Prevalence and clinical implications of sarcopenia in breast cancer: a systematic review and meta-analysis.

PURPOSE: The impact of sarcopenia in oncology is increasingly recognized, yet little is known about its clinical implications in breast cancer. This systematic review and meta-analysis estimates the overall prevalence of sarcopenia in breast cancer, quantifies skeletal muscle index (SMI), and comprehensively evaluates sarcopenia's impact on clinical outcomes. METHODS: We systematically searched primary original research published before June 2023 in four databases: the Cochrane Library via Wiley, CINAHL Plus with Full Text, Embase via Elsevier Excerpta Medica, and Medline via Ovid. Standardized mean SMI and 95% confidence interval (CI) were calculated by applying the random-effects model. The methodological quality of the included studies was assessed using the National Institutes of Health quality assessment checklist. RESULTS: The systematic review included 17 studies with a total of 9863 patients; the meta-analysis included 12 of these studies. The mean prevalence of sarcopenia in breast cancer (stages I-III) was 32.5%. The mean SMI assessed by CT was 43.94 cm2/m2 (95% CI 42.87, 45.01; p < .01). Overall, low muscle mass was associated with chemotherapy toxicities, dose reductions, dose delays, or treatment discontinuation. Low muscle mass was generally associated with poor survival, but in some studies, this association was not significant or reversed direction. CONCLUSION: Sarcopenia is not just a state of muscle mass loss, but an influencing factor on therapeutic effects and survival rates in oncology. It is thus necessary to recognize the risk of sarcopenia throughout the trajectory of cancer treatment, identify low muscle mass early, and manage it from a prehabilitation perspective.

Exploring physical and biological manifestations of burnout and post-traumatic stress disorder symptoms in healthcare workers: a scoping review protocol.

INTRODUCTION: The COVID-19 pandemic has strained the mental and physical well-being of healthcare workers (HCW). Increased work-related stress and limited resources have increased symptoms of anxiety, depression, insomnia and post-traumatic stress disorder (PTSD) in this population. Stress-related disorders have been strongly associated with long-term consequences, including cardiometabolic disorders, endocrine disorders and premature mortality. This scoping review aims to explore available literature on burnout, PTSD, and other mental health-associated symptoms in HCW to synthesise relationships with physiological and biological biomarkers that may be associated with increased risk of disease, creating an opportunity to summarise current biomarker knowledge and identify gaps in this literature. METHODS AND ANALYSIS: This scoping review uses the Arksey and O'Malley six-step scoping review methodology framework. The research team will select appropriate primary sources using a search strategy developed in collaboration with a health sciences librarian. Three reviewers will initially screen the title and abstracts obtained from the literature searches, and two reviewers will conduct independent reviews of full-text studies for inclusion. The research team will be reviewing literature focusing on which burnout and/or PTSD-associated physiological and biological biomarkers have been studied, the methodologies used to study them and the correlations between the biomarkers and HCW experiencing burnout/PTSD. Data extraction forms will be completed by two reviewers for included studies and will guide literature synthesis and analysis to determine common themes. ETHICS AND DISSEMINATION: This review does not require ethical approval. We expect results from this scoping review to identify gaps in the literature and encourage future research regarding improving biological and physiological biomarker research in HCW. Preliminary results and general themes will be communicated back to stakeholders. Results will be disseminated through peer-reviewed publications, policy briefs and conferences as well as presented to stakeholders to an effort to invest in HCW mental and physical health.

Exploring Physical and Biological Manifestations of Burnout and Post-Traumatic Stress Disorder Symptoms in Healthcare Workers: A Scoping Review Protocol.

Introduction: The COVID-19 pandemic has strained the mental and physical well-being of healthcare workers (HCW). Increased work-related stress and limited resources has increased symptoms of anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD) in this population. Stress-related disorders have been strongly associated with long-term consequences including cardiometabolic disorders, endocrine disorders and premature mortality. This scoping review aims to explore available literature on burnout, PTSD, and other mental health-associated symptoms in HCW to synthesize relationships with physiological and biological biomarkers that may be associated with increased risk of disease, creating an opportunity to summarize current biomarker knowledge and identify gaps in this literature. Methods and Analysis: This scoping review uses the Arksey and O'Malley six-step scoping review methodology framework. The research team will select appropriate primary sources using a search strategy developed in collaboration with a health sciences librarian. Three reviewers will initially screen the title and abstracts obtained from the literature searches, and two reviewers will conduct independent reviews of full-text studies for inclusion. The research team will be reviewing literature focusing on which burnout and/or PTSD-associated physiological and biological biomarkers have been studied, the methodologies used to study them and the correlations between the biomarkers and HCW experiencing burnout/PTSD. Data extraction forms will be completed by two reviewers for included studies and will guide literature synthesis and analysis to determine common themes. Ethics and Dissemination: This review does not require ethical approval. We expect results from this scoping review to identify gaps in the literature and encourage future research regarding improving biologic and physiologic biomarker research in HCW. Preliminary results and general themes will be communicated back to stakeholders. Results will be disseminated through peer-reviewed publications, policy briefs, and conferences, as well as presented to stakeholders to an effort to invest in HCW mental and physical health. Strengths and Limitations of This Study: This will be the first scoping review to assess the current understanding of the biologic and physiological impact of burnout on healthcare workers. The target population is restricted to healthcare workers; however, identified research gaps may be used to guide future studies in other high-burnout occupations and industries.This scoping review will be guided by the Arksey and O'Malley six-step methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review checklist.Both peer reviewed manuscript and pre-prints/abstracts will be evaluated, but studies that have not been peer reviewed will be notated in the summary table. Conference abstracts are excluded.Preliminary and final themes and results identified by this scoping review will be communicated to stakeholders, including hospital staff and HCW, to ensure agreement with our interpretation and to convey knowledge gained with our population of interest.This review will advance the field's current understanding of mechanisms connecting the burnout and pathogenic stress to biologic and physiologic outcomes in healthcare workers and provide researchers with gaps in the literature to inform opportunities for future research.

Significance of an Online Evidence-Based Practice Education Module for Acute, Ambulatory, Public, and School Health Nurses.

Recent surveys of Magnet facilities and nurses found low rates of implementation of evidence-based practice in U.S. health care settings. Nursing Experts: Translating the Evidence (NExT) is a collaboration of nurses and librarians providing free online evidence-based practice nursing education benefiting nurses in all settings. The NExT online modules empowered participants to efficiently access valuable resources to inform and improve their practice in a convenient, accessible, self-paced format. Quantitative and qualitative evaluation methods and the value of collaboration are discussed. [J Contin Educ Nurs. 2023;54(4):176-184.].

Community-based death preparation and education: A scoping review.

The COVID-19 pandemic revealed a need for people and communities for death preparation. Few studies have examined community-level interventions for death preparation and education. This scoping review scrutinized the relevant literature following PRISMA 2018 guidelines. Six databases were searched for articles published between 2010 and 2020. We found that cultural, socioeconomic, and individual values affected death preparation and that online courses and life-death education were effective preparation methods. Additional research is needed to identify the population-specific effectiveness of interventions. To fully investigate death preparation and education at the community level, theory-based studies employing quantitative and qualitative methods are also needed.

A comparative evaluation of three point-of-care tools by registered nurses.

Objective: This study compared three point-of-care tools (PoCTs) to determine which PoCT was rated highest based on key features and characteristics by registered nurses. Methods: The PoCTs reviewed were Nursing Reference Center Plus, ClinicalKey for Nursing, and UpToDate. Nurses were asked to use each PoCT to answer three clinical questions and then rate their experience based on the following areas: currency, relevancy, layout, navigation, labeling, and use of filters. They were also asked to indicate their familiarity with each PoCT, their overall opinions, and demographic information. Results: Seventy-six nurses completed the entire survey. Ratings of PoCTs did not differ by participant characteristics. Participants were most familiar with UpToDate, and average ratings were similar across all three PoCTs. Answers to open-ended questions suggested that nurses' experiences searching and locating relevant information to address clinical questions varied and that brand recognition might have impacted preference. Discussion: None of the PoCTs was significantly preferred over the others, nor received high ratings, which suggests that organizations need to survey their nurses to determine which PoCT is preferred by their staff. Findings also suggest that institutional priorities can guide the decision whether a library should license multiple PoCTs, nursing, and/or non-nursing specific PoCTs. Research is needed to understand how PoCTs could better meet the information needs of registered nurses. Librarians should learn more about what types of information nurses are seeking and explore opportunities to educate nurses on how to better utilize PoCTs for their practice.

Focus on nursing point-of-care tools: application of a new evaluation rubric.

Objective: Point-of-care tools (PoCTs) provide evidence-based information on patient care and procedures at the time of need. Registered nurses have unique practice needs, and many PoCTs are marketed to support their practice. However, there is little reported evidence in the literature about evaluating nursing-focused PoCTs. Case Presentation: The investigators developed a rubric containing evaluation criteria based on content, coverage of nursing topics, transparency of the evidence, user perception, and customization of PoCTs for supporting nursing practice. The investigators selected five PoCTs cited in the literature and of interest to local nursing leadership: ClinicalKey for Nursing, DynaMed, Lippincott's Advisor and Procedures, Nursing Reference Center Plus, and UpToDate. Application of the rubric found Lippincott had the highest coverage of diagnoses, while ClinicalKey for Nursing had strong content focused on interventions and outcomes. Nursing Reference Center Plus provided the most well-rounded coverage of nursing terminology and topics. DynaMed and UpToDate were more transparent with indicating conflict of interest, but both had lower coverage of nursing terminology, content, and care processes. Conclusion: None of the five PoCTs strongly met all of the evaluated criteria. The rubric developed for this study highlights each PoCT's strengths and weaknesses that can then be used to inform the decision-making process based on priorities and budget. The investigators recommend licensing a nursing PoCT and a PoCT like DynaMed or UpToDate to provide comprehensive, evidence-based, patient care coverage and to meet the diverse information needs of nurses.

Building a Bridge: A Review of Information Literacy in Nursing Education.

BACKGROUND: Although information literacy (IL) has been valuable in nursing education, guiding documents from librarianship (e.g., Framework for Information Literacy in Higher Education) remain relatively obscure among nursing faculty. This review analyzes the intersection of IL with nursing and offers analyses for a better understanding of integrating IL into nursing education settings. METHOD: Scholarly literature was searched, and Covidence was used to track themes regarding how (and where) IL literature (n = 179) connects to nursing educational settings. RESULTS: Librarians are not involved consistently within nursing education. Research and discussion on IL in nursing are published in librarianship, education, and health sciences literature, and the terminology does not always align across these disciplines. CONCLUSION: Findings indicate an opportunity for librarians to share the Framework and its connections to the research literature with the nursing community. Researchers share suggestions for how common themes, language, and ideas can be shared between librarians and nursing faculty. [J Nurs Educ. 2021;60(8):431-436.].

Exploring data management content in doctoral nursing handbooks.

OBJECTIVE: While data management (DM) is an increasing responsibility of doctorally prepared nurses, little is understood about how DM education and expectations are reflected within student handbooks. The purpose of this study was to assess the inclusion of DM content within doctoral nursing student handbooks. METHODS: A list of 346 doctoral programs was obtained from the American Association of Colleges of Nursing (AACN). Program websites were searched to locate program handbooks, which were downloaded for analysis. A textual review of 261 handbooks from 215 institutions was conducted to determine whether DM was mentioned and, if so, where the DM content was located. Statistical analysis was performed to compare the presence of DM guidance by type of institution, Carnegie Classification, and the type of doctoral program handbook. RESULTS: A total of 1,382 codes were identified across data life cycle stages, most commonly in the handbooks' project requirements section. The most frequent mention of DM was in relation to collecting and analyzing data; the least frequent related to publishing and sharing data and preservation. Significant differences in the frequency and location of codes were identified by program type and Carnegie Classification. CONCLUSIONS: Nursing doctoral program handbooks primarily address collecting and analyzing data during student projects. Findings suggest limited education about, and inclusion of, DM life cycle content, especially within DNP programs. Collaboration between nursing faculty and librarians and nursing and library professional organizations is needed to advance the adoption of DM best practices for preparing students in their future roles as clinicians and scholars.

A survey of current practices in data management education in nursing doctoral programs.

BACKGROUND: The inclusion of data management instruction within nursing doctoral curricula has not been systematically examined. PURPOSE: The purpose of this study is to determine the extent of data management education within nursing doctoral programs. METHOD: Separate surveys were created for DNP (332) and PhD (138) program directors. Survey questions were based on the stages of the UK Data Service Research Data Lifecycle. RESULTS: One hundred and four nursing doctoral program directors responded, a 22% response rate. Sixty-seven (64%) were from DNP programs while 37 (35%) were from PhD programs. Although program directors reported that they were teaching stages of the research data lifecycle, data management is mostly being taught through individual mentoring or a single lecture within a required course, and that students' project data were not being preserved. CONCLUSIONS: Nursing doctoral programs need to develop consistent data management education, build an awareness of data policies, and clarify student project data sharing and ownership.

Evaluating nursing faculty's approach to information literacy instruction: a multi-institutional study.

OBJECTIVE: In 2018, the Association of College & Research Libraries (ACRL) Health Sciences Interest Group convened a working group to update the 2013 Information Literacy Competency Standards for Nursing to be a companion document to the 2016 Framework for Information Literacy in Higher Education. To create this companion document, the working group first needed to understand how nursing faculty approached information literacy (IL) instruction. METHODS: The working group designed a survey that assessed how nursing faculty utilized IL principles in coursework and instruction. The survey consisted of nineteen mixed methods questions and was distributed to nursing faculty at eight institutions across the United States. RESULTS: Most (79%) faculty indicated that they use a variety of methods to teach IL principles in their courses. While only 12% of faculty incorporated a version of the ACRL IL competencies in course design, they were much more likely to integrate nursing educational association standards. Faculty perceptions of the relevance of IL skills increased as the education level being taught increased. CONCLUSION: The integration of IL instruction into nursing education has mostly been achieved through using standards from nursing educational associations. Understanding these standards and understanding how faculty perceptions of the relevance of IL skills change with educational levels will guide the development of a companion document that librarians can use to collaborate with nurse educators to integrate IL instruction throughout nursing curriculums at course and program levels.

Benefits of a joint health sciences practicum for students in library and information sciences: a case report.

BACKGROUND: A joint practicum gives library and information science (LIS) students the opportunity to compare two health sciences libraries' structures and workflows. The goal of this case report is to describe how a joint health sciences practicum can help LIS students and recent graduates develop skills that may be beneficial for their future positions in health sciences or other libraries.Case Presentation: Six participants in a joint health sciences library practicum underwent two interviews: the first interview focused on their practicum experiences, and the second interview sought to determine whether the participants had found employment and were using any skills in their new positions that they acquired during their practicums. Participants gave mostly positive feedback regarding their practicum experiences and expressed openness to applying for health sciences library positions. Although the participants who found employment did not work in health sciences libraries, their practicum projects served as supporting materials for their job applications, and they were using the skills they had gained from their practicums in their new positions. CONCLUSIONS: While most joint practicum participants were not working in a health sciences library, the practicum was beneficial to their new careers. This case report highlights that a joint health sciences practicum program can be beneficial in showing LIS students different approaches to health sciences librarianship.

NExT: creating an interdisciplinary alliance to diminish informational barriers for public health nursing.

BACKGROUND: Public health nurses (PHNs) are challenged in obtaining opportunities to learn evidence-based practice (EBP). An interdisciplinary alliance was created between health sciences librarians and nurse educators to create a continuing education (CE) opportunity. OBJECTIVE: To measure the effectiveness of CE training for PHNs on the knowledge gained about the EBP process and information resources. METHODS: Ten in-person CE workshops were offered to 69 attendees in rural and urban areas. A pre-test/post-test survey was administered immediately before and after the training that asked participants to rate their perceived knowledge and comfort levels with EBP concepts and resources. RESULTS: Ninety-seven per cent of participants reported the training was a good use of their time. Based on a 5-point Likert scale self-assessment, participants developed new skills (m = 4.06, SD = 0.968) and were able to find evidence-based literature (m = 4.16, SD = 0.980). Participants reported increasing their understanding of EBP concepts and familiarity of information resources. All data were statistically significant at P < 0.001 (95% CI). DISCUSSION: With the interdisciplinary collaboration capitalising on the instructors' disciplinary skill sets, the team was able to create a new effective EBP education intervention for PHNs. CONCLUSION: Public health nurses were able to increase knowledge of EBP concepts and information resources to utilise in practice or grant development.

Integrative review of clinical decision support for registered nurses in acute care settings.

Objective: To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses. Materials and Methods: We performed an integrative review of qualitative and quantitative peer-reviewed original research studies using a structured search of PubMed, Embase, Cumulative Index to Nursing and Applied Health Literature (CINAHL), Scopus, Web of Science, and IEEE Xplore (Institute of Electrical and Electronics Engineers Xplore Digital Library). We included articles that reported on CDS targeting bedside nurses and excluded in stages based on rules for titles, abstracts, and full articles. We extracted research design and methods, CDS purpose, electronic health record integration, usability, and process and patient outcomes. Results: Our search yielded 3157 articles. After removing duplicates and applying exclusion rules, 28 articles met the inclusion criteria. The majority of studies were single-site, descriptive or qualitative (43%) or quasi-experimental (36%). There was only 1 randomized controlled trial. The purpose of most CDS was to support diagnostic decision-making (36%), guideline adherence (32%), medication management (29%), and situational awareness (25%). All the studies that included process outcomes (7) and usability outcomes (4) and also had analytic procedures to detect changes in outcomes demonstrated statistically significant improvements. Three of 4 studies that included patient outcomes and also had analytic procedures to detect change showed statistically significant improvements. No negative effects of CDS were found on process, usability, or patient outcomes. Discussion and Conclusions: Clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality; however, this research is lagging behind studies of CDS targeting medical decision-making in both volume and level of evidence.

Nurses' Perceptions of Quality Care.

Limited research has been conducted on how nurses define or perceive "quality nursing care." We conducted focus groups to identify nurses' perceptions of quality care at a Midwestern academic medical center. Transcripts of the focus group sessions were analyzed using thematic analysis techniques, and 11 themes emerged: Leadership, Staffing, Resources, Timeliness, Effective Communication/Collaboration, Professionalism, Relationship-Based Care, Environment/Culture, Simplicity, Outcomes, and Patient Experience.

Evaluating nursing collections with the ICIRN's Essential Nursing Resources list.

This study examines libraries' nursing collections using the Interagency Council on Information Resources in Nursing's Essential Nursing Resources' (ENR) 26th edition. An inventory of the online collections of 235 libraries was assembled and compared to free, government, or National Library of Medicine resources and licensed resources from the ENR. The top five resources listed on library websites in descending order were MEDLINE, CINAHL, ERIC, PsycINFO, and Google Scholar. The availability of specialized resources varied, based on factors such as the level of nursing degree at each institution or the libraries' National Network of Libraries of Medicine membership statuses.

The data life cycle applied to our own data.

Increased demand for data-driven decision making is driving the need for librarians to be facile with the data life cycle. This case study follows the migration of reference desk statistics from handwritten to digital format. This shift presented two opportunities: first, the availability of a nonsensitive data set to improve the librarians' understanding of data-management and statistical analysis skills, and second, the use of analytics to directly inform staffing decisions and departmental strategic goals. By working through each step of the data life cycle, library faculty explored data gathering, storage, sharing, and analysis questions.

Rehabilitation interventions for the management of multiple sclerosis relapse: a short scoping review.

BACKGROUND: This review was undertaken to identify and summarize the existing evidence regarding postrelapse rehabilitation interventions in people with multiple sclerosis (MS). METHODS: Literature searches were conducted within the following databases: CINAHL Plus with Full Text, MEDLINE via Ovid, and PsycINFO via CSA Illumina. The following terms were searched as subject headings or keywords: choice behavior, counseling, decision making, disease management, health education, health promotion, patient education, patient participation, patient satisfaction, psychotherapy, rehabilitation, self-care, self-management. Then these searches were combined with the subject headings for relapsing-remitting multiple sclerosis and subject heading or keywords for recurrence/relapse. Through the initial database search and additional citation search, 260 potentially relevant citations were identified. After screening the titles and abstracts as well as the citation search results, the reviewers agreed to keep five studies for the full-text reviews. Three rehabilitation intervention studies were included in the final review. RESULTS: A combined total of 145 adults who experienced a relapse within the previous 5 months received 3 to 18 days of rehabilitation. All three studies suggested the benefit of multidisciplinary rehabilitation for individuals with MS to improve impairment or disability. CONCLUSIONS: The three multidisciplinary rehabilitation interventions included in this review appear to be effective in improving impairment or disability of people with MS who experienced a relapse. Given the limited number of studies and their methodological limitations, the results must be interpreted cautiously. Further investigation is needed to better understand the rehabilitation needs of people with MS after relapse in order to improve research and care.

Coverage of Google Scholar, Scopus, and Web of Science: a case study of the h-index in nursing.

PURPOSE: This study compares the articles cited in CINAHL, Scopus, Web of Science (WOS), and Google Scholar and the h-index ratings provided by Scopus, WOS, and Google Scholar. METHODS: The publications of 30 College of Nursing faculty at a large urban university were examined. Searches by author name were executed in Scopus, WOS, and POP (Publish or Perish, which searches Google Scholar), and the h-index for each author from each database was recorded. In addition, the citing articles of their published articles were imported into a bibliographic management program. This data was used to determine an aggregated h-index for each author. RESULTS: Scopus, WOS, and Google Scholar provided different h-index ratings for authors and each database found unique and duplicate citing references. CONCLUSIONS: More than one tool should be used to calculate the h-index for nursing faculty because one tool alone cannot be relied on to provide a thorough assessment of a researcher's impact. If researchers are interested in a comprehensive h-index, they should aggregate the citing references located by WOS and Scopus. Because h-index rankings differ among databases, comparisons between researchers should be done only within a specified database.