993 to 2023 was conducted. Clinical trials comparing pain relief drugs before PRP in patients diagnosed with DR requiring PRP treatment were eligible for inclusion. The assessment of pain scores involved the use of various scales, such as the visual analog scale (VAS), numerical rating scale (NRS), verbal rating scale (VRS), and other ordinal pain scales. In addition, laser parameters were taken into consideration during the analysis. Results. Twenty‐two clinical trials from initial 150 studies were included in the review. Nine studies evaluated the pain relief effects of nonsteroidal anti‐inflammatories NSAIDs (selective NSAID and nonselective NSAID), two studies compared the effects of opioids (conventional opioids and atypical opioids), and eleven studies investigated the effects of benzodiazepines, lidocaine, and other sedatives. Conclusion. This review synthesizes findings from multiple studies reporting pain as an adverse outcome of PRP in patients with advanced DR. Based on the evidence from reviewed clinical trials, the administration of lidocaine 2% via transconjunctival, retrobulbar, or peribulbar block along with specific NSAIDs, such as topical ketorolac administrated 24 hours before treatment or oral diclofenac potassium (50 mg) prior to PRP, demonstrated beneficial effects among patients with DR. [ABSTRACT FROM AUTHOR]

Aim. The objective of this study is to provide a comprehensive analysis and synthesis of pertinent research on the subject of nursing professionalism. Background. The number of studies documenting nursing professionalism has been consistently increasing over the years; however, a comprehensive synthesis and analysis of the evidence presented in these reports is currently lacking. Evaluation. The scope reviews were conducted using electronic databases including PubMed, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database. Key Issues. This review included 15 studies and identified 4 significant pertinent issues: (1) the need for further investigation into the implementation level of nursing professionalism; (2) the development of culturally sensitive instruments to assess nursing professionalism; (3) an in‐depth exploration of the associated factors influencing nursing professionalism; and (4) the critical implementation of diverse intervention strategies to enhance nursing professionalism. Conclusions. This review presents a comprehensive overview of the implementation level, assessment tools, influential factors, and intervention strategies in nursing professionalism research. In addition, it emphasizes the future research direction in this field. Implications for Nursing Management. Nursing administrators need to understand the significance of improving the professional education and training of nurses, fostering a conducive work environment, and providing support for their active development of professional skills and nursing professionalism. These factors collectively contribute to the long‐term professional development of nurses and enhance the quality of patient care. [ABSTRACT FROM AUTHOR]

Aim. This study aims to explore contributing factors, impacts, and strategies to address perioperative nursing shortages. Background. Health facilities worldwide are experiencing nursing shortages, especially in specialty fields such as perioperative nursing. Evaluation. This integrative review is reported according to the PRISMA guidelines. The title, abstract, and full article screening, as well as the quality appraisal process, were performed by two independent reviewers, with a third for disagreement. This review focused on empirical and theoretical research published from 2013 to 2023 using databases including CINAHL, Embase, Emcare (via OVID), Medline (via EBSCOhost), Scopus, Web of Science, ProQuest Dissertations and Theses Global, Overton, and GreyNet. Key Issues. This study thoroughly reviewed 84 articles. The perioperative domain confronts significant staffing challenges due to increased demand, lack of experienced nurses, insufficient new entrants, high turnover, and an aging workforce. Notably significant are the deficiencies in recruiting new nurses and the elevated turnover levels, potentially amendable issues. The shortages negatively impact the remaining nurses, patient care quality, and hospital revenue. Strategies to address perioperative nursing workforce challenges include promoting the specialty to undergraduate nursing students, bolstering recruitment efforts, and retaining experienced perioperative nurses. However, none of the studies examined in this review adopted a comprehensive approach. Furthermore, the effectiveness of these strategies relative to one another remains uncertain due to a lack of reliable measurements. Conclusion. Perioperative nursing faces considerable challenges, including an aging workforce, limited new recruits, and high turnover rates. Present strategies primarily prioritise workforce preparation over supporting current staff. Mitigating the perioperative nursing shortages requires comprehensive approaches integrating preparation, recruitment, retention, and retirement plans. In addition, these strategies must be adapted to the diverse regulatory environments of different countries, recognising the absence of a one‐size‐fits‐all solution to perioperative nursing shortages globally. Implication for Nursing Management. Perioperative nursing managers are vital in reducing shortages. [ABSTRACT FROM AUTHOR]

Background. Despite existing evidence on the efficacy of cardiac rehabilitation (CR), programs are underutilized. Factors affecting referral and enrolment in hospital‐based CR were identified; however, research into factors affecting referral and enrolment in community‐based CR is lacking. Aim. The purpose of this scoping review is to identify and synthesize facilitators and challenges in the transition of patient care from hospital to community healthcare services and how they influence CR referral and enrolment. Method. PubMed, Embase, CINAHL, Scopus, ProQuest, and Web of Science databases were searched for relevant publications. The data were analysed using thematic analysis by Braun and Clarke. The study followed the PRISMA extension for scoping reviews and the Joanna Briggs Institute's model. Result. In total, 36 studies were included in this analysis. The results show that facilitators and challenges for referral and enrolment in CR form a complex interaction. Factors influencing referral and enrolment may be setting‐dependent or ‐independent. However, each setting may influence the entire transition. Conclusion. The patient decision‐making process regarding CR may begin in the hospital, indicating that this period is the right time to encourage CR enrolment. To support patient transition, healthcare professionals at hospitals require knowledge of CR and the ability to prioritize patient support. Offering an initial meeting at a local site may decrease patient prejudice and facilitate enrolment. [ABSTRACT FROM AUTHOR]

Background. The misallocation of scarce healthcare resources globally raises concerns regarding the underuse of high‐value care and the overuse of low‐value care. Economic evaluations can help policy makers determine whether an intervention presents a better value for money and desirable clinical benefits, thus realizing value‐based care. Aim. We aimed to conduct a systematic review of the economic evaluations of clinical nursing practices to advance knowledge on value‐based care. Methods. A systematic review was conducted using MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, NHS Economic Evaluation Database, Health Technology Assessment, and Tufts CEA Registry for full economic evaluations of clinical nursing practices from January 2013 to January 2023. Outcomes were incremental cost‐effectiveness ratios, incremental cost‐utility ratios, incremental cost‐benefit ratios, incremental net benefit, and the differences in costs for cost‐minimization studies. Methodological quality was evaluated using the Consensus Health Economic Criteria–extended checklist. Results were synthesized using permutation matrices for all studies. The protocol was registered with PROSPERO (CRD42023415918). Results. Thirty‐five studies were included in this review, with 27 studies categorized as good methodological quality and 8 as moderate quality. Clinical nursing practices were dominant (i.e., more effective and less costly) in 19 studies, potentially cost‐effective depending on willingness‐to‐pay thresholds in 15 studies, and were dominated (i.e., less effective and more costly) in 1 study. Conclusion. Our study advanced knowledge on value‐based care for clinical nursing practices. Results suggest that most clinical nursing practices studied may be clearly economically favourable or potentially favourable. Implications for Nursing Management. The results of this review provide valuable insights into value‐based care in nursing and facilitate the decision‐making of healthcare policymakers regarding health resource allocation to achieve value‐based care. [ABSTRACT FROM AUTHOR]

Many people with intellectual disability live with swallowing, eating, and drinking difficulties (dysphagia). People living with both intellectual disability and dysphagia may require a range of supports in order to have the opportunity to participate in different eating and drinking environments of their choice. Understanding the nature of those supports is important to ensure that people with intellectual disability living with dysphagia can continue to create a good life for themselves at home and in their community. This study aimed to identify the nature of supports provided to people with intellectual disability and dysphagia when eating and drinking in different environments, as described in the published literature. A scoping review, underpinned by an a priori protocol, was conducted by a team of four reviewers. Four databases were searched. Sixteen papers were included for full‐text review. The review identified that studies most frequently reported support in the form of safety strategies to prevent the ill‐health consequences of dysphagia and training carers in those safety strategies by speech‐language pathologists. To a much lesser extent, studies identified the psychosocial needs of people with intellectual disability and dysphagia and how these were being considered in the design of training support. Overall, this review identified a significant need for future research into supports for eating outside the home and collaboration with people with intellectual disability and dysphagia about dysphagia training content which reflects the experience of living with dysphagia in social community environments. [ABSTRACT FROM AUTHOR]

Background: Negative leadership behaviour is very common and pervasive in nursing and healthcare, often leading to adverse effects such as nurses' silence, decreased job performance, and turnover. However, there is a lack of systematic reviews that summarize negative leadership types and nurses silencing behaviours. Aim: This systematic review examined the relationship between negative leadership behaviour and nurses' silence. Evaluation: We searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases from their inception until 30 April 2024 for articles examining the relationship between negative leadership and silent behaviour among nurses. The studies were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The risk of bias in the included studies was assessed using the Newcastle–Ottawa Scale. Key Issues: After full‐text analysis, six papers were included in this systematic review. Four of the studies were conducted with nurses, and the remaining two were conducted with all medical staff including nurses. While most studies have shown that negative leadership causes nurses to become increasingly silent, others have shown that appropriate negative leadership behaviour instead reduces nurses' silence. Conclusions: Negative leadership behaviour can affect the silent behaviour of nurses. Implications for Nursing Management: Hospitals need to take the initiative to build a harmonious and safe working environment, correctly recognize and identify negative management behaviour, take appropriate and effective measures to enhance the positive leadership of nurse managers, and make an effort to prevent nursing staff's exposure to the negative management of direct leadership and mental health threats, which is a key point that hospital administrators and health policymakers tend to overlook. This is also effective for enhancing the leadership of hospital administrators. [ABSTRACT FROM AUTHOR]

Introduction. Patients with hormone receptor‐positive (HR+), HER2‐negative (HER2−) breast cancers have the lowest response to neoadjuvant therapy of all subtypes. The role of neoadjuvant endocrine therapy (NET) in clinically node‐positive (cN+), HR+, HER2− patients is evaluated in this meta‐analysis. Methods. This study was performed between January 2010 and August 2022. We evaluated the node pathologic complete response (pCR) and axillary lymph node dissection (ALND) rates after neoadjuvant endocrine therapy (NET). Results. 18,037 HR+, HER2−, cN+ stage II and stage III breast cancer patients within eleven studies received neoadjuvant treatments. 3,707 (20.6%) patients received NET and 14,330 (79.4%) received NAC. The average age of the NET patients was higher than that of the neoadjuvant chemotherapy (NAC) patients (64.1 versus 47.6 years old, p < 0.001). 45.0% and 26.9% of the NET and the NAC groups underwent a lumpectomy. The pooled estimates of node pCR in NET and NAC groups were 8.9% and 14.9%, and the pooled proportion of ALND was 39.1% and 58.5%, respectively. Conclusion. The rate of node pCR was lower among cN+ patients who received NET compared to the NAC group. The rate of ALND among cN+ NET patients was lower than the NAC group, revealing more patients with residual nodal disease do not get ALND in the NET group. Further prospective studies are required to compare survival outcomes as a more reliable surrogate. [ABSTRACT FROM AUTHOR]

Objective. To investigate if the use of vision therapy (VT) in convergence insufficiency (CI) has a significant neural impact and how it correlates with the clinical changes occurring with this option of treatment. Methods. A systematic review of the scientific literature was carried out in the PubMed and Scopus databases, where all the scientific literature on the neural impact of VT in CI was analyzed. A total of 17 articles were initially found and a detailed analysis was carried out. After full‐text reading, only four studies met the defined inclusion criteria. The following data from them were extracted: CI cases and controls, clinical and neural parameters evaluated, the neural response to VT observed, type of study, and VT performed. The quality of the studies was assessed using the GRADE tool. Results. Some neural changes have been reported after VT in CI with the use of functional magnetic resonance imaging (fMRI). Specifically, a modification of the functional activity of some brain areas (especially front fields, oculomotor vermis, and cerebellum) was found. However, contradictory findings in terms of the change in functional activity (increase or decrease) were found that might be associated to differences in fMRI protocols. In the GRADE analysis, serious concerns were found in the categories of risk of bias, inconsistency, indirectness, and imprecision, so the certainty of evidence for each outcome was very low. Conclusion. The research performed to this date does not allow confirming if there are neural changes occurring after vision therapy in patients with CI because the quality of the research performed on this issue is very low, with several methodological concerns. [ABSTRACT FROM AUTHOR]

Aim. To examine the effectiveness of mobile health application‐based interventions on mortality, hospitalization rate, self‐care, and quality of life in people with heart failure. Background. Mobile health application‐based interventions are reported to potentially help people with heart failure improve health‐related clinical outcomes. However, evidence on the effects of mobile health application‐based interventions on mortality, hospitalization, self‐care, and quality of life remains inconclusive and limited. Methods. A systematic literature search was conducted in six databases (MEDLINE, CINAHL Plus with Full Text, PsycINFO, Web of Science, EMBASE, and CENTRAL) to identify relevant studies from inception to 21 October 2023. Two authors independently extracted the data and assessed the risk of bias using the Cochrane risk‐of‐bias tool. The meta‐analysis was conducted in Review Manager (version 5.4) and the statistical software R 4.3.3. Sensitivity analysis and subgroup analysis were also performed. The certainty of the evidence was evaluated by the GRADE approach. Results. Twenty‐four studies involving 2886 participants were identified in this review. The pooled analysis showed that mobile health application‐based interventions had statistically significant beneficial effects on reducing heart failure‐related hospitalization (RR = 0.72, 95% CI 0.57 to 0.91, p = 0.01) and improving quality of life (SMD = 0.46, 95% CI 0.09 to 0.83, p = 0.02), but had no statistically significant effects on all‐cause mortality (RR = 0.90, 95% CI 0.66 to 1.25, p = 0.47), cardiovascular mortality (RR = 0.87, 95% CI 0.59 to 1.26, p = 0.24), all‐cause hospitalization (RR = 0.74, 95% CI 0.39 to 1.42, p = 0.29), or self‐care (MD = −2.42, 95% CI −15.07 to 10.24, p = 0.64). Subgroup analyses indicated that intervention duration and monitoring frequency may influence the effects of mobile health application‐based interventions on quality of life. Conclusions. Mobile health application‐based interventions were effective at reducing heart failure‐related hospitalization and improving quality of life in people with heart failure. More well‐designed randomized controlled trials are needed to strengthen the evidence. Implications for Nursing Management. Mobile health application‐based interventions may have benefits for improving heart failure‐related hospitalization and quality of life. More rigorous studies are warranted to confirm the effects of mobile health application‐based interventions for people with heart failure. [ABSTRACT FROM AUTHOR]

Background. Changing demographics has led to healthcare systems reorientating healthcare delivery towards the community setting and implementing integrated models of care worldwide. This systematic review examines the effectiveness of community‐based multidisciplinary integrated care strategies with general practitioner (GP) participation for community‐dwelling older adults and describes the level of care integration in each study. Methods. PubMed, Embase, CINAHL, Central Register of Controlled Trials in the Cochrane Library, and MEDLINE were systematically searched in February 2024. Randomised controlled trials (RCTs) or cluster RCTs that focused on interventions for community‐dwelling older adults delivered by health and social care professionals with GPs were included. Two reviewers independently conducted the risk of bias assessment, applied the GRADE tool to quantify the certainty of evidence, and used the rainbow model of integrated care taxonomy to describe the elements of integrated care. Outcomes included functional status, healthcare utilisation, participant satisfaction with care, health‐related quality of life, mortality, nursing home admission, and adverse outcomes. Meta‐analyses were performed using Review Manager 5.4. Results. Twelve trials recruiting 8069 participants across 8 countries were included. Community‐based multidisciplinary team (MDT) integrated care demonstrated significant improvements in functional status (standardised mean difference (SMD): 0.21; 95% confidence interval (CI): 0.05–0.37; low certainty evidence), hospitalisation (risk ratio (RR): 0.77; 95% CI: 0.63–0.95; very low certainty evidence), and participant satisfaction with care (SMD: 0.46; 95% CI: 0.15–0.76; low certainty evidence) from 12 to 36 months. No statistically significant effects favouring community‐based MDT interventions for functional status at 6‐month follow‐up, emergency department presentation, mortality, health‐related quality of life, or nursing home admission were established. Conclusion. Community‐based MDT integrated care with GP participation improves functional status, reduces hospitalisations, and increases patient satisfaction among community‐dwelling older adults in the long term. Future research should focus on models of integrated care that respond to the needs and preferences of older adults. This trial is registered with CRD42022309744. [ABSTRACT FROM AUTHOR]

Most published results have revealed variations in the association of serum/plasma levels of malondialdehyde (MDA), apolipoprotein B (ApoB), and oxidized low‐density lipoprotein (OxLDL) and systemic lupus erythematosus (SLE). This study was performed to establish MDA, ApoB, and OxLDL levels in systemic lupus erythematosus (SLE) patients. Electronic databases were searched for the included articles up to 27th February 2023. The meta‐analysis included 48 articles with 2358 SLE patients and 2126 healthy controls considered for MDA, ApoB, and OxLDL levels. There were significantly higher MDA, ApoB, and OxLDL levels in SLE patients than those in the control groups. Subgroup analysis indicated that European/American SLE patients and patients of both ages <36 and ≥36 exhibited higher MDA, ApoB, and OxLDL levels. Arab and Asian SLE patients had higher ApoB and MDA/OxLDL levels. African SLE patients recorded higher OxLDL levels than the control groups. SLE patients with a body mass index (BMI) of ≥23 and a disease duration of <10 recorded significantly higher MDA, ApoB, and OxLDL levels. Patients with systemic lupus erythematosus disease activity index (SLEDAI) ≥8 of SLE had higher MDA and ApoB levels, whereas SLE patients with SLEDAI <8 showed significantly higher ApoB levels. Patients with BMI <23 of SLE had higher MDA and OxLDL levels. This study established significantly higher MDA, ApoB, and OxLDL levels in SLE patients, suggesting a possible role of MDA, ApoB, and OxLDL in the disease. [ABSTRACT FROM AUTHOR]

Background. The objective of this study is to determine optic nerve head vascular changes in patients with obstructive sleep apnea‐hypopnea syndrome (OSAS) by utilizing an optical coherence tomography angiography (OCTA) device. Methods. A detailed studies search was screened in the PubMed, Embase, the Cochrane Library, and Web of Science databases from inception to August 2023. We reviewed and examined optic nerve head vascular density in eyes with OSAS and controls. The mean difference and 95% confidence interval were calculated to evaluate continuous outcomes. Review Manager version 5.4.1 was applied for analysing pooled data. Results. Six eligible studies were included in our meta‐analysis. The radial peripapillary capillary (RPC) whole enface vessel density (VD) measured by OCTA in the mild‐to‐moderate and severe OSAS groups was significantly lower compared to the controls (MD = −0.96, P = 0.03; MD = −1.42, P = 0.001, respectively). For RPC peripapillary VD, eyes in mild‐to‐moderate OSAS showed a trending decrease compared to the controls (MD = −1.71, P = 0.05), and there was a remarkable difference between eyes with severe OSAS and the controls (MD = −3.08, P = 0.004). In addition, the RPC inside disc VD was decreased in severe OSAS eyes than in the controls (MD = −0.07, P = 0.94). Conclusions. Our results revealed that peripapillary vascular density was attenuated in patients with OSAS. Moreover, on the basis of these findings, we suggest that optic nerve head vascular density measured by OCTA may be used as a potential tool to diagnose and monitor the severity of patients with OSAS. [ABSTRACT FROM AUTHOR]

Introduction. Triple‐negative breast cancer (TNBC) is a subgroup of breast cancer characterized by the absence of estrogen and the human epidermal 2 receptor and also a lack of targeted therapy options. Chemotherapy has so far been the only approved treatment option, and patients with metastatic cancer have a dismal prognosis with a median overall survival (OS) of approximately 14 months. Identification of druggable targets for metastatic TNBC is therefore of special interest. Methods. A systematic search was performed, to review the existing evidence on targeted therapies in metastatic TNBC. Results. A total of 37 phase 2/3 studies were identified, evaluating 29 different targeted agents. In this review, results on progression free survival (PFS) and OS are presented. Conclusion. In most of the studies included, no improvement was observed for neither PFS nor OS; however, a few studies did show improvement with targeted agents and have led to new treatment options in subgroups of patients. The antibody drug conjugate, sacituzumab govitecan, demonstrated superior PFS and OS in comparison to chemotherapy. Immunotherapy with checkpoint inhibitors such as atezolizumab and pembrolizumab is now recommended as a first‐line treatment option for patients with expression a PD‐L1 positive tumor. Finally, the poly adenosine diphosphate‐ribose polymerase (PARP) inhibitors talazoparib and olaparib are recommended, as first‐line treatment options in patients with metastatic breast cancer and a germline BRCA mutation, but an immune checkpoint inhibitor should be considered for the subset of these patients who are PD‐L1 positive. [ABSTRACT FROM AUTHOR]

Background. The phenomenon of theory‐practice gap has endured within the field of nursing from the era of Florence Nightingale until today, persistently manifesting negative consequences within the profession by accentuating the dichotomy between theoretical understanding and the practical dimensions of nursing. This prevalent issue necessitates comprehensive examination to unveil all the circumstances and variables that fuel the gap, along with exploring viable resolutions to bridge these divides. Objective. To identify, summarize, and synthesize literature on the causes leading to theory‐practice gaps and solutions in nursing profession. Methods. MEDLINE, PubMed, Scopus, CINAHL, EMCARE, ERIC, and Ovid were searched from 2012 to December 2022. Eligible reviews addressed causes of the theory to practice gap in nursing. Extracted data from included reviews were synthesized using guidelines for meta‐synthesis along with the JBI Critical Appraisal Checklist for qualitative research. Result. The analysis of studies yielded 22 significant findings, subsequently categorized into six thematic areas based on their contextual similarity. Following this, a meta‐aggregation process combined these categories, generating two synthesized findings: (1) barriers for the gap and (2) facilitators for the gap. Barriers for the gap had three subcategories: "clinical life challenges," "misconception of clinical nursing," and "lack of collaboration between universities and clinical settings." The second synthesis was "Facilitators for the gap" which had two subcategories: "create clinically culture‐based content" and "develop clinically based curriculum." Conclusion. This review provides a comprehensive summary of the current understanding of barriers and facilitators influencing the theory‐practice gap in the field of nursing. To effectively reduce this gap in nursing care, stakeholders such as regulatory bodies, healthcare professionals, and academic institutions must take into account various contextual factors while recognizing the ever‐evolving nature of the healthcare environment. [ABSTRACT FROM AUTHOR]

Background and Purpose. Physical exercise (PE) is a well‐recognized means of ameliorating the burden of morbidity that is associated with aging. However, the specific components of exercise programs, and health outcomes that are of benefit, are less consistently agreed upon. Further, it is not evident if those who are not considered to be healthy benefit from the same exercise as those who are. In this systematic review, we collated evidence with the aim of determining if exercise needs to be tailored to suit the needs of those who are frail compared to those who are healthy. Methods. All English studies published after 1989 with a controlled design, investigating PE in adults 65 years and over were considered if the study design compared PE to a nonexercise control group. Health‐related outcomes included physical, cognitive, and psychological function. Studies that investigated cardiorespiratory disease and used designs like systematic review were excluded. Results and Discussion. Altogether, 57 studies were included of which 38 had data that were useable for meta‐analysis. In the healthy aged, a significant benefit of multicomponent exercises (p = 0.006, SMD = 1.40, CI = 0.41, 2.40) and tai chi (p = 0.01, MD = 0.51, CI = 0.12, 0.91) on physical function was revealed, while strength exercise benefitted cognitive function (p = 0.04, SMD = 0.86, CI = 0.03, 1.68). In frail older adults, there was a significant benefit of multicomponent exercises on physical function (p < 0.0001, SMD = −10.85, CI = 5.66, 16.04) and mental health (p = 0.0002, SMD = −0.39, CI=‐0.18, 0.59). Strength exercise had a significant benefit on activity of daily living (ADL) (p < 0.0003, SMD = 15.78, CI = 7.28, 24.28). Conclusion. The substantial disparity of research in the field of exercise in older adults renders synthesis of the evidence problematic. However, it appears that multicomponent exercise is the most suitable approach for both healthy and frail older adults although the benefit may be reflected in different health outcomes. [ABSTRACT FROM AUTHOR]

The turnover of nurses has been an ordeal for healthcare institutions not only locally but also globally. It ranges from changing unit or workplace to changing or leaving the nursing profession. High turnover rates affect care provision and organizational cost. Therefore, this review aims to identify the factors that influence nurse turnover in Saudi Arabia. An in‐depth review of quantitative, qualitative, and mixed‐method studies that includes all studies on nurses who intend to leave the job or profession (resigned or terminated) in any institution within Saudi Arabia was conducted. The grey literature and studies conducted outside of Saudi Arabia were excluded. PubMed, ScienceDirect, EBSCO Medline, ProQuest, and Web of Science were searched for relevant literature from inception to publication. MMAT (Mixed‐Methods Appraisal Tool) is used to assess the risk of bias. A narrative synthesis of the findings is conducted and presented in a table. A total of 1286 articles were retrieved from the initial search and managed using Rayyan software. Out of 1102 articles screened, 44 articles were reviewed for eligibility yielding to 21 articles included in this study. Preliminary screening is performed by two authors by independently scrutinizing the title and abstracts followed by full‐text screening. The data are carefully extracted by the author and validated by a second reviewer. The factors identified to influence nurse turnover in Saudi Arabia are classified into themes, namely, individual‐related factors (demographic characteristics and psychological and personal aspects), work environment, and organizational factors. More studies are needed in all regions using more robust designs. The review protocol is registered in Prospero with ID no. CRD42023433406. [ABSTRACT FROM AUTHOR]

The goal of this article was to review studies on distal humerus fracture plates (DHFPs) to understand the biomechanical influence of systematically changing the plate or screw variables. The problem is that DHFPs are commonly used surgically, although complications can still occur, and it is unclear if implant configurations are always optimized using biomechanical criteria. A systematic search of the PubMed database was conducted to identify English‐language biomechanical optimization studies of DHFPs that parametrically altered plate and/or screw variables to analyze their influence on engineering performance. Intraarticular and extraarticular fracture (EAF) data were separated and organized under commonly used biomechanical outcome metrics. The results identified 52 eligible DHFP studies, which evaluated various plate and screw variables. The most common plate variables evaluated were geometry, hole type, number, and position. Fewer studies assessed screw variables, with number and angle being the most common. However, no studies examined nonmetallic materials for plates or screws, which may be of interest in future research. Also, articles used various combinations of biomechanical outcome metrics, such as interfragmentary fracture motion, bone, plate, or screw stress, number of loading cycles to failure, and overall stiffness (Os) or failure strength (Fs). However, no study evaluated the bone stress under the plate to examine bone "stress shielding," which may impact bone health clinically. Surgeons treating intraarticular and extraarticular distal humerus fractures should seriously consider two precontoured, long, thick, locked, and parallel plates that are secured by long, thick, and plate‐to‐plate screws that are located at staggered levels along the proximal parts of the plates, as well as an extra transfracture plate screw. Also, research engineers could improve new studies by perusing recommendations in future work (e.g., studying alternative nonmetallic materials or "stress shielding"), clinical ramifications (e.g., benefits of locked plates), and study quality (e.g., experimental validation of computational studies). [ABSTRACT FROM AUTHOR]

Background. Global nursing shortages have led to the recruitment of culturally and linguistically diverse nurses from various countries. However, nurses face integration challenges in their host countries. Objective. This systematic review aimed to find the most recent evidence of factors associated with integrational strategies and models to support the transition and adaptation of culturally and linguistically diverse nurses to the professional workforce in healthcare settings. Methods. This systematic review used the population, exposure, outcome framework to select studies according to JBI guidelines. Original peer‐reviewed quantitative studies published between 2000 and 2021 were identified. Two researchers independently screened the studies based on eligibility criteria using title, abstract, and full text. The JBI critical appraisal tool assessed the methodology's quality for analytical cross‐sectional studies. Data were extracted, tabulated, and analysed narratively. PRISMA checklist was used in reporting. Data Sources. CINAHL (Ebsco), PubMed, Medic, ERIC (ProQuest), and Scopus. Results. The systematic review encompassed 19 articles and identified multiple factors associated with successful integration. These factors were classified into the following six categories: sociodemographic characteristics, discrimination, social support, organisational support, workplace environment, and acculturation. Conclusions. Comprehensive cultural competency training for healthcare staff, including managers, enhances cultural proficiency in work environments. Clear guidelines addressing bias and discrimination create a supportive environment where culturally and linguistically diverse nurses feel valued and respected, facilitating their adaptation and integration. Relevance to Clinical Practice. Patient care quality can be improved by ensuring sustainable culturally and linguistically diverse nurses' integration into healthcare organisations. Cultural diversity is a unique opportunity to bring a diverse range and experience to clinical settings. The diversity can also help enhance the cultural competence of healthcare staff, allowing them to better understand and cater to the needs of culturally diverse patients. Patient or Public Contribution. Not required for study design. [ABSTRACT FROM AUTHOR]

Background. Treatment burden is an illness‐management workload level that exceeds an individual's capacity to do that work. It is a complex concept that has not been comprehensively defined for people with type 2 diabetes (T2DM). Purpose. Provide a contemporary, holistic understanding of treatment burden among people with T2DM and understand its clinical implications. Methods. Walker and Avant's 8‐step method for concept analysis was used. PubMed, CINAHL, Web of Science, Embase, and PsychInfo databases were searched from 2012 to 2023 to identify uses of the concept, defining attributes, antecedents, and consequences of treatment burden. Empirical referents were identified and modeled; contrary and related cases are presented. Findings. Thirty‐three articles were identified to extract the concept of treatment burden. Defining attributes were responsibility for self‐care, complexity of interactions with the healthcare system, perpetual emotional management, medical expenses, and social network interactions. Antecedents of treatment burden among people with T2DM were workload designated to the patient, resource scarcity, and understanding of the disease state. Consequences include impaired ability to conduct treatment regimen, impacted quality of life, realization of the necessity to work, and fatigue or exhaustion. Empirical referents cover various clinical tools, but none comprehensively capture all defining attributes. Discussion. Treatment burden is not dependent solely on the objective complexity of self‐care tasks. Instead, it is inextricably linked with one's ecosystem, especially social interactions, interactions with the healthcare system, and available resources. Nurses and other healthcare professionals can use these findings to explore their patients' burden experiences and select appropriate treatment. [ABSTRACT FROM AUTHOR]

Fatigue is a common and debilitating symptom affecting a significant proportion of individuals with Parkinson's disease (PD), often overshadowing even motor symptoms in its impact on quality of life. The accurate definition and assessment of mental fatigue in PD is crucial for both clinical management and research, yet it remains a challenge due to the subjective nature of the symptom and the heterogeneity of assessment scales. This systematic review examined the existing measures of self‐reported mental fatigue in PD by searching through PubMed, Embase, and Scopus databases using specific keywords from 2001 to 2024. Out of the 4182 articles found, 40 met the inclusion criteria, and 14 different scales were identified to measure self‐reported fatigue in PD patients. However, most of these scales lack a consistent definition of fatigue, indicating a need for validated combinations of unidimensional and multidimensional scales to accurately assess mental fatigue in PD. The review found that it is best to use Fatigue Severity Inventory (FSI) and Multidimensional Fatigue Inventory (MdFI) to screen for severity of PD mental fatigue and Neuro‐QoL Item Bank v1.0 (Neuro‐QoL) to evaluate its impact on patients' lives. Furthermore, multidimensional scales Parkinson's Disease Questionnaire (PDQ) and Functional Assessment of Chronic Illness Therapy‐Fatigue Scale (FACIT‐F) are frequently coupled with Fatigue Severity Scale (FSS), Parkinson's Fatigue Scale (PFS), and/or Modified Fatigue Impact Scale (MFIS) due to their short length and holistic coverage of variables in patients' quality of life. Combining fatigue scales can be used for screening and scoring methods. The review also recommends validating fatigue scales translation and combining them with biomarkers to improve the accuracy and effectiveness of fatigue assessment in clinical practice. Future research should analyze correlations between fatigue scales, expand language types, and explore the link between fatigue scales and the pathophysiological basis of PD. Our findings underscore the need for a standardized approach to the measurement of fatigue in PD and set the stage for future research to consolidate assessment tools that can reliably guide treatment strategies and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background. A timely diagnosis of cancer is important for patient outcomes. The delay in the patient interval (time from symptom interpretation to seeking help) is often the longest throughout the cancer patient pathway. Factors extending this interval include vague symptom profiles increasing the difficulty of symptom appraisal and individual demographics influencing help‐seeking behaviours. An underexplored and potential source of delay in cancer diagnosis is associated with managing symptoms using self‐care activities prior to presentation to healthcare. Methods. This study aimed to characterise the use of self‐care activities in the context of managing nonspecific symptoms, prior to cancer diagnosis and their effect on the length of the patient interval. Eligible publications were identified using a rapid systematic review, and their qualitative self‐care data were extracted and analysed using thematic synthesis. Results. Forty‐five qualitative research papers between 2009 and 2024 were included in the final review. Self‐care was used as part of an iterative process, often resulting in delayed presentation to healthcare, if methods were effective in managing nonspecific symptoms. Across the literature, varying types of self‐care activities were reported across all cancers with nonspecific symptoms, including the use of over‐the‐counter or alternative medications, lifestyle changes, and watchful waiting. The individual's decision to self‐care was either prompted externally by a healthcare professional (HCP) (e.g., community pharmacists) or prompted by the individual depending on the availability of home remedies and medication. Patients used self‐care when there was a low perceived need to seek healthcare, to determine whether healthcare was required, or to avoid the use of healthcare. However, across the literature, there is limited evidence to understand the variation by cancer type, symptoms, and individual characteristics. Conclusions. The findings of this rapid review demonstrate that self‐care activities could hinder prompt help‐seeking and delay cancer diagnosis among people who are experiencing nonspecific cancer symptoms. However, more evidence is needed to understand which individual factors facilitate the adoption of self‐care behaviours over prompt help‐seeking for nonspecific cancer symptoms. [ABSTRACT FROM AUTHOR]

Introduction. Increased life expectancy leads to consequent long-term care needs, where informal caregivers may experience overload and strain associated with caregiving, influencing the well-being and health of individuals and eventually leading to an effort to fulfill their role. Within this context, a condition called caregiver role strain has been identified. Objective. To investigate the clinical indicators of the nursing diagnosis caregiver role strain as described in the literature. Materials and Methods. This study is a systematic review of diagnostic accuracy conducted in October 2023, following the recommendations of the Joanna Briggs Institute. The review protocol was registered and approved in the Prospective International Register of Systematic Reviews under registration number CRD42022377411. The QUADAS-2 tool was used to assess the risk of bias and quality of the studies. The databases included SciVerse Scopus (Elsevier), MEDLINE/PubMed (via National Library of Medicine), Latin American and Caribbean Health Sciences Literature (LILACS), CINAHL with Full Text (EBSCO), and PsycINFO (APA), with 48 articles included for quantitative synthesis. Results. Fourteen defining characteristics were identified from the literature, with a predominance of the following indicators: depressive symptoms (45.8%), anxiety (41.6%), physical decline (31.2%), fatigue (22.9%), disturbed sleep pattern (20.8%), emotional disturbance, and irritability (16.6%). The findings suggest that, within the defined circumstances and limitations of the study, examining defining characteristics for the diagnosis caregiver role strain holds potential for advancing scientific knowledge regarding human responses to the challenges experienced by caregivers. Evidence for Practice. The study aligns with clinically relevant indicators crucial for refining and updating the diagnosis, thereby enhancing its level of evidence and clinical accuracy. Simultaneously, it supports addressing the gap in caregiver support and standardized nursing care plans. [ABSTRACT FROM AUTHOR]

Aim. To assess the incidence trends in type 1 diabetes among children and adolescents across Europe during the period from 1994 to 2022 using a systematic methodology. Materials and Methods. Cross‐sectional or follow‐up studies reporting population‐based incidence rates (IRs) of European children and adolescents diagnosed aged <15 years with type 1 diabetes were included. The Mantel‒Haenszel or DerSimonian and Laird random‐effects method was used to compute the pooled IR estimates and their 95% confidence intervals (CIs). Subgroup analyses were conducted by study year, biological sex, age group (0–4, 5−9, and 10–14 years), country, and European regions. Results. A total of 75 studies (219,331 children and adolescents aged 0–14 years) with data from 32 countries were included. Generally, a high overall rate of increase in type 1 diabetes incidence has been shown in most European countries from 1994 to 2022 in both sexes, with an overall increase from 10.85 (95% CI, 9.62–12.07) per 100,000 person‐years from 1994 to 2003 to 20.96 (95% CI, 19.26–22.66) per 100,000 person‐years from 2013 to 2022. Conclusions. There are substantial between‐country differences in the current levels and trends of IR in type 1 diabetes in European children and adolescents. Our data suggest a worrying upward trend in most European countries. [ABSTRACT FROM AUTHOR]

Children with disabilities in out-of-home care (OOHC) are an overrepresented group in Australia, yet little is known about their circumstances, needs, and experiences within OOHC. Utilising a systematic scoping review methodology, we explored the state of knowledge about the experiences of children and young people with a disability in out-of-home care in Australia. Findings in this review speak to the unmet needs and challanges that children with disabilities face in child welfare systems and how systemic failures can lead to institutional pipelines of further maltreatment, adversity, and marginalisation. The review discusses the key themes in the literature, including (i) compounding trauma and placement failures, (ii) concerns of safety, stability, and neglect, (iii) limited control and choice, and (iv) disability and multisystem involvement. [ABSTRACT FROM AUTHOR]

Cisplatin (CDDP) is a highly potent chemotherapy drug. But its nephrotoxicity poses a significant limitation to its use. The renin-angiotensin system (RAS) has been proposed to play a role in drug-induced nephrotoxicity. This systematic review (SR) sought to identify the link between CDDP-induced nephrotoxicity and the RAS pathway. In this SR, relevant keywords were employed to explore databases such as PubMed (MEDLINE), Scopus (Elsevier), and Institute for Scientific Information (ISI) Web of Science up to October 2023. Nine studies were selected based on predefined inclusion/exclusion criteria. The findings support the involvement of the RAS in the CDDP-induced nephrotoxicity model, along with the activation of inflammatory mediators, lipid peroxidation, and changes in markers of kidney tissue damage. Furthermore, physiology and pathology of RAS-related interventions in CDDP-induced nephrotoxicity models have involved the factors such as human organic cation transporter 2 (hOCT2), organic anion transporting polypeptides 1B1 (OATP1B1) and 1B3, kallikrein-kinin system, and bradykinin receptors. CDDP-induced nephrotoxicity has been found to be substantially influenced by both classic and nonclassic RAS axes. Angiotensin II exacerbates renal damage induced by CDDP. Conversely, inhibiting the pressor arm of RAS in males mitigates this damage. However, activation of the renal vasodepressor arm of RAS exacerbates CDDP-induced nephrotoxicity in females. These findings underscore gender differences in renal function and response to RAS-related interventions in the presence of CDDP. This SR provides insights into both beneficial and adverse interventions associated with RAS in the CDDP-induced nephrotoxicity, offering valuable considerations for researchers and clinicians. [ABSTRACT FROM AUTHOR]

Providing formal care and support in the home has many benefits. Applying a human rights-based approach places the person and their human rights at the centre of all that a health and social care service does. There is a paucity of evidence on how to apply a human rights-based approach in practice when providing homecare. Increasing knowledge and understanding of human rights will empower health and social care practitioners to protect and promote human rights in formal homecare. The aim of this narrative review was to identify and describe human rights-based approaches in homecare, in order to promote awareness and understanding of a human rights-based approach. Five bibliographic databases were searched. Primary research studies pertaining to the delivery of formal homecare that included a human rights-based approach were eligible for inclusion. Sixteen articles were identified for inclusion. Quality appraisal and data extraction were conducted on included studies. A deductive framework analysis was used and concepts of a human rights-based approach that emerged from the literature as relevant to homecare were as follows: dignity and respect, autonomy, equality, participation, and communication. We found that homecare planning and delivery requires the integration of human rights, using approaches, such as person-centred care, partnerships in decision-making, supporting independence, and acknowledging a person's beliefs and cultures, in everyday practice. Findings from this review can support and enable service providers to apply human rights in everyday practice, ultimately for the benefit of people using homecare services. [ABSTRACT FROM AUTHOR]

Background. In addition to the usual difficulty of managing human capital in any organization, healthcare institutions have other problems to solve arising from the circumstances and the very nature of the work they perform, such as the ethical pressure on staff, emotional exhaustion, the distribution of work shifts, or the general shortage for nurses. In many cases, this situation has an impact on the quality of care. Objective. The main objective of this research is to compile, in a single document, human resource practices that help health centre managers improve results in terms of performance and quality of care, as well as avoid the intention of abandoning the job, specifically related to the work of nurses. Methods. To this end, a systematic literature review has been performed based on 229 papers published in the Web of Science database, from which the practical implications for nurses proposed by these authors have been extracted. Results. The main results suggest that developing affective commitment helps to improve organizational performance and enhance patient safety culture. Furthermore, improving communication and meaningfulness of work, recognition by superiors, or job flexibility would improve the quality of outcomes, for the work of nurses. Conclusions and Implications for Nursing. Stimulating normative commitment, reducing excessive control, and paying attention to job burnout and job stress help combat the intention of voluntary turnover or leaving the job, especially in the case of nurses. [ABSTRACT FROM AUTHOR]

Introduction. Many COVID-19 patients display adverse symptoms, such as reduced physical ability, poor quality of life, and impaired pulmonary function. Therefore, this systematic review is aimed at evaluating the effectiveness of physical exercise on various psychophysiological indicators among COVID-19 patients who may be at any stage of their illness (i.e., critically ill, hospitalized, postdischarge, and recovering). Methods. A systematic search was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from 2019 to 2021. Twenty-seven studies, which assessed a total of 1525 patients, were included and analysed. Results. Overall, data revealed significant improvements in the following parameters: physical function, dyspnoea, pulmonary function, quality of life (QOL), lower limb endurance and strength, anxiety, depression, physical activity level, muscle strength, oxygen saturation, fatigue, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-α), lymphocyte, leukocytes, and a fibrin degradation product (D-dimer). Conclusions. Physical training turns out to be an effective therapy that minimises the severity of COVID-19 in the intervention group compared to the standard treatment. Therefore, physical training could be incorporated into conventional treatment of COVID-19 patients. More randomized controlled studies with follow-up evaluations are required to evaluate the long-term advantages of physical training. Future research is essential to establish the optimal exercise intensity level and assess the musculoskeletal fitness of recovered COVID-19 patients. This trial is registered with CRD42021283087. [ABSTRACT FROM AUTHOR]

Purpose. Healthcare organisations need to define the role of the nurse manager in light of recent global health developments. For this purpose, several core competencies essential for each hierarchical management level need to be assessed. Different measurement instruments have been developed to assess nurse managers' competencies. This systematic review summarises the characteristics and psychometric properties of existing instruments measuring first-, middle-, and top-level nurse managers' competencies. Methods. Following PRISMA guidelines for reporting and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, 789 articles were retrieved from PubMed, Scopus, CINAHL, and APA PsycINFO databases with no time limitation. The review protocol was registered on PROSPERO (CRD42023425854). Results. Ten tools were identified, assessing one or more competencies among nurse managers: Competency Elements for Nurse Managers of Tertiary General Hospitals, NICA-NL, HCCI, I-FLNMMCS, NMCI, Chase Nurse Manager Competency Questionnaire, CASHN, Questionnaire for Head Nurses' Managerial Competencies, Nurse Manager EBP Competency Scale, and the Home Healthcare Nurse Manager Assessment Tool. Conclusion. Following the COSMIN assessment, the Chase Nurse Manager Competency Instrument was the most comprehensive among the included instruments, and the CASHN questionnaire scored highest on methodological quality and level of evidence. These instruments can be used in clinical practice to evaluate competencies and as a basis for developing managerial training courses. [ABSTRACT FROM AUTHOR]

Aim. To systematically map and identify key knowledge on organizational support for nurses' career planning and development. Design. Scoping review. Methods. Systematic electronic searches were carried out with the CINAHL, PubMed, Scopus, and Web of Science databases in May 2022. The searches were limited to scientific, peer-review papers that were published in English from January 2012 to May 2022. Data were extracted and synthetized and are presented in tables and text. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results. We identified 1,400 papers and 28 met the inclusion criteria. Organizations recognized nurses' career planning and development in relation to the individual's professional development and the organization's need to promote high-quality services and workforce engagement. The organizational support included strategic work to ensure there were adequate resources and purposeful vacancies and a structured framework based on objective qualification criteria and equal assessment. Organizations focused on sharing knowledge, structured career planning, and interpersonal support. Support within the nursing profession and multilayered interprofessional collaboration were also important. Conclusion. Nurses' career planning and development was linked to their personal development and the organization's aims and required support from both fellow nurses and other professionals. Implications for the Nursing Management. Identifying the organizational structures and methods that are needed to support nurses' career planning and development can help nursing management to evaluate and develop strategies that improve the attractiveness of a nursing career and nurses' engagement. [ABSTRACT FROM AUTHOR]

Aims. This umbrella review aims to comprehensively synthesize and analyze the findings of available systematic reviews on the effectiveness of individual-based strategies for reducing nurse burnout occurring in hospital-based settings. Methods. Following JBI guidelines, an umbrella review was conducted to integrate the effectiveness of various strategies to reduce burnout. Systematic reviews were searched in the Embase, MEDLINE (Ovid), Cochrane Library, CINAHL (EBSCO), Scopus, and WOS databases. Inclusion criteria included studies published in any language from database inception to April 2023. Eligibility assessment involved two independent reviewers who evaluated titles, abstracts, and full texts. The systematic reviews were critically evaluated using JBI SUMARI. The results were narratively synthesized and grouped by strategy. Results. Eleven systematic reviews were included, covering the years 2012 to 2021. The appraisal tools varied, though all included reviews were of high quality. The strategies were categorized into three domains: mental health (51%), physical activities (26%), and professional competence (13%). The interventions most identified were mindfulness-based stress reduction for mental health, yoga for physical activities, and professional competence education. These individual-based strategies were shown to effectively eliminate emotional exhaustion (72.7%), depersonalization (44%), and occupational stress (78%) among nurses in hospital-based settings. Conclusion. Mental health, physical activities, and professional competence are strategies to reduce nurse burnout. Implementing these approaches in healthcare settings can improve emotional exhaustion, depersonalization, and occupational stress of nurses. [ABSTRACT FROM AUTHOR]

Pediatric palliative care (PPC) programs are essential in encompassing not only the affected children but also their family system and the healthcare and educational professionals involved. Despite the field's significance, there is a notable scarcity in current literature, which underscores the pressing need for further research into the attributes of PPC programs that effectively enhance the quality of life (QoL) for pediatric patients. This study particularly emphasizes the pivotal role of schools as key community resources within this framework, highlighting the crucial aspect of educational integration in PPC. Through a systematic review of relevant literature and applying stringent inclusion and exclusion criteria, we identified pertinent studies across various databases. Of these, 30 articles met our criteria and were subject to a thorough qualitative analysis. Our findings indicate that while PPC programs may vary in their methodologies, they consistently share certain core elements that significantly boost the QoL for pediatric patients. These include a holistic approach that addresses the physical, emotional, psychosocial, and spiritual facets of care; encourages the active involvement of the patient in decision-making processes; and ensures timely access to PPC services. Importantly, our analysis identified the critical role of educational settings in enhancing QoL, shedding light on the vital need for educational inclusion and the integration of schools into the broader spectrum of PPC services. The distinct individual perceptions of QoL and the varied international practices in PPC underscore the imperative to tailor successful strategies to specific local contexts, thereby fostering the global well-being of pediatric palliative care patients. [ABSTRACT FROM AUTHOR]