Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics.

Aim: The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research. Design: Discussion Paper. Data Sources: Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR). Implications for nursing and midwifery: Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency. Conclusion: This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery. Impact: With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics

Investigating student teachers’ presentations of literacy and literacy pedagogy in a complex context

The field of literacy and primary literacy education is patterned by multiple discourses and this raises challenges for those educating the next generation of primary literacy teachers. In England, the last 15 years have seen considerable levels of prescription in the primary literacy curriculum and compliance by the school and teacher education sectors has been enforced through demanding accountability regimes. In this paper, the authors draw on findings of a small-scale interview study to consider how understandings of literacies associated with different contexts may or may not inflect student teachers’ orientations towards literacy provision in school. The authors explore how five student teachers presented their experiences of literacy within and beyond the classroom and how they seemed to position themselves in relation to literacy pedagogy. The authors focus particularly on continuities and discontinuities between literacies in the student teachers’ personal and professional lives, and on tensions they identified between the teachers they felt they wanted to, and were expected to, become. Reflecting on this work, the authors consider how they can best equip pre-service primary and early years teachers to develop as critical reflective literacy practitioners in the current context

Alternative Splicing Events Are a Late Feature of Pathology in a Mouse Model of Spinal Muscular Atrophy

Spinal muscular atrophy is a severe motor neuron disease caused by inactivating mutations in the SMN1 gene leading to reduced levels of full-length functional SMN protein. SMN is a critical mediator of spliceosomal protein assembly, and complete loss or drastic reduction in protein leads to loss of cell viability. However, the reason for selective motor neuron degeneration when SMN is reduced to levels which are tolerated by all other cell types is not currently understood. Widespread splicing abnormalities have recently been reported at end-stage in a mouse model of SMA, leading to the proposition that disruption of efficient splicing is the primary mechanism of motor neuron death. However, it remains unclear whether splicing abnormalities are present during early stages of the disease, which would be a requirement for a direct role in disease pathogenesis. We performed exon-array analysis of RNA from SMN deficient mouse spinal cord at 3 time points, pre-symptomatic (P1), early symptomatic (P7), and late-symptomatic (P13). Compared to littermate control mice, SMA mice showed a time-dependent increase in the number of exons showing differential expression, with minimal differences between genotypes at P1 and P7, but substantial variation in late-symptomatic (P13) mice. Gene ontology analysis revealed differences in pathways associated with neuronal development as well as cellular injury. Validation of selected targets by RT–PCR confirmed the array findings and was in keeping with a shift between physiologically occurring mRNA isoforms. We conclude that the majority of splicing changes occur late in SMA and may represent a secondary effect of cell injury, though we cannot rule out significant early changes in a small number of transcripts crucial to motor neuron survival

Abstracts from the NIHR INVOLVE Conference 2017

n/

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

An amendment to this paper has been published and can be accessed via the original article

Biomechanical Analysis of the Anterior Lunge During 4 External-Load Conditions

Context: Comprehensive analysis of ankle, knee, and hip kinematics and kinetics during anterior lunge performance in young adults has not been studied. In addition, the effects of adding external resistance on the kinematics and kinetics are unknown. Objective: To determine the effects of external load on ankle, knee, and hip joint kinematics and kinetics during the anterior lunge. Design: Crossover study. Setting: Laboratory environment. Patients or Other Participants: A total of 16 recreationally active, college-aged adults (8 men, 8 women). Intervention(s): Anterior lunges under 4 external-load conditions, 0% (control), 12.5%, 25%, and 50% of body mass. Main Outcome Measure(s): Ankle, knee, and hip peak flexion, net joint extensor moment impulse, and eccentric and concentric work were computed during the interval when the stepping limb was in contact with the ground. Additionally, 3 summary lunge characteristics were calculated. Results: No significant (P \u3e .05) load effects were noted for peak flexion angles or the lunge characteristics except for peak vertical total-body center-of-mass displacement. Trend analysis of significant condition-by-joint interactions revealed significant linear trends for all 3 joints, with the hip greater than the ankle and the ankle greater than the knee. Additionally, as the external load increased, mechanical work increased linearly at the hip and ankle but not at the knee. Conclusions: From a kinematic perspective, the lunge involves greater motion at the knee, but from a kinetic perspective, the anterior lunge is a hip-extensor–dominant exercise. Adding external weight prompted the greatest joint kinetic increases at the hip and ankle, with little change in the knee contributions. These results can assist clinicians in deciding whether the characteristics of the anterior lunge match a patient\u27s exercise needs during rehabilitation and performance-enhancement programs