Effect of pharmacist interventions on the management of overweight and obesity: A systematic review.

BACKGROUND: Pharmacists are underused healthcare professionals who are well positioned to provide weight management interventions; however, a systematic review of the literature supporting the role of pharmacists in weight management is lacking. OBJECTIVES: To conduct a systematic review to assess the body of evidence supporting the role of pharmacists in the management of obesity. METHODS: A literature search of OVID MEDLINE, Embase, Web of Science, and CINAHL was conducted from inception through February 23, 2023, to identify studies involving pharmacist interventions for weight management. Included studies were retrospective or prospective studies reporting a change in body weight, body mass index (BMI), or waist circumference as a primary endpoint; and a weight management intervention involving a pharmacist. Studies were excluded if they did not report the desired outcomes, involved pediatric populations, or lacked a pharmacist in the intervention. RESULTS: Twenty-nine studies met the eligibility criteria. A total of 6,423 study participants were enrolled with a mean BMI of 27 to 46 kg/m2. The included studies were conducted across 8 different countries with 15 from the United States. The primary approach was a prepost/quasi-experimental study design, typically conducted in community pharmacies. The pharmacists' role varied widely but mainly involved educational counseling as the pharmacist made medication recommendations in only 5 studies. Multidisciplinary collaboration was infrequent. All but 3 studies reported a significant improvement in the weight loss outcome of interest, although most study durations were less than 6 months. A critical appraisal of the 29 studies found the overall quality of the available studies to be relatively poor. CONCLUSION: Pharmacist interventions for weight management were mostly effective in reducing body weight; however, more robust clinical trials with a comparator group and for longer duration are warranted. The pharmacist's role in managing weight loss medications also requires further study.

The Association Between Magnet ® Recognition and Patient Outcomes : A Scoping Review.

BACKGROUND: Previous systematic reviews have explored nurse, patient, and organizational outcomes in Magnet®-recognized hospitals compared with non-Magnet hospitals, yet these did not comprehensively review a wide variety of patient outcomes. AIM: The purpose of this scoping review was to describe the findings from published research evaluating patient outcomes in Magnet-recognized hospitals compared with non-Magnet hospitals. METHODS: A medical librarian conducted a systematic search for published peer-reviewed, English-language literature and a search of the reference lists for retrieved publications to identify articles addressing Magnet compared with non-Magnet hospitals related to patient outcomes. RESULTS: Four patient outcomes improved in Magnet-designated hospitals: mortality, patient satisfaction, failure to rescue, and falls. Four patient outcomes showed undesirable or mixed outcomes. Five patient outcomes had insufficient evidence regarding patient outcomes when treated at Magnet-recognized hospitals. CONCLUSION: Magnet Recognition® is associated with improvement in a distinct set of patient outcomes, but not all key outcome measures. Standardized outcomes and rigorous study designs are needed to further explore the impact of Magnet Recognition on a wide variety of patient outcomes.

Role of lipoprotein(a) in atherosclerotic cardiovascular disease: A review of current and emerging therapies.

Lipoprotein(a), or Lp(a), is structurally like low-density lipoprotein (LDL) but differs in that it contains glycoprotein apolipoprotein(a) [apo(a)]. Due to its prothrombotic and proinflammatory properties, Lp(a) is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis. Lp(a) levels are genetically determined, and it is estimated that 20%-25% of the global population has an Lp(a) level ≥50 mg/dL (or ≥125 nmol/L). Diet and lifestyle interventions have little to no effect on Lp(a) levels. Lipoprotein apheresis is the only approved treatment for elevated Lp(a) but is time-intensive for the patient and only modestly effective. Pharmacological approaches to reduce Lp(a) levels and its associated risks are of significant interest; however, currently available lipid-lowering therapies have limited effectiveness in reducing Lp(a) levels. Although statins are first-line agents to reduce LDL cholesterol levels, they modestly increase Lp(a) levels and have not been shown to change Lp(a)-mediated ASCVD risk. Alirocumab, evolocumab, and inclisiran reduce Lp(a) levels by 20-25%, yet the clinical implications of this reduction for Lp(a)-mediated ASCVD risk are uncertain. Niacin also lowers Lp(a) levels; however, its effectiveness in mitigating Lp(a)-mediated ASCVD risk remains unclear, and its side effects have limited its utilization. Recommendations for when to screen and how to manage individuals with elevated Lp(a) vary widely between national and international guidelines and scientific statements. Three investigational compounds targeting Lp(a), including small interfering RNA (siRNA) agents (olpasiran, SLN360) and an antisense oligonucleotide (pelacarsen), are in various stages of development. These compounds block the translation of messenger RNA (mRNA) into apo(a), a key structural component of Lp(a), thereby substantially reducing Lp(a) synthesis in the liver. The purpose of this review is to describe current recommendations for screening and managing elevated Lp(a), describe the effects of currently available lipid-lowering therapies on Lp(a) levels, and provide insight into emerging therapies targeting Lp(a).

Domains of professional practice: analysis of publications in the Journal of the Medical Library Association from 2010 to 2019.

The Medical Library Association (MLA) has defined 7 domain hubs aligning to different areas of information professional practice. To assess the extent to which content in the Journal of the Medical Library Association (JMLA) is reflective of these domains, we analyzed the magnitude of JMLA articles aligning to each domain hub over the last 10 years. Bibliographic records for 453 articles published in JMLA from 2010 to 2019 were downloaded from Web of Science and screened using Covidence software. Thirteen articles were excluded during the title and abstract review because they failed to meet the inclusion criteria, resulting in 440 articles included in this review. The title and abstract of each article were screened by two reviewers, each of whom assigned the article up to two tags corresponding to MLA domain hubs (i.e., information services, information management, education, professionalism and leadership, innovation and research practice, clinical support, and health equity & global health). These results inform the MLA community about our strengths in health information professional practice as reflected by articles published in JMLA.

Scoping Review of the Use of the Edinburgh Postnatal Depression Scale in the United States.

Objective: To evaluate the validity of the Edinburgh Postnatal Depression Scale (EPDS) for screening during the perinatal period in the United States and concerns regarding its acceptability and performance. Methods: We conducted a systematic search in OVID MEDLINE, EMBASE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo (EBSCO) for articles published from inception of the database through February 2023. We included primary quantitative and qualitative studies on the validation of the EPDS in the United States and identified 880 articles of which 9 met criteria for inclusion. We extracted data related to aim, study population, setting, methods, outcomes, and key findings from each study into a table based on Joanna Briggs Institute (JBI) Scoping Review Guidelines. Results: We found no evidence that the original wording of the EPDS, which was developed in the United Kingdom, was adapted before validation in the United States. Conclusion: Our findings suggest that adaptation of the EPDS for use in the United States with a focus on contextual equivalence and validity could improve the performance of the tool and patients' experiences with completing the tool. Future research is warranted on optimal methods to adapt the EPDS for mental health screening in the perinatal period in the United States.

Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review.

BACKGROUND: Evidence-based practice and decision-making have been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes in isolated reports throughout the literature. However, a comprehensive summary and review of the extent and type of evidence-based practices (EBPs) and their associated outcomes across clinical settings are lacking. AIMS: The purpose of this scoping review was to provide a thorough summary of published literature on the implementation of EBPs on patient outcomes in healthcare settings. METHODS: A comprehensive librarian-assisted search was done with three databases, and two reviewers independently performed title/abstract and full-text reviews within a systematic review software system. Extraction was performed by the eight review team members. RESULTS: Of 8537 articles included in the review, 636 (7.5%) met the inclusion criteria. Most articles (63.3%) were published in the United States, and 90% took place in the acute care setting. There was substantial heterogeneity in project definitions, designs, and outcomes. Various EBPs were implemented, with just over a third including some aspect of infection prevention, and most (91.2%) linked to reimbursement. Only 19% measured return on investment (ROI); 94% showed a positive ROI, and none showed a negative ROI. The two most reported outcomes were length of stay (15%), followed by mortality (12%). LINKING EVIDENCE TO ACTION: Findings indicate that EBPs improve patient outcomes and ROI for healthcare systems. Coordinated and consistent use of established nomenclature and methods to evaluate EBP and patient outcomes are needed to effectively increase the growth and impact of EBP across care settings. Leaders, clinicians, publishers, and educators all have a professional responsibility related to improving the current state of EBP. Several key actions are needed to mitigate confusion around EBP and to help clinicians understand the differences between quality improvement, implementation science, EBP, and research.

Cognitive and physical impairment in spinal cord injury: A scoping review and call for new understanding.

Study Design: Scoping review.Objective: To examine potential underlying mechanisms of cognitive and physical impairment in patients with spinal cord injury and identify current research gaps.Methods: A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews to identify primary studies that explored mechanisms of cognitive and/or physical impairment after spinal cord injury. The databases searched were PubMed/MEDLINE, EMBASE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO), Web of Science, Scopus, and PsycInfo. These databases were searched from inception through December 20, 2021.Results: Accumulating research suggests that neuroinflammation and neurodegeneration after a traumatic event may be possible mechanisms for cognitive impairment among patients with SCI. In addition, lack of physical activity due to impaired mobility is associated with an increased risk of cognitive impairment.Conclusion: While the results establish a foundation for understanding how cognitive impairment, mental health, and physical function independently affect patients with SCI, further research is warranted to understand how these factors systemically impact the patient and discover refined targets for future rehabilitation therapies. Studies should also explore potential predisposing factors for the relationship between cognitive and physical impairment among patients with SCI.

Mindfulness as a Symptom Management Strategy for Fibromyalgia: An Integrative Review.

Introduction: Mindfulness Meditation is a complementary and alternative medicine (CAM) modality growing in popularity. Currently, mindfulness is under-studied regarding efficacy; however, it offers a potentially accessible way to contribute to symptom management in chronic pain conditions. The purpose of this integrative review was to examine the literature for the use of mindfulness as symptom management strategy for persons diagnosed with the chronic pain condition, fibromyalgia. Methods: Six scientific databases were searched, using various keywords. Inclusion criteria were: (a) fibromyalgia, (b) English language, (c) experimental research designs; (d) adults age ≥ 18 years, and (e) mindfulness. Results: Seven studies were reviewed. Most interventions were completed over several months in the form of multiple group sessions lasting several hours each. Evaluations of effectiveness varied by study, but variables most commonly demonstrating improvement from mindfulness were anxiety, depression, sleep-related symptoms, coping and perceived stress. Mechanisms by which these outcomes may have been mediated included increases in self-compassion and psychological flexibility. Discussion: There is insufficient evidence to recommend mindfulness as an effective way to manage all fibromyalgia symptoms; however, promise lies in its usefulness addressing mood- and sleep-related symptoms. We suggest that further, more rigorous, research is warranted.

The connection between loneliness and burnout in nurses: An integrative review.

Nurse burnout is a threat to safe, efficient health care delivery, yet estimated rates of nurse burnout are above 40 %. A critical step in reducing burnout is identifying phenomena that are amenable to intervention. Loneliness may be one such factor, yet the relationship between loneliness and burnout is not clearly described. This review aims to summarize existing literature documenting this connection. A systematic search was performed to identify studies reporting a relationship between burnout and loneliness with social support serving as a proxy construct. Twenty-four articles met inclusion criteria: 18 quantitative, two mixed-methods, and four qualitative studies. These studies identified a relationship between burnout and social support, with social support explaining approximately a third of the variability in burnout. Qualitative data suggest that social support is critical to coping with work stressors and is likely related to burnout. This review provides evidence that reducing nurse loneliness is a promising strategy for improving nurse wellbeing.

Parents' experiences with health care transition of their adolescents and young adults with medically complex conditions: A scoping review.

BACKGROUND: Health care transition (HCT) has become increasingly important as adolescents and young adults (AYAs) with complex medical conditions now live well into adulthood but little attention has been given to parents of AYAs preparing for HCT. OBJECTIVE: This scoping review aimed to identify and synthesize information on parental facilitators and barriers to health care transition readiness. ELIGIBILITY CRITERIA: English-language, peer-reviewed original studies focused on the parents' experience of HCT were included. Studies were excluded if AYAs were not anticipated to be independent or if AYAs had only mental health disorders. CHARTING METHODS: Parent-reported facilitators and barriers were identified in each study and then categorized to identify common themes. RESULTS: Themes related to parental facilitators included evidence of coordination between pediatric and adult levels of care, healthcare provider guidance for HCT, and parental awareness and acceptance of natural seasons of life. Themes related to parental barriers included relationship loss, loss of parental role, lack of knowledge and/or skills, and concerns related to the health care system in general. CONCLUSION: Common facilitators and barriers were found across studies, regardless of medical diagnosis. Relationships and role change figure prominently in parents' perceptions of the HCT experience and their readiness for their AYA children to transition. These findings suggest potential areas for future research inquiry as well as potential nursing interventions designed to aid parents through HCT.

Quality of life in older adults with opioid use disorder: A scoping review.

The increasing prevalence of Substance Use Disorder (SUD) and opioid use disorder (OUD) is part of a national health crisis and reflects an unfortunate trend among populations of older adults. Opioid Use Disorder and opioid-related mortalities are also rising among older adults following this trend. Compared to younger populations, the effect of SUD and OUD on quality of life (QOL) in older adults is complex and poorly understood. This scoping review explores how QOL has been evaluated in high-risk subpopulations of older adults with SUD, specifically OUD. The articles reviewed for this paper targeted studies measuring QOL in older adults with OUD. We uncovered a paucity of literature devoted to studying interventions to improve QOL in older adults with OUD. This review supports further research on clinical interventions targeting improving QOL for older adults with OUD.

Primary localized amyloidosis of the ureter with osseous metaplasia presenting as a suspicious ureteral mass.

Primary amyloidosis of the ureter is a rare disease that is difficult to distinguish from urothelial carcinoma. Only 50 cases of primary ureter amyloidosis have been reported since it was first described in 1937. Of these, only five cases of ureter amyloidosis with osseous metaplasia were reported. In this study, we report the clinical presentation of ureter primary amyloidosis that presented as a mass with osseous metaplasia. The aim of this study is to provide clinicians with knowledge about the clinical/radiologic manifestation that raise the suspicion of amyloidosis, bearing in mind the importance of differentiating it from other "malignant" processes.

A Bibliometric Analysis of Peer-Reviewed Journal Publications of Pharmacy Practice Department Chairs.

Objective. To perform a bibliometric analysis of pharmacy practice department chairs at US schools and colleges of pharmacy to determine factors associated with their level of scholarly productivity.Methods. Scopus was searched for all publications by pharmacy practice chairs from all pharmacy schools through August 11, 2020. Publication metrics (total number of publications and citations and the Hirsch-index (h-index), and year of first publication), as well as characteristics of the individual chair and institution were collected. Characteristics were compared across groups. A generalized linear model was used to determine the correlation between the total number of publications and h-index to school ranking by US News & World Report (USNWR).Results. One hundred forty-one pharmacy practice chairs were identified. The majority were male and at the rank of professor, with a similar proportion from public and private institutions. The median total number of publications and citations was 19 and 247, respectively, with a median h-index of eight. Compared with female chairs, male chairs had a higher median total of publications and citations and a higher h-index. Chairs at public institutions had a higher median total of publications and citations and a higher publication rate, h-index, and m quotient. The USNWR ranking for the school was significantly correlated with total publications and the h-index.Conclusion. Pharmacy practice chairs vary significantly in their scholarship productivity, although those at institutions with a larger emphasis on research were more prolific. Observed differences in the publication metrics of male and female chairs warrants further study to determine possible explanations for this finding and its potential impact.

Audit of Documentation of Forensic History on Admission Form in a Psychiatric Intensive Care Unit.

OBJECTIVE: To study the documentation of relevant components of forensic history on admission form for male patients admitted in psychiatric intensive care unit (PICU)/OAK ward of Phoenix Care Center. STUDY DESIGN: Clinical audit. PLACE AND DURATION OF STUDY: Psychiatric intensive care unit/OAK ward of Phoenix Care Center, from August 2019 to July 2020. METHODOLOGY: Charts of all patients admitted in PICU from August 2019 to July 2020 were analysed, and admission forms were reviewed for documentation of relevant parameters of forensic history. A structured tool was made after literature search, which included drug and alcohol history, history of assaults, protection/barring orders, number of previous PICU admissions, previous charges, pending charges, use of depot medications and previous encounters with police without pending charges. RESULTS: A total of 50 patients were admitted during the given time period. Drug and alcohol history was documented in 98% of the cases, previous charges were documented in 88% of the cases, protection/baring order was documented in 62% of the cases, while previous encounter with the police without being charged was documented in only 32% of the cases. CONCLUSION: Drugs and alcohol and previous charges were documented in most of the cases, but documentation of protection/baring order and encounter with the police without being charged was a neglected area, which should be worked upon in future. Key Words: Admission form, Forensic history, Medical audit.

Frailty in Patients With Hematologic Malignancies and Those Undergoing Transplantation: A Scoping Review.

PROBLEM IDENTIFICATION: Although frailty is an important parameter in treatment planning and in predicting prognosis and overall survival among patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation, frailty assessment tools are not standardized in clinical care settings. The purpose of this article is to provide an overview of the literature on frailty assessment tools in these patient populations. LITERATURE SEARCH: A systematic search of CINAHL®, Embase®, MEDLINE®, PubMed®, and Web of Science was performed using keywords and controlled vocabulary for the concepts "bone marrow transplants," "hematologic neoplasms," and "frailty." DATA EVALUATION: Extracted data included study type, diagnosis, transplantation status, frailty tools used, and outcome measures. SYNTHESIS: A systematic search resulted in 24 studies that met the inclusion criteria. There were significant differences in how various groups define and assess frailty. IMPLICATIONS FOR PRACTICE: Addressing the lack of standardized frailty assessments will assist healthcare providers to routinely integrate frailty measures in clinical assessments to identify those at risk for poor outcomes, improving personalized care.

GPS Tracking Technologies to Measure Mobility-Related Behaviors in Community-Dwelling Older Adults: A Systematic Review.

Global positioning system (GPS) technology has been increasingly used in aging research as a tool for reliably capturing the level and patterns of mobility among older adults. This article aims to systematically review the current state of GPS-based mobility research with community-dwelling older adults. Twenty-nine studies from 2008 to 2019 are included. Included studies examined various forms of temporal and spatial mobility measures. This review provides a synthesis of the current evidence on the risk factors or correlates of GPS-driven mobility limitations, such as demographic, cognitive, physical, psychological, and environmental factors. There is variability in types of GPS technology and GPS-derived mobility measures, GPS recording methods, data processing, and correlates of mobility limitation across studies. Future research should focus on identifying meaningful GPS-derived mobility measures and developing standardized protocols for GPS administration and data analytics for comparison across studies.

An Integrative Review of Yoga and Mindfulness-Based Approaches for Children and Adolescents with Asthma.

PROBLEM: Asthma affects almost 15% of children in the United States. Despite the availability of treatments and educational methods, children with asthma continue to report an impaired quality of life, including symptoms of anxiety and inability to participate in physical activity. As complementary health approaches are becoming more popular and show promise in the management of many chronic diseases, the purpose of this integrative review is to examine the state of the science regarding popular complementary health approaches- yoga and mindfulness- for children and adolescents with asthma. ELIGIBILITY CRITERIA: A comprehensive search of five databases for peer reviewed articles was performed to identify experimental and non-experimental studies. The search for each database was performed from the inception of each to January 2020 and limited to the English language. The search included terminology that addressed the concepts of "asthma", "yoga" and "mindfulness". SAMPLE: A total of eleven articles met the criteria for review from the years 1991 to 2019. RESULTS: Nine publications focused on the use of yoga in children and adolescents with asthma and two publications focused on mindfulness in adolescents with asthma. CONCLUSIONS: Interventions involving either mindfulness or yoga may be effective in reducing stress and anxiety and improving quality of life and lung function in this population. IMPLICATIONS: Mindfulness intervention studies in the pediatric and adolescent asthma population are warranted as are additional studies that include the use of yoga with skills in mindfulness in order to evaluate their physiological and psychological effects.

Evidence-Based Leadership Practice and the Role of the Librarian.

Evidence-based clinical practice is now the norm. When evidence exists to enhance practice, organizational leaders work to instill the best practices that benefit patient outcomes. Leaders are also responsible for organizational outcomes and best practices in human and material resource management, improving the culture, and ensuring and retaining a workforce with sufficient talent, skills, and abilities. The authors address the role of the librarian in securing evidence-based leadership practice. [J Contin Educ Nurs. 2019;50(12):537-539.].

Research and instruction services for online advanced practice nursing programs: a survey of North American academic librarians.

INTRODUCTION: The increasing popularity of distance education has led many advanced practice nursing (APN) programs to shift to either online or hybrid models. To meet the needs of these students, some nursing librarians are using technology for virtual research and instruction. This study was designed to assess the extent to which librarians in North America are providing virtual research and instruction services for APN students. METHODS: An institutional review board-approved, ten-question survey was developed to determine how librarians are providing services for APN students. It was announced in October 2017 through several health sciences librarian email discussion lists. The survey ran for four weeks. Data were analyzed using Qualtrics and Excel. RESULTS: Eighty complete responses were received. The majority of respondents (66%) indicated that their universities' APN programs were conducted in a hybrid format. Sixty-seven percent also indicated that they provide library instruction in person. Most librarians indicated that they have provided research assistance through some virtual method (phone or email, at 90% and 97%, respectively), and some have used online chat (42%) and video chat (35%). A strong majority of librarians (96%) indicated that they felt comfortable using technology to provide research assistance and instruction. CONCLUSION: Opportunities exist to leverage technology to provide virtual research assistance and instruction. Greater promotion of these alternative methods can supplement traditional in-person services to provide greater flexibility for graduate nursing students' busy schedules. Some outreach may be necessary to highlight the advantages of virtual services, and further research is needed to identify other barriers and potential solutions.

DNA methylation studies of depression with onset in the peripartum: A critical systematic review.

OBJECTIVE: Major depression with peripartum onset (MDP) has been associated with multiple adverse offspring health outcomes. The biological mechanisms underlying this relationship remain unclear, but DNA methylation (DNAm) represents a plausible mechanism for mediating MDP exposures and changes in offspring development, behavior, and health. Advances in DNAm research necessitate reevaluating the MDP-DNAm literature to determine how well past studies conform with current best practices. METHOD: Five databases were searched to identify studies of prenatal-onset MDP and DNAm. Quality scores were assigned to each article independently by two raters using a novel scale specific for MDP-DNAm research. RESULTS: Nineteen studies met inclusion criteria. Quality scores ranged from 10 to 17 out of 24 points (M = 12.8; SD = 1.9), with higher scores indicating increased study rigor. Poor covariate reporting was the most significant contributor to lower scores. CONCLUSION: No longitudinal MDP-DNAm studies exist. Earlier MDP-DNAm studies should be interpreted with caution, and future research must commit to sharing methodology and data to facilitate cross-study comparisons and maximize dataset utility.