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BACKGROUND: Studies have established the central role of the family in the recognition, treatment, and recovery of anorexia nervosa. The objective of this study was to review, synthesize, and critically appraise the literature on parents views on the treatment and recovery process of anorexia nervosa in their adolescent child. METHOD: A systematic search of Medline, PsychINFO, CINHAL, EMBASE, Cochrane library, and SSCI was conducted for qualitative studies published regarding parents views about the treatment of anorexia nervosa. The quality of articles was assessed using the critical appraisal skills program (CASP) and findings were analysed using thematic synthesis. RESULTS: A total of 25 studies from nine countries reporting the views of 357 parents met the inclusion criteria. Four major themes were developed from the analysis: understanding the child and the disease, experience of services and treatment modalities, the role of professionals, and the experience of recovery. CONCLUSION: Parents report struggles with delays in finding help, judgmental attitudes of professionals, and uncertainty about the future. Recognition of the challenges faced by parents and families empowers clinicians to build stronger therapeutic relationships essential for long-term recovery from anorexia nervosa.

Conceptualized in France during the sixties, the Theory of Didactical Situations [TDS] is a pivotal framework for developing mathematics teaching and learning processes. Despite the increasing qualitative studies over the last ten years, there remains a dearth of analysis of its effects on mathematics education. Through a Grounded Formal Theory approach, this paper presents the metasynthesis of 28 studies screened from four research databases— ProQuest, EBSCO, SCOPUS, and JSTOR. Data extraction was performed to enumerate the author/s, country, publication year, and connected theoretical approaches with TDS. Subsequently, the studies were categorized into three axial codes based on the studies’ goals of applying TDS: lesson sequence, teacher development, and learning innovations. The synthesis underscores TDS’ capacity to improve the sequence of mathematics lessons, particularly geometry and number patterns; develop teachers’ pedagogical practices in teaching elementary, high school, and college students; and be a practical tool in innovating didactical resources for learning mathematics. TDS was also associated with other theoretical approaches, such as constructivism, realistic mathematics education, gamification, and technology-based instruction. Most of these effects were rooted in the challenges experienced during the COVID-19 pandemic and the adaptation of TDS to the digital era, including distance and online learning. While the European and Western Asian countries have been at the forefront of TDS integration, the paper advocates for broader global adoption of this theory to enrich mathematics education worldwide.

Background: The organization of the Norwegian health service, with a division between specialist and primary health services, largely requires collaboration and integration across the sectors. Physiotherapists' practical approach can create challenges for collaboration across organizational boundaries with different contextual and cultural frameworks. The purpose of this study is to investigate physiotherapists' intraprofessional collaboration across health care sectors. Methods: We carried out a qualitative meta-synthesis based on searches in Oria, Google scholar, NORA, and PubMed. Through a systematic screening of qualitative primary studies, 6 studies were identified as relevant for our research question. We used metaethnographic analysis to synthesize data. Results: The studies showed that physiotherapists largely expressed a need for relational interaction that enabled practical approaches and clinical discussions. Guidance and supervision were identified as main forms of collaboration in the literature, where physiotherapists in the specialist health service are expected to support physiotherapists in the primary health service. This was identified as creating an asymmetric relationship between physiotherapists, potentially creating challenges for collaboration. However, our results show that communication and relational skills could help to compensate for the asymmetric relations. Conclusion: As a supplement to political guidelines that primarily highlight organizational strategies to meet collaborative challenges, this study shows that physiotherapists' relational competence is significant for cross-sectorial collaboration. The asymmetric relationship that is experienced in cross-sectoral interaction between physiotherapists can be adjusted for through structural frameworks in combination with relational skills, thus should be given increased attention.

Objective In the context of today's intensely competitive environments, the ability of organizations to meet and exceed the expectations of their key stakeholders has become increasingly crucial for their survival, as well as for boosting their overall competitiveness and productivity. This dynamic forms the crux of a significant issue in the realm of effective interaction between organizations and their external environment, widely recognized as "corporate social responsibility" (CSR). The critical importance of CSR in the competitive landscape of today's markets has led to a proliferation of scholarly studies from varied perspectives, each with distinct objectives. In pursuit of gaining a deeper and more comprehensive understanding of the CSR practices adopted by organizations, this research has undertaken a detailed review and classification of the strategies that banks have implemented in alignment with their responsibilities towards external stakeholders. Methods This study is conducted as qualitative applied research employing a meta-synthesis approach. The data sources for this investigation included a curated selection of articles from international scientific databases, carefully chosen based on stringent criteria designed specifically for the meta-synthesis process. Results The practices that banks have adopted in accordance with their corporate social responsibility towards their external stakeholders can be systematically categorized into five principal groups: actions related to society, the environment, customers, competitors, and suppliers. Delving deeper, societal-related actions are subdivided into six classifications: economic, social, legal, artistic-cultural, educational, and sanitary-health initiatives. Environmental CSR actions by banks are grouped into four distinct categories: resource and energy consumption management, environmental protection efforts, environmental development initiatives, and practices related to green banking. The classifications of actions related to customers are delineated based on the nature of customer interactions, the quality of customer service provided, the intrinsic qualities of the products, and the delivery methods of these products. Additionally, the expectations of stakeholders compel banks not only to act ethically towards their suppliers and competitors but also to avoid any unethical practices. Although the actions taken in this regard are less numerous than those aimed at other stakeholders, their importance in the CSR strategies of banks cannot be underestimated. Conclusion The diligent efforts of banks to align with the expectations of their stakeholders establish them as socially accountable entities, which significantly enhances their sustainability and continuous productivity within competitive markets. The distinctive nature of the research methodology, incorporating both qualitative approaches and meta-synthesis strategies, enabled the researchers to tackle this issue from a holistic perspective. Consequently, the practices of corporate social responsibility in the banking sector with regard to external stakeholders were exhaustively identified and systematically classified. These comprehensive findings provide a valuable and effective framework for banks and other akin organizations to develop and refine their corporate social responsibility programs concerning external stakeholders. [ABSTRACT FROM AUTHOR]

Despite the presentation of consumer nationalism models, its dimensions and various components are still not well understood. The purpose of this article is to identify the factors, components and consequences of consumer nationalism with an emphasis on resistive economy and accordingly to present a conceptual model based on it. In order to carry out this research, in addition to an in-depth study using the metasynthesis method, in order to identify the factors, components and consequences of consumer nationalism, the fuzzy Delphi technique was used and the opinions of 25 experts were used to refine the factors and components. The survey was carried out in four stages and the results of each stage were refined using the formulas of fuzzy Delphi method. Finally, the model of consumer nationalism with emphasis on resistive economy, with 37 components and 5 influencing factors, psychological factors, mixed marketing factors, social factors, resistive economy factors and political factors was designed and as a proposed model for consumer nationalism and with Emphasis on resistance economy is presented, in this way, in our country, while analyzing the existing situation and optimizing the effective and successful research in the field of consumer nationalism development, it is possible to present improvement plans and measures. [ABSTRACT FROM AUTHOR]

Abstract Background Studies have established the central role of the family in the recognition, treatment, and recovery of anorexia nervosa. The objective of this study was to review, synthesize, and critically appraise the literature on parents’ views on the treatment and recovery process of anorexia nervosa in their adolescent child. Method A systematic search of Medline, PsychINFO, CINHAL, EMBASE, Cochrane library, and SSCI was conducted for qualitative studies published regarding parents’ views about the treatment of anorexia nervosa. The quality of articles was assessed using the critical appraisal skills program (CASP) and findings were analysed using thematic synthesis. Results A total of 25 studies from nine countries reporting the views of 357 parents met the inclusion criteria. Four major themes were developed from the analysis: understanding the child and the disease, experience of services and treatment modalities, the role of professionals, and the experience of recovery. Conclusion Parents report struggles with delays in finding help, judgmental attitudes of professionals, and uncertainty about the future. Recognition of the challenges faced by parents and families empowers clinicians to build stronger therapeutic relationships essential for long-term recovery from anorexia nervosa.

Abstract Background Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. Methods A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. Results Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, “From learning opportunity to conscious multidimensional change,” and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. Conclusions Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors. Methods: The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol. Results: The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy. Conclusion: The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice. [ABSTRACT FROM AUTHOR]

Dietitians are included in eating disorder (ED) treatment teams for their expertise in nutrition. However, little is known about an individual's experience of dietetic intervention as part of their ED treatment and what they value as part of dietetic care. Therefore, the aim of this review was to synthesise the available qualitative literature to understand the role and value of a dietitian in ED treatment from the perspective of individuals with lived experience. Six databases and Google Scholar were searched and a thematic synthesis and meta-synthesis of fifteen studies were conducted. Four themes were constructed from the data: (1) "guidance and structure"—Provision of nutrition knowledge and skills; (2) "having all my bases covered"—Dietitians as part of a multidisciplinary team; (3) Challenges in nutritional treatment; and (4) "it was my treatment and my recovery"—Person-centred dietetic treatment. Across all identified themes was the cross-cutting theme of a shared treatment journey between the dietitian and the individual receiving treatment. These findings support dietitians having a role that is not limited only to the provision of nutrition treatment in ED care and illustrates the importance of dietitians engaging with clients by centring on the individual's needs and preferences. Further understanding helpful dietetic treatment components and identifying gaps in training is needed to develop these broader roles for dietetic care. [ABSTRACT FROM AUTHOR]

Background: Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. Methods: A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. Results: Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. Conclusions: Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking. Highlights: What is already known: Transcultural care promotes satisfaction among diverse populations. Cultural competence promotes an inclusive environment and mutual benefit. Cultural competence reduces biased decision making and promotes cultural awareness. What this paper adds: Transcultural learning in nursing is a complex learning process. Transcultural nursing learning is multifactorial and has an impact on students' personal and professional lives. Transcultural nursing learning experiences involve self-awareness, reflective thinking, cultural encounters, cultural skills, cultural desires and cultural knowledge. [ABSTRACT FROM AUTHOR]

Objective: In Hybrid warfare, logistics plays a fundamental and key role in improving combat readiness and the operational superiority of forces on the battlefield. Therefore, the aim of the current research is to identify the effective factors on improving the logistical readiness of the Islamic Republic of Iran Army in future combined wars.Methodology: Considering that the present research seeks to conceptualize and complete the theoretical foundations of the studied phenomenon, it is exploratory in terms of its purpose, and in terms of methodology, it is qualitative with meta-synthesis method. The statistical population of the research consists of valid qualitative studies published in the field of military logistics preparation from 2010 to 2022.Findings: Based on the data analysis, 5 components including mobilization of integrated resources, expertise in operational planning, stability of the supply chain, mental preparation and operational agility were extracted as effective factors in improving the logistics readiness of AJA in future combined wars.Originality: In combined wars, logistics readiness can be achieved through targeted planning of logistics resources and facilities and the creation of a combined logistics system based on the considerations and indicators of combined warfare, including the improvement of the mental readiness of human capital, integration, speed of action, flexibility and safety in operations. therefore, military logistics readiness requires a paradigm shift and a transition from the classic logistics command to mixed logistics

Transition from pediatric to adult care for adolescents and young adults (AYAs) with chronic illness affects the entire family. However, little research has compared AYA and parent experiences of transition. Using Sandelowski and Barroso’s method, the aim of this metasynthesis was to summarize findings of qualitative studies focusing on the transition experiences of AYAs and their parents across different chronic physical illnesses. PubMed, EMBASE and CINAHL were searched followed by forward and backward citation searching. Two authors completed a two-step screening process. Quality was appraised using Guba’s criteria for qualitative rigor. Study characteristics and second order constructs were extracted by two authors and an iterative codebook guided coding and data synthesis. Of 1,644 records identified, 63 studies met inclusion criteria and reflect data from 1,106 AYAs and 397 parents across 18 diagnoses. Three themes were synthesized: transition is dynamic and experienced differently (differing perceptions of role change and growth during emerging adulthood), need for a supported and gradual transition (transition preparation and the factors which influence it) and liminal space (feeling stuck between pediatric and adult care). While AYAs and parents experience some aspects of transition differently, themes were similar across chronic illnesses which supports the development of disease agnostic transition preparation interventions. Transition preparation should support shifting family roles and responsibilities and offer interventions which align with AYA and family preferences.

Abstract Aquatic food systems are important contributors to global food security to satisfy an intensifying demand for protein‐based diets, but global economic growth threatens marine systems. Cephalopod (octopus, squid and cuttlefish) fisheries can contribute to food security; however, their sustainable exploitation requires understanding connections between nature's contributions to people (NCP), food system policies and human wellbeing. Our global literature review methodology examined what is known about cephalopod food systems, value chains and supply chains, and associated market drivers. For analysis, we followed the IPBES conceptual framework to build a map of the links between cephalopod market drivers, NCP and good quality of life (GQL). Then we mapped cephalopod food system dynamics onto IPBES (in)direct drivers of change relating to catch, trade and consumption. This research contributes knowledge about key factors relating to cephalopods that can support transitions towards increased food security: the value of new aquatic food species; food safety and authenticity systems; place‐based innovations and empowerment of communities; and consumer behaviour, lifestyle and motivations for better health and environmental sustainability along the food value chain. We outline requirements for a sustainable, equitable cephalopod food system policy landscape that values nature's contributions to people, considers UN Sustainable Development Goals and emphasises the role of seven overlapping IPBES (in)direct drivers of change: Economic, Governance, Sociocultural and Socio‐psychological, Technological, Direct Exploitation, Natural Processes and Pollution. We present a novel market‐based adaptation of the IPBES conceptual framework—our ‘cephalopod food system framework’, to represent how the cephalopod food system functions and how it can inform processes to improve sustainability and equity of the cephalopod food system. This synthesised knowledge provides the basis for diagnosing opportunities (e.g. high demand for products) and constraints (e.g. lack of data about how supply chain drivers link to cephalopod NCP) to be considered regarding the role of cephalopods in transformations towards a resilient and more diversified seafood production system. This social–ecological systems approach could apply to other wild harvest commodities with implications for diverse marine species and ecosystems and can inform those working to deliver marine and terrestrial food security while preserving biodiversity. Read the free Plain Language Summary for this article on the Journal blog.

Purpose Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors. Methods The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol. Results The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy. Conclusion The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice.

The maturity of business intelligence is a result of the evolution and advancement of technology and management approaches that help to provide accurate information, predictive analyzes and improve decisions in organizations using advanced technologies such as artificial intelligence and data analysis. Despite technological maturity that improves the efficiency and performance of organizations over time, business intelligence is far from becoming a mainstream trend in organizations. According to numerous researches in the field of business intelligence, the aim of this research was to present the framework of factors affecting the maturity of business intelligence using a meta-composite approach. In order to reach a comprehensive framework that includes all the maturity factors of business intelligence, 221 scientific studies were reviewed. Relevant codes were extracted using content analysis in metacomposite method. The categories were leveled using the comprehensive interpretive structural modeling method and the most influential ones were determined. The findings show that a total of 93 codes were extracted and divided into 6 categories. These categories include organization and management factors, environment, technology infrastructure, human resources - knowledge, data management and data analysis. The categories of technology infrastructure, data management and data analysis were placed at level three and have the greatest impact on the maturity of business intelligence.

Copyright of Journal of Business Management (JBM) is the property of University of Tehran, Faculty of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This review paper identifies and compares models of inter-organizational relationship development that have evolved in qualitative studies and then proposes an original, situational framework for the evolution of inter-organizational relationships over time. Methodologically, this paper follows a systematic approach and uses metasynthesis of prior qualitative research as a reviewing technique. The analysis of prior qualitative investigations reveals the lack of consistency among authors referring to the number and specificity of phases, with no agreement about the trajectory of relationship development (its linearity, looping of phases, dynamics, start and end points). As its main theoretical contribution, this paper offers a multipath framework covering four phases of relationship development: (1) initiation and initial development, (2) development, (3) maintenance, and (4) dissolution, with three possible subphases to each of them (active, passive, and re-activated). From the managerial perspective, the developed framework may broaden managers' understanding and awareness of the different approaches to modeling the trajectory of the inter-organizational relationship life cycle and configuration of its particular phases. [ABSTRACT FROM AUTHOR]

Objective: Digital transformation is a relatively new concept in the university library environment and has become one of the key concepts of success and sustainability for university libraries in the competitive information environment. Based on the reviews conducted on the subject literature, no research was found that could present the construction requirements and the factors affecting the digital transformation of university libraries. Therefore, the purpose of the current research was to identify the components of the digital transformation of university libraries. Methodology: The approach of this research was qualitative and the Sandelowski and Barroso's seven-step meta-synthesis method (2007) has been used. The statistical population of the research includes all the scientific publications related to the foundations and dimensions of the digital transformation of university libraries, counting the scientific publications retrieved from 12 scientific databases in the period from 2004 to 2022 (corresponding to the solar Hijri years of 1383 to 1401), which is based on the Critical Appraisals Skills Programme (CASP) and screening process. Findings: Therefore, 32 works were selected for further review and analysis. In this research, first, a separate code was considered for all the factors extracted from the selected publications, and then considering the concept of each of the codes, they were categorized in a similar concept. In this way, the concepts of the research were determined. Based on the analysis done with the help of content analysis method, there are a total of 7 main categories and 24 concepts, including digital culture (digital attitude, user-oriented, agility, participation and cooperation, creativity and innovation, learning digital skills of employees), digital librarian (individual competence, knowledge competence, communication competence, skill competence), digital manager (individual competence, knowledge competence, skill competence), digital services and resources (optimally reorganizing library resources, providing digital services to users, providing digital services to the organization mother), digital technologies (digital infrastructure, technological readiness, use digital technologies), support and cooperation of upstream institutions and the mother organization (to provide human resources, to provide technological resources and equipment, to make macro policies), and Work process and development of digital strategy (digitalization of processes and development of library digital strategy). Conclusion: The discussion of the digital transformation of organizations, including the digital transformation of university libraries, is complex, and managers and librarians cannot be expected to be familiar with these concepts without training or study and be able to move in the right direction towards the digital transformation of libraries. This research is the first research inside and outside of Iran that identified the components of the digital transformation of university libraries. The results of this research can be a good guide for an easy understanding of the effective factors and requirements of digital transformation of libraries and the importance of understanding it for managers and librarians. [ABSTRACT FROM AUTHOR]

Copyright of People & Nature is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Plain English Summary Men are underrepresented in eating disorder (ED) services; are less likely to notice symptoms of an ED, and have this identified by professionals. To date, there has been limited research into the male experience of ED’s and this appears to be related to a difficulty with getting men involved in studies, as well as the lack of men in services. This review synthesised the existing literature, and four themes were generated: ‘Societal Construction of the Perfect Male’; ‘Striving to Maintain a Masculine Identity’; ‘The Interconnectedness of Control and Self-Worth’, and ‘The Hidden Man’. The results highlighted that the male experience is complex and influenced by societal assumptions and gender norms. EDs are predominately seen as a ‘women’s illness’, which affected the male experience in many ways but most importantly it prevented help seeking and recognition of eating disorders in men, arguably impacting their access to treatment. It is important to change the expectations we place upon men; enabling them to ask for help when needed in ways we allow women. Addressing societal pressures, combined with targeted training to improve understanding at the first point of seeking help, ensuring appropriate recognition of an ED and timely intervention for men.

A theory-generating qualitative metasynthesis was used to explore the questions: (a) How do mothers of low socioeconomic status in the United States express their attitudes and beliefs on breastfeeding? (b) How do mothers of low socioeconomic status in the United States describe the types of support received related to breastfeeding? Databases were searched from January 2000 to June 2022. Eleven qualitative studies were evaluated, and six themes were identified. A model was developed illustrating how the themes impact a mother's decision to breastfeed. Positive factors included shared narratives, knowledge of breastfeeding physiology, and social network. However, more negative influences were heard such as opinions passed on from family and friends, lack of teaching and anticipatory guidance, limited support and follow up, and the perception of conflicting messages from health care professionals. This model identifies constructs that can be used as starting points for interventions, policy development and/or health promotion education. [ABSTRACT FROM AUTHOR]

Background: Amid all public health measures to contain COVID-19, the most challenging has been how to break the transmission chain. This has been even more challenging in low- and middle-income countries (LMICs). A public health emergency warrants a public health perspective, which comes down to prevention. Rapid mass testing has been advocated throughout the pandemic as a way to promptly deal with asymptomatic infections, but its usefulness in LMICs is yet to be fully understood. Objective: The study objectives of this paper are to (1) investigate the impact of the different rapid mass testing options for SARS-CoV-2 that have been delivered at point of care in LMICs and (2) evaluate the diagnostic safety (accuracy) of rapid mass testing for SARS-CoV-2 in LMICs. Methods: This review will systematically search records in PubMed, EBSCOhost, Cochrane library, Global Index Medicus COVID-19 Register, and Scopus. Records will be managed using Mendeley reference manager and SWIFT-Review. Risk of bias for randomized controlled trials will be assessed using the RoB 2 assessment tool, while nonrandomized interventions will be assessed using the tool developed by the Evidence Project. A narrative approach will be used to synthesize data under the first objective, and either a meta-analysis or synthesis without meta-analysis for the second objective. Tables, figures, and textual descriptions will be used to present findings. The overall body of evidence for the first objective will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach, and for the second objective using GRADE. Results: The screening of records has been finalized. We hope to finalize the synthesis by the end of February 2023 and to prepare the manuscript for publication by April 2023. The study will be reported in accordance with standard guidelines for the reporting of systematic reviews. Review results will be disseminated through conferences and their peer-reviewed publication in a relevant journal. Conclusions: This review highlights the role of a preventive approach in infection control using rapid mass testing. It also flags the overriding need to involve users and providers in the evaluation of such tests in the settings for which they are intended. This will be the first review to the best of our knowledge to generate both qualitative and quantitative evidence regarding rapid mass testing specific to LMICs. [ABSTRACT FROM AUTHOR]

Background: The rate of infertility is increasing day by day. According to studies conducted worldwide, 30 million men are diagnosed with infertility. Cases of infertility are often associated with a failure to become male in society. Procreation and gender roles are often closely linked so that infertile men are often considered the second sex. Sometimes, this condition makes men question their masculinity. Methods: We performed a systematic review and metasynthesis with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline procedure on qualitative studies on ten databases exploring the experience of infertile men and their association with masculinity. Results: Twenty-four studies matched our question, and there are two major themes with eight subthemes that were obtained from the results of the metasynthesis of these studies. The impact of this gender issue is huge on men’s health and their social interactions. As a result, gender issues provide a space for debate and a burden on men. Sometimes, men develop mental health problems. The topic of masculinity and infertility is at odds with feminism and is susceptible to the societal stigma that results from the hegemonic conception of masculinity. Interestingly, the men must accept reality and follow the treatment process for infertility, although it affects their psychological well-being. Conclusions: These findings provide insight for physicians, as treating infertility requires a multidisciplinary team that does not only address procreation issues. Social issues related to gender roles often bring patients into harmful and dangerous conditions. To address the gender issue in men globally in several dimensions, however, a large study in various populations is still required.

Islamic finance, developed on the basis of Sharia principles, can benefit from the FinTech technologies. FinTech has been a beneficial innovation for the financial services industry, especially by reaching diverse groups of customers leading to the improvement of the level of financial participations. Islamic FinTech has paved the way for the development of innovative products in accordance with Sharia, thus benefitting the Islamic consumers and creating more competitive advantage for the Islamic financial sector. The purpose of this research is to identify the challenges and opportunities of Islamic financial technology. For this purpose, a systematic evaluation and analysis of 270previously found cases have been done through qualitative research and metasynthesis including the 7 steps of Sandelowski and Barroso. At the end, the opinions of 10 experts and professors were collected by a questionnaire in 2022 and the quantitative entropy method was used to determine the coefficient effect of identified challenges and opportunities. Finally, the challenges and opportunities that have the greatest impact on "Islamic financial technology" have been the use of ethically oriented skilled people for specialized matters, the increase of automatic interaction with customers in order to improve services, the integration of the systems and the connection between customers and all banking operations, and absence of any time limit for performing banking services in the field of Islamic finance.

Background: The rate of infertility is increasing day by day. According to studies conducted worldwide, 30 million men are diagnosed with infertility. Cases of infertility are often associated with a failure to become male in society. Procreation and gender roles are often closely linked so that infertile men are often considered the second sex. Sometimes, this condition makes men question their masculinity. Methods: We performed a systematic review and metasynthesis with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline procedure on qualitative studies on ten databases exploring the experience of infertile men and their association with masculinity. Results: Twenty-four studies matched our question, and there are two major themes with eight subthemes that were obtained from the results of the metasynthesis of these studies. The impact of this gender issue is huge on men’s health and their social interactions. As a result, gender issues provide a space for debate and a burden on men. Sometimes, men develop mental health problems. The topic of masculinity and infertility is at odds with feminism and is susceptible to the societal stigma that results from the hegemonic conception of masculinity. Interestingly, the men must accept reality and follow the treatment process for infertility, although it affects their psychological well-being. Conclusions: These findings provide insight for physicians, as treating infertility requires a multidisciplinary team that does not only address procreation issues. Social issues related to gender roles often bring patients into harmful and dangerous conditions. To address the gender issue in men globally in several dimensions, however, a large study in various populations is still required.

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Introduction The tourism industry is recognized as an asset for economic growth and poverty reduction in developing countries. World Tourism Organization reports show that the tourism industry is a leader in job creation. Many natural, cultural, and historical assets in developing countries create a comparative advantage in the tourism industry, hence a potential source of income for emerging economies. Sustainable tourism development is not possible without economic or social activities. The tourism industry is considered not only as the most extensive service industry at the global level but also as an essential job-creating industry. The concept of ecosystem captures the actors that are interdependent and make up the industry. The tourism ecosystem is a powerful tool for understanding the relationship between nature, society, and business. It can create competition and economically stimulate the development of the tourism industry. The tourism ecosystem achieves sustainable development by upgrading existing markets and creating new ones. Therefore, the tourism ecosystem can help achieve the objective of fostering economic and social development of a given geographical area. Attending to the sustainable tourism ecosystem can also bring about the satisfaction of tourists and residents in tourist areas. The development of the tourism industry can lead to economic development and improvement of infrastructure. In this respect, the sustainable tourism ecosystem can play an essential role, paving the way for new opportunities in less developed areas. Materials and Methods As a developmental–applied, descriptive, and exploratory research, the present study used a mixed methods research design incorporating both qualitative and quantitative data. Concerning the qualitative aspect, the meta-synthesis approach was used. Then, in the quantitative stage, the Shannon entropy method was employed to determine the coefficients of the identified factors. Hypertext is a method used here to review, synthesize, and evaluate past studies. In other words, the meta-synthesis approach examines the results obtained from other studies, leading to more new results. The data of the present study included the previous researches on the factors affecting sustainable tourism ecosystems. Having applied the purposeful sampling method, the research selected 39 studies as the final set of data. Then, the seven-step method proposed by Sandelowski and Barroso was used for conducting the meta-synthesis. Results and Discussion All the factors extracted from the previous studies were coded. Then, the similar items were grouped around one concept. The analysis of the studies finally resulted in 3 code axes, 7 categories, and 37 concepts related to the sustainable tourism ecosystem. Conclusion The sustainable tourism ecosystem not only contributes to the economic growth but also strengthens the culture of communities. The tourism ecosystem ensures that future generations have sustainable access to resources and fair opportunities. This study aimed to present a model of the sustainable tourism ecosystem by relying on the meta-synthesis approach. The meta-synthesis of the previous studies resulted in 37 concepts categorized under seven categories, which were grouped into three general categories: business-related factors, external industry-related factors, and industry-related micro-factors. The identified factors, in order of importance, included human capital training, culture, personal characteristics, networking and markets, investment and financing, legislation and policies, and infrastructure. Highlighting the interaction with markets, networking was found to be an essential factor in the sustainable tourism ecosystem. It is thus necessary to pay attention to the needs of stakeholders and involve them in processes. Moreover, the transformation of the traditional economy into a sharing economy has led to value creation and networking. However, it faces wide-ranging challenges, which can be tackled through culture-building and a transparent and cohesive legal framework between relevant institutions. Investing in tourism requires the development of economic infrastructure, the appropriate social conditions, and the improvement of political relations with other countries. To eliminate the barriers necessitates appropriate strategies, such as cooperation with foreign investors and allocation of funds for tourism development. Relying on the meta-synthesis approach and the Shannon entropy method, this research provided an integrated model of the sustainable tourism ecosystem, which is particularly relevant for the subject under study and the concepts extracted.

The purpose of the present study is to develop a model of posttraumatic growth according to positive psychology in cancer survivors. The research purpose was applied and was a qualitative and meta-synthesis. The statistical population was both foreign and domestic research articles published about the title of the research between 2005 and 2021. Science Direct, Springer, Google Scholar, Taylor & Francis, Noormags, Magiran, SID, and Civilica databases were used to access these studies. By reviewing 10,000 articles, 10 related studies that met the criteria were selected. In synthesizing the research findings, 6 main components were finally identified: psychological capital, self-compassion, meaning in life, spirituality, gratitude, and love. To evaluate the validity of the data research, the four assessment criteria proposed by Lincoln and Guba were credibility, transferability, reliability and confirmability, as well as Cohen's kappa coefficient.These extracted concepts are introduced in positive psychology and especially in character strength. In fact, these concepts are a set of thoughts, actions, and strengths that cancer survivors have used with regard to posttraumatic growth. The results of this study may provide appropriate insights in the context of positive psychology for medical and mental health professionals dealing with cancer patients and may be effective in developing intervention packages according to the needs of this group.

ObjectivesWe aimed to identify, appraise, and synthesise the qualitative literature to develop theory on heroism and paramedic practice.Hypothesis/research questionWhat does published literature tell us about heroism and paramedic practice?SettingParamedics and other healthcare workers (HCWs) faced an outpouring of public support for them early in the COVID-19 pandemic which brought into focus the relationship between them and society, where they are portrayed as heroes.ParticipantsWe conducted a metasynthesis using Evolved Grounded Theory and procedural guidelines of Noblit and Hare to guide analysis. Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) guidelines were also applied.Results151 papers were retrieved and eleven included in the final sample. Studies were moderate to very low quality, involving a wide range of methodologies and settings; none specifically explored heroism and paramedic practice. The following interrelated themes were constructed on heroism and paramedic practice: (a) Myth, Folk law, and storytelling in heroism and paramedic practice (b) The epic journey of heroism and paramedic practice (c) Heroes and Zeroes: The fluctuating Societal Value in heroism and paramedic practice (d) Politicisation, and objectification in Heroism and Paramedic practice.ConclusionParamedics have long been characterised as heroes, but this may not reflect their everyday experiences. Heroism in paramedic practice can provide scripts for prosocial action, inspiring others, and leading to more social heroic actions. Paramedics may however be ambivalent to such heroism narratives, due to politicisation, and objectification in the media and society. This metasynthesis is only one of many possible constructions of heroism and paramedic practice and is the first point in making sense of and developing theory on heroism and paramedic practice.Study registrationPROSPERO: CRD42021234851.

Background: Men are believed to be underrepresented in eating disorder services; there are many reasons presented to account for this such as a lack of recognition and detection. Due to the physical and psychological complexity of an eating disorder it is important to understand this underrepresentation. This qualitative evidence synthesis aimed to explore the literature relating to men's experiences of an eating disorder, in order to synthesise the findings and offer a more coherent understanding. Method: A systematic search of the literature was undertaken. Inclusion and exclusion criteria were applied to the findings resulting in 14 papers deemed suitable for inclusion. A Meta-Ethnographic approach to synthesising the data of the 89 participants was undertaken. Results: Four themes were identified: 'Societal Construction of the Perfect Male'; 'Striving to Maintain a Masculine Identity'; 'The Interconnectedness of Control and Self-Worth', and 'The Hidden Man'. There appeared to be an underlying concept relating to the conflict of being a man, with what is perceived to be a 'woman's illness' and how this challenged the men's experiences of masculinity. Conclusions: Being a man with an eating disorder conflicted with societal norms, exacerbating their experience of having an eating disorder.. To resolve this, gendered norms need to shift, at societal level as well as considering how best to improve understanding and recognition of men with an eating disorder at the first point of help seeking. Plain English Summary: Men are underrepresented in eating disorder (ED) services; are less likely to notice symptoms of an ED, and have this identified by professionals. To date, there has been limited research into the male experience of ED's and this appears to be related to a difficulty with getting men involved in studies, as well as the lack of men in services. This review synthesised the existing literature, and four themes were generated: 'Societal Construction of the Perfect Male'; 'Striving to Maintain a Masculine Identity'; 'The Interconnectedness of Control and Self-Worth', and 'The Hidden Man'. The results highlighted that the male experience is complex and influenced by societal assumptions and gender norms. EDs are predominately seen as a 'women's illness', which affected the male experience in many ways but most importantly it prevented help seeking and recognition of eating disorders in men, arguably impacting their access to treatment. It is important to change the expectations we place upon men; enabling them to ask for help when needed in ways we allow women. Addressing societal pressures, combined with targeted training to improve understanding at the first point of seeking help, ensuring appropriate recognition of an ED and timely intervention for men. [ABSTRACT FROM AUTHOR]

Objective Government data contains a large amount of valuable data that can be exploited in various fields if opened. Utilizing open government data, in addition to providing the opportunity to monitor government performance and to create transparency and justice, has another very important function. It helps with developing innovation and the issue has recently been considered by many researchers. However, past research has inconsistently examined the intra-organizational factors influencing open government data to achieve innovation. The present study seeks to identify the intra-organizational factors affecting open government data to achieve innovation in government services through applying the systematic metacombination method. Methods In this research, to identify the intra-organizational factors affecting open government data, the systematic meta-synthesis method was used. For this purpose, 888 related articles based on title, abstract and content were filtered and 51 final articles were obtained. Results Based on the results obtained from the theme analysis method, four main categories including technological, managerial, human, and governance dimensions were distinguished. Also, 13 sub-categories including infrastructure, application systems, data, structural, process, strategic, economic, individual, organizational communication, organizational culture, policy, legal, and governance data were extracted which includes 101 concepts and 479 final codes. Conclusion The results of this study, contrary to the initial expectations, proved hard technological factors as the least important and other factors, including data, structural and legal factors, respectively as the most important. Thus, in data policies, first, it’s necessary to access data and consider the data quality. In structural policies, it is necessary to pay attention to how to mobilize resources and facilities. In strategic policies, how to interact with stakeholders is vital to be explained. Based on the findings of this research, the internal organizational factors affecting the formation of innovation based on open government data were classified into four main categories for better policy-making. In the category of technology, it is necessary to consider the technical and technological principles of open data from the aspect of required infrastructure, application systems, and data sources. In the management category, it is necessary to pay attention to structural and process requirements along with strategic and economic aspects. In the human category that examines the soft aspects, it is necessary to pay attention to the issue of open data from individual perspectives, communication, and organizational culture. In the category of governance, policy aspects, organizational rules, and factors related to data governance need to be considered with the aim of achieving innovation from open government data. Therefore, the present study initially tried to provide a comprehensive framework for policy-making in government institutions by interpreting and presenting a new category of internal factors. Secondly, it sought to smooth the path of future research to expand and spread innovation based on open data. [ABSTRACT FROM AUTHOR]

Brain-derived neurotrophic factor (BDNF) has a critical role in stress response including neuropsychiatric disorders that are precipitated by stress, such as major depressive disorder (MDD). BDNF acts through its full length BDNF receptor, tyrosine kinase B (TrkB), to trigger a pro-plasticity effect. In contrast, the truncated isoform of the BDNF receptor (TrkB.t1) triggers an anti-plasticity effect. In stress outcomes, BDNF acting in the hippocampus has a stress resilient effect, whereas BDNF in the nucleus accumbens (NAc) promotes stress susceptibility. It is unknown if BDNF-TrkB acts on a specific NAc projection subtype or medium spiny neuron (MSN) subtype, in stress outcomes. To determine this, we performed chronic social or a vicarious witness defeat stress (CSDS or CWDS) in mice expressing TrkB.t1 in dopamine receptor 1 or 2 containing MSNs (D1- or D2-MSNs). Our results showed that TrkB.t1 overexpression in NAc D2-MSNs prevented the CSDS-induced social avoidance or other stress susceptible behaviors in male and female mice. Further, we showed that this overexpression in D2-MSNs blocked stress susceptible behavior induced by intra-NAc BDNF infusion. In contrast, our results demonstrate that overexpression of TrkB.t1 on NAc D1-MSNs facilitates the SDS susceptible behaviors. Our study provides enhanced understanding of NAc cell subtype roles of BDNF-TrkB signaling in stress outcomes. [ABSTRACT FROM AUTHOR]

Maturity models assess the prevailing capability level and proffer the necessary capabilities for effective adoption in a systematic roadmap. This is considered essential to achieve diffusion of the emerging technologies. The paper provides a guide to maturity model development in the digitisation era. This study adopted scientometrics and meta-synthesis to critically review and provide guidance on maturity model development. Firstly, bibliographic data was collected from the Scopus database and analysed using Scientometrics. Secondly, developed BIM maturity models were critically reviewed. The study identified areas of maturity model deployment and the industries of deployment. It also identified the present areas of deployment of maturity models. The second aspect critically reviewed selected BIM maturity models through stated parameters and outlined the necessary criteria for maturity model development. Maturity model is widely adopted to achieve optimisation and proper assessment in various industries. The study identified the industries where it is deployed and identified the areas of maturity model deployment in the digitisation era. In addition, it was observed that some existing BIM maturity models do not conform to the various requirements expected of a maturity model. The study is unique in the methods adopted to achieve its results. Also, it identified the areas of maturity model deployment. The study is helpful as it provides the criteria for maturity model development hereafter, while also helping BIM users choose among the existing BIM maturity models. The study is crucial for proper maturity model development in the digitisation era. [ABSTRACT FROM AUTHOR]

Purpose: It is impossible to increase the use of information resources in libraries and provide user-centered information services without understanding how users select and search for information resources. selecting information sources involves identifying a subset of available information sources that best meet the information needs of users. Selecting the right source of information has a significant effect on whether the source is read or not. On the other hand, acquisition, organizing resources, and arranging them in libraries, as well as designing an efficient and user-friendly user interface that supports book selection, requires sufficient knowledge of resource selection behaviors by users; This is what not sufficiently known in Iran. Thus, this study aimed to identify the components and dimensions of the selection behavior of information resources of public library users and to design the relevant conceptual model. Method: The present research is a meta-synthesis study that was conducted with a qualitative approach, using the seven-step Sandelowski and Barroso method. The research population consists of articles and dissertations published in seven Persian databases and eight international databases between 2000 and 2020 (1379 to 1399 SH). Out of 7560 identified sources, 35 sources were approved under the Vital Skills Assessment Program. The codes were extracted from the articles and the reliability of the coding was assessed using the kappa coefficient. Findings: A total of 176 codes including 26 concepts were extracted and categorized under five categories as follows: user-related factors (including source selection objectives, tasks, and needs, personality traits and user life, demographic characteristics, interest and emotion, previous user experiences, reasons for interaction or relationship with books, selection strategies and costs); book-related factors (including appearance features, bibliographic elements, content elements, content quality, storybook content, book style, language and relevance, popularity, and distinction); library-related factors (facilities, shelves, and arrangement of books and ancillary programs); barriers and restrictions (including individual, library and community barriers and restrictions); and recommendations and theatrical productions of works (including direct and indirect recommendations and theatrical productions of works). According to the findings, a user, depending on his situation, spends time and money under the influence of the library environment and its facilities, and examines and selects a source in terms of various appearance and content features, and communicates with that source (book) and reads it for reasons such as the overall perceived attractiveness of a book, being engaged with the story in the book, the atmosphere of the book, the personal experience narrated by the characters, and so on. Influenced by the recommendations and theatrical productions of works, he may face obstacles in choosing the source that have been created by himself, library or the community. Originality/value: The model of information resource selection behavior of public library members is indicative of the complexity and effectiveness of this behavior from a wide range of factors, including individual differences, physical and content characteristics of the book, and environmental factors. The designed model can be used as a basis for a broad survey of users’ information resource selection behavior in physical and virtual environments, as well as as a guide to collection building, space designing, and service designing in libraries, compilation of resources, and designing the appearance and structure of books by authors and publishers.

ObjectiveSexual abuse is a major public health problem. Its disclosure to a health professional could help to reduce its impact on survivors’ lives. The objective of this metasynthesis, combining a systematic review and an analysis of the qualitative studies, was to explore the qualitative literature concerning the experience of a survivor disclosing sexual violence experienced in childhood to a health professional, from the perspective of both.Methods and Data SourcesWe used four databases and two journals (Medline, PsycINFO, EMBASE, and SSCI, and the Journal of Sexual Abuse and Child Abuse and Neglect) to identify studies concerning this disclosure of sexual abuse to healthcare professionals from the point of view of the survivors and the health professionals. After assessing the methodological quality of the articles with the “Critical Appraisal Skills Program (CASP),” we conducted a thematic analysis of the data extracted during the review.ResultsThis review includes 20 articles, covering the data of 612 participants: 291 who were adults at the time of the study but abused in childhood, 152 minors, 14 parents of adolescents, and 155 healthcare professionals. Two themes emerged from the analysis: (1) the disclosure as experienced by the professionals, and (2) the disclosure as experienced by the survivors.ConclusionOur results show that survivors had a diachronic approach to the experience of disclosure. They suggest a change over time in how survivors experience disclosure: relief and release were seen only among the adult participants, at a distance from — long after — the disclosure. This study made it possible to identify new perspectives for research in the field of child psychiatry and to formulate concrete clinical proposals, in particular, by applying the principle of patient experts to involve now-adult survivors in training and increase the awareness of the healthcare professionals concerned.

Abstract Background There has been a considerable increase in the number of traditional and complementary medicine (T&CM) practitioners over the past 20 years and in some jurisdictions are estimated to outnumber general practitioners. Despite this globally significant role, it is apparent that worldwide not all T&CM professions operate under adequate accountability and regulatory oversight for maintaining public protection. To date there has been no published systematic examination of stakeholder opinions regarding regulated and unregulated T&CM occupations. In response, this review aims to investigate, describe, and analyse attitudes held by a range of stakeholder groups towards the regulation of T&CM professions. Methods A database search of AMED, CINAHL, Embase, Ovid MEDLINE, ProQuest, PsycINFO, PubMed, Scopus, and Google Scholar was conducted for original research published between 2000 and 2020 on stakeholder opinions regarding the regulation of T&CM professions. Results Sixty studies across 15 countries reported on the views of six health care stakeholder groups: consumers, T&CM practitioners, conventional medicine practitioners, professional associations, education providers, and policy-makers. Across all stakeholder groups there was between 15% and 95% (median 61%) support for, and 1% to 57% (median 14%) opposition to the regulation of various T&CM professions. The main reasons for supporting regulation included providing greater public protection, raising training and practice standards, establishing title protection, and gaining acceptance from conventional medicine providers. Concerns regarding regulation included potential restrictions to practice, misappropriation of practice, and medical oversight of T&CM practitioners. Few studies canvassed the views of professional associations (n = 6), education providers (n = 2), and policy-makers (n = 2). Conclusions There appears to be broad support for the regulation of T&CM professions, although there was wide variation in attitudes as to how this should be applied. Further research, with a particular focus on policy-makers, education providers, and professional associations, is critical to inform appropriate health policy and practice recommendations relating to T&CM professional regulation across jurisdictions. Systematic review registration: the a priori protocol for this systematic review was registered in PROSPERO and is available at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020198767 .

Background: There has been a considerable increase in the number of traditional and complementary medicine (T&CM) practitioners over the past 20 years and in some jurisdictions are estimated to outnumber general practitioners. Despite this globally significant role, it is apparent that worldwide not all T&CM professions operate under adequate accountability and regulatory oversight for maintaining public protection. To date there has been no published systematic examination of stakeholder opinions regarding regulated and unregulated T&CM occupations. In response, this review aims to investigate, describe, and analyse attitudes held by a range of stakeholder groups towards the regulation of T&CM professions. Methods: A database search of AMED, CINAHL, Embase, Ovid MEDLINE, ProQuest, PsycINFO, PubMed, Scopus, and Google Scholar was conducted for original research published between 2000 and 2020 on stakeholder opinions regarding the regulation of T&CM professions. Results: Sixty studies across 15 countries reported on the views of six health care stakeholder groups: consumers, T&CM practitioners, conventional medicine practitioners, professional associations, education providers, and policy-makers. Across all stakeholder groups there was between 15% and 95% (median 61%) support for, and 1% to 57% (median 14%) opposition to the regulation of various T&CM professions. The main reasons for supporting regulation included providing greater public protection, raising training and practice standards, establishing title protection, and gaining acceptance from conventional medicine providers. Concerns regarding regulation included potential restrictions to practice, misappropriation of practice, and medical oversight of T&CM practitioners. Few studies canvassed the views of professional associations (n = 6), education providers (n = 2), and policy-makers (n = 2). Conclusions: There appears to be broad support for the regulation of T&CM professions, although there was wide variation in attitudes as to how this should be applied. Further research, with a particular focus on policy-makers, education providers, and professional associations, is critical to inform appropriate health policy and practice recommendations relating to T&CM professional regulation across jurisdictions. Systematic review registration: the a priori protocol for this systematic review was registered in PROSPERO and is available at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020198767. [ABSTRACT FROM AUTHOR]

Aim of the Study: There is currently no meta-synthesis focused on the lived experiences of health-care providers during COVID-19. This meta-synthesis adds to evidence-based literature with an in-depth exploration of how health-care providers responded to the COVID-19 crisis. Materials and Methods: The meta-synthesis approach was used for the extraction and synthesis of data. Results: Fifteen qualitative research articles were identified and analyzed; the majority of which were done in China 7 (48%) and Iran 6 (40%). The total sample size was 383, and the majority of the samples were nurses 282 (74%). Three overarching themes identified were "It is my duty," "I am exhausted and about to fall," and "I have overcome it." The subthemes were professional responsibility, challenges faced, the unexpected burden at work, self-coping and reflection, hospital support, government support, and social support. Conclusion: The recommendations for the policy-makers, put forward by the current study are; designing and engineering effective personal protective equipment (lightweight protective suit with long-lasting durable diapers and face masks with a portal for drinking juice or water), rostering minimal working hours, live-in care facilities, exclusion of pregnant and sick health care providers during an epidemic assignment and frequent outbreak training sessions for all department staff. [ABSTRACT FROM AUTHOR]

Background: Midwifery Units (MUs) are associated with optimal perinatal outcomes, improved service users' and professionals' satisfaction as well as being the most cost-effective option. However, they still do not represent the mainstream option of maternity care in many countries. Understanding effective strategies to integrate this model of care into maternity services could support and inform the MU implementation process that many countries and regions still need to approach.Methods: A systematic search and screening of qualitative and quantitative research about implementation of new MUs was conducted (Prospero protocol reference: CRD42019141443) using PRISMA guidelines. Included articles were appraised using the CASP checklist. A meta-synthesis approach to analysis was used. No exclusion criteria for time or context were applied to ensure inclusion of different implementation attempts even under different historical and social circumstances. A sensitivity analysis was conducted to reflect the major contribution of higher quality studies.Results: From 1037 initial citations, twelve studies were identified for inclusion in this review after a screening process. The synthesis highlighted two broad categories: implementation readiness and strategies used. The first included aspects related to cultural, organisational and professional levels of the local context whilst the latter synthesised the main actions and key points identified in the included studies when implementing MUs. A logic model was created to synthesise and visually present the findings.Conclusions: The studies selected were from a range of settings and time periods and used varying strategies. Nonetheless, consistencies were found across different implementation processes. These findings can be used in the systematic scaling up of MUs and can help in addressing barriers at system, service and individual levels. All three levels need to be addressed when implementing this model of care. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this metasynthesis was to explore adult anorexia nervosa (AN) treatment experiences, including facilitators and barriers to treatment engagement and ways that questions of identity and personal agency were negotiated in treatment contexts. Methods From 14 qualitative studies that met the search criteria, this thematic synthesis analyzed the sensitized concept of identity in the participants’ experiences of AN treatments, including their sense of personal agency, and implications for their recovery. The study was registered with Prospero (ID: CRD42018089259) and is reported according to PRISMA guidelines. Results Three meta-themes were generated with the following key findings: grappling with identity, where collaborative and tailored interventions were positively experienced; the quality of the therapeutic relationship, which existed in a recursive relationship; and, rebuilding identity that included therapists standing with the person in recovering a sense of identity outside the anorexic identity. Importantly, interventions that failed to be negotiated with the person were experienced as disempowering however, where a two-way trust existed in the therapeutic relationship, it critically empowered and shaped participants’ sense of identity, and broadened the perception that they were valuable as a person. Conclusions There was consensus across the range of treatment contexts that individuals with a lived AN experience preferred treatments where they experienced (1) a sense of personal agency through tailored interventions; and (2) therapists who treated them as a person who, in the face of their struggles, had skills and capacities in the processes of recovering and rebuilding sustainable and preferred identities outside the AN identity.

Purpose: This metasynthesis reviews and synthesizes the existing qualitative research on adolescent well-being, with explicit attention to how context shapes girls' well-being. Well-being can be understood as a product of transactions between the individual and their context. Using qualitative research, this metasynthesis shows that girls face several threats to their well-being, often related to gender interwoven with the context in which girls operate. Methods: A Qualitative Metasynthesis was used. It included 10 qualitative studies. Results: Findings of this metasynthesis explain that context plays a relevant role in girls' access to resources and opportunities within families and communities. They show that context defines expectations on how girls should behave and spend their time, which often become stressors for girls. Girls examine their context and use it to set up ideals and compare themselves to others. These comparisons impact girls' self-image and structure aspects of their social life. Conclusions: Context and gender affect girls' well-being at different levels. Therefore, interventions and public policies should study the key factors girls identified as influencing their well-being, and address them using a multilevel rationale. Qualitative research can offer complex and illustrative insights on girls' well-being, exploring their perspectives and experiences, and shedding light on how interlocking systems of oppression affect their well-being. [ABSTRACT FROM AUTHOR]

Background the perceptions and experiences of care home residents and their families are important for understanding and improving the quality of emergency care. Methods we conducted a systematic review and metasynthesis to understand the perceptions and experiences of care home residents and their family members who experienced medical emergencies in a care home setting. The review protocol was registered in PROSPERO (CRD42020167018). We searched five electronic databases, MEDLINE, CINAHL, PubMed, Cochrane Library and PsycINFO, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The Critical Appraisal Skills Programme qualitative checklist was used to assess the quality of studies included in this review. Results of the 6,140 references retrieved, 10 studies from four countries (Australia, Canada, UK and USA) were included in the review and metasynthesis. All the included studies were assessed as being of good quality. Through an iterative approach, we developed six analytical themes: (i) infrastructure and process requirements in care homes to prevent and address emergencies; (ii) the decision to transfer to hospital; (iii) experiences of transfer and hospitalisation for older patients; (iv) good communication is vital for desirable outcomes; (v) legal, regulatory and ethical concerns and (vi) trusting relationships enabled residents to feel safe. Conclusions the emergency care experience for care home residents can be enhanced by ensuring resources, staff capacity and processes for high quality care and trusting relationships between staff, patients and relatives, underpinned by good communication and attention to ethical practice. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this systematic review (PROSPERO Ref: CRD42017053264) was to describe and interpret the qualitative research on parent’s decision-making and informed choice about their pregnancy and birth care. Given the growing evidence on the benefits of different models of maternity care and the prominence of informed choice in health policy, the review aimed to shed light on the research to date and what the findings indicate. Methods a systematic search and screening of qualitative research concerning parents’ decision-making and informed choice experiences about pregnancy and birth care was conducted using PRISMA guidelines. A meta-synthesis approach was taken for the extraction and analysis of data and generation of the findings. Studies from 1990s onwards were included to reflect an era of policies promoting choice in maternity care in high-income countries. Results Thirty-seven original studies were included in the review. A multi-dimensional conceptual framework was developed, consisting of three analytical themes (‘Uncertainty’, ‘Bodily autonomy and integrity’ and ‘Performing good motherhood’) and three inter-linking actions (‘Information gathering,’ ‘Aligning with a birth philosophy,’ and ‘Balancing aspects of a choice’). Conclusions Despite the increasing research on decision-making, informed choice is not often a primary research aim, and its development in literature published since the 1990s was difficult to ascertain. The meta-synthesis suggests that decision-making is a dynamic and temporal process, in that it is made within a defined period and invokes both the past, whether this is personal, familial, social or historical, and the future. Our findings also highlighted the importance of embodiment in maternal health experiences, particularly when it comes to decision-making about care. Policymakers and practitioners alike should examine critically current choice frameworks to ascertain whether they truly allow for flexibility in decision-making. Health systems should embrace more fluid, personalised models of care to augment service users’ decision-making agency.

The reform movement in statistics education has led to a revitalization of the undergraduate introductory statistics course. However, many students satisfy their degree requirements by taking statistics courses in “client departments” such as business, the social sciences, and the lab sciences, typically taught by non-statisticians. This article presents the findings of a metasynthesis of the existing literature on teaching statistics in these client disciplines to learn (1) what is currently being taught and how, and (2) the most important challenges for statistics teachers in other departments. Articles were reviewed using qualitative axial coding and quantitative text analysis to identify common research themes and ideas in the literature for each discipline. Research themes, attitudes toward statistics instruction, and pedagogical techniques were found to vary from discipline to discipline. Collaboration with instructors in other disciplines may be a welcome step toward improving statistics instruction across the university.

Introduction: Health literacy has been attended by UNESCO and all human societies from years ago. Due to the importance of this kind of literacy in individual and society health status, many studies have been conducted on the development of this type of literacy in various fields of health and medicine. Self-efficacy can help the people to promote their health literacy, and on the other hand, is related to the ability of individuals to maintain their own, family, and community health. This study reviewed the self-efficacy of health literacy and affecting factors in previous studies. Methods: The present study used a far-reaching approach to analyze the findings of qualitative studies on health literacy. After identifying the keywords and searching the internal and external databases including Magiran, Scientific Information Database (SID), and PubMed, 649 articles were found. By reviewing articles and applying language, years, and study type filters 25 papers were selected, and the categories were extracted using Shannon's table and Cohen's Kappa coefficient. Results: Codes were classified into three categories and eight concepts. The category of psychological factors included three concepts of self-management, individual skills, and social skills, the category of communication components included two concepts of communication and health information exchange, and the category of educational factors included three concepts of educational content and resources, educational barriers and constraints, and educational effectiveness. Codes such as self-efficacy, self-management, awareness of disease symptoms, and awareness of preventive measures had the most prevalence among various categories. Conclusion: In this study, factors affecting the self-efficacy of health literacy were identified, that could be used to plan effective health literacy training programs to promote health status.