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Health Technology Assessment (HTA) practitioners recognize the significance of qualitative methodologies that focus on how a technology is feasible, meaningfulness, acceptable, and equitable. This mapping aimed to delineate the frameworks employed to synthesize qualitative evidence and assess the quality of synthesis in HTA .
Methods
Mapping was conducted using Medline, LILACS, CINAHL, Embase, Web of Science, Scopus, PsycINFO, Cochrane Library, JBI, and ScienceDirect databases. Gray literature searches included PROQUEST, Open Grey, Canadian Agency for Drugs and Technologies in Health’s Grey Matters, Google Scholar, and HTA agency websites. The inclusion criteria were centered on global qualitative evidence synthesis frameworks. The data are presented in the tables.
Results
Of the 2054 articles, 31 were included, mostly from Europe. Guide was the type of document more cited, and most authors are from HTA agencies and universities. Incorporating both patient and family perspectives is the most cited reason for include qualitative evidence. Regardless of the framework or tool, SPICE was the main acronym, and RETREAT was preferred for approach selection. Thematic synthesis dominated analytic methods, and CASP was the primary quality appraisal tool. GRADE-CERQual graded evidence synthesis, with ENTREQ as the top reporting guidance. The GRADE evidence-to-decision framework was mentioned for recommendations.
Conclusion
This mapping highlights the movement incorporate qualitative evidence in HTA employing specific frameworks. Despite the similarities among documents, most of them describe part of the process to synthesize qualitative evidence. Standardizing procedures to incorporate qualitative evidence into HTA can enhance decision-making. These findings offer essential considerations for HTA practice.
Multiple reviews have examined the impact of nutritional interventions in patients with burn injuries; however, discrepancies among results cast doubt about their validity. We implemented this review to assess the impact of various nutritional interventions in adult patients with burn injuries. We conducted a thorough search of PubMed, Scopus and Web of Science databases until 1 August 2024, to identify relevant meta-analyses of intervention trials, examining the impact of nutritional interventions on burn patients. We adopted the random-effect models to determine the pooled effect sizes while employing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to examine evidence certainty. Thirty-three original intervention trials from eleven meta-analyses were entered in our review. Early enteral nutrition could substantially reduce overall mortality (relative risk (RR): 0·36, 95 % CI: 0·19, 0·68, GRADE = moderate certainty), hospital stay (mean difference (MD): −15·3, 95 % CI: −20·4, −10·2, GRADE = moderate certainty) and sepsis risk (RR: 0·23, 95 % CI: 0·11, 0·45, GRADE = moderate certainty). Glutamine showed a notable decrease in the length of hospital stay (MD: −6·23, 95 % CI: −9·53, −2·94, GRADE = low certainty). However, other nutritional interventions, including combined immunonutrition, branched-chain amino acids, fish oil, ornithine α-ketoglutarate and trace elements, did not significantly affect the assessed clinical outcomes. Early enteral nutrition might impose a beneficial effect on mortality, hospital stay length and incidence of sepsis with moderate evidence. Lower length of hospital stay was also seen in burn patients supplemented with glutamine, although the evidence was weak.
Difficulty falling asleep and/or maintaining sleep are common complaints in patients visiting medical clinics. Insomnia can occur alone or in combination with other medical or psychiatric disorders. Diagnosis and management of insomnia at times are perplexing. This updated study review aimed at a clinical algorithm for diagnosis and treatment of insomnia in adults. We developed an easy-to-apply algorithm to diagnose and manage insomnia that can be used by general practitioners and non-sleep specialists. To this end, our team reviewed the previous studies to determine the prevalence, evaluation, and treatment of insomnia. We used the results to develop a clinical algorithm for diagnosing and managing insomnia.
Insomnia occurs in a short (less than 3 months duration) or chronic form (≥3 months duration). Insomnia management includes both pharmacological and non-pharmacological interventions. There is ample research evidence for the impact of a variety of non-pharmacological treatments, but both types of treatments can be used for each patient. If there are any contradictions in the diagnosis process, therapists should use objective instruments, such as polysomnography, but they should not be in a hurry to use these instruments.
This scoping review addresses gaps in the existing literature on dietary guidelines for pregnant and lactating women globally. The study delves into adherence levels, identifies influencing factors and examines outcomes associated with these guidelines. Analysing food-based dietary guidelines (FBDG) from around the world, the review reveals that half of the countries lack FBDG, with only 15% providing tailored advice for pregnant and lactating women. Utilising data extracted from forty-seven articles across MEDLINE and EMBASE, the study highlights a scarcity of adherence studies, particularly in low- or middle-income countries (LMIC), and emphasises the lack of research during lactation. Overall adherence to dietary guidelines is low, with disparities in fruit, vegetable, whole grain and fish consumption. Positive correlations with adherence include age, education, employment, social class and certain medical histories, while negative correlations involve smoking, alcohol consumption, metropolitan residence and elevated BMI. The study documented significant associations between adherence and reduced risks of gestational complications but calls for further exploration of intermediate nutritional outcomes such as micronutrient deficiencies and child growth. Emphasising the urgency for globally standardised guidelines, especially in LMIC, this review provides a foundational call for prioritised studies and strategies to enhance dietary practices for pregnant and lactating women worldwide.
Inflammation is increasingly recognised as a fundamental component of the pathophysiology of major depressive disorder (MDD), with a variety of inflammatory biomarkers playing pivotal roles. These markers are closely linked to both the severity of symptoms and the responsiveness to treatments in MDD.
Aims
This scoping review aims to explore the scientific literature investigating the complex relationships between inflammatory biomarkers and depression, by identifying new studies and critical issues in current research.
Method
Following the PRISMA Extension for Scoping Reviews guidelines, we systematically searched databases including PubMed, Scopus, PsycINFO, Open Grey and Cochrane Library. Our search focused on articles published from 1 January 2020 to 1 May 2024. We included studies evaluating inflammatory biomarkers in adult patients with MDD, utilising observational and randomised controlled trial designs, and review studies.
Results
Our analysis examined 44 studies on the complex interplay between inflammation and its multiple effects on MDD. Significant associations between specific inflammatory biomarkers and depression severity were found, requiring cautious interpretation. We also highlight several methodological limitations in the current studies, which warrant caution in directly applying these findings to clinical practice. However, identified methodologies show potential for using these biomarkers as diagnostic tools or therapeutic targets, including anti-inflammatory interventions.
Conclusions
The findings emphasise the need for sophisticated, integrative research to understand inflammation's role in MDD. Future studies should identify specific biomarker panels for diagnosing depression and bridging peripheral biomarker measurements with central neuroinflammatory processes, leading to better diagnostic and treatment strategies.
The chapter presents an overview of the procedural arrangements adopted at the international criminal jurisdictions, namely the UN ad hoc tribunals for the former Yugoslavia and Rwanda and the International Criminal Court (ICC), covering the main milestones from the initiation of the investigation to trial phase to appeals against the judgment and sentence and review. Before delving into the trajectories of an criminal case before international criminal courts and tribunals, the chapter highlights the origins of international criminal procedure in the common law (Anglo-American, or ‘adversarial’) and civil law (Continental, or ‘inquisitorial’) approaches, resulting in its legal nature as a hybrid scheme where the balance between the domestic influences varies by tribunal and over time due to reforms pursued by judge-legislators (ICTY and ICTR) or by states and, to a lesser extent, judges (ICC). The chapter reviews the role and functions of the main actors in international criminal proceedings, including repeat or professional players (judges, prosecutors, and defence) and other participants such as victims and witnesses and states and international organisations. It also highlights the normative importance of human rights to international criminal process and the imperative of complying with the principles of public, fair and expeditious proceedings.
Aside from its intellectual content, the essay provides a space for contemporary British novelists to enhance their career prospects. This takes the threefold forms of intertexual affiliation by co-publication within the same title as other writers; of creating a space in which to generate prestige-enhancing controversy; and of enabling novelists to hold academic affiliations. This chapter examines these features through a network analysis of the publications in The London Review of Books over the past two decades and then through case studies of Hilary Mantel, Will Self, Tom McCarthy, and Zadie Smith.
The role of Artificial Intelligence (AI) in design is clearly growing. One of the tenets of the paper is that stimulation could be among the design processes mostly benefitting from the introduction of AI. Available contributions have been reviewed to understand the current support AI can give in design inspiration and ideation. We also reflected on what AI should and ahould not do in the future: a framework is proposed. Based on the reviewed contributions, in no case, AI is seen as a substitute of designers. Most contributions originate from the IT domain and have a demonstrative purpose.
While farming practices such as intercropping, cover cropping, and green manuring are promoted as contributors to environment-friendly agriculture by balancing agricultural production with environmental sustainability, their uptake by farmers has still been limited. This paper provides a holistic global view of the adoption factors of such agri-environmental cropping practices based on a systematic literature review of 53 international peer-reviewed articles. Qualitative analysis of the reviewed studies shows that adoption factors explored by researchers can be categorized along nine thematic groups (sociodemographic characteristics, socioeconomic/financial conditions, environmental conditions, tangible assets and inventory, pre-existing farm practices, agrotechnical aspects of the practice, public support instruments, information and knowledge resources, community dynamics) and two transversal dimensions (generic and practice-specific attitudes), with an additional differentiation of micro- and macro-levels within the former. While many individual factors across the various groups and dimensions are highly context sensitive in terms of their impact on practice adoption, the analysis also identifies a set of factors that demonstrate common trends across the studies. The offered holistic conceptualization and analysis of the adoption factors of the reviewed set of practices contribute to a more comprehensive understanding of the broader potential impact pathways in the farmer reorientation toward sustainable crop production.
This umbrella review will summarize palliative and end-of-life care practices in peri-intensive care settings by reviewing systematic reviews in intensive care unit (ICU) settings. Evidence suggests that integrating palliative care into ICU management, initiating conversations about care goals, and providing psychological and emotional support can significantly enhance patient and family outcomes.
Methods
The Joanna Briggs Institute (JBI) methodology for umbrella reviews will be followed. The search will be carried out from inception until 30 September 2023 in the following databases: Cochrane Library, SCOPUS, Web of Science, CINAHL Complete, Medline, EMBASE, and PsycINFO. Two reviewers will independently conduct screening, data extraction, and quality assessment, and to resolve conflicts, adding a third reviewer will facilitate the consensus-building process. The quality assessment will be carried out using the JBI Critical Appraisal Checklist. The review findings will be reported per the guidelines outlined in the Preferred Reporting Items for Overviews of Reviews statement.
Results
This umbrella review seeks to inform future research and practice in critical care medicine, helping to ensure that end-of-life care interventions are optimized to meet the needs of critically ill patients and their families.
Chlorite minerals, found in a great variety of rocks and geological environments, display a wide range of chemical compositions and a variety of polytypes, which reflect the physicochemical conditions under which they formed. Of particular importance for studies dealing with ore deposit genesis, metamorphism, hydrothermal alteration or diagenesis is the paleotemperature of chlorite crystallization. However, in order to understand the relationship between chlorite composition and formation temperature and hence use chlorite as a geothermometer, one must determine how other parameters influence chlorite composition. These parameters may include fO2 and pH of the solution and Fe/(Fe + Mg) and bulk mineral composition of the host rock.
Four approaches to chlorite geothermometry, one structural and three compositional, have been proposed in the past: 1) a polytype method based on the (largely qualitative) observation that structural changes in chlorite may be partly temperature-dependent (Hayes, 1970); 2) an empirical calibration between the tetrahedral aluminum occupancy in chlorites and measured temperature in geothermal systems (Cathelineau, 1988), which has subsequently been modified by several workers; 3) a six-component chlorite solid solution model based upon equilibrium between chlorite and an aqueous solution, which uses thermodynamic properties calibrated with data from geothermal and hydrothermal systems (Walshe, 1986); and 4) a theoretical method based on the intersection of chlorite-carbonate reactions and the CO2-H2O miscibility surface in temperature-XCO2 space, which requires that the composition of a coexisting carbonate phase (dolomite, ankerite, Fe-calcite or siderite) be known or estimated (Hutcheon, 1990). These four approaches are reviewed and the different calculation methods for the compositional geothermometers are applied to a selection of chlorite analyses from the literature. Results of this comparative exercise indicate that no single chlorite geothermometer performs satisfactorily over the whole range of natural conditions (different temperatures, coexisting assemblages, Fe/(Fe + Mg), fO2, etc.). Therefore, chlorite geothermometry should be used with caution and only in combination with alternative methods of estimating paleotemperatures.
First responders’ training and learning regarding how to handle a mass-casualty incident (MCI) is traditionally based on reading and/or training through computer-based scenarios, or sometimes through live simulations with actors. First responders should practice in realistic environments to narrow the theory-practice gap, and the possibility of repeating the training is important for learning. High-fidelity virtual reality (VR) is a promising tool to use for realistic and repeatable simulation training, but it needs to be further evaluated. The aim of this literature review was to provide a comprehensive description of the use of high-fidelity VR for MCI training by first responders.
Methods:
A systematic integrative literature review was used according to Whittemore and Knafl’s descriptions. Databases investigated were PubMed, CINAHL Complete, Academic Search Ultimate, Web of Science, and ERIC to find papers addressing the targeted outcome. The electronic search strategy identified 797 potential studies. Seventeen studies were deemed eligible for final inclusion.
Results:
Training with VR enables repetition in a way not possible with live simulation, and the realism is similar, yet not as stressful. Virtual reality offers a cost-effective and safe learning environment. The usability of VR depends on the level of immersion, the technology being error-free, and the ease of use.
Conclusions:
This integrative review shows that high-fidelity VR training should not rule out live simulation, but rather serve as a complement. First responders became more confident and prepared for real-life MCIs after training with high-fidelity VR, but efforts should be made to solve the technical issues found in this review to further improve the usability.
Lack of evidence regarding safety and effectiveness at market entry is driving the need to consider adopting a lifecycle approach to evaluating medical devices, but it is unclear what lifecycle evaluation means. This research sought to explore the tacit meanings of “lifecycle” and “lifecycle evaluation” as embodied within evaluation models/frameworks used for medical devices.
Methods
Drawing on qualitative evidence synthesis methods and using an inductive approach, novel methods were developed to identify, appraise, analyze, and synthesize lifecycle evaluation models used for medical devices. Data was extracted (including purpose; audience; characterization; outputs; timing; and type of model) from key texts for coding, categorization, and comparison, exploring embodied meaning across four broad perspectives.
Results
Fifty-two models were included in the synthesis. They demonstrated significant heterogeneity of meaning, form, scope, timing, and purpose. The “lifecycle” may represent a single stage, a series of stages, a cycle of innovation, or a system. “Lifecycle evaluation” focuses on the overarching goal of the stakeholder group, and may use a single or repeated evaluation to inform decision-making regarding the adoption of health technologies (Healthcare), resource allocation (Policymaking), investment in new product development or marketing (Trade and Industry), or market regulation (Regulation). The adoption of a lifecycle approach by regulators has resulted in the deferral of evidence generation to the post-market phase.
Conclusions
Using a “lifecycle evaluation” approach to inform reimbursement decision-making must not be allowed to further jeopardize evidence generation and patient safety by accepting inadequate evidence of safety and effectiveness for reimbursement decisions.
This review is concerned with the synthesis and physical-chemical characteristics of a specific type of modified clay material: Ti-PILCs. The two general synthetic procedures and the main problems associated with the scale-up synthesis of these pillared materials are discussed in detail. The general characteristics of Ti-PILCs in terms of basal spacing, pillar homogeneity, surface area, microporosity, mesoporosity, pore size and distribution, thermal resistance and acidity are discussed in depth. Likewise, the most important synthesis parameters that have a clear and marked influence on the final characteristics of the materials are summarized.
Although research on the consumers of farmers' markets spans four decades, no prior study has reviewed the most important characteristics of this consumer segment. Our study collects all the survey-based empirical information available in academic journals listed by WoS and Scopus. Based on the outcomes of 103 studies from 21 countries, consumers are described according to their sociographic characteristics and economic, environmental, and social parameters. Results clearly indicate a homogeneous group, with minor variation mainly due to regional specificities, and identify 27 very typical characteristics. The study identifies key implications for managers and policymakers and provides an agenda for further research.
Climate change is expected to affect parasitic nematodes and hence possibly parasite–host dynamics and may have far-reaching consequences for animal health, livestock production, and ecosystem functioning. However, there has been no recent overview of current knowledge to identify how studies could contribute to a better understanding of terrestrial parasitic nematodes under changing climates. Here we screened almost 1,400 papers to review 57 experimental studies on the effects of temperature and moisture on hatching, development, survival, and behaviour of the free-living stages of terrestrial parasitic nematodes with a direct life cycle in birds and terrestrial mammals. Two major knowledge gaps are apparent. First, research should study the temperature dependency curves for hatching, development, and survival under various moisture treatments to test the interactive effect of temperature and moisture. Second, we specifically advocate for more studies that investigate how temperature, and its interaction with moisture, affect both vertical and horizontal movement of parasitic nematodes to understand infection risks. Overall, we advocate for more field experiments that test environmental effects on life-history traits and behaviour of parasitic nematodes in their free-living stages under natural and realistic circumstances. We also encourage studies to expand the range of used hosts and parasitic nematodes because 66% of results described in the available studies use sheep and cattle as hosts and 32% involve just three nematode species. This new comprehension brings attention to understudied abiotic impacts on terrestrial parasitic nematodes and will have broader implications for livestock management, wildlife conservation, and ecosystem functioning in a rapidly warming climate.
Chapter 4 gives a basic review of the fair process effect. Research conducted in laboratory settings is able to study the fair process effect with causal control. This has revealed insights into basic reasons why the fair process effect is important for people. Studies done in work organizations typically have more difficulty showing the causal quality of the effect, but are important in showing the relevance of positive associations between employees’ perceptions of procedural fairness and other reactions, such as trust in management and organizational citizenship behavior. Similarly, research in legal settings indicates that citizens are more willing to trust the legal system and voluntarily accept decisions by important legal authorities, such as police officers and judges. Related to this, in various societal contexts, high levels of perceived procedural fairness are associated with positive reactions and constructive behaviors, such as voting in democratic elections and efforts to improve one’s community. In contrast, low levels of perceived procedural fairness are linked with negative reactions and destructive behaviors, such as radicalization into violent extremism and terrorism. This chapter also warns against unwarranted simplifications about the fair process effect, thereby adopting a realistic perspective when combating fundamental distrust, polarization, and conspiracy thinking.
Skilled medical interpreters are essential to providing high-quality, culturally sensitive palliative care and addressing health-care disparities for patients with limited English proficiency (LEP). While the benefits of utilizing medical interpreters are well documented, interpreter roles and experiences in palliative care are unique and poorly defined. This narrative review examines the extant literature on medical interpreters in palliative care to define their unique roles and describe their experiences and recommendations.
Methods
A narrative literature review was completed through systematically searching the following databases: Medline, Embase, Web of Science, and CINHAL. Title and abstract screening was completed, followed by full-text review.
Results
Ten articles met inclusion criteria and were included in the review. Medical interpreters play several roles in palliative care for patients with LEP including interpreting language and meaning, acting as a cultural broker, and advocating for patients and families. Medical interpreters report being comfortable interpreting palliative care discussions; however, they face challenges in navigating their complex roles and the emotional impact of palliative care encounters. Their recommendations to improved palliative care encounters involving medical interpreters are careful language choice, holding pre- and post-meetings, education for interpreters and health-care professionals, and further integrating the medical interpreter into the interprofessional team.
Significance of results
Medical interpreters play several complex roles when participating in palliative care encounters for patients with LEP. Understanding these roles and the experiences allows medical interpreters to be better integrated into the interprofessional team and enhances the ability to provide quality, culturally sensitive palliative care for patients with LEP. Further research is required to understand how implementing the recommendations of medical interpreters impacts patient outcomes.