Bone marrow edema syndrome (BMES), transient osteoporosis of the hip (TOH), and regional migratory osteoporosis (RMO), along with numerous variants of these terms, are used inconsistently to describe spontaneous pain, typically in the lower extremity, accompanied by bone marrow edema on MRI and/or bone demineralization. In the present review, we aimed to determine whether these designations represent distinct conditions or varying manifestations of a shared pathology. We employed a scoping review methodology, following a preregistered protocol, utilizing a comprehensive systematic search of electronic databases. Eligible publications reported on patients designated with BMES, TOH, RMO, or related terms. A total of 2924 patients, across 561 studies, were included. Data extraction focused on demographics, clinical features and imaging results. Descriptive statistics and meta-analytic methods were used to synthesize the data. Our results show that patients described by terms related to bone marrow edema syndrome, or transient or migratory osteoporosis, displayed similar demographic and clinical profiles. Our findings strongly suggest that these various designations refer to the same clinical entity. Bone marrow edema syndrome appears to be the most suitable term to describe this condition, facilitating a more standardized approach to future diagnosis, management and research.

This qualitative systematic review aimed to synthesize and discuss family members' perspectives of helpful and unhelpful factors in family therapy (FT) sessions, to benefit the application of FT interventions and training. Eleven studies met eligibility criteria and were critically appraised and thematically synthesized. Four themes resulted: therapist qualities contributing to the therapeutic alliance, practitioners' use of therapeutic techniques, intervention delivery, and family engagement with the process. Helpful factors included therapist warmth, kindness, and genuine care; therapist connecting with family in a sensitive, respectful, and nonjudgmental manner; effective use of therapeutic techniques that facilitated self-reflection, emotional expression, communication, and perspective-taking; therapy sessions conducted collaboratively with active family participation; focusing on family strengths and resources; and tailoring format to family needs. Unhelpful factors included participants sharing before ready, therapist siding with a family member, therapy process not matching family needs, and insufficient progress early on. Implications for practice and future research are discussed.

Artificial Intelligence (AI) has significantly reshaped Primary Health Care (PHC), offering various possibilities and complexities across all functional dimensions. The objective is to review and synthesize available evidence on the opportunities, challenges, and requirements of AI implementation in PHC based on the Primary Care Evaluation Tool (PCET).

We conducted a systematic review, following the Cochrane Collaboration method, to identify the latest evidence regarding AI implementation in PHC. A comprehensive search across eight databases- PubMed, Web of Science, Scopus, Science Direct, Embase, CINAHL, IEEE, and Cochrane was conducted using MeSH terms alongside the SPIDER framework to pinpoint quantitative and qualitative literature published from 2000 to 2024. Two reviewers independently applied inclusion and exclusion criteria, guided by the SPIDER framework, to review full texts and extract data. We synthesized extracted data from the study characteristics, opportunities, challenges, and requirements, employing thematic-framework analysis, according to the PCET model. The quality of the studies was evaluated using the JBI critical appraisal tools.

In this review, we included a total of 109 articles, most of which were conducted in North America (n = 49, 44%), followed by Europe (n = 36, 33%). The included studies employed a diverse range of study designs. Using the PCET model, we categorized AI-related opportunities, challenges, and requirements across four key dimensions. The greatest opportunities for AI integration in PHC were centered on enhancing comprehensive service delivery, particularly by improving diagnostic accuracy, optimizing screening programs, and advancing early disease prediction. However, the most challenges emerged within the stewardship and resource generation functions, with key concerns related to data security and privacy, technical performance issues, and limitations in data accessibility. Ensuring successful AI integration requires a robust stewardship function, strategic investments in resource generation, and a collaborative approach that fosters co-development, scientific advancements, and continuous evaluation.

Successful AI integration in PHC requires a coordinated, multidimensional approach, with stewardship, resource generation, and financing playing key roles in enabling service delivery. Addressing existing knowledge gaps, examining interactions among these dimensions, and fostering a collaborative approach in developing AI solutions among stakeholders are essential steps toward achieving an equitable and efficient AI-driven PHC system.

Registered in Open Science Framework (OSF) ( https://doi.org/10.17605/OSF.IO/HG2DV ).

To synthesize the current literature on the impact of bridging education programs for internationally educated nurses (IENs) from low- and middle-income countries (LMICs) seeking to become registered nurses (RNs) in high-income countries (HICs).

The issue of qualification pathways for IENs through bridging programs has garnered significant attention in contemporary discourse. The growing population of IENs in HICs has made it imperative to streamline the qualification process to facilitate their integration into the healthcare system.

Utilizing a structured review method, we sourced data between January 2023 and April 2024 from the CINAHL, Scopus, and MEDLINE databases with no year limitations. Out of 817 studies, eight were included. The mixed-methods systematic review was carried out by two authors who adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We employed a qualitative content analysis from a feminist standpoint to assess the impact of bridging programs on the transition of IENs to become RNs.

Eight studies were included (mixed methods = 1, quantitative = 3, qualitative = 4). Three themes revealed important key findings. Language proficiency emerged as a critical factor influencing success in bridging programs, with IENs needing to attain a certain level of proficiency in the local language required for licensure. Enhancing nursing competence highlighted skepticism and the need for tailored educational approaches. Transitioning into the workplace emphasized cultural challenges, highlighting the importance of targeted support for continuous integration.

Our findings revealed that despite previous higher education attainment in nursing and nursing experience in the home countries from LMICs, bridging programs aided IENs in transitioning and assimilating into the host country's healthcare employment sector.

It is essential for policymakers in the education sector to integrate language instruction, cultural sensitivity training, and adapted educational approaches into bridging programs to enhance IENs' readiness for efficient healthcare delivery.

Upper-limb neurodynamic tests are commonly used to diagnose neuropathies in this area, including cervical radiculopathy and carpal tunnel syndrome, although their diagnostic accuracy remains uncertain across different conditions and criteria.

To assess the diagnostic accuracy of upper-limb neurodynamic tests and their variations and criteria for upper-limb entrapment neuropathies.

A systematic review with meta-analysis was conducted in different databases (for their inception in February 2025), including studies evaluating the diagnostic accuracy of these tests. Sensitivity, specificity, likelihood ratios (LR), diagnostic odds ratios, diagnostic accuracy and the area under the curve (AUC) were calculated using a bivariate and univariate meta-analysis. The quality of evidence was evaluated using the GRADE approach, and meta-regression was performed to examine the influence of diagnostic criteria.

Twelve studies were included. Likelihood ratios for neuropathic pain conditions were LR+:1.65 and LR-:0.57, for cervical radiculopathy were LR+:2 and LR-:0.47, and for carpal tunnel syndrome were LR+:1.45 and LR-:0.66. The upper-limb neurodynamic test 2A showed the highest diagnostic accuracy (AUC: 0.76), with LR+:2.59 and LR-:0.42 for cervical radiculopathy, while test 3 had the highest specificity (0.92; LR+:7, LR-:0.48). Diagnostic accuracy for carpal tunnel syndrome was lower (AUC: 0.62). Meta-regression showed significant diagnostic criteria interaction, favoring structural differentiation maneuvers (p = 0.002).

Upper-limb neurodynamic tests show moderate sensitivity and low to moderate specificity for diagnosing upper-limb entrapment neuropathies, with diagnostic accuracy varying across conditions. The certainty of evidence ranges from very low to moderate, emphasizing the need for cautious clinical interpretation. Diagnostic reference criteria significantly influence test performance.

Nurses can be involved in interventions that they perceive as hastening death. These interventions may intentionally cause death, as in the case of assisted dying or result in death as an unintended consequence, such as when life-sustaining treatment is withdrawn. There is increasing evidence regarding nurses' experiences of providing care in these separate contexts. However, it remains less clear whether parallels exist in experiences across various acts that nurses might consider death hastening.

To synthesise qualitative research findings on the lived experiences of nurses when involved with acts that may be perceived as death hastening.

A qualitative evidence synthesis utilising thematic synthesis.

An initial search of CINHAL, PsychInfo and Medline was undertaken in December 2022 and updated in August 2024. Papers were quality assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.

Twenty-three papers were included in the review. An overarching theme linked to the emotional labour required to provide care was developed. Three sub-themes influence emotional labour: (1) experiencing personal and professional conflicts, (2) the provision of 'normal(ised)' care and (3) perceptions of palliative care as a proxy for hastening death.

This synthesis demonstrates that nurses experience significant emotional labour across acts that may be perceived as death hastening. The level of emotional labour is influenced by nurses' uncertainty of the ethical and moral status of these interventions and navigating these uncertainties alongside colleagues, patients and those important to them during care delivery.

Transgender and gender-diverse (TGD) populations are identified as high-risk for negative healthcare outcomes. Limited data exists on experiences of TGD youths in healthcare. The review aim is to systematically review literature on healthcare experiences of TGD youths. Seven electronic databases were systematically searched for relevant studies. Pre-determined eligibility criteria were used for inclusion with a double-screening approach. Sixteen studies were included. Studies included were quality appraised, data were extracted, and findings were synthesized narratively. Four narratives were identified including experiences of: accessing care, healthcare settings and services, healthcare providers, and healthcare interventions. Long waiting times, lack of competent providers, and fear were reported as challenges to accessing gender-affirming care. Negative experiences occurred in mental health services and primary care, while school counseling and gender clinics were affirming. Puberty blockers and hormone-replacement therapy were identified as protective factors. TGD youths are at risk of negative health outcomes due to an under resourced healthcare system. Further research is needed to assess interventions implemented to improve TGD youth's experiences.

Adults experiencing homelessness in high-income countries are more likely to have mental ill-health and engage in problematic substance use. They are also more likely to experience challenges when accessing services. Psychosocial interventions are increasingly used with this group. Most of the evidence around these interventions is not specific to their use with adults experiencing homelessness.

To summarise the best available evidence of the views and experiences of adults experiencing homelessness in high-income countries about psychosocial interventions.

This review is based on evidence identified in an Evidence and Gap Map (EGM) on interventions for people experiencing homelessness. The EGM searches were conducted in September 2021. Additionally, we undertook a call for evidence and hand searches of key journals.

We included qualitative data from studies of psychosocial interventions. Participants were adults aged 18+ experiencing homelessness in high-income countries. Only studies that reported the views, opinions, perceptions, and experiences of participants were included.

Of the 468 studies originally screened, 17 were eligible for full-text review, which was undertaken independently by two reviewers. Ten were excluded at this stage, and seven were identified as meeting the inclusion criteria. Analysis was undertaken using thematic synthesis in three stages: (1) findings data were extracted from studies. Two reviewers independently extracted findings from included studies. These were compared and agreed on which findings to include for analysis; (2) two reviewers gave each line of extracted data a descriptive code (a short descriptive summary). These were compared and a set of codes for inclusion in the next stage of analysis was agreed; (3) the reviewers iteratively examined the descriptive themes, inferring from these themes the experiences of participants and their perceptions of how the intervention worked for them. These analytical themes were discussed with a panel of people with experience of homelessness.

Seven studies were included in this review, covering several intervention types. A total of 84 adults experiencing homelessness were included in these studies. Three studies were conducted in Canada, three in the United States, and one in Scotland. All were published after 2009. The studies used various qualitative methods of data collection and analysis. None of the included studies were assessed as high quality. The most significant area of concern across the included studies concerned relationships between researchers and research participants, where five included studies were assessed as low quality. Areas of higher quality were clarity of research questions and methods. Overall, 368 lines of findings were extracted and coded under 118 descriptive codes. Of these, 55 related to direct quotes of participants' views and experiences. The remainder were the study authors' interpretations of the research participants' experiences. The 118 descriptive codes were grouped into 14 descriptive themes. The themes are descriptions of patterns in the data (the findings extracted from the included studies). These 14 descriptive themes (and the 118 descriptive codes underpinning them) summarise data from the primary studies. The final analysis stage was interpretation of the descriptive themes and development of analytical themes to answer the review questions. The reviewers were able to answer two of the four review questions: the experiences of participants when using psychosocial interventions, and whether they felt the interventions worked for them. The question concerning underlying theories of how the interventions are intended to work was addressed through a separate analysis. The question of differences between interventions could not be answered because of the small number of included studies. The final analysis stage identified three analytical themes. These are: (1) the individual plays a pivotal role in their recovery and change journey; (2) accessibility is a key component of intervention success; and (3) relationships are an important intervention ingredient.

The reviewers draw two broad conclusions from this analysis: (1) it is important to place adults experiencing homelessness at the centre of the design of psychosocial interventions; and (2) it is important to treat adults experiencing homelessness as individuals.

This article aims to provide a comprehensive review of the current knowledge on the prevention and treatment of left ventricular outflow tract obstruction (LVOTO) associated with transcatheter mitral valve replacement-a novel and evolving treatment alternative for mitral regurgitation-encompassing both surgical and pharmacological interventions. LVOTO is a potentially catastrophic complication of transcatheter mitral valve replacement. Therefore, identifying patients at high risk for LVOTO and implementing a carefully tailored medical and surgical strategy are essential for optimizing perioperative management and improving patient outcomes.

Gestational Diabetes Mellitus (GDM) represents a growing challenge worldwide, with significant risks to both women and their babies that extend beyond the duration of the pregnancy and immediate post-partum period. Healthcare professionals (HCPs) play important roles in the screening, diagnosis, treatment and management of women with GDM.

For this qualitative systematic review, a comprehensive search strategy explored the electronic databases Web of Science, CINAHL, Medline, and Scopus, as well as the reference lists of the included papers, for primary studies investigating the experiences, perspectives and practices of HCPs providing care to women with GDM in high-income healthcare settings. Studies were assessed with the Crowe Critical Appraisal Tool, and findings were synthesised using the approach described by Thomas and Harden.

This review included 33 articles - 26 qualitative and seven mixed method studies, representing ten high-income nations. The total number of HCP participants represented across the studies is 989. This figure is constituted by medical professionals (n = 226), nurses and midwives (n = 583), allied health (n = 40) and other or not numerically specified HCPs (n = 140). From 149 findings, four major themes and 10 subthemes were constructed. The four major themes are: multidisciplinary collaboration; healthcare practice; organizational factors; and working with women.

There are barriers to providing optimal care to women with GDM. Including, time and resource constraints, a lack of consensus in practice guidelines, and variable multidisciplinary collaboration. Moving forward, there needs to be a focus on more explicit guidelines, multidisciplinary collaboration, and appropriate resources to support HCPs in providing care to women to manage the short-term and longer-term risks that are associated with a pregnancy affected by GDM.

Parent experiences of child health services can be used to understand their value and optimise the support provision to families during critical developmental periods. A gap in the literature exists regarding parental perspectives of linked child development supports, particularly in disadvantaged areas. This study examined parent experiences of the impact and value of a community paediatric clinic (Kidscope) with linked, multi-agency supports in a disadvantaged area of Ireland. Using a qualitative analysis design, 10 parents participated in one-to-one interviews. A Community Advisory Group consulted on interview schedules. Data was thematically analysed in line with Braun & Clarke's Framework. Five themes and twenty-two sub-themes emerged. Kidscope's linked, multi-agency approach was valuable for engaging families, addressing developmental delay, supporting readiness for education, and developing parent-child relationships. Relational working and a child and family centred model of care empowered parents to become active agents in children's health. Coronavirus disease 2019, national deficits in healthcare, and staff turnover impeded service delivery. Kidscope and linked supports work in partnership to disrupt the impact exclusion from healthcare has on vulnerable children and families. This study provides evidence of an effective integrated paediatric service delivery model designed around vulnerable children and families and highlights areas for improvement.

This study addresses the needs of skilled birth attendants (SBAs) of primary healthcare centers (PHCs) in Nigeria using the human resources for health (HRH) solutions model. A model analysis approach was adopted to understand existing frameworks in the global HRH landscape. An initial framework identification and contextualization were conducted to guide the analysis of the models identified in the literature. Relevant frameworks were identified, reviewed, and consolidated using the WHO HRH Action Framework (HAF). A total of 109 articles were included in the study after thorough screening out of which only nine (9) models of improving HRH planning and implementation in global health were reviewed. These were the Task Shifting/Sharing Model, Community Midwifery Model (CMM), Performance-Based Financing Model (PBF), Needs-Based Planning Model, Facilities-Based HRH Planning Model, Utilization-Based HRH Planning Model, Workforce Indicator Staffing Needs Model, USAID-Financing Innovations for Nutrition (FINFI) Model, and Micro-Learning Model. The proposed HRH solution model was adapted based on the gaps identified in all analyzed models. This study showed that there are different HRH models which address specific elements of the HRH value chain. However, these models are not comprehensive, therefore, tackling the challenges of SBA shortage in Nigeria would either require the integration of multiple models or the deployment of models in a phased approach which is what informed the proposed HRH solution model in addressing SBAs' needs of PHCs in Nigeria. We therefore recommend the implementation of the model.

Migration is an established global phenomenon. While many newly arrived migrants have better health than the general population of the country they have moved to, migrants also have their own healthcare needs and face particular issues when diagnosed with a terminal illness. First generation migrants are less likely to have social, financial, and medical supports when faced with a terminal illness. These factors make first generation migrants an important group to understand in order to inform service commissioning and delivery.

The systematic review was an international qualitative evidence synthesis of English language papers from 2000 to 2023. The primary research question underpinning this novel review was: What are the experiences of first-generation migrants who live with or who are supporting a relative with a terminal illness in the country to which they have moved? Databases (MEDLINE; CINAHL; PsycINFO; SocIndex; Web of Science) were searched in August 2023. Records of 1593 publications were screened, resulting in 39 included papers. CASP was used to inform quality appraisal.

First generation migrants struggled with accessing suitable health services and treatments. Structural barriers, such as lack of support for translation/interpreting and for navigating care was visible alongside limited social support networks. Financial precarity ran as a thread through the data, with participants needing to work while unwell, and being unable to return to their country of origin for their own death or to bear witness to the deaths of relatives. First generation migrants experienced caregiving through the lens of difference; maintaining autonomy in the country they would die in, intersected with cultural practices and expectations such as not sharing the prognosis, and mis-matched ideas regarding quality of care provided. The identity of 'migrant' is heterogenous, poorly defined, and may have resulted in identifying studies conducted in the global north.

Diasporic dying is not a new phenomenon, yet services and policies fail to meet people's needs. Services urgently need to identify and dismantle structures which uphold and perpetuate inequality, including this population who suffer multiple disadvantages and risks.

CRD42023457054.

The purpose of this systematic review was to identify and synthesise the literature regarding barriers and enablers affecting general practitioner (GP) referral to hearing care for their older patients (50 years and over).

A search of peer-reviewed articles reporting primary empirical studies was conducted across CINAHL, Ovid Medline and Scopus, with search terms relating to the search domains "General Practitioner", "Referral", "Hearing loss", and "adults aged 50 and older". Qualitative and quantitative studies were included if they reported barriers or enablers to referral. A mixed-methods approach was used to synthesise the findings of the included studies, firstly into the Theoretical Domains Framework of behaviour change, and then into more granular sub-themes.

The initial search yielded 859 unique studies. Title and abstract screening identified 21 studies of possible relevance, and full text review identified seven studies for inclusion in this review. A total of 19 unique themes were identified and coded to 10 of the 14 domains of the Theoretical Domains Framework; however thematic overlap between studies was low and fewer than half of these themes were consistently identified as either a barrier or enabler. Four main barriers to referral to hearing care were identified: Lack of time, lack of familiarity with diagnostic criteria and tools, lack of knowledge of treatments and higher relative importance of other health conditions.

The minimal overlap of themes and low agreement on which of these constitute barriers and enablers for referral indicates a need for further research to provide greater clarity in this area and explain the heterogeneity of these results.

BackgroundThere is a need to strengthen the existing qualitative literature to begin exploring the self-management experiences of individuals with bipolar disorder.AimThis meta-synthesis aimed to identify the common components of self-management in individuals with bipolar disorder and provide a synthesis of the qualitative literature on self-management strategies and patients' experiences with bipolar disorder.MethodThe SPIDER framework tool guided the development of an appropriate search strategy. Studies published between 2011 and 2023 in widely used health databases, including PubMed, Cochrane, and Science Direct, were searched. Included studies underwent quality assessment, and data were synthesized and analyzed using the thematic synthesis method.ResultsThe synthesis identified four analytical themes, encompassing 14 subthemes. These themes include (a) understanding bipolar disorder, (b) coping strategies, (c) changing lifestyle behaviors, and (d) social support. Most of the included studies encompassed self-management strategies and experiences developed to cope with the symptoms of the illness.ConclusionsIndividuals diagnosed with bipolar disorder identified effective self-management strategies, including exercising, regular and sufficient sleep routines, and maintaining social connections. They stressed the importance of being competent, self-aware, and resourceful. Additionally, understanding how they perceived bipolar disorder was crucial for making sense of past mood experiences.

Extended family members play an important role in meeting the care needs of autistic individuals, yet family support policies and practices often overlook this role. We aimed to synthesise qualitative research on the role played by extended family members in the lives of autistic individuals and their parents and identify cultural patterns. We searched eight databases and selected relevant studies through a two-stage screening process. We synthesised the results and discussions described in the selected studies using template analysis. The review included 42 studies (40 qualitative; 2 mixed methods), reporting on 1048 parents and 2140 grandparents. While aunts, uncles, and cousins were not direct participants, their roles were described in participants' narratives. Three main themes were developed: (1) types of support from extended family members, including emotional, financial, instrumental, and informational support; (2) unhelpful or lack of support from extended family members, including misunderstanding about autism, absence of support with caregiving, and negative attitudes and discriminatory behaviours against autistic individuals as well as their parents; (3) factors influencing the role of extended family members, including individuals, family unit, family interaction characteristics, and a journey towards acceptance and cultural influences. Novel findings on the influence of culture suggested in cultures highly valuing family interdependence, extended relatives play a more prominent support role, yet the emphasis on family reputation might hinder the acceptance of autism by extended relatives. Based on a family systems approach, we recommend priorities for intervention development and clinical practice to support the effective involvement of extended family members.

It has been postulated, but not empirically validated, that breast implants may cause a range of systemic symptoms, recently aggregated into a syndrome termed Breast Implant Illness (BII). Research literature has focused on exploring these symptoms and possible aetiologies, however, it has not been formally recognised as a medical condition. The psychosocial experience of women who self-report BII is not well understood. This review aimed to synthesise findings from qualitative literature relating to BII. A systematic review and evidence synthesis of qualitative research was conducted and analysed using thematic synthesis. Searches were conducted in MEDLINE, CINHAL, Scopus, PsycINFO and secondary sources. Findings from nine studies were included, representing the experiences of women who had breast implants for reconstructive and cosmetic reasons. Four themes were identified: the decline in women's psychosocial wellbeing, the search for answers to their ill health, a lack of solicitude from healthcare professionals and industry, and surgery viewed as both the problem and solution. Women reported an array of distressing challenges that affected their overall quality of life. Findings highlight the need for psychosocial support and enhancing the integration of patient-entered perspectives. Further research is warranted to understand how these women can be better supported.

Persisting sex- and gender-based disparities in access to high-quality, personalized health care in the United States can lead to devastating outcomes with long-lasting consequences. Strategic use of virtual resources could expand equitable health care access for women. However, optimal approaches and timing for individualized, virtually delivered health care for women are unclear.

This study aims to conduct a detailed analysis of the current literature to answer the following question: "According to women and their health care teams, what are the reported successes and challenges in accessing, delivering, and participating in synchronous virtual health care for women?"

We conducted a qualitative evidence synthesis using a best-fit framework approach based on the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework and concepts from the Public Health Critical Race Praxis. We searched MEDLINE, Embase, and CINAHL from January 1, 2010, to October 10, 2022, using a combination of database-specific, relevant, controlled vocabulary terms and keywords; this search was updated in MEDLINE through January 2024. Additional citations were identified through handsearching. Our eligibility criteria were developed using the Sample, Phenomenon of Interest, Design, Evaluation, Research type tool to identify qualitative studies addressing synchronous virtual care for women. Citations were screened in duplicate, and eligible articles were abstracted. An iterative thematic synthesis approach was used to identify descriptive themes related to the successes and challenges related to delivering high-quality virtual care. Data reduction was performed using inductive and deductive reasoning. Quality assessment was conducted using the Critical Appraisal Skills Program and certainty of evidence using Confidence in the Evidence from Reviews of Qualitative Research approaches.

Of 85 eligible articles, we sampled 51 (60%) for data extraction based on representation of patient and clinician perspectives, marginalized voices, and relevance to a variety of clinical contexts. We identified themes across NASSS domains, including difficulty building rapport and emotional connections in the virtual setting, the amplification of barriers for women with preexisting challenges (eg, language barriers, limited transportation, and family and social commitments), and differing perceptions of privacy and safety related to virtual care depending on patient home context. Themes found to have high confidence included the value of convenience and cost savings offered by virtual care, the importance of patient choice in visit modality, the potential for negative impact on user well-being, considering the clinical context of modality choice, the importance of technology usability, and the value of virtual care for women located in regions without adequate supply of clinical offerings.

The benefits of virtual care for health care access may be more acutely felt by women, especially those with preexisting challenges. Strategic incorporation of virtual modalities into health care delivery for women could improve equitable access to high quality, patient-centered care.

PROSPERO CRD42021283791; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021283791.

RR2-10.1089/heq.2023.0089.

This systematic review and meta-analysis evaluates how the flipped classroom model-considered as a neurocognitive training environment-affects cognitive-motor integration and brain-mediated motor skill performance in university students, providing scientific evidence for optimizing higher-education physical education pedagogy (a course related to physical literacy and the cultivation of physical and mental health, rather than a training program for professional physical education teachers).

In order to compare the effects of flipped classroom and traditional teaching on the motor skill performance of university students, this study conducted a systematic review and meta-analysis according to PRISMA rules, whereby studies were screened according to specific inclusion criteria and data were extracted, assessed for quality, and then meta-analyzed to assess the effectiveness of the flipped classroom model in improving motor skill performance.

A total of 12 original randomized controlled trials (RCTs) were included in the study. The meta-analysis results indicated that the flipped classroom model significantly outperformed traditional teaching methods in improving university students' motor skill scores (standardized mean difference (SMD) = 1.22, 95% CI = 0.64-1.79, p < 0.0001). Subgroup analysis showed significant effects in both general major students and sports science major students, with no significant difference between studies conducted in China and those conducted in non-China regions.

The flipped classroom model demonstrates significant advantages over traditional PE teaching methods in improving motor skill performance. It enhances students' skill acquisition and classroom engagement, showing promising potential for future implementation in university PE programs. Further research should explore the model's applicability across different sports and student populations, as well as its long-term impact on skill retention and postgraduation sports participation.

Psychiatric disorders in patients with inflammatory bowel disease (IBD) represent a significant but uncertain facet of the disease, with unsolved questions regarding their overall magnitude, their impact on intestinal disease, and the whole burden of psychiatric manifestations.

This systematic review summarizes the evidence on the prevalence and impact of psychiatric disorders, including depression, anxiety, bipolar disorder (BD), and schizophrenia, among patients with IBD.

A systematic search across PubMed/MEDLINE, Embase, and Scopus databases from January 2010 to January 2023 was performed to identify relevant studies. The focus was on studies exploring the prevalence of specific psychiatric disorders in IBD patients compared to the general population and that reported specific outcome measures. A subsequent meta-analysis (MA) assessed the strength of the association between IBD and these psychiatric disorders, with data reliability ensured through rigorous extraction and quality assessment.

Out of 3,209 articles, 193 met the inclusion criteria and only 26 provided complete data for comprehensive analysis. These studies showed a significantly higher overall prevalence of psychiatric comorbidities in IBD patients compared to the general population. The MA showed a significant association between IBD and depression (pooled OR 1.42, 95% CI = 1.33-1.52, P < .0001) and anxiety (pooled OR 1.3, 95% CI = 1.22-1.44, P < .0001). The association between IBD and BD was significant (pooled OR 1.64, 95% CI = 1.20-2.24, P < .0001) but showed considerable heterogeneity (I2 = 94.01%). Only 3 studies examined the association between schizophrenia and IBD, providing widely heterogeneous results, with an inconclusive OR, estimated at 0.93 (95% CI = 0.62-1.39, P = .73).

This MA highlights the high prevalence of psychiatric disorders, particularly depression and anxiety, in IBD patients, which exceeds rates in the general population. BD in IBD is proving to be an important but under-researched area. The sparse and contradictory data on schizophrenia requires further investigation. These findings highlight the need for better understanding, early detection, and tailored mental health interventions in the management of IBD to significantly improve patients' quality of life.

The teaching profession is widely recognized as highly challenging due to its intense workload, emotional demands, and ongoing stressors. This Systematic Literature Review (SLR) aims to identify and evaluate various interventions that have been implemented to address lecturer burnout over the past five years. A thorough review of 21 studies published between 2020 and 2024 was conducted across five major databases: Web of Science, Scopus, PubMed, ERIC, and APA PsycINFO. Relevant search terms were used to explore the effectiveness of different interventions aimed at reducing lecturer burnout. Articles were extracted, reviewed, collated, and thematically analyzed to synthesize the findings. Seven distinct interventions were identified as effective in reducing burnout. The most commonly studied intervention was social support, followed by training programs. Other interventions demonstrating positive results include supportive work environments, Rational Emotive Behavior Therapy (REBT), and psychological capital. Additionally, interventions that balanced work and life conditions, facilitated teaching transitions, helped lecturers reevaluate major work demands, and encouraged the utilization of character strengths were also found to yield beneficial outcomes. The implementation of targeted, school-based interventions is crucial for reducing burnout and enhancing the overall well-being of university lecturers. Policymakers, administrators, and educational leaders should prioritize the implementation of school-based awareness and intervention programs.

Increasingly, substance use and homelessness services have peer workers, those with lived or living experience of substance use and homelessness, who provide support to those experiencing similar challenges. While research regarding the effectiveness of such peer workers in helping others achieve better outcomes is growing, little is known about their experiences in this role.

A systematic review and qualitative evidence synthesis was conducted to better understand the experiences of peer workers who have lived/living experience of substance use and homelessness who are providing support to those experiencing similar challenges within substance use and homelessness settings. Nine electronic databases were searched for primary qualitative research published from 1990. Studies meeting the inclusion criteria were quality assessed using the Critical Appraisal Skills Programme checklist. Data from included studies were extracted, entered into NVivo, and analysed using a thematic synthesis approach.

Nine studies were identified, published from 2006 from three countries with 272 participants. Three themes were identified: peer workers' reflections on the key components of their role; peer work as enabling individual growth and recovery; and destabilising challenges peer worker growth and recovery.. Peer workers described many essential qualities, and their lived experience was valued as a way of enabling deeper trust and empathy with the people they supported. Strong relationships with other peer workers were described as important. Many benefits to the peer workers were described, including positive life changes and increased responsibility. Challenges were also identified, with professional boundaries causing particular tensions.

This qualitative evidence synthesis provides unique insight into the experiences of peer workers who are working at the intersection of homelessness and substance use. Their experiences highlight the real benefits that peer workers have, whilst working in challenging situations in often precarious contracts. Such insights can inform the employment of peer workers. Those employing peer workers should prioritise clear job descriptions encompassing specific peer qualities, training and education opportunities, and peer-to-peer, professional, and organisational support.

The aim of this systematic review was to analyze the published research on training approaches for preparing current and future speech-language pathologists (SLPs) to work effectively with people with aphasia (PWA). The review addresses key questions regarding the described training approaches, their key features, research quality, and efficacy.

The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with International Prospective Register of Systematic Reviews (CRD42024453742). The literature search spanned nine databases. Eligibility criteria included peer-reviewed publications in English that reported on training programs involving current or future SLPs working with PWA. Studies were assessed for research quality using the American Speech-Language-Hearing Association's (ASHA's) levels of evidence framework. Narrative synthesis was used to identify key features in the training programs.

A total of 920 citations were identified, with 50 studies meeting the inclusion criteria for analysis. Included studies represented a broad range of training approaches, research designs, and research quality. The 50 studies fell into ASHA levels of evidence Ib, IIa, IIb, III, and IV. Statistical meta-analysis was not possible because of variability in research design and outcome measures, but the studies revealed statistically significant findings relevant to the question of what makes training effective for preparing clinicians to work with people with aphasia.

The current literature related to training of clinicians to work with PWA is heterogeneous in approach, outcome metrics, and methodological quality. There is evidence supporting several recommendations for training clinicians including integrating direct interactions with PWA during training, combining didactic and experiential learning, and incorporating reflective practices. Overall, the review highlights the need for well-described evidence-based training standards for speech-language pathology students working with PWA. Future research should aim to develop and validate comprehensive training guidelines to improve care quality for individuals with aphasia.

Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care.

This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice.

This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care.

This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on.

This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care.

PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Given the significant burden and rising prevalence of dementia, it is essential that personalised care is available to people with dementia (PWD) and their family carers. This involves tailoring support to meet individuals' unique needs and preferences. Effective communication is fundamental to delivering such care, yet dementia impacts communication, posing challenges in meeting individuals' needs.

To understand key communication strategies used by healthcare professionals (HCPs) in delivering personalised dementia care.

A systematic search across MEDLINE, EMBASE, EMCare, PsycINFO, CINAHL, Scopus, and Web of Science was conducted (April 2024) without limits on care setting, country or publication date. We identified studies examining communication strategies, barriers, and facilitators for delivering personalised care for PWD and their carers. Study quality was assessed using Joanna Briggs Institute critical appraisal tools and the Mixed Methods Appraisal Tool. Using codebook thematic analysis, a narrative synthesis of findings was developed.

The review included 33 studies, encompassing qualitative, quantitative and mixed-methods research conducted in hospitals, care homes and community settings. Most studies originate from high-income countries and care homes, limiting generalisability. Three themes on communication strategies for delivering personalised dementia care were developed: understanding the person, their family and their care context; communication techniques (verbal, nonverbal and use of external aids); and support for the workforce. The review underscores the importance of combining practical, emotional and relational approaches while highlighting current gaps, such as the need for better workforce support and more research in primary care and culturally diverse contexts.

Given uncertain illness trajectories faced by older adults with frailty and risk of decline and poor outcomes, intervention development for readiness to engage with advance care planning may confer benefits. However, evidence in this area remains limited.

DESIGN: A mixed-methods systematic narrative review, underpinned by the COM-B system behaviour change model and employing thematic data synthesis.

Primary studies were included using experimental or observational designs, qualitative and quantitative. Eligible studies were identified through searches of four electronic databases from inception to January 19, 2025.

26 articles met the inclusion criteria. The data synthesis generated 14 themes across the three COM-B system components. The review identified the components of older adults' readiness, such as their limited physical and cognitive capacity for engaging in ACP (capability), influence and involvement of family (opportunity), and their desire to maintain the present and fear of change (motivation). It emphasised that readiness for advance care planning is a dynamic process influenced by family carers' and professionals' attitudes and behaviours, uncertainties inherent in older adults' conditions, as well as healthcare system, political, and social factors. The review also highlighted the uncertainties and ongoing changes involved in readiness, such as fluctuating physical and cognitive capabilities and changeable social situations. Based on these findings, a logic model was constructed to guide intervention development, outlining the components, intended outcomes, and influential factors.

Individual behaviour change models alone are insufficient to demonstrate older adults' readiness for advance care planning, as various external factors can influence their readiness. This emphasised the need for a comprehensive understanding of the contextual factors affecting readiness and the importance of flexibility in adapting interventions accordingly. Continuous assessment and enhancement of an individual's readiness for advance care planning, initiating conversations about what matters to them now, and improving family carers' readiness for advance care planning by assessing family dynamics and relationships are essential in practice. Further research is needed to elucidate the processes and causal pathways between intervention components and intended outcomes. This systematic review was registered on PROSPERO (CRD42023389337).

The ecological model of communication in medical encounters (EMCME) could provide a framework for examining issues related to health equity in healthcare interactions. This study seeks to understand how scholarship has engaged with the model and the extent of its use in health equity work.

A scoping review of the EMCME was conducted using three major databases: Scopus, Web of Science, and Google Scholar in September 2023. Databases were searched for works citing the article explicating the model.

The search returned 336 unique documents. After inclusion and exclusion criteria were applied, 85 documents remained and were analyzed. Many pieces described the model or used the model to frame their work; far fewer pieces used the model to test empirical relationships. Most works, however, focused on a single context: interpersonal. Twenty-five works directly used the model in relation to health equity.

There are several contexts of the model that remain underexplored. More attention to these contexts may not only help to better the clinical encounter but advance health equity.

Increased use of the full EMCME in all facets - research, practice, and teaching - could provide a framework for framing and organizing work around health equity.

Improving patient safety and healthcare quality is necessary to advance value-based health care. Spine surgery is complex, entailing joint efforts between different disciplines. This scoping review aimed to map the research on establishing and implementing institution-based quality improvement (QI) initiatives in spine surgery.

Studies were identified in electronic searches of PubMed, Web of Science, and Scopus databases. Qualitative or quantitative studies that report the implementation of QI programs that occurred in or covered spine surgery were included; studies that did not describe the establishment, implementations, impacts, barriers, and facilitators of QI initiatives were excluded. Three reviewers independently screened the retrieved studies, and 2 reviewers extracted data and conducted a quality assessment of full-text articles. Studies were categorized according to dimensions of quality (timely, effective, patient-centered, efficient, equitable, and safe), and quality appraisal was conducted using the Standards for Quality Improvement Reporting Excellence reporting guidelines.

The search from the 3 databases yielded 2,876 returns; after removing duplicates, there were 1,274 in total. After screening, 228 records were entered into a full-text review, resulting in 133 records included in the review. Specifically, 88 addressed aspects of efficiency, 74 on safety, 32 on improving effectiveness, 23 on patient-centeredness, 7 on timeliness, and 1 on equity. Of the studies included, 71 rely on retrospective audits, 19 are prospective, and only 8 are interventional trials. Only 67 QI initiatives leveraged the advantages of multidisciplinary teams or the rigor of evidence-based protocols. Study gaps include limited follow-up, small sample sizes, and lack of comprehensive assessment using both objective measures and patient-reported outcomes.

This scoping review maps the current research on developing and implementing institution-based QI initiatives in spine surgery. Although most of the initiatives reported show improvement in the quality of health care and patient safety from multiple aspects, the sustainability of these initiatives remains unknown, and further studies are needed to trace the long-term effects and generalizability of these initiatives.

Preparing informal caregivers for a patient's transition to outpatient care is an important component of safe, quality hematological cancer care. The development of many novel therapies and emerging treatments has created opportunities to address the needs of informal caregivers following the discharge of patients from inpatient settings.

To review and synthesize the literature on the needs of informal caregivers of patients with a hematological malignancy postdischarge from inpatient care.

Integrative review methodology was used to explore the body of evidence available. This included a quality appraisal of qualitative, quantitative, and mixed-methods research findings, subsequent data extraction, and inductive thematic synthesis.

One thousand eight articles were screened with 10 included in the review. Key insights into the needs of caregivers entering the outpatient setting were identified and grouped into key subheadings: Encountering complex emotions knowing what to know, little time for yourself, and collateral impact.

Findings convey the complex and multiple needs of informal caregivers of hematological cancer patients. With a growing population of people with hematological malignancies and innovations in outpatient cancer therapies, there is a pressing need to codesign interventions to support their caregivers.

This review has identified a need for more robust research to coproduce interventions in collaboration with caregivers. In addition, interventions developed from further research should be tested in quality implementation science studies to determine their feasibility, sustainability, and impact on outcomes that matter to hematological cancer caregivers.

Acquired Brain Injury (ABI) often results in significant challenges, yet it may also facilitate Post-Traumatic Growth (PTG). This review explores a critical question: "What are the main factors contributing to PTG following ABI, and what potential barriers to its development are perceived by ABI survivors?" Here we aim to systematically uncover these contributors and barriers to PTG through a meta-synthesis, involving a comprehensive review of previously published qualitative research on this topic. A literature search was conducted across PsycINFO, CINAHL, and MEDLINE up to December 2022 to identify studies for inclusion. From an initial pool of 1,946 records, eleven articles were selected for inclusion. Reflexive thematic analysis yielded three analytical themes including "Journey to Self-Rediscovery", "Strength in Connection" and "Overcoming Obstacles". Our findings also revealed facilitators and barriers across multiple levels of scale including personal (e.g., acceptance versus resignation), interpersonal (e.g., positive social ties versus difficulties making social connections), and systemic (e.g., new meaning and purpose versus financial constraints) scales. Our research extends existing knowledge in ABI rehabilitation, providing a more nuanced understanding of the dynamics influencing PTG with implications for clinicians seeking to promote wellbeing following brain injury.

The aim of this study is to explore the experiences of nurses who resigned from healthcare organisations or abandoned the profession and explore the reasons behind them.

A systematic review of qualitative studies and meta-summary.

Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase (Ovid), MEDLINE (Ovid), Social Science Citation Index (Web of Science), and Scopus.

The search was conducted up to May 2024. Primary qualitative studies focused on nurses who had resigned or left the profession were included. The meta-summary was conducted using method: findings were extracted from the reports, edited, grouped, abstracted into key meta-findings, and finally, their frequency effect sizes were calculated.

A total of 282 findings were extracted from 12 studies, generating 49 statements of findings that were aggregated into nine key meta-findings. Poor management practices presented a frequency effect size of 100%. Other key meta-findings included excessive workload, teamwork hurdles, health issues related to work shifts and difficulty in maintaining work-life balance, a lack of career growth opportunities and promotion chances, disillusionment with nursing, dissatisfaction due to salary, bullying and horizontal violence, and moral distress over ethical dilemmas.

The findings can help support the development of targeted strategies and the implementation of effective policies aimed at reducing nursing turnover.

The major impact of these findings is the recognition of rising factors that negatively affect nurses' quality of life, including workload pressures and poor management strategies, which significantly lower job satisfaction. To address these challenges, the profession should prioritise tools that value nurses in their roles, implement strategies to manage workloads more effectively and advocate for policies promoting flexible scheduling. Additionally, investing in professional development and fostering a supportive work environment can help retain skilled nurses and nurture the growth of new talent.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

No patient or public contribution.

Incarcerated women are confined in institutions designed to punish. These sites often ignore the complex mental and physical health needs of people who are incarcerated. Despite the World Health Organization stressing the need for access to reproductive healthcare in carceral institutions, stigma surrounding abortion care and health inequalities create contextually specific issues for incarcerated people seeking to access these services. There is also a dearth of research conducted directly with incarcerated women, trans men and non-binary people to examine their experiences of abortion. A systematic review of international peer-reviewed and grey literature was completed to summarise existing evidence from research conducted on the experiences of needing abortion care whilst incarcerated. Various experiences were identified including: conditions of confinement shaping abortion decisions; bureaucratic obstacles to accessing abortion services; incarcerated women, carceral staff and carceral healthcare staff's lack of understanding of abortion rights and procedures; and a scarcity of support and empathy, including experiences of stigmatisation and lack of confidentiality. There exists a significant gap in research examining the experiences of incarcerated people who may need an abortion, emphasising the need for international collaboration and advocacy to address systemic issues that extend beyond local contexts.

We aimed to identify the factors influencing the success of Pain Neuroscience Education (PNE) in chronic musculoskeletal (MSK) pain from the perspective of those experiencing PNE first-hand.

We conducted a meta-synthesis of qualitative studies. Articles were found on MEDLINE via Pubmed, EMBASE, Cochrane Library, CINHAL, and PsycINFO up to April 2023. Eligible qualitative studies focussed on adults (>16 years old) with a diagnosis of chronic primary or secondary MSK pain who performed PNE. Thematic synthesis by Thomas and Harden was followed. The Critical Appraisal Skills Programme (CASP) tool ensured the quality of the studies, while the Confidence in Evidence from the Reviews of Qualitative Research (CERQual) approach facilitated data confidence assessment.

Nine studies were included (188 participants). Three analytical themes were developed: (i) "Efficient Communication of Information", emphasising the importance of accurate content transmission; (ii) "Emotional Support and Well-being", recognising emotional aspects as integral to treatment; and (iii) "Empowerment Promotion", focusing on information retention and personal transformation. The studies showed good quality, with moderate confidence in the evidence.

The perceived factors influencing the success of PNE are intricately related to the domain of communication, the emotional dimension of personal experience, and the capacity to be empowered.

Concussions most commonly affect the vestibular and ocular systems. Clinical measures used in the assessment of vestibular and ocular deficits should contain strong psychometric properties so that clinicians can accurately detect abnormality to guide treatment interventions.

The aim of this scoping review was: (1) to identify the measures used to evaluate the vestibular and ocular domains postconcussion and (2) to document the psychometric properties of the measures.

Two databases (Medline (Ovid) and Embase) were searched from inception to May 2023. An updated search was completed in January 2024 using the same databases and search terms. Studies were screened and data were extracted independently by 2 reviewers. Measures were categorized into vestibular, ocular, or both (vestibular and ocular) domains, and relevant psychometric properties were documented.

Fifty-two studies were included in this review. 28 studies explored the use of vestibular measures, 12 explored ocular measures, and 12 explored both vestibular and ocular measures or explored the use of vestibulo-ocular reflex measures. Most studies explored the properties associated with balance measures, particularly the balance error scoring system. Diagnostic accuracy (sensitivity and specificity metrics) of the associated measures was the most frequently documented characteristic in the literature.

Identification of clinical measures used to evaluate vestibular and ocular deficits postconcussion is needed to understand the evidence supporting their use in practice. Documenting the psychometric properties will allow clinicians and researchers to understand the status of the current literature and support for the use of certain measures in practice in terms of their ability to appropriately detect deficits in people with concussion when deficits are truly present.

This review analyses and thematically structures the literature exploring the everyday care practices of healthcare support workers (HCSWs) based on hospital wards caring for patients with dementia in the National Health Service in the United Kingdom. Understanding the experiences of this staff group can enhance education, research, and practice initiatives, which in turn supports high-quality dementia care.

In February 2024, we searched a range of databases: PsycINFO, EMBASE, Medline, CINAHL, British Nursing Index, AMED and ASSIA, to identify qualitative and mixed methods papers exploring HCSW's care practices. We extracted and tabulated: research focus, methods of data collection and analysis, themes, findings, and all quotes attributed to HCSWs. The CASP tool was used for quality appraisal. We analysed the data following guidance for the thematic synthesis of qualitative research in systematic reviews to generate overarching themes.

We uncovered 19 papers, and our thematic analysis generated four themes: i) roles and responsibilities, ii) training and teamwork, iii) practicing and reflecting, and iv) always being front and centre.

Our themes are consistent with the literature exploring HCSW practice generally, including the challenges, skills and dedication to their craft demonstrated by this staff group. However, the nature of working with patients with dementia with behaviours that challenge is a more prominent issue within this data compared to the generic HCSW literature. This includes the need to recognise the complexity of bodywork and the interactional skills required when supporting activities of daily living in the context of behaviour change.

Childbirth related perineal trauma affects 80 % of women during vaginal birth in the UK. Childbirth related perineal trauma can create short and long term complications for women such as pain and incontinence.

The review aimed to explore women's, their birth partners' and health care professionals' views and experiences of childbirth related perineal trauma care provision in high income countries.

Search terms and eligibility criteria were developed and four databases (MEDLINE, Embase, PsychINFO and CINAHL) were searched in February 2024, yielding 5638 results. Studies were independently screened by two reviewers and disputes resolved by a third. Study quality was assessed using the critical appraisal skills programme, thematic synthesis analysed primary data, and confidence in findings were evaluated.

22 studies were included, containing 3473 women and 56 HCPs. No studies were identified for views of birth partners. Women reported they wanted more antenatal and postnatal information about childbirth related perineal trauma, that experiences of perineal repair were affected by health care professional behaviours, and that postnatal care was not always sufficient to meet their needs. Health care professionals highlighted a need for improved education for providing care to women after childbirth related perineal trauma.

Findings from the review can inform the development of care pathways to improve care and associated outcomes for women after childbirth related perineal trauma. Further research is needed to explore the views of birth partners and a wider range of health care professionals involved in caring for women after childbirth related perineal trauma.

To explore how children and adolescents with chronic pain describe their pain experiences.

A systematic search of OVID Medline, CINAHL Complete, OVID Embase and APA PsycINFO (database inception to 19th August 2024) was conducted for qualitative or mixed-method studies investigating children's chronic pain experiences. Studies were excluded if focused on post-surgical or acute pain. Two independent reviewers screened studies, and disagreements resolved by a third reviewer. Methodological quality was assessed with the CASP checklist. Data from included studies were extracted and analysed using qualitative analysis.

Forty studies were included, and 4 main themes were identified: 1. 'I'm missing out because of my pain'; in which children described frustration and isolation due to missing activities. 2. 'Things that help me to get by with my pain'; described a variety of children's coping mechanisms. 3. 'It hurts and no one else understands my pain'; where children felt frequently disbelieved about their pain severity, and 4. 'I keep trying to make sense of my pain'; in which children identified ways they seek to understand the cause and possible outcomes of their pain, including accessing health care services.

This review highlights how children describe their pain challenges in managing their day to day while emphasising the necessity of understanding and incorporating children's perspectives into research and practice.

This review found that children were primarily concerned by how their pain affects their day-to-day activities and highlights the need to equip children with multiple strategies and promote autonomy in managing their pain. Additionally, further research is warranted into the ways that children understand their pain experience and seek information about their pain.

Flourishing and belonging are key concepts for the wellbeing of staff and the success of a profession. Alienation and anomie are distinct types of psycho-social ills which inhibit flourishing and belonging. A better understanding of these may offer hope in preventing many negative work endpoints, including burnout and intention to leave.

To systematically review and narratively synthesise alienation and/or anomie in pharmacists across the globe, reviewing all types of methodological designs, published in peer-reviewed journals.

We identified published peer-reviewed research through searching eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science - Core Collection, Scopus, and Google Scholar) and extensive hand/citation searching. Two independent reviewers identified and critiqued eligible studies, extracted data, and synthesised the findings. The synthesis evaluated the focuses, causes, associated factors, and/or consequences of alienation and/or anomie and aligned these to six deductive themes from alienation theory: care; values; meaning; recognition; autonomy; and shared responsibility.

Searches identified 886 papers, with 47 included in the final results. From the synthesis, ten key causes of alienation and/or anomie were identified; 1) Changing Professional Identity, 2) Reimbursement Models & Corporatisation, 3) Focus on Medicines Rather than People, 4) Misunderstanding & Deprofessionalisation, 5) Environments & Culture, 6) Suboptimal Societal Mandate, 7) Roles Misaligned with Aspirations, 8) Systematic Underutilisation, 9) Lack of Professional Agency, and 10) Value Conflict. From the evidence, there was high confidence that inhibitions of care, values, recognition, and/or autonomy (four of the six deductive themes) were associated with alienation and/or anomie.

Alienation and/or anomie are present across many countries and regions. This paper helps us understand the aetiology of this complex psycho-social syndrome, a necessary first step in creating an inclusive profession where all pharmacists can flourish. Future research needs to trial new interventions targeted at correcting this professional malady.

Most women suffering from urinary incontinence (UI) report that leakage occurs during everyday movement. These precise observations raise a potential association between standing postural control and UI. The aim of this systematic review is to compile studies investigating the link between standing postural control and UI, according to the presence or absence of UI, the severity of UI and bladder fullness.

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Observational studies providing data on standing postural control in women with and without UI were considered for inclusion.

Ten studies met the inclusion criteria, representing 4262 middle-aged and older active women. According to the modified version of the Newcastle-Ottawa quality assessment Scale, one was study rated as having a high risk of bias, 3 studies fair quality and 6 good quality. Four studies reported results using stabilographic measurement (p = 124 women). Six reported results using standing balance tests (p = 4138). All studies revealed some differences between UI and non-UI groups in standing postural control (p < 0.05).

Our analysis provides a high level of evidence that women with UI have more impaired standing postural balance control than women without UI. According to the dual-task theory, worsening continence control is associated with a decline in standing postural balance, and conversely, a decline in standing postural balance is associated with the development of UI. Developing prospective planned physiotherapy intervention studies that address the impact of standing postural control interventions on UI signs and symptoms seems advisable.

Research has highlighted under-utilisation of mental health services by older adults. This review aims to systematically review existing literature on older adults' experiences of accessing community mental health support from secondary care services. The review aims to develop recommendations to improve the mental health support older adults receive.

A comprehensive systematic search was conducted across four databases. Terms relating to older adult experiences and factors impacting access to secondary mental health community services were included. Nineteen eligible papers were identified. Data were thematically synthesised.

Four analytical themes and 12 descriptive subthemes were identified. Overarching themes included social influences and service factors which impacted engagement and accessibility, and personal factors. Sub-themes included mental health knowledge and beliefs, the impact of past experiences and social factors including discrimination and support. Help-seeking behaviours were influenced by accessibility of services, service support and clinician factors.

Educational initiatives can help to increase mental health knowledge of older adults and their families allowing for improved access to services. Increased training for clinicians can improve referral processes and enable services to adapt to the unique needs of older adults. Studies reviewed were worldwide and reflected a range of views supporting relevance of outcomes globally.

(1) Background: Tendon and ligament injuries are a leading cause of lameness in horses, with significant economic implications. Platelet-rich plasma (PRP) has gained attention for its regenerative potential, but its efficacy remains uncertain due to inconsistent study designs and reporting. (2) Methods: This systematic review, following the PRISMA guidelines, evaluated 22 studies (clinical and experimental) to assess the safety and efficacy of PRP in treating equine tendon and ligament injuries. The risk of bias was analyzed using the ROBINS-I and RoB 2.0 tools. (3) Results: PRP demonstrated a favorable safety profile, with no severe adverse effects reported. Clinical outcomes included improved lameness scores, ultrasonographic tissue organization, and return-to-work rates. However, variability in PRP formulations (e.g., leukocyte-rich vs. leukocyte-reduced) and activation methods (e.g., calcium chloride, thrombin) contributed to inconsistent results. Experimental studies supported PRP's role in collagen synthesis and neovascularization, but comparative trials with stem cells or other therapies (e.g., extracorporeal shockwave) showed mixed results. The methodological quality of studies varied, with only 27% achieving "good" scores for PRP reporting. (4) Conclusions: PRP is a safe and potentially effective treatment, but its clinical application is hindered by a lack of standardization. Future research should focus on large, randomized controlled trials with uniform PRP protocols, long-term (≥2 years) efficacy assessments, comparative studies with MSC combinations, and cost-effectiveness analyses.

Child-to-parent violence (CPV) is an increasing issue globally, leading to serious adverse effects on families. This research aimed to conduct a systematic review and meta-analysis to assess the prevalence of CPV and identify its associated risk factors, thereby enhancing understanding of this escalating global issue.

In this systematic review and meta-analysis, a thorough search was carried out across various databases in English. The inclusion criteria were developed based on the SPIDER framework, targeting quantitative studies that focused on the prevalence and risk factors associated with CPV. Data were extracted systematically using a validated collection form, and the risk of bias was assessed using the Newcastle-Ottawa Scale. Statistical analyses included meta-regression and sensitivity analyses to determine the prevalence of CPV using Comprehensive Meta-Analysis version 3 software. Among the 25 included studies, 12 studies were included in the meta-analysis for prevalence, both overall and separately for violence against mothers and fathers. Additionally, 8 studies were analyzed through systematic and narrative data synthesis to examine determinants of CPV.

The meta-analysis involving 25,000 participants revealed that the overall prevalence of CPV against both parents was 34.8%. Subgroup analyses indicated that physical violence prevalence was 10.0%, while psychological violence was significantly higher at 82.6%. Additionally, the descriptive analysis identified key determinants of CPV, including family conflict, parental stress, and adolescent behavioral issues, highlighting the complex interplay of factors contributing to this phenomenon and emphasizing the need for targeted interventions.

The findings underscore the urgent need for targeted interventions that address these multifaceted issues to effectively reduce CPV and its impact on families. Future research should continue to explore these dynamics to inform effective prevention strategies.

University students from racially minoritised backgrounds are at an increased risk of experiencing mental health difficulties but are less likely to seek support compared to students from racial and ethnic majority backgrounds. To increase the accessibility and appropriateness of mental health support for university students, it is important to understand the attitudes towards seeking help for mental health of underserved student groups. This is the first systematic review to synthesise the available qualitative data which explores attitudes toward seeking help for mental health problems among students from racially minoritised backgrounds.

This systematic review includes qualitative studies exploring attitudes towards seeking help for mental health difficulties among racially minoritised university students. A literature search was carried out using PsycINFO, CINAHL, Medline and Web of Science in March 2024. Participants were racially minoritised university students. Data were synthesised using a thematic synthesis.

Of 493 papers identified, 15 were included in the final thematic synthesis following methodological appraisal of their quality using the Critical Appraisal Skills Programme. There were a total of 314 participants across all included papers. Four analytical themes were identified: "cultural attitudes" outlined how culturally specific experiences of stigma, lack of conversations about mental health, faith, and gender influenced attitudes; "interpersonal relationships" explored the impact of family and peer relationships on attitudes; "psychological barriers" described how psychological constructs, such as preference for self-reliance and feared consequences of disclosure, were culturally-informed barriers to help-seeking; and "systemic barriers" encompassed the structural barriers, discriminatory practices and perceived cultural incompetence of services and institutions that negatively impacted on attitudes towards help-seeking for mental health difficulties.

Culture, identity and social inequality inform attitudes towards help-seeking among racially minoritised students. Exploration of how these factors interact with university systems may improve the provision of mental health support. Systemic change is needed within universities and mental health services to tackle inequality and improve support for racially minoritised students.

Home-based hospice care offers terminal cancer patients the comfort of receiving care in a familiar environment while enabling family members to provide personalised support. Despite the critical role families play, the literature remains underexplored in terms of their experiences, needs, and perceptions. A robust qualitative synthesis is needed to inform improvements in palliative care services.

This meta-synthesis aims to systematically review and synthesise qualitative evidence regarding the experiences, needs, and perceptions of family caregivers in home-based hospice care for terminal cancer patients. The goal is identifying key themes that can improve caregiver support and service delivery.

A systematic search was conducted across MEDLINE, EMBASE, SCOPUS, PsycINFO, CINAHL, Google Scholar and relevant grey literature sources up to 14 March 2025. Studies were included if they focused on family caregivers' experiences in home-based hospice care settings, excluding those that addressed only patients or healthcare providers. Two independent reviewers performed study selection, data extraction, and quality assessment using the Critical Appraisal Skills Programme (CASP) checklist. Data were synthesised using a three-step thematic synthesis approach, and the confidence in the findings was assessed via the GRADE-CERQual framework.

Five studies published between 1989 and 2022 from diverse geographical regions (including Asia and Western settings) met the inclusion criteria. Two major themes emerged: (1) Being Physically and Emotionally Present-where caregivers expressed a strong commitment to remain with their loved ones, providing emotional support and maintaining a sense of control; and (2) Sharing Responsibilities-which underscored the importance of both formal support from palliative care teams and informal support from family and friends in mitigating caregiver burden. These findings directly address the study's aims by illustrating how caregivers balance emotional commitment with the practical challenges of providing home-based care.

While family caregivers are dedicated to delivering high-quality, personalised care, they encounter significant emotional and logistical challenges. Variability in study settings, potential recall bias from retrospective interviews, and limited grey literature access may affect the generalisability of the findings. This meta-synthesis underscores the essential role of family involvement in home-based hospice care for terminal cancer patients. The combined reliance on emotional commitment and shared responsibilities-with support from professional care teams-is vital for optimal care delivery. Future interventions should enhance formal and informal support systems to meet family caregivers' diverse needs better.

Prospero: CRD42023486012.

Objective: Psychological safety (PS) is essential for health and social care professionals (HSCPs) working in high-stress environments. While much of the existing research focuses on PS within teams, less is known about HSCPs' lived experiences across diverse health and social care settings. This scoping review aims to synthesise the qualitative literature on PS, identifying key barriers and enablers to its development in health and social care workplaces. Methods: A systematic search was conducted across MEDLINE, PsycINFO, Embase, CINAHL, Scopus, Web of Science, and the Cochrane Library, covering a 20-year period (2004-2024). Eligible studies included primary qualitative research exploring HSCPs' experiences of PS. Screening and data extraction were managed using Rayyan. An inductive thematic synthesis approach was applied to identify key patterns in the data. Results: The review identified several enablers and barriers to PS. The main enablers included (1) feeling safe within the team and (2) personal factors, which encompassed professional skills, experience, social support, and self-care. Conversely, key barriers were identified: (1) the normalisation of traumatic incidents, (2) unsupportive team and management structures, (3) organisational constraints, and (4) a lack of knowledge and training on PS. Conclusions: Understanding the enablers and barriers of PS is critical for improving workplace culture, resilience, and wellbeing among HSCPs. These findings provide a foundation for future research and interventions aimed at strengthening PS at individual, team, and organisational levels across diverse health and social care settings. The results also offer valuable insights for informing policies and practice to ultimately enhance both staff wellbeing and patient care quality.

Objectives: to systematically examine and synthesize qualitative evidence on adult patients' psychological distress during an intensive care unit stay to inform development of interventions tailored to their needs. Method: We conducted systematic literature searches in CINAHL, MEDLINE, EMBASE, PsycINFO, Scopus, Dissertations and Theses Global, and Google Scholar databases using predefined eligibility criteria. We synthesized primary qualitative research evidence using Noblit and Hare's meta-ethnographic approach. Reporting was based on the eMERGe framework. The quality of included articles was assessed by the Critical Appraisal Skills Program tool. Findings: We identified 31 primary studies from 19 countries. The studies were of moderate to high quality. Data analysis revealed five themes: "disempowerment", "altered self-identity" "fighting", "torment", and "hostile environment". One overarching theme, "the disempowered warrior", captured the perpetual tension between the need to fight for their lives and the need to succumb to the care process. Our synthesis discloses that critically ill patients perceive themselves to be in a battle for their lives; while at the same time they may feel helpless and disempowered. Conclusions: Our review revealed the tension between the need to fight for one's life and the sense of powerlessness in the intensive care unit environment. Although participants recognize the important role of healthcare workers, they desired more involvement, collaboration, control, empathy, and empowerment in the care process. These findings can inform approaches to empowering critically ill patients and managing their psychological responses. Care standards must include distress assessment and management that maximize patients' empowerment and emotional safety with the care process.