Background Measuring nursing interventions and nurse-sensitive outcomes in a standardized manner is essential because it provides insight into the quality of delivered care. However, there is currently no systematic overview of the interventions conducted by district nurses, the evidence for the effects of these interventions, or what nurse-sensitive outcomes should be measured. Objective 1) To provide an overview of interventions for community-living older people evaluated in district nursing care and evidence for the effects of these interventions and 2) to identify the nurse-sensitive outcomes that are used to evaluate these district nursing care interventions, how these outcomes are measured, and in which patient groups they are applied. Design A systematic review of the literature. Setting District nursing care. Data sources MEDLINE, CINAHL, PsycInfo, and EMBASE. Methods Only experimental studies evaluating district nursing care interventions for communkity-living older people were included. A data extraction form was developed to extract the study characteristics and evaluate interventions and nurse-sensitive outcomes. The methodological quality of the included studies was reviewed using the 13-item critical appraisal tool for randomized controlled trials by the Joanna Briggs Institute. Results A total of 22 studies were included. The methodological quality of the studies varied, with scores ranging from 6 to 11 on a scale of 0–13. The 22 interventions identified were heterogeneous with respect to intervention components, intervention delivery, and target population. The 44 outcomes identified were grouped into categories following the Nursing Outcome Classification and were measured in various ways and at various times. Conclusion This is the first systematic review summarizing the evidence for the effectiveness of nurse-led interventions conducted by district nurses on community-living older people. It is unclear what interventions are effective and what outcomes should be used to substantiate district nursing care effectiveness. Because only studies with experimental designs were included, this analysis may provide an incomplete assessment of the effectiveness of interventions in district nursing care. Therefore, it is highly necessary to produce methodologically strong evidence through research programs focusing on district nursing care.
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This paper aims to present a systematic literature review on state-of-the-art Educational Escape Rooms (EERs) with the use of digital technologies. More specifically, the focus of the study is to present the current developments and trends concerning Digital Educational Escape Rooms (DEERs) and investigate how they foster learning outcomes for online learners. Additionally, the present study provides insights into the design process of such technology enhanced EERs. This review is attributed to identifying and covering research gaps since the current literature has focused on the pedagogical aspects of Escape Rooms (ERs) in education, but no studies seem to have been conducted in regard to the pedagogical implications of Digital Escape Rooms (DERs) in educational environments. Based on the exhaustive literature review, an agenda for future research is promised and the implications for designing innovative ER approaches have been highlighted. The anatomy of the fundamental components of conducting systematic literature reviews was followed. The results of the review could be addressed to multidisciplinary teams related to education, game researchers, educational researchers, faculty members, scholars, instructors, and protagonists of educational systems to encourage them to thoroughly study the core elements of DEERs and how they can be applied in virtual educational contexts to facilitate students’ learning achievements.
Background The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC. Methods The bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, ‘Effective Public Health Practice Project’. The primary outcome measure was VBAC rates. Results 238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates. Conclusions This systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were performed during the late 1980s-1990s. An opinion leader educational strategy confers benefit for increasing VBAC rates. This strategy should be further studied in different maternity care settings and with professionals other than physicians only.
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The research proposal aims to improve the design and verification process for coastal protection works. With global sea levels rising, the Netherlands, in particular, faces the challenge of protecting its coastline from potential flooding. Four strategies for coastal protection are recognized: protection-closed (dikes, dams, dunes), protection-open (storm surge barriers), advancing the coastline (beach suppletion, reclamation), and accommodation through "living with water" concepts. The construction process of coastal protection works involves collaboration between the client and contractors. Different roles, such as project management, project control, stakeholder management, technical management, and contract management, work together to ensure the project's success. The design and verification process is crucial in coastal protection projects. The contract may include functional requirements or detailed design specifications. Design drawings with tolerances are created before construction begins. During construction and final verification, the design is measured using survey data. The accuracy of the measurement techniques used can impact the construction process and may lead to contractual issues if not properly planned. The problem addressed in the research proposal is the lack of a comprehensive and consistent process for defining and verifying design specifications in coastal protection projects. Existing documents focus on specific aspects of the process but do not provide a holistic approach. The research aims to improve the definition and verification of design specifications through a systematic review of contractual parameters and survey methods. It seeks to reduce potential claims, improve safety, enhance the competitiveness of maritime construction companies, and decrease time spent on contractual discussions. The research will have several outcomes, including a body of knowledge describing existing and best practices, a set of best practices and recommendations for verifying specific design parameters, and supporting documents such as algorithms for verification.
Worldwide, a third of all adults is suffering from feelings of loneliness, with a peak at young adulthood (15-25 years old). Loneliness has serious consequences for mental and physical health and should therefore be urgently addressed. However, existing interventions targeting loneliness mainly focus on older adults [1], and rarely consider the physical living environment, while studies prove that the physical environment (e.g. amenities, green, walkability, liveliness) has a significant impact on loneliness. Collaboration between the psychosocial and physical domains is key, to gain insight into the mechanisms and pathways linking characteristics of the physical living environment and loneliness among young adults and which spatial interventions are effective in managing loneliness. The main research questions are thus: how are physical environment and loneliness related, and which interventions should be implemented? The I BELONG proposal aims to build a European consortium that will address these questions. WP1 encompasses collaboration and networking activities that will form the basis for future collaboration, for instance a European research grant application. WP2 will provide insight in the pathways linking spatial attributes and loneliness. This will be achieved by doing a systematic literature review, a photovoice and interview study to collect data on specific locations that affect young people’s experiences with loneliness, and Group Model Building with experts. Building on this, WP3 aims to co-create spatial interventions with partners and young adults, and test ‘proof of concept’ interventions with virtual environments among young adults. WP3 will result in a spatial intervention toolkit. This project has both societal and scientific impact, as it will provide knowledge on pathways between physical environment characteristics and feelings of loneliness among young people, evidence of what spatial interventions work, and design guidelines that can be used in urban design and management that can contribute to managing loneliness and related health risks.
