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Abstract Software that employs screening prioritization through active learning (AL) has accelerated the screening process significantly by ranking an unordered set of records by their predicted relevance. However, failing to find a relevant paper might alter the findings of a systematic review, highlighting the importance of identifying elusive papers. The time to discovery (TD) measures how many records are needed to be screened to find a relevant paper, making it a helpful tool for detecting such papers. The main aim of this project was to investigate how the choice of the model and prior knowledge influence the TD values of the hard-to-find relevant papers and their rank orders. A simulation study was conducted, mimicking the screening process on a dataset containing titles, abstracts, and labels used for an already published systematic review. The results demonstrated that AL model choice, and mostly the choice of the feature extractor but not the choice of prior knowledge, significantly influenced the TD values and the rank order of the elusive relevant papers. Future research should examine the characteristics of elusive relevant papers to discover why they might take a long time to be found.

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There is uncertainty whether postoperative application of paper tape (PT) improves scar aesthetics and reduces wound closure complications. This study aimed to review and assess the quality of applicable findings from studies investigating PT’s efficacy. We queried PubMed and SCOPUS using the search terms “((“paper tape”) AND (wound OR closure OR heal* OR complication OR skin OR prevent* OR scar*)).” We excluded articles that were duplicates, basic science, or not clinically relevant. We assessed the level of evidence for each article using the American Society of Plastic Surgeons (ASPS) Rating Levels of Evidence and Grading Recommendations for Therapeutic Studies, ranging from I (highest) to V (lowest). Of 186 publications reviewed, we included eight studies in the literature review. Five of these studies reported statistically significant positive outcomes on scar aesthetics and wound closure associated with using PT. Using the ASPS rating system, we found that two studies were Level I, three studies were Level II, two studies were Level IV, and one study was Level V. Notably, heterogeneity in the study designs limited outcome comparison. The data from the studies included in this literature review support using PT to optimize scar and wound management. The lack of higher levels of evidence, however, suggests the need for additional randomized controlled trials to rigorously evaluate patient outcomes when using PT compared with other forms of adhesive dressings. [ABSTRACT FROM AUTHOR]

Purpose: This narrative review explores papers published in peer-reviewed journals reporting research from a practice research module of a qualifying program to examine their potential contribution to knowledge in mental health social work. Methods: A narrative review was undertaken according to the PRISMA extension for scoping reviews of papers published by the first three cohorts of a practice research module. Results: Eleven papers were included in the review which found, for example, some deficits in practitioners' knowledge, confidence and understanding. The studies were modest and had some common limitations, but a high number of online views indicate that the papers have the potential to impact on practice. Conclusion: This review found that it is possible to use a practice research module of a qualifying program to train social workers to undertake and publish high-quality research which has the potential to influence policy or practice beyond a students' own learning. [ABSTRACT FROM AUTHOR]

Software that employs screening prioritization through active learning (AL) has accelerated the screening process significantly by ranking an unordered set of records by their predicted relevance. However, failing to find a relevant paper might alter the findings of a systematic review, highlighting the importance of identifying elusive papers. The time to discovery (TD) measures how many records are needed to be screened to find a relevant paper, making it a helpful tool for detecting such papers. The main aim of this project was to investigate how the choice of the model and prior knowledge influence the TD values of the hard-to-find relevant papers and their rank orders. A simulation study was conducted, mimicking the screening process on a dataset containing titles, abstracts, and labels used for an already published systematic review. The results demonstrated that AL model choice, and mostly the choice of the feature extractor but not the choice of prior knowledge, significantly influenced the TD values and the rank order of the elusive relevant papers. Future research should examine the characteristics of elusive relevant papers to discover why they might take a long time to be found. [ABSTRACT FROM AUTHOR]

Objective: Increases in global temperatures and extreme weather events associated with climate change have complex yet poorly understood detrimental impacts on human health. We reviewed the current published literature on climate change–related effects and rheumatic conditions. Methods: To summarize our current understanding of the likely effects of climate change, including increased air pollution, on rheumatic disease, we searched the published, peer‐reviewed English‐language literature from January 2000 to December 2022. Articles were reviewed by a team of rheumatologists and clinical and translational science researchers. Systematic review articles were not included but informed additional literature searches. Results: After extensive examination and adjudication, 88 articles met inclusion criteria and were selected for review. Much of the epidemiologic investigations assessed associations between air pollution and increased risk of development of rheumatoid arthritis, anti–citrullinated protein antibodies, flares of gout, and hospitalizations for systemic lupus erythematosus. Increased heat vulnerability was associated with higher odds of recurrent hospitalizations across rheumatic conditions. Mechanisms for observed associations are poorly understood but could include the effects of epigenetic changes, oxidative stress, and inflammatory cytokines. Studies had limitations, including restricted geography and populations studied without focus on historically marginalized communities at highest risk for adverse effects from pollution and climate change, the relative lack of mechanistic evaluations, and most with only indirect links to climate change. Conclusion: To date, the published literature lacks studies that directly examine effects of climate change on rheumatic diseases. Collaborative translational and epidemiologic research is needed to enhance our understanding and awareness in this area. [ABSTRACT FROM AUTHOR]

Background: Undocumented immigrants face many obstacles in accessing emergency healthcare. Legal uncertainties, economic constraints, language differences, and cultural disparities lead to delayed medical care and thereby exacerbate health inequities. Addressing the healthcare needs of this vulnerable group is crucial for both humanitarian and public health reasons. Comprehensive strategies are needed to ensure equitable health outcomes. Objective: This study aimed to identify and analyze the barriers undocumented immigrants face in accessing emergency healthcare services and the consequences on health outcomes. Methods: We used a scoping review methodology that adhered to established frameworks. Utilizing MEDLINE/PubMed, Embase, Web of Science, PsychoInfo, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), we identified 153 studies of which 12 focused on the specific challenges that undocumented immigrants encounter when accessing emergency healthcare services based on the inclusion and exclusion criteria. Results: The results show that undocumented immigrants encounter significant barriers to emergency healthcare, including legal, financial, linguistic, and cultural challenges. Key findings were the extensive use of emergency departments as primary care due to lack of insurance and knowledge of alternatives, challenges faced by health professionals in providing care to undocumented migrants, increased hospitalizations due to severe symptoms and lack of healthcare access among undocumented patients, and differences in emergency department utilization between irregular migrants and citizens. The findings also serve as a call for enhanced healthcare accessibility and the dismantling of existing barriers to mitigate the adverse effects on undocumented immigrants' health outcomes. Conclusions: Undocumented immigrants' barriers to emergency healthcare services are complex and multifaceted and therefore require multifaceted solutions. Policy reforms, increased healthcare provider awareness, and community-based interventions are crucial for improving access and outcomes for this vulnerable population. Further research should focus on evaluating the effectiveness of these interventions and exploring the broader implications of healthcare access disparities. [ABSTRACT FROM AUTHOR]

The high prevalence and costs of urinary incontinence and related pelvic floor disorders in adults highlights the need for competent nurses and advanced practice nurses who can provide high-quality continence and pelvic health care. However, challenges exist in recognizing this as a nursing specialty, preparing new and experienced nurses with specialty knowledge and skills, increasing the number and diversity of the workforce, and promoting individual achievement and professional recognition as a continence and pelvic health nursing specialist. This White Paper provides recommendations based on evidence and expert opinion to support the Society of Urologic Nurses and Associate's efforts in advancing the roles of registered nurses and advanced practice registered nurses in the expanded specialty area of continence and pelvic health nursing. [ABSTRACT FROM AUTHOR]

Background Since the outbreak of COVID-19, how to reduce the risk of spreading viruses and other microorganisms while performing aerosol generating procedures (AGPs) has become a challenging question within the dental and dental hygiene communities. The purpose of this position paper is to summarize the existing evidence about the effectiveness of various mitigation methods used to reduce the risk of infection transmission during AGPs in dentistry. Methods The authors searched six databases, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, and Google Scholar, for relevant scientific evidence published in the last ten years (January 2012 to December 2022) to answer six research questions about the the aspects of risk of transmission, methods, devices, and personal protective equipment (PPE) used to reduce contact with microbial pathogens and limit the spread of aerosols. Results A total of 78 studies fulfilled the eligibility criteria. There was limited literature to indicate the risk of infection transmission of SARS-CoV-2 between dental hygienists and their patients. A number of mouthrinses are effective in reducing bacterial contaminations in aerosols; however, their effectiveness against SARS-CoV-2 was limited. The combined use of eyewear, masks, and face shields are effective for the prevention of contamination of the facial and nasal region, while performing AGPs. High volume evacuation with or without an intraoral suction, low volume evacuation, saliva ejector, and rubber dam (when appropriate) have shown effectiveness in reducing aerosol transmission beyond the generation site. Finally, the appropriate combination of ventilation and filtration in dental operatories are effective in limiting the spread of aerosols. Conclusion Aerosols produced during clinical procedures can potentially pose a risk of infection transmission between dental hygienists and their patients. The implementation of practices supported by available evidence are best practices to ensure patient and provider safety in oral health settings. More studies in dental clinical environment would shape future practices and protocols, ultimately to ensure safe clinical care delivery. [ABSTRACT FROM AUTHOR]

Data culture/s as a research topic has begun to attract attention from a wide range of disciplines, albeit with inconsistent application of definitions, dimensions, and applications. This work builds on a call to investigate data culture/s within the information studies domain as a topic related to, but distinct from, information culture. The purpose of this study is to explore what is known about data culture/s in greater depth. We apply a retroductive approach to select and consider likely dimensions, inputs, and aspects of data culture/s in order to further map this construct to the literature, and thereby highlight gaps and opportunities to add to this body of knowledge. The initial candidate dimensions explored below include data‐related skills and attitudes, data sharing, data use/reuse, data ethics and governance, and a specific focus on Indigenous perspectives to provide insights on why and how a group may contest the emergent dominant discourse of data culture/s. Our conclusion highlights areas needing further research to fully define and examine the dimensions, inputs, and aspects of data culture/s, and calls for greater understanding and engagement with data culture/s from the information studies community. [ABSTRACT FROM AUTHOR]

BACKGROUND: Data about performance measures (PM) in patients with ST segment Elevation Myocardial Infarction (STEMI) in low- and middle-income countries is really scarce. One of the reasons is the lack of appropriate measures for these scenarios where coronary intervention is not the standard treatment. OBJECTIVE: This study aimed to develop a set of PM and quality markers for patients with STEMI in these countries. METHODS: Two investigators systematically reviewed existing guidelines and scientific literature to identify potential PM by referring to documents searched through PubMed from 2010 through 2019, using terms "Myocardial Infarction", "STEMI", "quality indicator", and "performance measure". A modified Delphi technique, involving multidisciplinary panel interview, was used. A 15-member multidisciplinary expert panel individually rated each potential indicator on a scale of 1 (lowest) to 5 (highest) during three rounds. All indicators that received a median score ≥4.5, in final round without significant disagreement were included as PM. RESULTS: Through the consensus-building process, 84 potential indicators were found, of which 10 were proposed as performance measures and 2 as quality metrics, as follows: Pre-Hospital Electrocardiogram; Patients with reperfusion therapy; Pre-hospital Reperfusion; Ischemic time less than 120 minutes; System delay time less than 90 minutes; In-hospital Mortality; Complete in-hospital Treatment; Complete in-hospital Treatment in patients with Heart Failure; 30 day-Re-admissions; 30 day-mortality; Patients with in-hospital stress test performed; and, Patients included in rehabilitation programs. CONCLUSION: This document provides the official set of PM of attention in ST segment Elevation Myocardial Infarction of the Cuban Society of Cardiology and Cuban National Group of Cardiology. [ABSTRACT FROM AUTHOR]

This study examined the current approach to the inclusion of race and ethnicity among frequently referenced shoulder surgery literature and discussed guidance for best practices for the inclusion of race and ethnicity in shoulder research. The shoulder literature were systematically reviewed for the most frequently cited studies discussing rotator cuff repair, total shoulder arthroplasty, and Bankart repair. All reviewed studies met the timeline criteria (2013-2022). Only studies with clinical outcomes were included. Review articles, meta-analyses, systematic reviews, basic science studies, or any manuscript that did not represent clinical outcomes research were excluded. Author, year issued, the journal in which the paper was published, study design, the number of subjects, duration of follow-up, independent variables, dependent variables, results, and conclusions were extracted from the articles that met the inclusion criteria. Whether race and/or ethnicity were included in the study design in any way was also recorded. For those studies in which race and ethnicity were included, a detailed analysis of the paper's treatment of race using the JAMA Updated Guidance on Reporting of Race and Ethnicity in Medical and Science Journals was performed and recorded. In the "rotator cuff repair" cohort of papers, there were 2 articles that mention race. Out of the 2 articles that mentioned race, neither included race appropriately using the JAMA Updated Guidance on Reporting of Race and Ethnicity in Medical and Science Journals. In the "Bankart repair" cohort of papers, each article lacked the mention of race among their patient population. The "total shoulder arthroplasty" manuscripts also did not include treatment of race and ethnicity in any way. Race and ethnicity and other social determinants of health can be used to understand the source of healthcare disparities. Unless a thoughtful and deliberate consideration of race and ethnicity is undertaken, their inclusion in clinical research can be a double-edged sword due to the potential race and ethnicity-centered treatment involvement can be rooted in fallacies. In shoulder surgery clinical research, race and ethnicity should be considered in concert with social factors that could exacerbate poor patient outcomes in our patient population. Level V. [ABSTRACT FROM AUTHOR]

The First 1000 Days (the period from conception to a child's second birthday) is an important developmental period. However, little is known about experiences of parents with refugee and migrant backgrounds during this period. A systematic review was conducted according to PRISMA guidelines. Publications were identified through searches of the Embase, PsycINFO, PubMed, and Scopus databases, critically appraised, and synthesised using thematic analysis. A total of 35 papers met inclusion criteria. Depressive symptomatology was consistently higher than global averages, however maternal depression conceptualisations differed across studies. Several papers reported changes in relationship dynamics as a result of having a baby post-migration. Consistent relationships were found between social and health support and wellbeing. Conceptualisations of wellbeing may differ among migrant families. Limited understanding of health services and relationships with health providers may impede help-seeking. Several research gaps were identified, particularly in relation to the wellbeing of fathers, and of parents of children over 12 months old. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The term 'complex emotional needs' (CEN) is used here to describe people with difficulties and needs that are often associated with the diagnostic label of 'personality disorder'.People with CEN might use out of hours services such as emergency departments and Crisis Resolution/Home Treatment (CRHT) teams more often when experiencing a mental health crisis.Very little is understood about the experiences of both those receiving, and those delivering care, for people with CEN within CRHT settings. What this paper adds to existing knowledge?: There are differences between priorities for those delivering and those receiving care within CRHT settings. CRHT staff members are likely to focus more upon those aspects of their role relating to risk issues. managing resources, anxieties and the expectations of others. Service users, meanwhile, focus upon the caring relationship, wanting staff to listen to them, and to feel supported and reassured.In the papers reviewed, service users experiencing CEN did not always feel 'listened to' or 'taken seriously' especially in relation to risk issues and decision‐making. What are the implications for practice?: Relating the findings to mental health nursing and CEN within the context of CRHT, to better understand the person experiencing a mental health crisis, mental health nurses need to focus more upon the person and when making decisions around their care and must be aware of the potential for power imbalances.Collaborative 'sense‐making' in relation to a person's risk behaviours may help. Background: A growing body of qualitative evidence focusing upon the experiences of care within Crisis Resolution/Home Treatment (CRHT) is emerging; however, a firm evidence base regarding both the giving and receiving of care for those with complex emotional needs (CEN) in this context is yet to be established. Objective: A qualitative evidence synthesis was used to develop a comprehensive understanding of how crisis care for people with CEN is experienced by both those giving and receiving care, within the context of CRHT. Method: Findings from 19 research papers considering both clinician and service users' experiential accounts of CRHT were synthesised using meta‐ethnography. Findings: Both the giving and receiving of care within a CRHT context was experienced across four related meta‐themes: 'contextual', 'functional', 'relational' and 'decisional'. Discussion: Service user accounts focused upon relational aspects, highlighting a significance to their experience of care. Meanwhile, clinicians focused more upon contextual issues linked to the management of organisational anxieties and resources. For those with CEN, a clinician's focus upon risk alone highlighted power differentials in the caring relationship. Conclusions: There is a need for nurses to connect with the experience of the person in crisis, ensuring a better balance between contextual issues and relational working. [ABSTRACT FROM AUTHOR]

Background: Access to an on-demand pericoital oral contraceptive pill – used to prevent pregnancy within a defined window around sexual intercourse – could offer women more reproductive agency. A contraceptive with this indication is not currently available in any market. This review aims to understand international user appeal for an on-demand pericoital oral contraceptive pill. Methods: Systematic scoping review, comprising 30 peer-reviewed papers published between 2014–2023. Results: Data from 30 papers reporting on research from 16 countries across five World Health Organisation regions suggests widespread user appeal for on-demand oral contraceptive pills that can be used peri- or post-coitally, especially among women who are younger, more educated or who have less frequent sex. Women of varying age, wealth, employment or relationship status, and with different prior experience of using modern contraceptives, were also interested. Women identified clear rationale for use and preference of these types of product: close alignment with women's sexual lives that comprised unplanned, spontaneous or occasional sex; perceived convenience and effectiveness; discreet use of pills to negotiate contextual circumstances that constrained their reproductive agency. Factors inhibiting use included knowledge barriers and attitudes of service providers, a lack of knowledge and misinformation among end-users, women's dislike of menstrual side effects and myths related to the effects of hormone content on future fertility. Conclusions: Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and international rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to on-demand oral contraceptives; and unpacking how to bring new pericoital contraceptives to the market in a variety of international settings. Plain English Summary: Access to an oral contraceptive pill that is used as needed to prevent pregnancy and taken within a defined window around sexual intercourse (i.e. an on-demand pericoital oral contraceptive pill) could offer women more reproductive agency. Though not currently available in any market, our analysis from this review of international literature reveals widespread appeal among women for using this type of contraceptive product. Clear rationale supporting use and preference included: (1) closer alignment with women's sexual lives that comprised desired but unplanned, spontaneous or occasional sex than other contraceptives; (2) perceived convenience and effectiveness, offering benefits over other modern contraceptives; and (3) women feeling able to overcome social values and beliefs that constrained their reproductive agency. There were also barriers to use of this type of product, including knowledge gaps and attitudes of service providers, a lack of knowledge and misinformation among end-users, women's dislike of the side effects, and myths and misconceptions about the impact of the hormone content in pills on future fertility. Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to this type of contraceptive; and unpacking how to bring this new contraceptive to the market in a variety of international settings. [ABSTRACT FROM AUTHOR]

Introduction: In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are unique digital assets on the blockchain, representing ownership of digital objects, including health data. By minting their data as NFTs, patients can track access, monetize its use, and build secure, private health information systems. However, research on NFTs in healthcare is in its infancy, warranting a comprehensive review. Methods: This study conducted a systematic literature review and thematic analysis of NFTs in healthcare to identify use cases, design models, and key challenges. Five multidisciplinary research databases (Scopus, Web of Science, Google Scholar, IEEE Explore, Elsevier Science Direct) were searched. The approach involved four stages: paper collection, inclusion/exclusion criteria application, screening, full-text reading, and quality assessment. A classification and coding framework was employed. Thematic analysis followed six steps: data familiarization, initial code generation, theme searching, theme review, theme definition/naming, and report production. Results: Analysis of 19 selected papers revealed three primary use cases: patientcentric data management, supply chain management for data provenance, and digital twin development. Notably, most solutions were prototypes or frameworks without real-world implementations. Four overarching themes emerged: data governance (ownership, tracking, privacy), data monetization (commercialization, incentivization, sharing), data protection, and data storage. The focus lies on user-controlled, private, and secure health data solutions. Additionally, data commodification is explored, with mechanisms proposed to incentivize data maintenance and sharing. NFTs are also suggested for tracking medical products in supply chains, ensuring data integrity and provenance. Ethereum and similar platforms dominate NFT minting, while compact NFT storage options are being explored for faster data access. Conclusion: NFTs offer significant potential for secure, traceable, decentralized healthcare data exchange systems. However, challenges exist, including dependence on blockchain, interoperability issues, and associated costs. The review identified research gaps, such as developing dual ownership models and data pricing strategies. Building an open standard for interoperability and adoption is crucial. The scalability, security, and privacy of NFT-backed healthcare applications require further investigation. Thus, this study proposes a research agenda for adopting NFTs in healthcare, focusing on governance, storage models, and perceptions. [ABSTRACT FROM AUTHOR]

Background: The social determinants of health (SDOH) are the focus of an exponentially increasing number of publications, including evidence syntheses. However, there is not an established standard for searching for SDOH literature. This study seeks to identify published evidence syntheses pertaining to the SDOH, analyzing the search strategies used and the studies included within these reviews. The primary objectives are to compare search strategies and create a test set of SDOH publications. Methods: We searched PubMed, Embase, and Scopus for evidence syntheses that mentioned the SDOH in their research questions and included an SDOH search strategy. Relevant data extracted from each review included databases searched; search terms used for the SDOH; conceptual frameworks referenced; and the citations of primary studies included in the reviews, which were compiled to form a test set of cited papers. The relative recall of the respective search strategies was tested by documenting the total number of MEDLINE results each retrieved and the number of test set papers retrieved. Results: Sixty-four evidence syntheses were identified and included in the analysis, and 2750 cited papers were extracted. Findings indicate few commonalities across search strategies in search terms used, the total number of results retrieved, and the number of test set cited papers retrieved. One hundred and ninety-three unique MeSH terms and 1385 unique keywords and phrases were noted among the various search strategies. The number of total results retrieved by the SDOH search strategies ranged from 21,793 to over 16 million. The percentage of cited papers retrieved by the search strategies ranged from 2.46 to 97.9%. Less than 3% of the cited papers were indexed with the Social Determinants of Health MeSH. Conclusions: There has been little consistency across evidence syntheses in approaches to searching for SDOH literature. Differences in these strategies could have a significant impact on what literature is retrieved, included in reviews, and, consequently, incorporated into evidence-based practice. By documenting these differences and creating a set of papers relevant to SDOH, this research provides a snapshot of the current challenges in searching for SDOH content and lays the groundwork for the creation of a standardized search approach for SDOH literature. [ABSTRACT FROM AUTHOR]

Donor human milk (DHM) from a milk bank is the recommended feeding method for preterm infants when the mother's own milk (MOM) is not available. Despite this recommendation, information on the possible contamination of donor human milk and its impact on infant health outcomes is poorly characterised. The aim of this systematic review is to assess contaminants present in DHM samples that preterm and critically ill infants consume. The data sources used include PubMed, EMBASE, CINAHL and Web of Science. A search of the data sources targeting DHM and its potential contaminants yielded 426 publications. Two reviewers (S. T. and D. L.) conducted title/abstract screening through Covidence software, and predetermined inclusion/exclusion criteria yielded 26 manuscripts. Contaminant types (bacterial, chemical, fungal, viral) and study details (e.g., type of bacteria identified, study setting) were extracted from each included study during full‐text review. Primary contaminants in donor human milk included bacterial species and environmental pollutants. We found that bacterial contaminants were identified in 100% of the papers in which bacterial contamination was sought (16 papers) and 61.5% of the full data set (26 papers), with the most frequently identified genera being Staphylococcus (e.g., Staphylococcus aureus and coagulase‐negative Staphylococcus) and Bacillus (e.g., Bacillus cereus). Chemical pollutants were discovered in 100% of the papers in which chemical contamination was sought (eight papers) and 30.8% of the full data set (26 papers). The most frequently identified chemical pollutants included perfluoroalkyl substances (six papers), toxic metal (one paper) and caffeine (one paper). Viral and fungal contamination were identified in one paper each. Our results highlight the importance of establishing standardisation in assessing DHM contamination and future studies are needed to clarify the impact of DHM contaminants on health outcomes. Key messages: Research regarding chemical contamination in donor human milk (DHM) is limited and needs to be studied further to draw appropriate conclusions on reducing potential risks for infants.Parents/guardians should be educated on the availability of DHM as a supplemental feeding option and made aware of the current research in the field.DHM use requires further standardisation both within the United States and abroad. This standardisation should ensure that risks are not overemphasised and DHM is a cost‐effective, accessible resource as a short‐term intervention when used appropriately as part of optimal lactation and breastfeeding support. [ABSTRACT FROM AUTHOR]

Background: Depression is prevalent across the spectrum of Chronic Kidney Disease and associated with poorer outcomes. There is limited evidence regarding the most effective interventions and care pathways for depression in Chronic Kidney Disease. Objectives: To investigate how depression is identified and managed in adults with Chronic Kidney Disease. Design: Scoping review. Methods: Systematic search of eight databases with pre‐defined inclusion criteria. Data relevant to the identification and/or management of depression in adults with Chronic Kidney Disease were extracted. Results: Of 2147 articles identified, 860 were included. Depression was most identified using self‐report screening tools (n = 716 studies, 85.3%), with versions of the Beck Depression Inventory (n = 283, 33.7%) being the most common. A total of 123 studies included data on the management of depression, with nonpharmacological interventions being more frequently studied (n = 55, 45%). Cognitive Behavioural Therapy (n = 15) was the most common nonpharmacological intervention, which was found to have a significant effect on depressive symptoms compared to controls (n = 10). However, how such approaches could be implemented as part of routine care was not clear. There was limited evidence for antidepressants use in people with Chronic Kidney Disease albeit in a limited number of studies. Conclusions: Depression is commonly identified using validated screening tools albeit differences exist in reporting practices. Evidence regarding the management of depression is mixed and requires better‐quality trials of both pharmacological and nonpharmacological approaches. Understanding which clinical care pathways are used and their evidence, may help facilitate the development of kidney care specific guidelines for the identification and management of depression. [ABSTRACT FROM AUTHOR]

Introduction Clinical debriefing (CD) improves teamwork and patient care. It is implemented across a range of clinical contexts, but delivery and structure are variable. Furthermore, terminology to describe CD is also inconsistent and often ambiguous. This variability and the lack of clear terminology obstructs understanding and normalisation in practice. This review seeks to examine the contextual factors relating to different CD approaches with the aim to differentiate them to align with the needs of different clinical contexts. Methods Articles describing CD were extracted from Medline, CINAHL, ERIC, PubMed, PsychINFO and Academic Search Complete. Empirical studies describing CD that involved two or more professions were eligible for inclusion. Included papers were charted and analysed using the Who-What-When-Where-Why-How model to examine contextual factors which were then used to develop categories of CD. Factors relating to what prompted debriefing and when debriefing occurred were used to differentiate CD approaches. Results Forty- six papers were identified. CD was identified as either prompted or routine, and within these overarching categories debriefing was further differentiated by the timing of the debrief. Prompted CD was either immediate or delayed and routine CD was postoperative or end of shift. Some contextual factors were unique to each category while others were relatively heterogeneous. These categories help clarify the alignment between the context and the intention of CD. Conclusions The proposed categories offer a practical way to examine and discuss CD which may inform decisions about implementation. By differentiating CD according to relevant contextual factors, these categories may reduce confusion which currently hinders discourse and implementation. The findings from this review promote context-specific language and a shift away from conceptions of CD that embody a one-size-fits-all approach. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness can have a negative impact on people's physical and psychological well‐being; building social capital is a potential means of addressing this connection. Community initiatives (e.g. groups, clubs, neighbourhood activities) may be a route that enables people to build social capital to tackle loneliness. Understanding what is known, and where gaps in knowledge exist, is important for advancing research on this topic. Methods: A scoping review was undertaken to explore the question – What community initiatives, with a focus on well‐being, have been evaluated in the United Kingdom that include information about social capital and loneliness? Four databases (Medline, CINAHL, ASSIA and Embase) were searched for relevant research papers. References were screened by two researchers to identify if they met the review's inclusion criteria. Data were summarised as a narrative and in tables. Results: Five papers met the review's inclusion criteria. They all used qualitative methods. Findings suggested that social capital could be developed through creating a sense of trust, group cohesion and reciprocity among participants in the community initiatives. This connection enabled people to experience a sense of belonging and to feel they had a meaningful relationship with others, which appeared to alleviate feelings of loneliness. Conclusion: More research is warranted on the review topic, including studies that have employed quantitative or mixed methods. Clarity around definitions of social capital and loneliness in future research is required. Engagement with community initiatives can provide a formalised route to help people develop connections and counteract limitations in their social networks. However, individuals may be wary about attending community initiatives, needing support and encouragement to do so. Social prescribing link workers are one means of motivating people to access groups, events or organisations that could improve their well‐being. [ABSTRACT FROM AUTHOR]

Background: Food allergy (FA) affects approximately 8% of children and may be immunoglobulin E (IgE)-mediated or non-IgE-mediated. It is recognized clinically that children with both subtypes of FA may present with features of pediatric feeding disorder (PFD); however, there is currently a limited detail of presenting characteristics. Objective: The objective of this study was to synthesize the current evidence regarding the feeding characteristics of children with FA, with a focus on the feeding skills and psychosocial domains of PFD. Method: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Papers published between 2001 and 2022 describing feeding characteristics in the feeding skills and psychosocial domains in children with FA/history of FA were included. Papers that focused solely on characteristics from the medical or nutritional domains were excluded. Descriptive information regarding demographics, methodology, allergy profile and history, and the characteristics of PFD observed was extracted using a preconceived data extraction form. Results: Overall, 40 papers contained descriptions of feeding characteristics of children with non-IgE-mediated FA (n = 22) and IgE-mediated FA (n = 11), while four were nonspecific. In the psychosocial domain, food refusal/aversion, anxiety with eating, and poor intake were the most frequently reported, regardless of FA subtype. Less information was reported regarding feeding skills, although slowness in eating, immature diet, and delays in oral sensory-motor skills were described. Conclusions: Children with FA/history of FA may present with a range of characteristics that map across the feeding skill and psychosocial domains of PFD. Systematic research is needed to fully describe the feeding characteristics of children with FA. [ABSTRACT FROM AUTHOR]

Background: Homelessness is a traumatic experience, and can have a devastating effect on those experiencing it. People who are homeless often face significant barriers when accessing public services, and have often experienced adverse childhood events, extreme social disadvantage, physical, emotional and sexual abuse, neglect, low self‐esteem, poor physical and mental health, and much lower life expectancy compared to the general population. Rates of problematic substance use are disproportionately high, with many using drugs and alcohol to deal with the stress of living on the street, to keep warm, or to block out memories of previous abuse or trauma. Substance dependency can also create barriers to successful transition to stable housing. Objectives: To understand the effectiveness of different substance use interventions for adults experiencing homelessness. Search Methods: The primary source of studies for was the 4th edition of the Homelessness Effectiveness Studies Evidence and Gaps Maps (EGM). Searches for the EGM were completed in September 2021. Other potential studies were identified through a call for grey evidence, hand‐searching key journals, and unpacking relevant systematic reviews. Selection Criteria: Eligible studies were impact evaluations that involved some comparison group. We included studies that tested the effectiveness of substance use interventions, and measured substance use outcomes, for adults experiencing homelessness in high income countries. Data Collection and Analysis: Descriptive characteristics and statistical information in included studies were coded and checked by at least two members of the review team. Studies selected for the review were assessed for confidence in the findings. Standardised effect sizes were calculated and, if a study did not provide sufficient raw data for the calculation of an effect size, author(s) were contacted to obtain these data. We used random‐effects meta‐analysis and robust‐variance estimation procedures to synthesise effect sizes. If a study included multiple effects, we carried out a critical assessment to determine (even if only theoretically) whether the effects are likely to be dependent. Where dependent effects were identified, we used robust variance estimation to determine whether we can account for these. Where effect sizes were converted from a binary to continuous measure (or vice versa), we undertook a sensitivity analysis by running an additional analysis with these studies omitted. We also assessed the sensitivity of results to inclusion of non‐randomised studies and studies classified as low confidence in findings. All included an assessment of statistical heterogeneity. Finally, we undertook analysis to assess whether publication bias was likely to be a factor in our findings. For those studies that we were unable to include in meta‐analysis, we have provided a narrative synthesis of the study and its findings. Main Results: We included 48 individual papers covering 34 unique studies. The studies covered 15, 255 participants, with all but one of the studies being from the United States and Canada. Most papers were rated as low confidence (n = 25, or 52%). By far the most common reason for studies being rated as low confidence was high rates of attrition and/or differential attrition of study participants, that fell below the What Works Clearinghouse liberal attrition standard. Eleven of the included studies were rated as medium confidence and 12 studies as high confidence. The interventions included in our analysis were more effective in reducing substance use than treatment as usual, with an overall effect size of –0.11 SD (95% confidence interval [CI], −0.27, 0.05). There was substantial heterogeneity across studies, and the results were sensitive to the removal of low confidence studies (−0.21 SD, 95% CI [−0.59, 0.17] − 6 studies, 17 effect sizes), the removal of quasi‐experimental studies (−0.14 SD, 95% CI [−0.30, 0.02] − 14 studies, 41 effect sizes) and the removal of studies where an effect size had been converted from a binary to a continuous outcome (−0.08 SD, 95% CI [−0.31, 0.15] − 10 studies, 31 effect sizes). This suggests that the findings are sensitive to the inclusion of lower quality studies, although unusually the average effect increases when we removed low confidence studies. The average effect for abstinence‐based interventions compared to treatment‐as‐usual (TAU) service provision was –0.28 SD (95% CI, −0.65, 0.09) (6 studies, 15 effect sizes), and for harm reduction interventions compared to a TAU service provision is close to 0 at 0.03 SD (95% CI, −0.08, 0.14) (9 studies, 30 effect sizes). The confidence intervals for both estimates are wide and crossing zero. For both, the comparison groups are primarily abstinence‐based, with the exception of two studies where the comparison group condition was unclear. We found that both Assertative Community Treatment and Intensive Case Management were no better than treatment as usual, with average effect on substance use of 0.03 SD, 95% CI [−0.07, 0.13] and –0.47 SD, 95% CI [−0.72, −0.21] 0.05 SD, 95% CI [−0.28, 0.39] respectively. These findings are consistent with wider research, and it is important to note that we only examined the effect on substance use outcomes (these interventions can be effective in terms of other outcomes). We found that CM interventions can be effective in reducing substance use compared to treatment as usual, with an average effect of –0.47 SD, 95% CI (−0.72, −0.21). All of these results need to be considered in light of the quality of the underlying evidence. There were six further interventions where we undertook narrative synthesis. These syntheses suggest that Group Work, Harm Reduction Psychotherapy, and Therapeutic Communities are effective in reducing substance use, with mixed results found for Motivational Interviewing and Talking Therapies (including Cognitive Behavioural Therapy). The narrative synthesis suggested that Residential Rehabilitation was no better than treatment as usual in terms of reducing substance use for our population of interest. Authors' Conclusions: Although our analysis of harm reduction versus treatment as usual, abstinence versus treatment as usual, and harm reduction versus abstinence suggests that these different approaches make little real difference to the outcomes achieved in comparison to treatment as usual. The findings suggest that some individual interventions are more effective than others. The overall low quality of the primary studies suggests that further primary impact research could be beneficial. [ABSTRACT FROM AUTHOR]

Background Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Method Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. Results The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. Conclusion The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare. [ABSTRACT FROM AUTHOR]

Objectives. The present study aimed to review the changes in anthropometric dimensions around the world during the last 30 years. Methods. The search for this study was conducted in four databases with related keywords. Papers from 1990 to 2021 were reviewed and 4139 articles were identified, with 505 related titles. Of these, 187 articles met the eligibility criteria, and their whole text was examined; 132 articles were then included for the final review. Results. The reviewed studies showed that a large number of anthropometric dimensions of the human body have become larger than in the past, such as height. Although the increasing trend of anthropometric dimensions in the past has been faster than in recent years, decreasing changes have also been seen in some anthropometric dimensions, such as the human jaw, face width and head width. It should be noted that the main reasons for the changes mentioned in the studies are economics and family income, social conditions, health and nutrition. Conclusion. Since the process of changes in anthropometric dimensions is not always the same, anthropometric data should be updated regularly, and work environments and equipment should be reviewed or redesigned according to the new anthropometric data. [ABSTRACT FROM AUTHOR]

Background: Meeting the health needs of crisis-affected populations is a growing challenge, with 339 million people globally in need of humanitarian assistance in 2023. Given one in four people living in humanitarian contexts are women and girls of reproductive age, sexual and reproductive health care is considered as essential health service and minimum standard for humanitarian response. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on appropriate methods and analytical frameworks is limited. Methods: A scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Peer-reviewed papers published from 2013 to 2022 were identified through relevant systematic reviews and a literature search of Pubmed, Embase, PsycInfo, CINAHL and Global Health databases. Papers that presented primary quantitative or qualitative data pertaining to a sexual and reproductive health intervention in a humanitarian setting were included. Results: Seven thousand thirty-six unique records were screened for inclusion, and 69 papers met inclusion criteria. Of these, six papers explicitly described the use of an implementation research framework, three citing use of the Consolidated Framework for Implementation Research. Three additional papers referenced other types of frameworks used in their evaluation. Factors cited across all included studies as helping the intervention in their presence or hindering in their absence were synthesized into the following Consolidated Framework for Implementation Research domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process. Conclusion: This review found a wide range of methodologies and only six of 69 studies using an implementation research framework, highlighting an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization. Plain English summary: Three hundred thirty-nine million people globally were in need of humanitarian assistance in 2023, and meeting the health needs of crisis-affected populations is a growing challenge. One in four people living in humanitarian contexts are women and girls of reproductive age, and provision of sexual and reproductive health care is considered to be essential within a humanitarian response. Implementation research can help to better understand how real-world contexts affect health improvement efforts. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on how best to do so is limited. This scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Of 69 papers that met inclusion criteria for the review, six of them explicitly described the use of an implementation research framework. Three used the Consolidated Framework for Implementation Research, a theory-based framework that can guide implementation research. Three additional papers referenced other types of frameworks used in their evaluation. This review summarizes how factors relevant to different aspects of implementation within the included papers could have been organized using the Consolidated Framework for Implementation Research. The findings from this review highlight an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization. [ABSTRACT FROM AUTHOR]

Aim: To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult. Design: A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR). Methods: A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions. Results: A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood. Conclusion: Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group. What is known about this topic?: Eating and drinking provides more than nutrition and hydration.A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth).Being nil by mouth (NBM) for short periods such as pre‐operative fasting causes distress; however, little is understood about impact on longer‐term abstinence from eating and drinking. What this paper adds?: Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies.Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation.Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM. [ABSTRACT FROM AUTHOR]

Aim. To systematically map and identify key knowledge on organizational support for nurses' career planning and development. Design. Scoping review. Methods. Systematic electronic searches were carried out with the CINAHL, PubMed, Scopus, and Web of Science databases in May 2022. The searches were limited to scientific, peer-review papers that were published in English from January 2012 to May 2022. Data were extracted and synthetized and are presented in tables and text. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results. We identified 1,400 papers and 28 met the inclusion criteria. Organizations recognized nurses' career planning and development in relation to the individual's professional development and the organization's need to promote high-quality services and workforce engagement. The organizational support included strategic work to ensure there were adequate resources and purposeful vacancies and a structured framework based on objective qualification criteria and equal assessment. Organizations focused on sharing knowledge, structured career planning, and interpersonal support. Support within the nursing profession and multilayered interprofessional collaboration were also important. Conclusion. Nurses' career planning and development was linked to their personal development and the organization's aims and required support from both fellow nurses and other professionals. Implications for the Nursing Management. Identifying the organizational structures and methods that are needed to support nurses' career planning and development can help nursing management to evaluate and develop strategies that improve the attractiveness of a nursing career and nurses' engagement. [ABSTRACT FROM AUTHOR]

Rationale: Economic evaluations play an important role in the development and implementation of healthcare innovations. For pharmaceutical products, the methodologies used are laid down in guidelines, whereas for medical technologies the guidelines are not as strenuous. The aim of this review was therefore to analyze what types of methodologies are used in economic evaluations of medical technologies. Methods: We performed a mapping review to identify economic evaluations for medical technologies. We decided to limit our search to one year (2022) and included cost utility and cost effectiveness analyses in which health technologies were evaluated. For each included study we identified the main methodological characteristics. Results: A total of 364 papers were included in the analysis, 268 (74%) contained cost-utility analyses and 91 (25%) cost-effectiveness analyses. A model was used in 236 (64%) analyses, 117 analyses were trial based evaluations. Probabilistic sensitivity analyses and/or bootstrapping was performed in 266 (73%) analyses. Deterministic sensitivity analyses were used in 306 (84%). Time horizon and perspective were underreported in 15–25% of the included studies. Conclusions: This review shows the wide range of methodologies used in economic evaluations as well as the extent and rigor in which these methodologies are used. Many of the included papers did no use or did not sufficiently report the use of appropriate standard methods. This may lead to research waste, a delay in successful implementation of valuable innovations and in the end may delay improvement patient outcomes. [ABSTRACT FROM AUTHOR]

Despite guidance to minimize restrictive practice within the UK, seclusion and long-term segregation are necessary to maintain the safety of patients and clinicians. There is little evidence to guide the work of occupational therapists with secluded patients. A literature search identified seven papers that met the study inclusion criteria. A deductive approach to thematic analysis was conducted using the 'Model of Human Occupation' as a theoretical framework to identify issues related to occupational need during a period of seclusion. Findings indicate ways in which occupational therapists could engage with patients in seclusion and suggest a need for future research. [ABSTRACT FROM AUTHOR]

Some researchers suggest difficulties synchronising with a partner could underpin the social differences associated with Autism Spectrum Condition, potentially acting as a marker for autism. Social Motor Synchrony (SMS) is one aspect of synchrony that could augment observational diagnostic procedures. However, the full breadth of literature examining SMS in autism has not been systematically reviewed. A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines yielded 29 papers meeting inclusion criteria. Of 21 studies including a comparison group, all indicated weaker SMS between two autistic partners and in mixed-neurotype partnerships compared with two non-autistic partners. Papers involving mixed-neurotype pairs without a comparison group showed higher than chance SMS and demonstrated an increase in SMS over time following rhythm-based interventions. Although research so far demonstrates weaker SMS in pairs involving an autistic partner compared with non-autistic pairs, we identified several limitations which may have influenced SMS in autistic people and their partners. Further work is needed with autistic partnerships, more natural and preferred tasks within comfortable settings and partnerships, and more work to identify the basis of synchrony differences. We set out implications for design of further research. When two people interact, they often fall into sync with one another by moving their bodies at the same time. Some say autistic people are not as good as non-autistic people at moving at the same time as a partner. This has led some researchers to ask whether measuring synchrony might help diagnose autism. We reviewed the research so far to look at differences in Social Motor Synchrony (SMS) (the way we move together) between autistic people and people they interact with. The research suggests that interactions involving an autistic partner (either two autistic partners, or an autistic and non-autistic partner) show lower synchrony than a non-autistic pair. However, we recognised elements in the research so far that may have affected SMS in interactions involving an autistic person. One way SMS may have been affected in research so far might be the way interactions have been set up in the research studies. Few papers studied interactions between two autistic people or looked at synchrony in comfortable environments with autistic-preferred tasks. The studies also do not explain why synchrony might be different, or weaker, in pairs involving autistic partners. We use these limitations to suggest improvements for future research. [ABSTRACT FROM AUTHOR]

Aim(s): To synthesise the literature about transgender and non‐binary people's experiences of cervical cancer screening and identify ways to improve screening. Background: Transgender people often face barriers to accessing health services including cervical screening, where transgender people have a lower uptake than cisgender women. Design: A scoping review was undertaken following the Arksey and O'Malley (2005) framework and the PRISMA‐ScR checklist. Following database searching of Medline via PubMed, Web of Science, Scopus and CINHAL, 23 papers published between 2008 and 2003 were included. Papers were included if they shared trans and non‐binary people's experiences of cervical screening and were written in English. There were no date or geographical data restrictions due to the paucity of research. Results: Transgender people experience barriers to cervical screening including gender dysphoria, a history of sexual trauma, and mistrust in health professionals or health services, which can result in having negative experiences of screening or avoiding screening. Health professionals can help to create a positive experience by informing themselves about best practices for trans+ health. Conclusion: Changes are required to improve transgender people's experiences and uptake of cervical screening. Improving medical education about trans health and updating health systems would help to combat issues discussed. Implications for the Profession and/or Patient Care: Having an understanding of the reasons why accessing health services can be more difficult for transgender people will help health professionals to provide appropriate care for transgender patients. This paper details this in the context of cervical cancer screening and can be applied to other areas of healthcare. Reporting Method: We have adhered to relevant EQUATOR guidelines and used the PRISMA‐ScR reporting method. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Introduction: Ambulance personnel are exposed to traumatic and stressful situations, which can increase the risk of mental health conditions, such as post-traumatic stress disorder (PTSD). High rates of PTSD have been found in ambulance personnel (Petrie et al., 2018), but no review is available to examine post-traumatic growth (PTG - positive psychological change following a trauma) in this population. This literature review provides an overview of the prevalence rates and facilitators that may contribute to PTG in ambulance personnel. Methods: A systematic search was conducted on EBSCOhost in January 2024 across the following six databases: Academic Search Ultimate, PsycINFO, PsycARTICLES, MEDLINE, ERIC and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate. Results: Eleven papers were identified for this review. Pooled prevalence of PTG was moderate (52%), and facilitators for PTG were grouped into five categories: coping style/strategies, resilience, personality traits, gender and incident characteristics. Conclusions: Numerous facilitators contributed to the development of PTG, although these did not arise in all papers. The quality of research ranged from satisfactory to excellent. Evidence suggested that adaptive coping style, high levels of resilience, the absence of a personality trait (neuroticism) and being female may facilitate PTG. Further research is needed to support the reliability of findings. [ABSTRACT FROM AUTHOR]

Collegiality is one of the fundamental values of the nursing profession. During the nursing history, collegiality has been described as part of a nurse's relationship with their peers and it influences the quality of care they provide and job satisfaction and commitment to their work. Despite earlier definitions, the concept of collegiality in nursing has remained unclear. The aim of this study was to clarify the concept of collegiality in the nursing profession, using Rodger's evolutionary concept analysis. We carried out electronic searches using the CINAHL, PubMed, Scopus, Web of Science, SocINDEX, PsycINFO and Eric databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers published in English language from the inception of database to November 2022. This identified 25 papers. Based on our analysis, the attributes of the concept of collegiality were achieving mutual goals together with equality, reciprocity, trusted advocacy, powerful self-regulation and engaged belongingness. Antecedents of the concept included existing professional group, connection between professionals and professional self-esteem. The consequences were strengthening nurses' professional status, job satisfaction and their ability to provide the best possible patient care. We found that nurses' collegiality was a value-based concept, with a unique character based on professional connections. The concept brought together ethical and pragmatic strategies to achieve the best possible results for the nursing profession. Provided knowledge can be applied for further development of the concept and applying it in clinical research and practice. The concept of nurses' collegiality should also be studied in the future because both the profession and their working environment are constantly changing. [ABSTRACT FROM AUTHOR]

The aim of this scoping review was to examine the national and international literature on the response of adult Hospital at Home (HAH) services to the global Covid-19 pandemic and explore key themes to emerge and make recommendations for further research. The databases were searched using agreed search terms and Arksey and O'Malley's scoping review framework was utilized and papers were identified and analyzed for common themes. Thirty-one papers were included in the review. Of the papers included, general adult medicine was the largest service group (n = 15) with geriatric services the next largest (n = 12). Most papers were European in origin (n = 19). Key themes to emerge include (1) similar outcomes for HAH patients compared with traditional inpatient care, (2) expansion of capacity for inpatient care due to HAH use, (3) growth of virtual monitoring in HAH setting, (4) reduction in infection transmission in HAH setting, and (5) cost reduction due to HAH utilization. Hospital at home demonstrated good outcomes for both patients with Covid-19 and other conditions during the pandemic. These services also expanded capacity during a global healthcare crisis. Remote monitoring played a major role in the expansion of capacity and the reduction of infection transmission during the pandemic. Although some papers discuss how HAH is more cost effective than traditional hospital, more work is needed around this as many of the patients may not have been as sick as those admitted to traditional hospital during the pandemic. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: It was previously reported that perceived external locus of control may exacerbate depressive symptoms, is associated with anxiety, boosts stress and general mental distress and weakens resilience against traumatic situations or difficulties. What the paper adds to existing knowledge?: Those with a higher external locus of control are more prone to develop PTSD symptoms since the perceived external locus of control is among the predictors of PTSD. An internal locus of control is considered important in preventing PTSD, although an external locus of control appears to be a variable that causes/increases the prevalence of PTSD. What are the implications for practice?: It is known that nurses are deployed in clinical and fieldwork during disaster and assume key roles both interventional practices and psychosocial education. Thus, it is of particular importance for mental health nurses to be aware of the locus of control in themselves, their colleagues, and the community before, during and after disasters to be able to combat the risk/presence of PTSD. Aim: The present systematic review explored the impacts of perceived locus of control on PTSD among individuals experiencing disasters. Method: This is a systematic review study carried out through a search of the relevant research published in English over the period December 2021 to April 2022. Accordingly, we sought the studies to review on the Web of Science, PubMed, Scopus, Cochrane and Google Scholar databases using the keywords "Child, Children, Adolescent, Adolescence, Adult, Aged, Elderly, Post‐Traumatic Stress Disorder, PTSD, Internal‐External Control, Locus of Control, Disasters, Natural Disasters." Results: A total of 1.011 studies were found in the five databases using the keywords above. Following the exclusions, the remaining six studies were recruited for this systematic review. The six studies in question addressed earthquakes (2), hurricanes (1), wildfires (1), SARS (1) and fireworks explosions (1). In the study with wildfire survivors, there was a weak significant association between external locus of control and PTSD among those directly exposed to the disaster (r =.15, p <.01). The study with survivors of the SARS epidemic demonstrated that those with a high perceived chance (external) locus of control suffered PTSD (p =.001). An internal locus of control is considered important in preventing PTSD, although an external locus of control appears to be a variable that causes/increases the prevalence of PTSD. Conclusion: It was concluded that perceived locus of control is related to PTSD in individuals experiencing a disaster. The additional evidence was that post‐disaster PTSD among those with a high perceived external locus of control is stronger than those with a high perceived internal locus of control. [ABSTRACT FROM AUTHOR]

The validity of driving simulators is a topic that has been addressed ever since their first use. In practice, a comparison of field data and simulator data is often used for validation purposes. A systematic literature search was conducted which identified large heterogeneity in both study designs and statistical methods used in research on simulator validity. Most of the included studies concluded simulator validity (thus equivalence of field data and simulator data) from non-significant results in Null-Hypothesis Significance Testing (NHST), which is a well-known yet somewhat controversial practice. In this work, the consequences of both study design choice and the choice of the statistical method are outlined and alternatives such as using Bayes factor hypothesis testing and equivalence tests are discussed and applied to a real data example. The present paper is intended to shed light on the influence of the statistical method on conclusions drawn from experimental data. For research on driving simulator validity, we highly encourage the use of equivalence tests or Bayes factor hypothesis tests, in particular when evidence of the data suggests that an effect might be absent. [ABSTRACT FROM AUTHOR]

Introduction: To contribute to addressing diagnostic health inequalities in the United Kingdom, this review aimed to investigate determinants of diagnostic service use amongst people experiencing high deprivation in the United Kingdom. Methods: A systematic review was conducted using three databases (EBSCO, Web of Science and SCOPUS) to search studies pertaining to diagnostic service use amongst people experiencing high deprivation. Search terms related to diagnostics, barriers and facilitators to access and deprivation. Articles were included if they discussed facilitators and/or barriers to diagnostic service access, contained participants' direct perspectives and focussed on individuals experiencing high deprivation in the United Kingdom. Articles were excluded if the full text was unretrievable, only abstracts were available, the research did not focus on adults experiencing high deprivation in the United Kingdom, those not including participants' direct perspectives (e.g., quantitative studies) and papers unavailable in English. Results: Of 14,717 initial papers, 18 were included in the final review. Determinants were grouped into three themes (Beliefs and Behaviours, Emotional and Psychological Factors and Practical Factors), made up of 15 sub‐themes. These were mapped to a conceptual model, which illustrates that Beliefs and Behaviours interact with Emotional and Psychological Factors to influence Motivation to access diagnostic services. Motivation then influences and is influenced by Practical Factors, resulting in a Decision to Access or Not. This decision influences Beliefs and Behaviours and/or Emotional and Psychological Factors such that the cycle begins again. Conclusion: Decision‐making regarding diagnostic service use for people experiencing high deprivation in the United Kingdom is complex. The conceptual model illustrates this complexity, as well as the mediative, interactive and iterative nature of the process. The model should be applied in policy and practice to enable understanding of the factors influencing access to diagnostic services and to design interventions that address identified determinants. Patient or Public Contribution: Consulting lived experience experts was imperative in understanding whether and how the existing literature captures the lived experience of those experiencing high deprivation in South England. The model was presented to lived experience experts, who corroborated findings, highlighted significant factors for them and introduced issues that were not identified in the review. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Open Dialogue was developed in Finland in the 1980s by clinical psychologist, Jaakko Seikkula. It is a development of family therapy, recognises previous trauma and has proven to be very effective in situations of acute mental illness, and in particular psychosis.Trauma Informed Care is a practice based on the understanding of and responsiveness to the impact of trauma. When people have experienced trauma, they may have difficulties in their everyday life and experience negative physical health outcomes as well as the risk of developing mental ill health.Open Dialogue is aligned to mental health care which aims to be trauma‐informed, person‐centred and rights‐based. Examples exist of the use of both approaches for service delivery with limited evaluation. What the paper adds to existing knowledge?: To our knowledge, no formal evaluation has been made of the use of open dialogue as a Trauma Informed therapy approach to support individuals and their family networks.Although both approaches recognise the impact of trauma on individuals, no study has explored the effectiveness of this treatment combination for use by mental health nurses.This review is timely as it provides insights into contemporary services that are trauma informed and have used Open Dialogue to extend therapy work with individuals and their family/networks.This scoping review was able to determine whether recommendations for clinical practice and training in Open Dialogue with Trauma Informed Care approaches could be identified. What are the implications for practice?: This review provided a broad overview on the current types of trauma‐informed care services incorporating Open Dialogue approaches into their practice.The literature, though sparce, identifies that Trauma Informed Care recognises multiple origins for mental ill health. Open dialogue has an affinity with the common values of mental health nurses. As combined therapies, they are demonstrating usefulness in engaging families and people in their journey towards recovery.Rigid adherence to Open Dialogue focus and delivery as well as training practices could be revised to make them more open to what people and their families wish to discuss. The person with mental ill health and previous trauma should be able to direct the narrative. Trauma Informed Practice principles could be adapted to improve consumer satisfaction with Open Dialogue approaches. Introduction: A large proportion of people who access mental health services have a lived experienced of trauma and are more likely to have a history of complex trauma. Open Dialogue and Trauma Informed Care practices identify previous trauma as a factor related to later psychosis. This scoping review has identified similarities and contrasts in how an Open Dialogue and Trauma Informed Care approach have been combined to complement one another for clinical work with people presenting with psychosis and previous trauma. Aim: We aimed to answer the following research question in this scoping review: What is known of the combined use of Open Dialogue and Trauma Informed Care practice when working with consumers and their family networks? As such, the purpose of this paper was to explore the application to practice and identify if any training existed and been evaluated. Method: This scoping review was based on the Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Grey literature was also searched through Psyche Info and Google Scholar for books, Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2013 to January 2023. Results: Five distinct themes were identified from the literature: (1) Linking open dialogue with trauma, (2) Response to treatment, (3) Empowerment and information sharing, (4) Interpretation by clinical services, (5) Staff training outcomes. Discussion: Some tentative recommendations for practice recognised the individuals' unique story and perspective, suggested that trauma is an important concept to assess. Services practising as Trauma Informed Services that have incorporated an Open Dialogue approach have mixed experiences. The use of Open Dialogue may have some benefits for family work and exploring consumer narratives while building a network of support. However, consumers identified similar frustrations with service delivery as with the family therapy literature. For example, it was difficult to bring family members together and difficult to discuss previous traumatic events in front of family. People experiencing training in Open Dialogue reported it taking a slow pace and not what they were familiar with. Implications for Practice: Open Dialogue can facilitate engagement of consumers and their family networks and greater recognition of the peer workforce to promote collaboration in therapy is needed. Future research should also focus on evaluating the effectiveness of such services and comparing their outcomes across regions. [ABSTRACT FROM AUTHOR]

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This study aims to conduct a systematic analysis of literature published between 1 January 2018 and 1 September 2022, exploring factors influencing the progression or development of temporomandibular disorders (TMD), diagnosed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Three electronic databases were reviewed to identify papers that examined TMD factors using DC/TMD or RDC/TMD. Inclusion criteria encompassed original research published in English between 1 January 2018 and 1 October 2022, online, and complete DC/TMD or RDC/TMD studies on human participants aged 18 or older. Two authors independently assessed the risk of bias using The Joanna Briggs Institute (JBI) Analytical cross-sectional studies' Critical Appraisal Tool. Of 1478 articles, 11 were included. The studies revealed strong associations between TMD and factors such as female, poor sleep quality, depression, oral parafunction, anxiety, somatization, and anatomical features. However, variables such as education, living conditions, socioeconomic status, marital status, chronic pain, and stress did not exhibit statistically significant correlations. Based on the obtained data, it can be concluded that the causes of TMD are largely related to psychological factors, which supports the biopsychosocial theory of the disorder. [ABSTRACT FROM AUTHOR]

Systematic reviews and meta-analyses typically require significant time and effort. Machine learning models have the potential to enhance screening efficiency in these processes. To effectively evaluate such models, fully labeled datasets—detailing all records screened by humans and their labeling decisions—are imperative. This paper presents the creation of a comprehensive dataset for a systematic review of treatments for Borderline Personality Disorder, as reported by Oud et al. (2018) for running a simulation study. The authors adhered to the PRISMA guidelines and published both the search query and the list of included records, but the complete dataset with all labels was not disclosed. We replicated their search and, facing the absence of initial screening data, introduced a Noisy Label Filter (NLF) procedure using active learning to validate noisy labels. Following the NLF application, no further relevant records were found. A simulation study employing the reconstructed dataset demonstrated that active learning could reduce screening time by 82.30% compared to random reading. The paper discusses potential causes for discrepancies, provides recommendations, and introduces a decision tree to assist in reconstructing datasets for the purpose of running simulation studies. [ABSTRACT FROM AUTHOR]

Objective: The Montgomery T-tube is a commonly used device initially designed as a temporary airway stent, but also used as a long-term airway solution for stenosis. For patients undergoing either endoscopic or open airway procedures, proper techniques for inserting these tubes are well documented. This review compiles the techniques used for insertion of the Montgomery T-tube stent. Methods: The NCBI Pubmed database was queried using the keywords: "stent," "Montgomery," "T-tube," "stenosis," "technique." A total of 33 papers were reviewed with 12 papers selected for the study. Papers were selected based on inclusion criteria of English language and whether the paper described a technique for insertion of a Montgomery T-tube into the airway. Papers were excluded if they did not describe the technique of insertion of Montgomery T-tubes or dealt with another aspect of T-tube management. Results: The 12 selected papers each described a different technique for insertion of a Montgomery T-tube stent. Though nearly all the selected studies described using a modified Seldinger technique for insertion of the T-tube, there were discrepancies and a wide array of different instruments used. The instrument and/or technique that was selected was often determined by the individual need of the patient. Several studies addressed the challenge of interrupting ventilation while inserting or exchanging a T-tube in the operating room. These studies described attaching the T-tube to the endotracheal tube to pass the T-tube into the airway while allowing for continuous ventilation. Yet other studies used optical forceps or rigid bronchoscopes to allow placement of the T-tube with direct visualization. Conclusion: There are many techniques used for the insertion of a Montgomery T-tube. Nearly all studies described using a modified Seldinger technique and all the studies agreed on the necessity of a team approach for placement of the Montgomery T-tube. [ABSTRACT FROM AUTHOR]

Background: Deaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise literature related to the essential elements in the provision of end-of-life care in the PICU from the perspectives of both healthcare professionals (HCPs) and families. Methods: A systematic integrative review was conducted by searching EMBASE, CINAHL, MEDLINE, Nursing and Allied Health Database, PsycINFO, Scopus, Web of Science, and Google Scholar databases. Grey literature was searched via Electronic Theses Online Service (EthOS), OpenGrey, Grey literature report. Additionally, hand searches were performed by checking the reference lists of all included papers. Inclusion and exclusion criteria were used to screen retrieved papers by two reviewers independently. The findings were analysed using a constant comparative method. Results: Twenty-one studies met the inclusion criteria. Three elements in end-of-life care provision for children in the PICUs were identified: 1) Assessment of entering the end-of-life stage; 2) Discussion with parents and decision making; 3) End of life care processes, including care provided during the dying phase, care provided at the time of death, and care provided after death. Conclusion: The focus of end-of-life care in PICUs varies depending on HCPs' and families' preferences, at different stages such as during the dying phase, at the time of death, and after the child died. Tailoring end-of-life care to families' beliefs and rituals was acknowledged as important by PICU HCPs. This review also emphasises the importance of HCPs collaborating to provide the optimum end-of-life care in the PICU and involving a palliative care team in end-of-life care. [ABSTRACT FROM AUTHOR]

Background During the first epidemic wave, COVID-19 surveillance focused on quantifying the magnitude and the escalation of a growing global health crisis. The scientific community first assessed risk through basic indicators, such as the number of cases or rates of new cases and deaths, and later began using other direct impact indicators to conduct more detailed analyses. We aimed at synthesizing the scientific community's contribution to assessing the direct impact of the COVID-19 pandemic on population health through indicators reported in research papers. Methods We conducted a rapid scoping review to identify and describe health indicators included in articles published between January 2020 and June 2021, using one strategy to search PubMed, EMBASE and WHO COVID-19 databases. Sixteen experts from European public health institutions screened papers and retrieved indicator characteristics. We also asked in an online survey how the health indicators were added to and used in policy documents in Europe. Results After reviewing 3891 records, we selected a final sample of 67 articles and 233 indicators. We identified 52 (22.3%) morbidity indicators from 33 articles, 105 severity indicators (45.1%, 27 articles) and 68 mortality indicators (29.2%, 51). Respondents from 22 countries completed 31 questionnaires, and the majority reported morbidity indicators (29, 93.5%), followed by mortality indicators (26, 83.9%). Conclusions The indicators collated here might be useful to assess the impact of future pandemics. Therefore, their measurement should be standardized to allow for comparisons between settings, countries and different populations. [ABSTRACT FROM AUTHOR]

Purpose: Mentalization-based treatment (MBT) is a psychotherapeutic approach that aims to increase mentalizing capacity. The purpose of this meta-ethnography was to synthesize the available qualitative literature on MBT to allow for a more thorough understanding of the lived experience of those who have undergone this therapy. Design/methodology/approach: A systematic search of seven databases was carried out. The Critical Appraisal Skills Programme was used to appraise the papers suitable for inclusion. The data were synthesized using a meta-ethnographic approach in which the second-order constructs from each paper were translated and reinterpreted creating a line of argument synthesis. Findings: A total of 11 studies were included in the meta-ethnography. Three overarching themes were identified within the included papers which outlined that participant experience of MBT consisted of three different developmental stages. Navigating the therapeutic process describes the participant's experience of the therapeutic process of MBT. The processes of change in MBT outlined participant reports of mechanisms of change experienced in MBT. Mentalizing self and others described the experience of generalizing new knowledge and skills to the world outside of therapy and unveiled the impact that engaging in MBT had on participants. Originality/value: This meta-ethnography offers new insights into how clients experience MBT as a therapeutic process and offers suggestions for implementation in clinical practice as well as areas of focus for research of this therapeutic approach. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this paper is to develop a redesigned commissioning process for social care services that fosters integrated care, encourages collaboration and balances professional expertise with client engagement. Design/methodology/approach: This study employs a two-pronged approach: a case study of a municipality's use of subsidy tables and a literature scoping review on integrated care research. Findings: The paper introduces a new framework for the study of the new "subsidy tables." A well-defined and extensive consultation process involving both social care providers (suppliers), the Service Triad, and client representation adds to the existing research on supplier consultation, and on how to define the outcomes for clients via client engagement. Research limitations/implications: While aspects are clearly relevant to the Netherlands, the design of the commissioning process of social care has international relevance as well: finding definitions, formulating outcomes and incentives, designing a more collaborative instead of competitive process, stakeholder engagement and consultation. Practical implications: Several Dutch municipalities started using the "subsidy tables" method for commissioning integrated social care. This paper offers clear improvements that benefit the commissioners, the social care providers and their clients. Social implications: Improving the commissioning process of integrated social care will lead to better fitting care for people who need social care. Originality/value: This paper is one of the first to do a thorough analysis of the "subsidy tables" method for commissioning integrated social care. [ABSTRACT FROM AUTHOR]

Background: As evidence related to the COVID-19 pandemic surged, databases, platforms, and repositories evolved with features and functions to assist users in promptly finding the most relevant evidence. In response, research synthesis teams adopted novel searching strategies to sift through the vast amount of evidence to synthesize and disseminate the most up-to-date evidence. This paper explores the key database features that facilitated systematic searching for rapid evidence synthesis during the COVID-19 pandemic to inform knowledge management infrastructure during future global health emergencies. Methods: This paper outlines the features and functions of previously existing and newly created evidence sources routinely searched as part of the NCCMT's Rapid Evidence Service methods, including databases, platforms, and repositories. Specific functions of each evidence source were assessed as they pertain to searching in the context of a public health emergency, including the topics of indexed citations, the level of evidence of indexed citations, and specific usability features of each evidence source. Results: Thirteen evidence sources were assessed, of which four were newly created and nine were either pre-existing or adapted from previously existing resources. Evidence sources varied in topics indexed, level of evidence indexed, and specific searching functions. Conclusion: This paper offers insights into which features enabled systematic searching for the completion of rapid reviews to inform decision makers within 5–10 days. These findings provide guidance for knowledge management strategies and evidence infrastructures during future public health emergencies. [ABSTRACT FROM AUTHOR]

Background. A timely diagnosis of cancer is important for patient outcomes. The delay in the patient interval (time from symptom interpretation to seeking help) is often the longest throughout the cancer patient pathway. Factors extending this interval include vague symptom profiles increasing the difficulty of symptom appraisal and individual demographics influencing help‐seeking behaviours. An underexplored and potential source of delay in cancer diagnosis is associated with managing symptoms using self‐care activities prior to presentation to healthcare. Methods. This study aimed to characterise the use of self‐care activities in the context of managing nonspecific symptoms, prior to cancer diagnosis and their effect on the length of the patient interval. Eligible publications were identified using a rapid systematic review, and their qualitative self‐care data were extracted and analysed using thematic synthesis. Results. Forty‐five qualitative research papers between 2009 and 2024 were included in the final review. Self‐care was used as part of an iterative process, often resulting in delayed presentation to healthcare, if methods were effective in managing nonspecific symptoms. Across the literature, varying types of self‐care activities were reported across all cancers with nonspecific symptoms, including the use of over‐the‐counter or alternative medications, lifestyle changes, and watchful waiting. The individual's decision to self‐care was either prompted externally by a healthcare professional (HCP) (e.g., community pharmacists) or prompted by the individual depending on the availability of home remedies and medication. Patients used self‐care when there was a low perceived need to seek healthcare, to determine whether healthcare was required, or to avoid the use of healthcare. However, across the literature, there is limited evidence to understand the variation by cancer type, symptoms, and individual characteristics. Conclusions. The findings of this rapid review demonstrate that self‐care activities could hinder prompt help‐seeking and delay cancer diagnosis among people who are experiencing nonspecific cancer symptoms. However, more evidence is needed to understand which individual factors facilitate the adoption of self‐care behaviours over prompt help‐seeking for nonspecific cancer symptoms. [ABSTRACT FROM AUTHOR]

Digital health technologies (DHTs) at the intersection of health, medical informatics, and business aim to enhance patient care through personalised digital approaches. Ensuring the efficacy and reliability of these innovations demands rigorous clinical validation. A PubMed literature review (January 2006 to July 2023) identified 1250 papers, highlighting growing academic interest. A focused narrative review (January 2018 to July 2023) delved into challenges, highlighting issues such as diverse regulatory landscapes, adoption issues in complex healthcare systems, and a plethora of evaluation frameworks lacking pragmatic guidance. Existing frameworks often omit crucial criteria, neglect empirical evidence, and clinical effectiveness is rarely included as a criterion for DHT quality. The paper underscores the urgency of addressing challenges in accreditation, adoption, business models, and integration to safeguard the quality, efficacy, and safety of DHTs. A pivotal illustration of collaborative efforts to address these challenges is exemplified by the Digital Health Validation Center, dedicated to generating clinical evidence of innovative healthcare technologies and facilitating seamless technology transfer. In conclusion, it is necessary to harmonise evaluation approaches and frameworks, improve regulatory clarity, and commit to collaboration to integrate rigorous clinical validation and empirical evidence throughout the DHT life cycle. [ABSTRACT FROM AUTHOR]