Critical Interpretive Synthesis Research Articles

A critical interpretive synthesis of interprofessional education interventions

ABSTRACT Interprofessional practice can look quite different depending on a number of dynamics. Interprofessional education interventions may or may not orient toward this range of practice possibilities. This literature review explores: (1) how interprofessional education interventions relate to different kinds of interprofessional practice and (2) the range of interprofessional practices assumed by interprofessional education interventions. Four databases were searched for articles published between 2011–2021 describing pre-licensure level interprofessional education interventions, resulting in a dataset of 110 articles. Our analysis involved (1) descriptive summaries of the articles, and (2) content analysis of the rationale and description of the intervention. Of the articles, 93% (102/110) of interprofessional education interventions were designed and/or evaluated using the concept of interprofessional education competencies. “Teamwork” was the most relied upon competency. Most articles were not explicit about the different kinds of interprofessional practices that these competencies might be oriented toward. Our study substantiates earlier claims that interprofessional education literature tends to focus on competencies and orient toward undifferentiated understandings of “teamwork.” This analysis is particularly important as interprofessional teams are engaging in increasingly complex, fluid, and distributed forms of interprofessional practice that may not be captured in an undifferentiated approach to “teamwork.”

A critical literature review: deconstructing narratives of trauma in art therapy with young people

ABSTRACT Background This paper addresses the need for critical reflection on how art therapists position themselves and represent their work in the context of diverse frameworks for understanding young people’s adverse life experiences, particularly in relation to the prevalence of trauma discourses. Aims The study examined how art therapists have represented in the literature their practice and research with young people (12-18 years old) experiencing adversity, from 2000 to 2019. Methods Employing Critical Interpretive Synthesis (Dixon-Woods et al., 2006), 26 theoretically-sampled articles were systematically reviewed through an interpretive, inductive and recursive process. Results Art therapists commonly use trauma as a lens to conceptualise young people’s diverse adverse life experiences, with variations based on their theoretical and philosophical orientations. These variations influence how they perceive young people’s needs and art therapy aims. The study also highlights varying levels of creativity and self-agency that young people express in art therapy, emphasising the importance of art therapists’ flexible and tailored approaches. Conclusions The importance of art therapists’ critical awareness when framing and working with young people’s complex life experiences and presentations to avoid stigmatisation and disempowerment is underscored. Implications for practice/policy/future research The study suggests that art therapists’ critical awareness that can enable collaborative practice and researchwith young people with adverse life experiences. It encourages more research into and cultivating art therapists’ conscious awareness of their choice of theoretical alignment and its implications. Additionally, it encourages future research to understand young people’s own conceptualisations of their lived experiences and their perspectives on the ongoing relevance and meaning of art therapy. Plain-language summary This study sought to present the key findings of a critical review of art therapy literature. The main focus of the review was to examine how art therapists represented their work and if there were dominant understandings of trauma influencing art therapists. Using a Critical Interpretive Synthesis method developed by Dixon-Woods et al. (2006), 26 peer-reviewed journal articles published between 2000-2019 were selected based on their relevance to this study. The selected articles described art therapy practice and research with young people (12-18 years old) who had various adverse life experiences. These articles were thoroughly reviewed and analysed through a cyclic process of re-examination and interpretation. Findings indicated that while young people’s diverse adverse life experiences were often labelled as trauma, art therapists’ conceptualisations of trauma varied depending on their theoretical and philosophical orientations. Intriguingly, how art therapists perceived the meaning of adverse life experiences influenced how they formulated young people’s needs and the aims of art therapy. Findings also highlighted young people’s creativity and expression of self-agency in their art therapy programmes and the importance of art therapists’ flexible and tailored approaches. Overall, this study highlights the importance of art therapists’ critical awareness when framing and working with young people’s complex life experiences and presentations to avoid stigmatisation and disempowerment. It recommends further exploring and cultivating art therapists’ conscious awareness of what theoretical concepts they align with and the implications of their choice. Additionally, future art therapy practice and research should actively explore the perspectives of young people with adverse life experiences to inform the ongoing relevance and meaning of art therapy.

The challenges and solutions of technology integration in rural schools: A systematic literature review

The digital divide between urban and rural schools challenges efforts to promote technology integration in education, and contributes to growing educational inequity in many contexts. Using the most current version of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020), we identified and extracted 36 articles and conference papers on the use of technology in rural schools from the Scopus and Web of Science databases. We used Critical Interpretive Synthesis to identify the challenges and solutions involved in integrating technology in rural schools. The analysis revealed 29 challenges, which were categorized using the framework of the ecological perspective into macro level, meso level, and micro level challenges. The analysis also identified solutions to the challenges discussed in these studies. By focusing on the challenges and proposed solutions at different contextual levels, this review is intended to identify what constitutes good practices when integrating technology in rural schools. Future research should focus on factors which facilitate the use of technology and how the integration of technology impacts students’ learning experiences and achievement in rural schools.

Profissionalismo e controle disciplinar de terapeutas à margem

Abstract Occupational therapy’s goal of professional status comes with costs. Sociologists argue that ‘professionalism’ exhorts workers to conform with normative expectations for behaviour and performance, becoming a mechanism of social control. Those performative expectations are established by socially dominant groups, constructing occupational therapists from marginalized groups as not-professional, unless they can contort themselves to conform. Here we explore the specific behaviours and forms of embodiedness that become encoded as ‘professional’ in occupational therapy, leaving particular groups of occupational therapists subject to discipline through the concept of ‘unprofessional’. We conducted a critical interpretive synthesis of literature indexed in CINAHL and EBSCOhost defining professional behaviour in occupational therapy (n=26). We also draw from in-depth qualitative interviews with 20 Canadian occupational therapists who self-identified as racialized, ethnic minority, disabled, 2SLGBTQ+, and/or from working-class/impoverished family origins, exploring how ‘professionalism’ serves to discipline and control them. For both approaches, we employed reflexive thematic analysis. Texts encode professionalism as specific behaviours and forms of embodiedness grounded in white, western politics of respectability. Some also exhort occupational therapists to never make the profession ‘look bad’. In our interview data, occupational therapists from marginalized groups risked being construed as ‘unprofessional’ by having the ‘wrong’ bodies, appearances, presentation of self, speech language use, emotions, behaviours, and boundaries. When ‘professionalism’ demands assimilation to normative standards that exclude particular kinds of people, we narrow the potential of occupational therapy to encompass diverse valuable ways of doing, being, becoming and belonging. There is an important role for ‘professional resistance.’

Music in medical education: A critical interpretive synthesis.

While many have championed the value of music in medical education, research specific to how and why music has been offered in medical education is sparse and there have been few attempts to synthesise the literature. A Critical Interpretive Synthesis (CIS) of 56 texts including published articles, correspondence, abstracts and one thesis published between 1977 and 2022 was undertaken to explore the evidence basis for offering music in medical education. A total of 52 music-focused programmes/activities were described, encompassing both curricular and extra-curricular, receptive and participatory music activities and a wide range of musical genres. Inductive analysis of data extracted from texts revealed a variety of rationales for the use of music in medical education, which could be grouped within seven interrelated themes: well-being; supportive learning environment; affective engagement; teaching and learning; developing skills for clinical practice; humanism in medicine; and creative expression (identity). The results of this synthesis demonstrate that there remains a gap between what is claimed about the affordances of music and what has been explicitly addressed in medical education research. Despite a paucity of research in this area, the available data support that the affordances of music are 'multiple' and may not be well represented by linear models. Evidence that engagement with music is beneficial for medical students is strongest in relation to the affordances of music for well-being, facilitating a supportive learning environment, affective engagement, memorisation and creative expression (identity). That engagement with music might enhance humanism, including developing skills for clinical practice, requires further investigation. Accounting for student agency and the 'multiple' affordances of music will ensure that future teaching and research are best positioned to benefit medical students' well-being and personal and professional development.

Meta-Synthesis As an Original Method to Synthesize Qualitative Literature in Chronic Diseases: A Narrative Review

Context: The recent growth of research and the vast amount of knowledge available highlight the necessity for synthesizing existing research in a reliable and high-quality manner. The substantial body of qualitative meta-synthesis studies on chronic diseases indicates the need for a deeper understanding of this methodology. Therefore, the purpose of this paper was to explain the process of meta-synthesis in qualitative research. Methods: This was a narrative review with predefined inclusion and exclusion criteria, followed by a web search using relevant keywords. Initially, 980 relevant articles were selected. Subsequently, the titles, abstracts, and full texts were assessed for eligibility using the Critical Appraisal Skills Program checklist. Finally, 21 articles were included in this study. Results: Various approaches have been adopted to address the meta-synthesis of qualitative studies. Common types of qualitative meta-synthesis include meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis, and ecological triangulation. However, concerning chronic diseases, the most commonly used methods were ethnography and Sandelowski and Barroso’s method. Conclusions: Meta-synthesis is a method for integrating the results of studies, re-understanding the findings, and ultimately interpreting them to generate new insights beyond what is obtained from individual studies. Given the extensive body of qualitative research on chronic diseases, it is recommended to conduct this type of research to develop new knowledge based on the findings of previous studies.

A Critical Interpretive Synthesis of the Role of Arecoline in Oral Carcinogenesis: Is the Local Cholinergic Axis a Missing Link in Disease Pathophysiology?

Arecoline is the primary active carcinogen found in areca nut and has been implicated in the pathogenesis of oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSF). For this study, we conducted a stepwise review process by combining iterative scoping reviews with a post hoc search, with the aim of identifying the specific mechanisms by which arecoline initiates and promotes oral carcinogenesis. Our initial search allowed us to define the current trends and patterns in the pathophysiology of arecoline-induced OSF and OSCC, which include the induction of cell proliferation, facilitation of invasion, adhesion, and migration, increased collagen deposition and fibrosis, imbalance in immune and inflammatory mechanisms, and genotoxicity. Key molecular pathways comprise the activation of NOTCH1, MYC, PRDX2, WNT, CYR61, EGFR/Pl3K, DDR1 signaling, and cytokine upregulation. Despite providing a comprehensive overview of potential pathogenic mechanisms of OSF, the involvement of molecules functioning as areca alkaloid receptors, namely, the muscarinic and nicotinic acetylcholine receptors (AChRs), was not elucidated with this approach. Accordingly, our search strategy was refined to reflect these evidence gaps. The results of the second round of reviews with the post hoc search highlighted that arecoline binds preferentially to muscarinic AChRs, which have been implicated in cancer. Consistently, AChRs activate the signaling pathways that partially overlap with those described in the context of arecoline-induced carcinogenesis. In summary, we used a theory-driven interpretive review methodology to inform, extend, and supplement the conventional systematic literature assessment workflow. On the one hand, the results of this critical interpretive synthesis highlighted the prevailing trends and enabled the consolidation of data pertaining to the molecular mechanisms involved in arecoline-induced carcinogenesis, and, on the other, brought up knowledge gaps related to the role of the local cholinergic axis in oral carcinogenesis, thus suggesting areas for further investigation.

Evaluating mental health decision units in acute care pathways (DECISION): a quasi-experimental, qualitative and health economic evaluation.

People experiencing mental health crises in the community often present to emergency departments and are admitted to a psychiatric hospital. Because of the demands on emergency department and inpatient care, psychiatric decision units have emerged to provide a more suitable environment for assessment and signposting to appropriate care. The study aimed to ascertain the structure and activities of psychiatric decision units in England and to provide an evidence base for their effectiveness, costs and benefits, and optimal configuration. This was a mixed-methods study comprising survey, systematic review, interrupted time series, synthetic control study, cohort study, qualitative interview study and health economic evaluation, using a critical interpretive synthesis approach. The study took place in four mental health National Health Service trusts with psychiatric decision units, and six acute hospital National Health Service trusts where emergency departments referred to psychiatric decision units in each mental health trust. Participants in the cohort study (n = 2110) were first-time referrals to psychiatric decision units for two 5-month periods from 1 October 2018 and 1 October 2019, respectively. Participants in the qualitative study were first-time referrals to psychiatric decision units recruited within 1 month of discharge (n = 39), members of psychiatric decision unit clinical teams (n = 15) and clinicians referring to psychiatric decision units (n = 19). Primary mental health outcome in the interrupted time series and cohort study was informal psychiatric hospital admission, and in the synthetic control any psychiatric hospital admission; primary emergency department outcome in the interrupted time series and synthetic control was mental health attendance at emergency department. Data for the interrupted time series and cohort study were extracted from electronic patient record in mental health and acute trusts; data for the synthetic control study were obtained through NHS Digital from Hospital Episode Statistics admitted patient care for psychiatric admissions and Hospital Episode Statistics Accident and Emergency for emergency department attendances. The health economic evaluation used data from all studies. Relevant databases were searched for controlled or comparison group studies of hospital-based mental health assessments permitting overnight stays of a maximum of 1 week that measured adult acute psychiatric admissions and/or mental health presentations at emergency department. Selection, data extraction and quality rating of studies were double assessed. Narrative synthesis of included studies was undertaken and meta-analyses were performed where sufficient studies reported outcomes. Psychiatric decision units have the potential to reduce informal psychiatric admissions, mental health presentations and wait times at emergency department. Cost savings are largely marginal and do not offset the cost of units. First-time referrals to psychiatric decision units use more inpatient and community care and less emergency department-based liaison psychiatry in the months following the first visit. Psychiatric decision units work best when configured to reduce either informal psychiatric admissions (longer length of stay, higher staff-to-patient ratio, use of psychosocial interventions), resulting in improved quality of crisis care or demand on the emergency department (higher capacity, shorter length of stay). To function well, psychiatric decision units should be integrated into the crisis care pathway alongside a range of community-based support. The availability and quality of data imposed limitations on the reliability of some analyses. Psychiatric decision units should not be commissioned with an expectation of short-term financial return on investment but, if appropriately configured, they can provide better quality of care for people in crisis who would not benefit from acute admission or reduce pressure on emergency department. The systematic review was registered on the International Prospective Register of Systematic Reviews as CRD42019151043. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/49/70) and is published in full in Health and Social Care Delivery Research; Vol. 11, No. 25. See the NIHR Funding and Awards website for further award information.

Advancing the communication of genetic risk for cardiometabolic diseases: a critical interpretive synthesis

BackgroundGenetics play an important role in risk for cardiometabolic diseases—including type 2 diabetes, cardiovascular disease and obesity. Existing research has explored the clinical utility of genetic risk tools such as polygenic risk scores—and whether interventions communicating genetic risk information using these tools can impact on individuals’ cognitive appraisals of disease risk and/or preventative health behaviours. Previous systematic reviews suggest mixed results. To expand current understanding and address knowledge gaps, we undertook an interpretive, reflexive method of evidence synthesis—questioning the theoretical basis behind current interventions that communicate genetic risk information and exploring how the effects of genetic risk tools can be fully harnessed for cardiometabolic diseases.MethodsWe obtained 189 records from a combination of database, website and grey literature searches—supplemented with reference chaining and expert subject knowledge within the review team. Using pre-defined critical interpretive synthesis methods, quantitative and qualitative evidence was synthesised and critiqued alongside theoretical understanding from surrounding fields of behavioural and social sciences.FindingsExisting interventions communicating genetic risk information focus predominantly on the “self”, targeting individual-level cognitive appraisals, such as perceived risk and perceived behavioural control. This approach risks neglecting the role of contextual factors and upstream determinants that can reinforce individuals’ interpretations of risk. It also assumes target populations to embody an “ascetic subject of compliance”—the idea of a patient who strives to comply diligently with professional medical advice, logically and rationally adopting any recommended lifestyle changes. We developed a synthesising argument—“beyond the ascetic subject of compliance”—grounded in three major limitations of this perspective: (1) difficulty applying existing theories/models to diverse populations, (2) the role of familial variables and (3) the need for a life course perspective.ConclusionsInterventions communicating genetic risk information should account for wider influences that can affect individuals’ responses to risk at different levels—including through interactions with their family systems, socio-cultural environments and wider health provision.Protocol registrationPROSPERO CRD42021289269

Components of Outpatient Child and Youth Concurrent Disorders Programs: A Critical Interpretive Synthesis: Composantes des programmes de troubles concomitants des enfants et des jeunes ambulatoires : une synthèse interprétative critique.

Co-occurring mental health and substance use disorders (concurrent disorders) lead to significant morbidity in children and youth. Programs for integrated treatment of concurrent disorders have been developed; however, there exists little guidance outlining their structure and activities. Our objective was to synthesize available information on outpatient child and youth concurrent disorders programs and produce a comprehensive framework detailing the components of such programs. We used a four-stage critical interpretive synthesis design: (1) systematic review of published and grey literature, (2) data abstraction to identify program components and purposive sampling to fill identified gaps, (3) organization of components into a structured framework, (4) feedback from programs. We employed an iterative process by which programs reviewed data abstraction and framework development and provided feedback. Through systematic review (yielding 1,408 records total and 7 records eligible for inclusion) and outreach strategies (yielding an additional 7 eligible records), we identified 11 programs (4 American, 7 Canadian) and 2 theoretical models from which data could be abstracted. Program activities were categorized into 12 overarching constructs that make up the components of the framework: accessibility, engagement, family involvement, integrated assessment, psychotherapy for patients, psychotherapy for families, medication management, health promotion, case management, vocational support, recreation and social support, and transition services. Program components are informed by the philosophical orientation of the program and models of care. This framework considers health system factors, clinical service factors, program development, and community partnership that impact program structure and activities. Multidisciplinary teams provide care and include addiction medicine, psychiatry, psychology, nursing, social work, occupational therapy, recreation therapy, peer support, and program evaluation. We developed a comprehensive framework describing components of child and youth outpatient concurrent disorders programs. This framework may assist programs currently operating, and those in development, to reflect on their structure and activities.

Knowledge Mobilisation in Safeguarding Adults and Children for Healthcare in England

Safeguarding for healthcare involves working together to protect adults, children, and young people at risk of harm. Despite global research and national guidance outlining health professionals’ roles in this regard, there is limited knowledge about the type of strategies used to mobilise safeguarding research to practitioners in England. Our critical interpretive synthesis (CIS) sought to explore how safeguarding knowledge is mobilised to enable practitioners to use research effectively. This synthesis aimed to bridge the theory-practice gap in mobilising safeguarding knowledge to practitioners. Knowledge mobilisation (KMb) is an emerging discipline concerned with moving knowledge across communities to catalyse change. This review aimed to build understanding about how safeguarding knowledge is mobilised for healthcare in England and to synthesise the type of approaches undertaken to protect adults and children from harms, including abuse. A critical interpretive synthesis was undertaken using KMb theory and computer-assisted modelling technologies for secondary thematic analysis of complex literature of relevance, including qualitative research, reviews, and reports. Few papers informed how safeguarding knowledge is mobilised for healthcare in England. Learning from experience dominated the literature in three ways: (i) crisis response, (ii) practice engagement, and (iii) influencing actions (for “best” practice). Embedding safeguarding knowledge and skills in healthcare settings usually followed a crisis response. Learning from experience showed movement between practice engagement and influencing actions for adult and/or child protection. KMb might be useful in supporting the implementation of evidence-based safeguarding for practice. CIS identified a gap in how safeguarding research is mobilised to practitioners for healthcare. KMb theory provided an analytical bridge to computer-assisted modelling of factors associated with moving learning from experience to learning in practice. Future research could build on hybrid synthesising of safeguarding functions and impacts for healthcare, to enable practitioners to protect adults and children from multiple harms, including violence and abuse.

Mapping the Indigenous Postcolonial Possibilities of Teacher Preparation

In this article, a team of teacher educators collectively think through the many possibilities of how concepts such as decolonization, abolition, and fugitivity intersect with and are taken up by teacher education programs. To do so, we undertook a critical interpretive synthesis of scholarly literature spanning 2000 to 2020 to locate, examine, and organize existing examples of teacher education programs that work to transgress hegemonic colonial models of education. We revisit de Oliveira Andreotti et al.’s social cartography as a framework for comparing the theoretical foundations and social implications of each teacher education program.

A critical interpretive synthesis of the lived experiences and health and patient-reported outcomes of people living with COPD who isolated during the COVID-19 pandemic.

To determine the lived experiences of people with COPD who isolated at home during the coronavirus disease 2019 (COVID-19) pandemic, and explore how these experiences affected health and patient-reported outcomes. Keyword searches were performed in five bibliographic databases. Critical interpretative synthesis (CIS) methods were used to interrogate and understand patterns across studies. 23 studies were identified; three employed qualitative methods and 20 quantitative methods. Application of CIS methods highlighted a core synthetic concept that appeared to underpin experiences and outcomes, that of a heightened perception of risk. Using the Risk Perception Model as a framework, we found that cognitive factors such as knowledge of underlying health status and the transmissibility of COVID-19; experiential factors including previous episodes of breathlessness and hospitalisation; and sociocultural factors such as access to trusted sources of information, influenced perceptions of risk. In turn, this influenced behaviour, which translated to outcomes such as reduced hospitalisations, deconditioning and social isolation as people avoided "high-risk" situations and settings. Patients with COPD who isolated at home during the COVID-19 pandemic had a heightened perception of risk which was influenced by cognitive, experiential and sociocultural factors. The consequences of this were varied and included both positive (reduced exacerbations and hospitalisations) and negative (social isolation, deconditioning, diminished capacity for self-care) outcomes. Understanding risk and the impacts it can have could help clinicians to support people with COPD return to their pre-pandemic way of living and enable better communication of ongoing risk from respiratory viral illness.

The conceptualisation and operationalisation of ‘marketing’ in public health research: a review of reviews focused on food marketing using principles from critical interpretive synthesis

BackgroundExtensive public health research reports the nature, scope and effects of various marketing activities used by food and drinks companies to support the sale of their products. Such literature informs the regulation of food marketing that encourages unhealthy eating behaviours and poor diet-related health outcomes. However, it is not clear whether this literature consistently conceptualises and applies marketing, which could in turn influence the approach and efficacy of policies to regulate food marketing. We aimed to understand the conceptualisation and operationalisation of marketing in public health research of food marketing, eventually focusing on the conceptualisation of integrated marketing.MethodsWe conducted a review of reviews that drew on scoping review methods and applied principles of critical interpretive synthesis. Five databases of peer-reviewed literature and websites of relevant organisations were searched in June – August 2020. Articles were screened against inclusion criteria to identify reviews examining food marketing in a health context. Informative text segments from included articles were coded using NVivo. Codes were grouped into synthetic constructs and a synthesising argument.ResultsAfter screening against inclusion criteria, 60 publications were eligible for inclusion. Informative text segments from 24 publications were coded, after which no new codes were identified. Our synthesising argument was that the understanding of integrated marketing appeared inconsistent across publications, such as by differences in use of underlying conceptual frameworks and in the application of terms such as marketing strategy and tactics.ConclusionsUsing our synthesising argument, we suggest ways to improve the future study of food marketing in public health research, for example by using in-depth case studies to understand the integrated operation and effect of multi-component marketing strategies. Improving conceptual clarity in the study of food marketing in public health research has the potential to inform policy that is more reflective of the true nature of marketing, and thus more effective in combating food marketing effects and protecting public health.Protocol registrationThe review protocol was made publicly available on Open Science Framework prior to the start of the study (DOI: https://doi.org/10.17605/OSF.IO/VSJCW).

A Multilevel Framework for Complex Care: A Critical Interpretive Synthesis

Health systems are poorly equipped to respond to complex health and social needs, which span sectors and diagnoses. This study puts forward a framework for complex care policy. The framework was developed using critical interpretive synthesis, a method for developing theory on the basis of a transparent search and critical analysis of a heterogenous body of the literature. Seventy-three results were included from a systematic search. We suggested that complex needs can be understood as a pattern of unmet needs occurring at the intersection of fragmented health systems and services, multimorbidity, and social marginalization. We proposed a multilevel framework to inform complex care policy design that accounts for each of these issues and their intersections at the individual, service, and system level. We further identified five principles that have relevance at all levels of complex care. Our framework centres clients and their relationships with providers and suggests how services and systems can support client-level interactions. Conceptualizing complex care policy as a multilevel intervention offers a tool for understanding unexpected effects. Further work is needed to test and refine this framework and to contextualize it for particular populations and settings.

Applying an equity lens to hospital safety monitoring: a critical interpretive synthesis protocol

IntroductionHospital safety monitoring systems are foundational to how adverse events are identified and addressed. They are well positioned to bring equity-related safety issues to the forefront for action. However, there...

Why Is It So Hard to Evaluate Knowledge Exchange? Comment on "Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis".

Despite a growth in knowledge translation (KT) or exchange activities, and a smaller growth in their evaluations, it remains challenging to identify evidence of efficacy. This could be due to well-documented political and logistical difficulties involved in evaluating knowledge exchange interventions. By bringing in theory from science and technology studies (STS), Borst et al1 offer a new way of thinking about this problem. Most KT evaluations draw on health research traditions; centralising comparability, efficacy, and so on. Borst et al propose focusing on the work it takes to move knowledge over boundaries between these communities, seeing relationships as interactions, not just conduits for evidence. They show how 'context' can be understood as a mutual creation, not a static environment; and that institutions shape behaviours, rather than merely being sites or platforms for evidence mobilisation. Seeing KT as a creative, active practice opens new ways to design and evaluate KT mechanisms.

Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy.

Non-communicable diseases (NCDs) kill 41 million people a year. The products and services of unhealthy commodity industries (UCIs) such as tobacco, alcohol, ultra-processed foods and beverages and gambling are responsible for much of this health burden. While effective public health policies are available to address this, UCIs have consistently sought to stop governments and global organisations adopting such policies through what is known as corporate political activity (CPA). We aimed to contribute to the study of CPA and development of effective counter-measures by formulating a model and evidence-informed taxonomies of UCI political activity. We used five complementary methods: critical interpretive synthesis of the conceptual CPA literature; brief interviews; expert co-author knowledge; stakeholder workshops; testing against the literature. We found 11 original conceptualisations of CPA; four had been used by other researchers and reported in 24 additional review papers. Combining an interpretive synthesis of all these papers and feedback from users, we developed two taxonomies - one on framing strategies and one on action strategies. The former identified three frames (policy actors, problem, and solutions) and the latter six strategies (access and influence policy-making, use the law, manufacture support for industry, shape evidence to manufacture doubt, displace, and usurp public health, manage reputations to industry's advantage). We also offer an analysis of the strengths and weaknesses of UCI strategies and a model that situates industry CPA in the wider social, political, and economic context. Our work confirms the similarity of CPA across UCIs and demonstrates its extensive and multi-faceted nature, the disproportionate power of corporations in policy spaces and the unacceptable conflicts of interest that characterise their engagement with policy-making. We suggest that industry CPA is recognised as a corruption of democracy, not an element of participatory democracy. Our taxonomies and model provide a starting point for developing effective solutions.

Money Multiplication in Islamic Banking – A Discussion on its Impact on Distributive Justice

This paper explores the legitimacy of the use of Fractional Reserve System in Islamic banking from the normative premise of Islamic economics. The paper uses a methodology of structured literature review and a conceptual analysis of the literature following the approach of Critical Interpretive Synthesis (CIS). The first section of the paper presents the analysis on fractional Reserve Bank (FRB) system, how it leads to multiplication of money supply and influence the long-term inflation and business cycles; the second part of the article explains the extent to which this framework obstructs in the achievement of the objectives of Islamic Economics. This is followed by a reflective analysis of concepts and information gathered from the literature to evaluate how FRB system fits into the fabric of Islamic Economic. The second section of this paper explains how Islamic Banks, with an FRB model and its inclination towards debt-based instruments, would allow Islamic banks to contribute to the problem of inflation, even if they use Musharakah and Mudarabah as a mode of finance.

Representations of parenting autistic children: A critical interpretive synthesis

Background Many taken-for-granted expectations for parents in Western societies are situated in normative assumptions. Social constructions of ‘good’ parenting may be a poor fit for parents whose children’s development varies from a so-called typical trajectory. Normative assumptions about parenting can have harmful effects for parents of autistic children. Aims/Objectives This paper examines representations of parenting autistic children in contemporary research and considers the potential effects of these representations on these parents’ occupational possibilities. Methods Informed by a critical occupational perspective, a critical interpretive synthesis (CIS) of 27 research articles focussed on parenting autistic children was conducted. Findings Three major discursive threads were identified regarding how parents of autistic children are represented in research: gendered assumptions, caregiving as all-consuming, and disruption of normative expectations of parenting. Conclusions and significance Normative discourses about parenting were (re)produced within this body of research which may perpetuate limitations in the occupational possibilities of parents of autistic children. Critical investigation into contemporary research is necessary to challenge taken for granted expectations for parents of children with autism, to mitigate harmful effects for parents, to inform transformative OT practices and policies, and to promote equitable service provision.