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The optimal maternal age at childbirth has been a topic of bourgeoning literature, with earlier ages offering physiological benefits for maternal recovery. In contrast, later ages to give birth may provide psychological advantages due to greater emotional maturity. This study investigates the impact of maternal age at childbirth on children’s internalising problems and explores the mediating roles of housing instability and family support in this relationship.
Cross-sectional study; mediation analysis of the 2022 National Survey of Children’s Health (NSCH) data.
Response in the 2022 NSCH in the USA.
This study is based on the 2022 NSCH, collecting a total of 54 103 completed surveys from randomly selected households across the USA. In this study, after excluding participants due to missing values in critical variables, 48 073 participants were included in the final analysis.
Our findings are consistent with the hypothesis that increasing maternal age at childbirth is associated with lower children’s internalising problems. Analysis suggested this association operates directly and is indirectly linked to child outcomes through lower levels of housing instability and higher levels of family support. However, a distinct indirect effect emerged: increased maternal age was also associated with reduced family support, which was in turn linked to more internalising problems. The results illuminate potential mechanisms linking maternal age at childbirth to children’s internalising problems and underscore the importance of stable housing and family support in mitigating risk factors for children’s emotional well-being.
We found an association between advanced maternal age and fewer internalising problems in children. This relationship appears to operate directly and indirectly via a sequential pathway: higher maternal age correlates with lower housing instability, which in turn is associated with increased family support, ultimately correlating with improved child mental health outcomes.
The use of technology to support nurses' decision-making is increasing in response to growing healthcare demands. AI, a global trend, holds great potential to enhance nurses' daily work if implemented systematically, paving the way for a promising future in healthcare.
To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.
A systematic literature review.
CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.
JBI guidelines guided the review. At least two researchers independently assessed the eligibility of the studies based on title, abstract, and full text, as well as the methodological quality of the studies. Narrative analysis of the study findings was performed.
Eight studies showed AI tools improved decision-making, patient care, and staff performance. A discharge support system reduced 30-day readmissions from 22.2% to 9.4% (p = 0.015); a deterioration algorithm cut time to contact senior staff (p = 0.040) and order tests (p = 0.049). Neonatal resuscitation accuracy rose to 94%–95% versus 55%–80% (p < 0.001); seizure assessment confidence improved (p = 0.01); pressure ulcer prevention (p = 0.002) and visual differentiation (p < 0.001) improved. Documentation quality increased (p < 0.001).
AI integration in nursing has the potential to optimise decision-making, improve patient care quality, and enhance workflow efficiency. Ethical considerations must address transparency, bias mitigation, data privacy, and accountability in AI-driven decisions, ensuring patient safety and trust while supporting equitable, evidence-based care delivery.
The findings underline the transformative role of AI in addressing pressing nursing challenges such as staffing shortages, workload management, and error reduction. By supporting clinical decision-making and workflow efficiency, AI can enhance patient safety, care quality, and nurses' capacity to focus on direct patient care. A stronger emphasis on research and implementation will help bridge usability and scalability gaps, ensuring sustainable integration of AI across diverse healthcare settings.
Nurses are pivotal in EBHC implementation; however, its adoption remains limited, highlighting the need to investigate nurses' experiences and perceptions of their EBHC competence.
To critically appraise and synthesise qualitative evidence of nurses' experiences and perceptions of EBHC competence.
A qualitative systematic review.
The review followed the JBI methodology for qualitative systematic reviews. Inclusion criteria were qualitative studies published in Finnish, Swedish or English that explored nurses' experiences and perceptions of EBHC competence. Data were synthesised using JBI's meta-aggregation method and the findings were graded with the ConQual approach.
CINAHL, Medic, PubMed, Scopus and grey literature from EBSCO Open Dissertations and MedNar, searched in December 2023.
Seventeen qualitative studies were included. The study findings were generated from four synthesised findings with low confidence scores. The synthesised findings were: (1) Nurses' competence in Global Health, (2) Nurses' competence in enhancing Evidence generation, (3) Nurses' competence in optimising Evidence Transfer and (4) Nurses' competence in effective implementation of evidence. A new finding of this systematic review was that nurses did not express their experiences or perceptions on evidence synthesis.
Nurses' experiences of EBHC competence focus mainly on evidence implementation and global health. The lack of findings to evidence synthesis suggests that core principles of the EBHC model are not yet fully embedded in nursing practice. Nurses emphasised the need for greater support for developing EBHC competence.
Integration of EBHC into education, mentoring and adequate resources enhances nurses' competence, motivation and commitment to EBHC sub-dimensions, while also strengthening their professional confidence and development.
Strengthening nurses' EBHC competencies contributes to supporting the delivery of high-quality, effective and sustainable healthcare services.
PRISMA guidelines followed.
None.
PROSPERO-registered: CRD42021285179
by Evelyn Aboagye Addae, Moses Adjei, Uchechi Shirley Anaduaka, David Kyetuo Wuollah-Dire, Regobert Bondong
Though the impact of COVID-19 pandemic’s effects on individuals’ life domains and quality of life has been widely researched, there remains unanswered questions on the mechanisms that explain the impact of fear of COVID-19 on different measurements of adolescents’ subjective well-being (SWB) particularly in the sub-Saharan African context. In a mediation model, we employed data collected during the pandemic to examine the mediating mechanisms that links fear of COVID-19 and COVID-19-induced changes in multiple life domains (subjective feelings of unsafety, positive affect and peer relationships) to different measurements of adolescents’ SWB (overall life satisfaction, overall happiness, subjective happiness, and composite SWB). Findings revealed significant negative correlations between fear of COVID-19 and all employed measurements of SWB as well as between the proposed mediating variables – changes in peer relationship, positive affect, subjective feelings of unsafety and the different measurements of SWB. Adolescents who reported negative changes in peer relationship, positive affect and subjective feelings of unsafety were more likely to report poorer SWB including lower life satisfaction and happiness. For instance, adolescents who experienced increase in peer relationship were more likely to experience higher overall life satisfaction (B = .169, p B = .172, p B = .056, p B = .416, p B = .381, p B = −1.350, p
Teenage pregnancy is a significant global public health challenge with far-reaching consequences for young mothers, their children, families and society at large. Yet, the evidence synthesis landscape in teenage pregnancy prevention remains fragmented, with systematic reviews typically examining specific intervention types, target populations or geographical settings in isolation. This protocol outlines a scoping review to map and describe the extent, range and nature of existing systematic review evidence on interventions aimed at addressing teenage pregnancy.
We will conduct a comprehensive search of multiple databases, including PubMed Central, Embase, CINAHL and ProQuest Central, systematic review repositories and grey literature sources from inception to date. Two reviewers will independently screen titles, abstracts and full-text articles using predetermined inclusion and exclusion criteria, with disagreements resolved through discussion or third-party adjudication. Data will be extracted using a standardised form and synthesised narratively, with results presented descriptively, as no meta-analysis is planned for this scoping review.
This review does not require ethical approval, as only published data will be analysed. Results will be shared using peer-reviewed publications. Data sets emerging from the study will be made available on the Open Science Framework.
This review was initially registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/F2AH7) in July 2025. The protocol will be updated and re-registered after incorporating feedback from the journal’s peer review process.
To determine the barriers, facilitators and effectiveness of using an intergenerational café to enable intergenerational learning.
Implementation science using the ‘Consolidated Framework for Implementation Research’ framework.
Ethical approval for this research was granted by the University of Limerick. Online intergenerational cafés were held with older people and student nurses. Original data were collected through surveys and facilitator reflections. Participants were invited post-café to participate in the study. Student nurses (n = 50) and older people (n = 49) participated in an anonymous online survey, and facilitators (n = 7) took part in a peer focus group on planning and co-ordinating the cafés. Post hoc ‘CFIR’ analysis comprised secondary data analysis through mapping descriptive statistics and thematically analysed data to codebooks derived from CFIR domains and constructs.
Barriers and facilitators to café implementation were identified. Organisational factors are important for effective implementation. More students felt that the purpose, topics and running of the café were clear and organised. In contrast, more older people wanted additional time in the discussion groups. Technical difficulties (e.g., computer, logging on) were identified by some as a barrier to participation. Overall, having a clear purpose and topics along with an online approach facilitated implementation. All participants supported the café innovation as a way of increasing intergenerational learning. Facilitators worked effectively as a team to ensure the smooth running of the cafés. The analysis helped determine the effectiveness of the intervention.
These cafés facilitated mutual learning and understanding and were well received by participants.
Intergenerational cafés can support intergenerational learning.
Intergenerational cafés facilitated intergenerational learning.
SRQR/EQUATOR.
There was no patient/public contribution.
Medication returned by patients to healthcare facilities is a critical aspect of reverse logistics, intersecting healthcare delivery, patient safety and environmental sustainability, especially in low- and middle-income countries (LMICs) where systemic inefficiencies and socio-cultural factors may exacerbate the issue. While emerging medication return programmes are recognised for their potential to enhance resource efficiency and prevent misuse, they also signal inefficiencies in medical supply chains, prescribing practices and patient-provider interactions. This scoping review aims to systematically map the incidence and drivers of medication returned to health facilities by patients in LMICs.
This review follows Arksey and O'Malley’s scoping review framework and the PRISMA-ScR reporting guidelines. Searches will be conducted in Google Scholar, PubMed, CINAHL, Embase, Web of Science and Scopus, supplemented by grey literature sources and reference list screening. Searches will include studies from January 2005 to December 2025 and English-language publications, reflecting both the relevance of recent evidence and practical considerations for screening and analysis. Eligible studies must address the incidence or drivers of medication returned in LMICs and meet predefined inclusion criteria based on the Population, Concept, Context framework. Data will be extracted using a standardised charting form and analysed using narrative synthesis, supported by descriptive statistics and thematic analysis.
No ethical approval is required as this scoping review will analyse publicly available literature. Findings will be disseminated through peer-reviewed publications, academic conferences and healthcare organisations, with all data and search strategies made openly accessible through Springer Nature’s protocols.io preprint repository to support transparency and future research.
Springer Nature’s protocols.io dx.doi.org/10.17504/protocols.io.3byl4wd5ovo5/v1.
Child malnutrition remains a pressing public health challenge in sub-Saharan Africa (SSA), where approximately 148 million children are stunted and 45 million are wasted. Although often conceptualised as a persistent condition, evidence indicates that malnutrition among children under 5 years frequently follows seasonal patterns shaped by agricultural cycles, climatic variability and socioeconomic conditions. Current interventions have paid limited attention to the food system dynamics that underpin these fluctuations. Adopting a system perspective, this scoping review will synthesise existing evidence on the food system determinants of seasonal malnutrition in children under 5 years in SSA.
The review will be conducted in accordance with the Joanna Briggs Institute methodological framework for scoping reviews and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search will be undertaken across electronic databases (Google Scholar, ProQuest Central, PubMed, Scopus and African Index Medicus) for literature published from 2015 onwards. Grey literature will also be sought from institutional repositories of the WHO, United Nations Children’s Fund, Food and Agriculture Organization and World Food Programme. Screening of titles, abstracts and full texts will be performed independently by two reviewers using predefined eligibility criteria. Data extraction will capture study characteristics and food system determinants of seasonal malnutrition at micro, meso and macro levels. The Food Insecurity and Vulnerability Information and Mapping Systems framework will guide the analysis and synthesis.
As this review involves analysis of previously published data, ethical approval is not required. Findings will be disseminated through a peer-reviewed publication and social media engagements. Results will inform the development of integrated system-based approaches to address seasonal malnutrition in children under five in SSA. The full study protocol, datasets and supplementary forms will be published in an open-access repository in compliance with the Findability, Accessibility, Interoperability and Reuse principles.
This scoping review protocol is registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/RU4ZX).
Psychotic disorders are more prevalent among minority ethnic groups in the UK. However, there is no research on how the British Sikh community understands and seeks help for psychosis. The way in which a community understands the nature, causes and treatment of psychosis can impact their duration of untreated psychosis, treatment pathways, experience and engagement with mental health services, and outcomes.
To explore the lay understandings of psychosis and associated help-seeking within the Sikh community in England, and how family, religion and culture influence these perspectives
An exploratory qualitative design, consisting of online semistructured interviews across the UK.
30 participants, 11 men and 19 women, ages ranged from 19 to 69, who identified as Sikh.
Thematic analysis revealed several common themes, including a lack of awareness and knowledge of psychosis, variety of causal beliefs held about psychosis, professional help-seeking being encouraged, religious practices regarded as helpful coping mechanisms, supernatural beliefs influencing alternative help-seeking, strong negative perceptions towards psychosis and general mental illness, the significant role of family and community, and conflicting religious and cultural beliefs.
Participants showed limited understanding of psychosis and mental illnesses, accompanied by widespread negative perceptions, potentially delaying help-seeking. Increasing awareness may prompt earlier help-seeking, enhancing outcomes and diminishing stigma.
Objetivo: Valorar los beneficios del uso de la PEEP frente a su ausencia, así como identificar los daños que pueda ocasionar un uso indebido de ella. Métodos: Revisión sistemática cuya pregunta PICO fue ¿El establecimiento de un nivel de PEEP en el paciente someti-do a VMI sin patología pulmonar asociada proporciona beneficios en oxigenación y ventilación frente al no establecimiento de PEEP? El período de búsqueda fue de diciembre de 2019 a marzo de 2020 en las bases de datos Medline/Pubmed, Cochrane, Cuiden, Y Science-direct. Los descriptores MeSH utilizados fueron “positive end final expiration’’, “artificial respiration’’, “zero end expiratory pressure’’, “lung’’, “general anesthesia’’, seleccionándose 220 artículos de los que se excluyeron 215. Resultados: Fueron incluidos 5 artículos; el uso de la PEEP presentó mejores resultados en la dinámica respiratoria en aquellos pacientes que fueron sometidos a ventilación invasi-va, frente aquellos que no la tuvieron. Este fenómeno fue debido a una mejora de la oxigenación, disminución de la aparición del número de atelectasias y mejora en la mecánica ventilatoria. Conclusiones: El uso de un nivel adecuado de PEEP en pacientes bajo ventilación invasiva presentó mejores resultados en la dinámica pulmonar.
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