Human and environmental impacts of nanoparticles: a scoping review of the current literature

Use of nanoparticles have established benefits in a wide range of applications, however, the effects of exposure to nanoparticles on health and the environmental risks associated with the production and use of nanoparticles are less well-established. The present study addresses this gap in knowledge by examining, through a scoping review of the current literature, the effects of nanoparticles on human health and the environment. We searched relevant databases including Medline, Web of Science, ScienceDirect, Scopus, CINAHL, Embase, and SAGE journals, as well as Google, Google Scholar, and grey literature from June 2021 to July 2021. After removing duplicate articles, the title and abstracts of 1495 articles were first screened followed by the full-texts of 249 studies, and this resulted in the inclusion of 117 studies in the presented review. In this contribution we conclude that while nanoparticles offer distinct benefits in a range of applications, they pose significant threats to humans and the environment. Using several biological models and biomarkers, the included studies revealed the toxic effects of nanoparticles (mainly zinc oxide, silicon dioxide, titanium dioxide, silver, and carbon nanotubes) to include cell death, production of oxidative stress, DNA damage, apoptosis, and induction of inflammatory responses. Most of the included studies (65.81%) investigated inorganic-based nanoparticles. In terms of biomarkers, most studies (76.9%) used immortalised cell lines, whiles 18.8% used primary cells as the biomarker for assessing human health effect of nanoparticles. Biomarkers that were used for assessing environmental impact of nanoparticles included soil samples and soybean seeds, zebrafish larvae, fish, and Daphnia magna neonates. From the studies included in this work the United States recorded the highest number of publications (n = 30, 25.64%), followed by China, India, and Saudi Arabia recording the same number of publications (n = 8 each), with 95.75% of the studies published from the year 2009. The majority of the included studies (93.16%) assessed impact of nanoparticles on human health, and 95.7% used experimental study design. This shows a clear gap exists in examining the impact of nanoparticles on the environment

Evidence-informed practice: simplifying and applying the concept for nursing students and academics

This document is the Accepted Manuscript version of a Published Work that appeared in final form in British Journal of Nursing, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see [journal link].Abstract Background: Nurses’ ability to effectively apply evidence into practice is a critical factor in the delivery of quality patient care. Evidence-Based Practice (EBP) is recognized as the gold standard for the delivery of safe and effective person-centred care. Yet, after several decades of its inception, nurses continue to encounter difficulties in implementing the concept. Existing models for implementing EBP offer stepwise approaches, nevertheless, certain factors, such as the context of care and its mechanistic nature act as barriers to the effective and consistent implementation of EBP. It is, therefore, imperative that a solution to solving the way in which evidence is applied into practice is found. Evidence-Informed Practice (EIP) is an evolving concept. In recent times, there has been a focus on EIP as an alternative to EBP. This has generated an international debate as to which of the two concepts better facilitate the application of evidence into practice. While several EBP models and educational interventions exist, there is limited research directed towards understanding the concept of EIP and how it facilitates the application of evidence into clinical nursing practice. Aim: This article aims at clarifying the concept of EIP and provides an integrated systems-based model of EIP in facilitating the application of evidence into clinical nursing practice. This is achieved through the application of two nursing case scenarios. Case scenario 1 is about caring for a high-dependent patient and case scenario 2 involves a patient with a low white blood cell count. Method: this article takes the reader through the various factors, elements, and associated systems and processes of the EIP model. Results: The case scenarios detail the various factors and elements of the EIP model and defines how it facilitates the application of evidence into clinical nursing practice. Conclusion: The EIP model provides a framework for nurses (indeed all healthcare practitioners) to deliver clinically effective care, and to be able to defend the processes used and the service provided by referring to reliable evidence. Revise

Evidence-informed practice: simplifying and applying the concept for nursing students and academics

From Crossref journal articles via Jisc Publications RouterHistory: ppub 2022-03-24, issued 2022-03-24Publication status: PublishedBackground: Nurses' ability to apply evidence effectively in practice is a critical factor in delivering high-quality patient care. Evidence-based practice (EBP) is recognised as the gold standard for the delivery of safe and effective person-centred care. However, decades following its inception, nurses continue to encounter difficulties in implementing EBP and, although models for its implementation offer stepwise approaches, factors, such as the context of care and its mechanistic nature, act as barriers to effective and consistent implementation. It is, therefore, imperative to find a solution to the way evidence is applied in practice. Evidence-informed practice (EIP) has been mooted as an alternative to EBP, prompting debate as to which approach better enables the transfer of evidence into practice. Although there are several EBP models and educational interventions, research on the concept of EIP is limited. This article seeks to clarify the concept of EIP and provide an integrated systems-based model of EIP for the application of evidence in clinical nursing practice, by presenting the systems and processes of the EIP model. Two scenarios are used to demonstrate the factors and elements of the EIP model and define how it facilitates the application of evidence to practice. The EIP model provides a framework to deliver clinically effective care, and the ability to justify the processes used and the service provided by referring to reliable evidence

Development and Validation of a Questionnaire to Assess Evidence-Based Practice and Evidence-Informed Practice Knowledge, Attitudes, Understanding and Behaviour

Good-quality questionnaires are needed to assess the effectiveness of educational programs on undergraduate healthcare students’ knowledge, attitudes, understanding and behavior regarding evidence-based practice and evidence-informed practice. However, there is currently no available questionnaires designed to evaluate the outcomes of evidence-based practice and evidence-informed practice education. Based on the methods proposed by Streiner et al., this study developed and validated a questionnaire for assessing evidence-informed practice and evidence-based practice knowledge, attitudes, understanding, self-perceived application and use, and behavior among undergraduate preregistration students in the nursing and allied health disciplines. Seventy-three questionnaire items were developed and administered to varied groups of people, including students and academics. Principal component analysis was conducted to reduce dimensions and establish construct validity and internal consistency of the developed questionnaire. Following pilot-testing and expert review, the final validated questionnaire consists of 53 items (8 demographic items, 25 evidence-based practice items, and 20 evidence-informed practice items). The evidence-based practice and evidence-informed practice questionnaire is a valid and reliable tool to measure the outcomes of evidence-based practice and evidence-informed practice education

A systematic review and meta-analysis of fluoride exposure in community prevention programmes for oral health using nail clippings and spot urine samples

Due to practical difficulties in quantifying fluoride exposure in populations, practical and accurate biomarkers can play a major role in the surveillance of fluoride. Among different fluoride biomarkers, spot urine and nail-clippings have gained more attention due to their ease of acquisition. However, there is no robust consensus about the accuracy of these biomarkers for the estimation of fluoride exposure. This systematic review and meta-analysis aimed to synthesize evidence on the association between fluoride exposure and the fluoride concentration of spot urine and nail-clippings. This review was conducted and reported using the PRISMA Statement. Nine databases (Medline, CINAHL, Web of Science, Scopus, ScienceDirect, Sage Journals Online, Campbell Collaboration, Cochrane Collaboration, and Embase); search engines (Google and Google Scholar); and grey literature were searched up to September 2022. All screening, data extraction, and quality assessments were conducted in duplicate. All experimental and observational research studies that reported the correlation between fluoride exposure and fluoride concentrations of spot urine and/or nail clippings were included. The Mixed-Methods Appraisal tool was used to assess the methodological quality of the included studies. A random effect meta-analysis was carried out to determine the relationship between fluoride exposure and fluoride concentration of biomarkers (i.e., spot urine and nail clippings). Forty-four studies met the inclusion criteria. A total of 694,578 participants were included in this review. Twenty-five studies were included in the meta-analysis. The primary meta-analysis showed a moderate correlation of 0.674 (95%CI: 0.623-0.725, n=25) between fluoride intake and fluoride concentration of spot urine and a strong correlation of 0.938 (95%CI: 0.520-1.355, n=11) between fluoride intake and the fluoride concentration of nail-clippings in all age groups. The findings of secondary meta-analyses showed a strong positive correlation between fluoride intake and fluoride/creatinine ratio of spot urine in children (0.929; 95%CI: 0.502-0.991; n=2). In conclusion, spot urine and nail-clippings have the potential to be employed as non-invasively obtained biomarkers in populations. However, due to the scarcity of high-quality, relevant studies, more research is needed to establish the validity of these biomarkers

Mapping the evidence for monitoring fluoride exposure in community prevention programmes for oral health using nail clippings and spot urine samples:a scoping review

Background: There is an increased interest in identifying practical and accurate biomarkers for fluoride exposure. Due to the narrow ‘dose-gap’ between the benefit of caries reduction and the risk of dental fluorosis, monitoring of fluoride exposure is vital when introducing any fluoridation programme for the prevention of dental caries. This scoping review aimed to ascertain the nature and extent of the available evidence on how spot urine and nail clippings are used to measure fluoride intake/exposure, by using a unique approach of mapping the studies according to population, setting, type of study design, methodology and analytical approach in community prevention programmes. Methods: Multiple relevant databases were searched up to July 2021 for any study designs, including randomised controlled studies, quasi-experimental studies, surveys, retrospective and prospective cohort studies, case studies, phenomenological studies, and expert opinions. Results: The search retrieved 9,222 studies of which 155 met the inclusion criteria. A high proportion of the studies (25.2%) originated from Latin America and the Caribbean continent subregion. However, per country, China recorded the highest number, followed by India and Mexico. The majority (62.6%) employed a cross-sectional study design, and 65.8% combined participants from different age groups. Of the included studies, 82.6% used spot urine samples as a biomarker for assessing fluoride intake/exposure. Water fluoride concentration was reported in 66.5% of the studies with 46.6% of all included studies reporting a water fluoride concentration of > 1.2 mg/L. The methods used in assessing oral hygiene and dietary intake were not reported in 72.3% and 71.0% of the included studies, respectively. Only 35.5% of the included studies assessed the relationship between fluoride exposure and excretion. Conclusions: This review revealed a large variability in the way in which spot urine samples and/or nail clippings are used to measure fluoride exposure in different settings and situations. Particularly, there are inconsistencies in the methodologies and the analytical approaches used in assessing fluoride exposure. Therefore, there is a need for more rigorous primary research studies using standardised approaches to determine the suitability of spot urine samples and nail clipping as biomarkers for monitoring fluoride exposure