Pain assessment and management in care homes: understanding the context through a scoping review.

BACKGROUND: Internationally, 2-5% of people live in residential or nursing homes, many with multi-morbidities, including severe cognitive impairment. Pain is frequently considered an expected part of old age and morbidity, and may often be either under-reported by care home residents, or go unrecognized by care staff. We conducted a systematic scoping review to explore the complexity of pain recognition, assessment and treatment for residents living in care homes, and to understand the contexts that might influence its management. METHODS: Scoping review using the methodological framework of Levac and colleagues. Articles were included if they examined pain assessment and/or management, for care or nursing home residents. We searched Medline, CINAHL, ASSIA, PsycINFO, EMBASE, Cochrane Library, and Google Scholar; reference lists were also screened, and website searches carried out of key organisations. Conversations with 16 local care home managers were included to gain an understanding of their perspective. RESULTS: Inclusion criteria were met by 109 studies. Three overarching themes were identified: Staff factors and beliefs - in relation to pain assessment and management (e.g. experience, qualifications) and beliefs and perceptions relating to pain. Pain assessment - including use of pain assessment tools and assessment/management for residents with cognitive impairment. Interventions - including efficacy/effects (pharmaceutical/non pharmaceutical), and pain training interventions and their outcomes. Overall findings from the review indicated a lack of training and staff confidence in relation to pain assessment and management. This was particularly the case for residents with dementia. CONCLUSIONS: Further training and detailed guidelines for the appropriate assessment and treatment of pain are required by care home staff. Professionals external to the care home environment need to be aware of the issues facing care homes staff and residents in order to target their input in the most appropriate way.

The psychometric properties of Orthorexia Nervosa assessment scales: A systematic review and reliability generalization.

The main objective of this systematic review was to provide a comprehensive overview of the psychometric properties of all available Orthorexia Nervosa (ON) assessment tools, in order to evaluate their scope of application for research and practice. Ten databases were searched for studies quantitatively assessing ON. The psychometric properties were evaluated according to specified quality criteria, focusing on the reliability, structural validity and construct validity of the scales. A meta-analytic approach was used to summarize eligible Cronbach's alpha coefficients between studies. Sixty-eight unique studies fulfilled the inclusion criteria for this systematic review. Ten discrete ON scales were identified. Half of the included studies exclusively utilized a version of the ORTO-15. The evaluation of all available ON measures raise issues regarding ON's dimensionality and conceptualization. Most of the identified scales require further validation. Based on the reported psychometric properties it is advised to re-evaluate existing tools and to focus on establishing consensus regarding the conceptualization of ON to establish a measure with sound psychometric properties.

Temporal dynamic of parasite-mediated linkages between the forest canopy and soil processes and the microbial community.

Parasitic plants are important drivers of community and ecosystem properties. In this study, we identify different mechanisms by which mistletoe (Viscum album subsp. austriacum) can affect soil chemical and biological properties at different temporal stages of parasitism. We quantified the effect of parasitism on host growth and the number of frugivorous mutualists visiting the host canopy. Then we collected, identified, and weighed the organic matter input underneath tree canopies and analyzed its nutrient content. Simultaneously, we analyzed soil samples under tree canopies and examined the chemical properties, microbial abundance, and functional evenness of heterotrophic microbial communities. Mistletoe increased the amount, quality, and diversity of organic matter input beneath the host canopy, directly through its nutrient-rich litter and indirectly through a reduction in host litterfall and an increase in bird-derived debris. All these effects gave rise to enriched hotspots able to support larger and more functionally even soil microbial communities beneath parasitized hosts, the effects of which were accentuated after host death. We conclude that mistletoe, together with the biotic interactions it mediates, plays a key role in intensifying soil resource availability, regulating the functional evenness, abundance, and spatial distribution of soil microbial communities.

Linking safe sites for recruitment with host-canopy heterogeneity: The case of a parasitic plant, Viscum album subsp. austriacum (Viscaceae).

• Premise of the study: Canopies are ecologically relevant compartments of forests. Multiple sources of heterogeneity interact within forest canopies due to their structural complexity, which exert major influences on the structure and composition of epiphyte communities. Here, we explore canopy environmental heterogeneity of a Mediterranean pine forest, identifying the key biotic and abiotic factors determining mistletoe (Viscum album subsp. austriacum) recruitment at coarse and fine spatial scales.• Methods: Through field experiments, we assessed the range of suitable host species for V. album subsp. austriacum (hereafter, V. a. austriacum). We characterized the variation in abiotic factors at a fine spatial scale on the host species. Finally, we examined the effects of biotic (predation) and abiotic (light, temperature) factors on the fate of mistletoe seeds and seedlings along host branches.• Key results: We confirmed the tight specificity of V. a. austriacum to pine species, in particular to P. nigra at the local scale. Biotic constraints increased toward the branch interior, with minor effects on apical locations due to the positive effect of pine-needle coverage. Contrarily, abiotic constraints increased toward branch extremities, harming mistletoe seeds by encouraging their desiccation.• Conclusions: Biotic and abiotic variables exert a strong, nonrandom filter on V. album regeneration, resulting in recruitment hotspots at the periphery of the branches and sites with a high probability of recruitment failure at thicker and more exposed locations. The narrow range of suitable host species and the scarcity and spatially restricted recruitment hotspots for V. a. austriacum leads to the clumping of mistletoe populations at the finer spatial scale.

Generalist birds govern the seed dispersal of a parasitic plant with strong recruitment constraints.

Mistletoes constitute instructive study cases with which to address the role of generalist consumers in the study of plant-animal interactions. Their ranges of safe sites for recruitment are among the most restricted of any plant; therefore, frugivores specializing in mistletoe have been considered almost indispensable for the seed dispersal of these parasitic plants. However, the absence of such specialists in numerous regions inhabited by many mistletoe species raises the question of whether unspecialized vectors may successfully disperse mistletoe seeds to narrowly defined safe sites. Using the European mistletoe Viscum album subsp. austriacum as a study case, we recorded a broad range of 11 bird species that disperse mistletoe seeds. For these species, we studied the mistletoe-visitation rate and feeding behavior to estimate the quantity component of dispersal effectiveness, and the post-foraging microhabitat use, seed handling, and recruitment probabilities of different microhabitats as a measure of the quality component of effectiveness. Both endozoochory and ectozoochory are valid dispersal mechanisms, as the seeds do not need to be ingested to germinate, increasing seed-dispersal versatility. Thrushes were the most effective dispersers, although they were rather inefficient, whereas small birds (both frugivores and non-frugivores) offered low-quantity but high-quality services for depositing seeds directly upon safe sites. As birds behave similarly on parasitized and non-parasitized hosts, and vectors have broad home ranges, reinfection within patches and the colonization of new patches are ensured by an ample assemblage of generalist birds. Thus, a parasitic plant requiring precision in seed dispersal can rely on unspecialized dispersers.

LifeWatch ERIC: papers collection on original datasets and new e-services for the biodiversity and ecosystems' scientific community.

Papers including articles that are produced because of the activities of LifeWatch ERIC, in the context of its second implementation period (2022 - 2026) and through the implementation of its new Strategic Working Plan, are published in this special collection. The articles include data papers, papers describing the development and functioning of analytical services and papers describing any other research outcome, produced either by LifeWatch ERIC or by any collaboration with any other ERIC, Research Infrastructure, global aggregator or other legal entity.

El cribado nutricional como parte de los cuidados enfermeros / Nutritional screening as part of nursing care

Objetivo: explorar el conocimiento y las actitudes de las enfermeras en relación con la valoración o cribado nutricional en pacientes hospitalizados. Método: se llevó a cabo una narrativa entre noviembre de 2017 y enero de 2018, mediante el diseño de estrategias de búsqueda en lenguaje libre y controlado en las bases de datos Pubmed, Cinahl, Cuiden, Cochrane Library, Sicelo, Dialnet Plus, Lilacs y la Colección principal de la Web of Science. Se emplearon los operadores booleanos "AND" y "OR" y se aplicó el limitador temporal de los últimos 10 años. Se contemplaron como variables la evaluación y el estado nutricional y las actitudes y conocimientos de las enfermeras. Los artículos fueron revisados por todas las autoras. Resultados: de los 1.054 artículos recuperados se seleccionaron 17. Si bien las/os enfermeras/os perciben la valoración nutricional y el cribado como importante, son varias las barreras que dificultan su realización: la falta de conocimientos y de entrenamiento en la utilización de las herramientas, la preferencia por el empleo del juicio personal para realizar esta actividad, la percepción de que han de ser otros profesionales quienes la efectúen, la falta de tiempo o la priorización de otras actividades de cuidados, entre otras. Se excluyeron aquellos artículos que se referían a pacientes no hospitalizados, con trastornos de la conducta alimentaria, mujeres embarazadas y pacientes paliativos. Conclusiones: ante la escasez de bibliografía se hace necesario realizar estudios de investigación que permitan visibilizar los factores que dificultan la implantación de las herramientas de cribado y la evaluación nutricional de los pacientes hospitalizados

Objective: to explore the knowledge and attitudes of nurses regarding nutritional assessment or screening in hospitalized patients. Method: a narrative study was conducted between November, 2017 and January, 2018, through the design of search strategies in free and controlled language in the following databases: Pubmed, Cinahl, Cuiden, Cochrane Library, Sicelo, Dialnet Plus, Lilacs, and the Web of Science Core Collection. The Boolean operators "AND" and "OR" were used, and there was a time limitation for the past 10 years. The variables observed were nutritional assessment and status, and attitudes and knowledge by nurses. Articles were reviewed by authors. Results: seventeen (17) articles were selected of the 1,054 articles retrieved. Even though nurses perceived nutritional assessment and screening as important, there are various barriers that render difficult its implementation: lack of knowledge and training in the use of tools, preference for using personal judgment for this activity, the perception that other professionals must be the ones to conduct it, lack of time, or prioritizing other care activities, among others. The study excluded those articles that dealt with non-hospitalized patients, those with eating disorders, pregnant women, and palliative care patients. Conclusions: given the lack of bibliography, it is necessary to conduct research studies which allow to visualize the barriers for the implementation of screening tools and nutritional assessment of hospitalized patients