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Evolving aspects of oral care in modern nursing: a systematic review
Get PDFIntroduction: Oral care is a critical yet often neglected aspect of nursing, essential for preventing complications like ventilator-associated pneumonia and systemic inflammation. Despite its importance, nurses face challenges due to limited training, time constraints, and inconsistent protocols. The evolving role of nurses in oral care reflects broader healthcare shifts toward interprofessional and patient-centered models. This systematic review examines these dynamics to inform evidence-based improvements. Methods: Following PRISMA guidelines, this systematic review synthesized qualitative, quantitative, and mixed-methods studies from 2015 to 2025, sourced from PubMed, CINAHL, Scopus, Web of Science, Embase, and grey literature. Search terms targeted nurses’ roles, perceptions, barriers, and interventions in oral care. Eligible studies involved registered nurses or students in healthcare settings, with data extracted on study characteristics, outcomes, and interventions. Quality was assessed using JBI and MMAT tools, and a narrative synthesis integrated findings via thematic analysis using NVivo. Results: From 2,347 records, 32 studies across 12 countries were included, covering ICUs (n = 12), general wards (n = 8), and nursing homes (n = 5), with sample sizes ranging from 7 to 1,576 participants. Key themes emerged: inadequate knowledge due to limited education, variable attitudes influenced by setting, inconsistent practices lacking standardized tools, and barriers like workload and resource shortages. Enablers included enhanced training, with over 80% of nurses in multiple studies seeking further education, patient empowerment, interdisciplinary collaboration, and policy support. Training programs, such as virtual reality simulations, improved knowledge and confidence, while resource availability enhanced practice quality. Conclusion: Nurses’ effectiveness in oral care is hindered by educational gaps, systemic barriers, and inconsistent prioritization, but bolstered by targeted training and resources. These findings can guide nursing curricula and hospital policy reforms to prioritize oral care globally. Comprehensive nursing curricula, evidence-based protocols, and interdisciplinary collaboration are essential to elevate oral care as a core responsibility. Future research should focus on scalable interventions in diverse settings to enhance patient outcomes
Third sector perspectives on community link worker referrals in social prescribing: a realist analysis
Get PDFIntroduction: Community link workers (CLWs), also known as social prescribing link workers, connect individuals to community support, much of which is provided by third-sector organisations (TSOs). TSOs are common referral destinations for CLWs, yet the relationships between CLWs and TSOs remain under-explored. Method: This realist study investigated TSOs’ perceptions of link working, focusing on referral and collaboration dynamics. Conducted across 22 TSOs in Scotland, it involved in-depth interviews with TSO staff and consultations with CLWs and managers, analysing data via realist heuristics to identify contexts, mechanisms, and outcomes. Results: Targeted referrals by experienced CLWs, with follow-up, and strong TSO-CLW relationships, improved client health, wellbeing, and independence while reducing reliance on statutory services. These processes fostered professionals’ trust, satisfaction, and innovation, creating a positive feedback loop. Conversely, inconsistent referrals, such as over-referral or scattergun approaches, compounded by resource constraints and perceptions of inequitable partnerships, led to suboptimal client outcomes, dissatisfaction, and weakened collaboration. Important contexts included extreme resource pressures, varying CLW expertise, and perceptions of power imbalances. Discussion: Effective social prescribing needs sustained TSO-CLW collaboration, supported by third-sector investment and tools for equitable partnerships. Rather than a referral process, social prescribing should be envisioned as a community of practice, defined by relationships, a common purpose and shared responsibility for challenges and solutions. Future models should prioritise strengthening statutory and third-sector trust and collaboration
No nighttime I can own: The experience of insomnia expressed through poetry
Get PDFInsomnia is a chronic sleep disorder associated with difficulty sleeping and a significant deleterious impact on daytime function and quality of life. This novel study investigates the experience of insomnia, and the impact and coping strategies expressed via the creative medium of poetry.A total of 33 poems containing the word ‘insomnia’ were selected from The Poetry Foundation and analysed using poetic content analysis; a qualitative inductive technique that involved coding meaning units to the poetry, which were then categorised and agreed between the two authors.The final agreed categories were: Coping Strategies and Mental Engagement, which reflected a range of standard and non-standard treatments and thoughts; Physical Experiences and Reactions, such as discomfort; Socio-Emotional Dynamics and Life Impact, such as emotional impact and relationships; Environment and Temporal Factors, including the sleeping area and house, and the passage of time; and Sleep, which included dreams and nightmares, and the lack thereof.Themes broadly represented the biopsychosocial model, which then served as a framework for interpreting the study's findings. The study provided an interesting and novel approach to investigating the creative expression of insomnia, and could be further developed by soliciting poetry from contemporary poets to provide a more immediate and diverse range of experiences
Work re‐entry following maternity leave for first‐time mothers: An events, social identity and intersectional theories informed identity work framework
Get PDFMany first‐time mothers experience significant identity issues on work re‐entry following maternity leave, an important individual and life‐related event. Work re‐entry prompts significant identity tensions leading to identity work challenges and potential career changes. We address this significant life event and develop a subjective identity informed conceptual framework explaining its key components and outcomes. We propose that for first‐time mothers, re‐entry following maternity leave triggers a cognitive and subjective assessment of identity threat and opportunity leading to the use of multiple identity work strategies to address personal, role, and collective identities. We analyze the impacts of these reworked identities and identity work for career decision making and outcomes. We theoretically underpin our framework using event systems, a subjective perspective on social identity and intersectional theories and in doing so, propose future research questions and highlight implications for national policy and organizational practices
Material matters: recommendations for the analysis of relational spaces in sociotechnical transition studies
Get PDFThis Opinion Paper examines the interplay between materiality, relational spaces, and technological change dynamics. The objective is to introduce a novel theoretical perspective and a structured analytical process designed to enrich the investigation of relational spaces within the context of sociotechnical transitions. Our perspective aims to help transition scholars integrate the often-overlooked importance of material arrangements with the analyses of material flows and social components. We interpret this integration as a morphological approach to the analysis of relational spaces. The development of our perspective is grounded in a thorough review of existing literature on transition studies, complemented by the application of the theory of space constitution. Through our theoretical contribution, we advance the spatial discourse in transition studies, offering the means required to produce novel insights into how diverse social and material dimensions of spatial contexts affect, and are affected by, sociotechnical transition pathways and the technological change they produce
Responsible AI for Cities: A Case Study of GeoAI in African Informal Settlements
Get PDFGeospatial Artificial Intelligence (GeoAI) systems are increasingly used by local governments to manage urban planning activities. However, there is a lack of clear guidelines for responsible artificial intelligence (AI) implementation. We address this gap by applying the task-data-user-technology fit theory. First, we create a conceptual framework that translates ethical AI principles into practical system requirements. Second, we apply this framework through a case study analysis. We examine the geospatial AI system that the city of eThekwini, South Africa, has deployed to monitor their informal settlements. Based on expert interviews, our analysis highlights the ethical trade-offs inherent in the interactions between fits, data, tasks, users, and AI interactions, especially in an inherently localized and multi-stakeholder field such as urban planning. Additionally, we show how these fits are interconnected and cross-dependent. For example, the technical skills and resources of users can influence all other fits. Our study also reveals how task reconfiguration, user adaptability, and data improvement can enhance or hinder alignment with technology. From these insights, we introduce practical and theoretical recommendations for responsible AI development, adoption, and use
Quantifying the phenome-wide response to sex-specific selection in Drosophila melanogaster
Get PDFIn species with separate sexes, selection on males causes evolutionary change in female traits values (and vice versa) via genetic correlations, which has far-reaching consequences for adaptation. Here, we utilise a sex-specific form of Robertson’s Secondary Theorem of Natural Selection to estimate the expected response to selection for 474 organismal-level traits and ~28,000 gene expression traits measured in the Drosophila Genetic Reference Panel (DGRP). Across organismal-level traits, selection acting on males produced a larger predicted evolutionary response than did selection acting on females, even for female traits; while for transcriptome traits selection on each sex produced a roughly equal average evolutionary response. For most traits, selection on males and females was predicted to move average trait values in the same direction, though for some traits, selection on one sex increased trait values while selection on the other sex decreased them, implying intralocus sexual conflict. Our results provide support for the hypothesis that males experience stronger selection than females, potentially accelerating adaptation in females. Furthermore, sex-opposite responses to selection appear to exist for only a small proportion of traits, consistent with observations that the inter-sex genetic correlation for fitness is positive but less than one in most populations so far studied
Internal business process governance and external regulation: How does AI technology empower financial performance?
No full textWe examine the impact of artificial intelligence (AI) technology on the financial performance of financial firms, focusing on the transmission role of business process governance from the perspective of corporate governance. We examine whether there is heterogeneity in the effects of different institutional environments, conducting an empirical analysis of the sample data of 152 Chinese financial firms from 2011 to 2022. AI technology improves financial enterprises' operational quality through risk management, internal governance, and internal control. Moreover, AI provides technical support to enhance service derivative capability by enhancing the number of businesses across cross-regional operations, resource competition, and customer excavation. We also identify that the enabling effect of digital technology on business process governance is affected by imitation pressure from peer firms. In contrast, the impact of government regulatory pressure is not significant
Accelerating the development of a psychological intervention to restore treatment decision-making capacity in patients with schizophrenia-spectrum disorder: An umbrella trial
Get PDFIntroductionMany individuals with schizophrenia-spectrum disorder (‘psychosis’) lack capacity to make decisions about psychiatric treatment (‘incapacity’), however we lack robust evidence from clinical trials on interventions to improve it. To accelerate their development, we tested whether an ‘umbrella’ trial was feasible. This involved running multiple randomised controlled ‘interventionist-causal’ trials (IC-RCTs) concurrently. Each tested the effect on incapacity of targeting an individual psychological mechanism.MethodsWe did 3 assessor-blind, multi-site, pilot IC-RCTs. Each compared 6 sessions of psychological therapy for either self-stigma (SS), low self-esteem (SE) or the jumping-to-conclusions (JTC) bias, to 6 sessions of collaborative assessment of the causes of incapacity (control). Adults with psychosis, incapacity and ≥1 target mechanism could participate. Primary outcomes were recruitment feasibility, and data retention on the MacArthur Competence Assessment Tool-Treatment (MacCAT-T).ResultsWe recruited 57 participants and performed 60 randomisations (3 patients participated in 2 trials); 82 % provided post-treatment data. Standardised mean differences (Hedges' g) for MacCAT-T ‘understanding’ were g = 0.35 (SS; 95 % CI −0.51, 1.22), g = 0.41 (JTC; −0.55, 1.38) and g = 0.74 (SE; −0.73, 2.21), with positive values favouring treatment. For ‘reasoning’, they were −0.20 (SS; −1.05, 0.66), 0.79 (JTC; −0.20, 1.79) and 0.79 (SE −0.69, 2.27). For ‘appreciation’ they were −0.39 (SS; −1.25, 0.48), 1.76 (JTC; 0.62, 2.90) and 0.57 (SE; −0.87, 2.02). Four control participants had 9 serious adverse events between randomisation and post-treatment; two intervention participants had 2.DiscussionAn umbrella trial of psychological interventions to improve capacity in psychosis is feasible. A definitive trial is warranted.Trial pre-registrationNCT0430943
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