Critical Tool Research Articles

Young People Transitioning From Child and Adolescent to Adult Mental Health Services: A Qualitative Systematic Review.

To critically synthesise the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. Young people within child and adolescent mental health services are usually required to transition to adult mental health services at the age of 18, despite evidence showing cognitive and emotional development impacted by childhood trauma, illness and adverse life events. This qualitative systematic review searched relevant electronic databases, policy documents, grey literature and theses examining original qualitative peer-reviewed studies published from 2009 to 2022 in English. The process utilised the PRISMA guidelines and the quality of papers assessed by the JBI critical appraisal tool. Nine papers met the criteria for inclusion in the review. The results indicate that qualitative research listening to the voices of young people transitioning to adult mental health services is a rarity. Even fewer papers examine the perspectives of key people in their lives: this review has critically synthesised the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. The main themes identified include: age 18 is not a helpful trigger to transition; young people want more individualised planning; parents want more involvement and clinicians open up about a challenging nexus with adult mental health services.

Modelling the impact of host galaxy dust on type Ia supernova distance measurements

ABSTRACT Type Ia Supernovae (SNe Ia) are a critical tool in measuring the accelerating expansion of the universe. Recent efforts to improve these standard candles have focused on incorporating the effects of dust on distance measurements with SNe Ia. In this paper, we use the state-of-the-art Dark Energy Survey 5 year sample to evaluate two different families of dust models: empirical extinction models derived from SNe Ia data and physical attenuation models from the spectra of galaxies. In this work, we use realistic simulations of SNe Ia to forward-model different models of dust and compare summary statistics in order to test different assumptions and impacts on SNe Ia data. Among the SNe Ia-derived models, we find that a logistic function of the total-to-selective extinction $R_V$ best recreates the correlations between supernova distance measurements and host galaxy properties, though an additional 0.02 mag of grey scatter is needed to fully explain the scatter in SNIa brightness in all cases. These empirically derived extinction distributions are highly incompatible with the physical attenuation models from galactic spectral measurements. From these results, we conclude that SNe Ia must either preferentially select extreme ends of galactic dust distributions, or that the characterization of dust along the SNe Ia line-of-sight is incompatible with that of galactic dust distributions.

Barriers to Meaningful Connectivity

Community networks risk failure when they attempt to emulate models from elsewhere without engaging the community in the process and making appropriate adaptations. These ‘build it and they will come’ models rarely work over the long term. This research project explored claims from residents of a low-income neighbourhood in the “North End” of Winnipeg in Manitoba, Canada, that inadequate and unaffordable Internet connectivity limits their access to critical communication tools, resources, and information. Through the research, we identified the need for a sustainable model of affordable, accessible Internet connectivity that centers on building a cooperative-owned and operated community network with Indigenous and newcomer families at its heart. Findings revealed that high connectivity costs, limited digital literacy, and inadequate infrastructure are the primary barriers to meaningful connectivity in the community. The intent of the “North End Connect” research project was to work directly with the residents, to learn about their connectivity needs and wants, inform the project’s technical team as to how and where to build a solution that works for the community, removing explicit and implicit barriers to access. Through our research, we validated that digital connectivity is a problem in the community. Utilizing a CBPAR approach provided a more nuanced understanding of the barriers to access from the resident’s perspective and lived experience. This allowed for the development of a strengths-based roadmap that utilized existing assets to provide affordable, accessible, trustworthy, and secure Internet access to anyone who wants it. The research acted as the catalyst to motivate the community and led to ongoing interventions aimed at addressing each of the identified barriers. As we investigate these barriers, it becomes evident that addressing these issues is not just a matter of technological access but a crucial step toward fostering a more inclusive and equitable society. The project serves as a model for community-driven digital inclusion efforts and contributes to global conversations about equitable access to the internet.

Role of grass endophytic fungi as a natural resource of bioactive metabolites.

Grass endophytic fungi have garnered increasing attention as a prolific source of bioactive metabolites with potential application across various fields, including pharmaceticals agriculture and industry. This review paper aims to synthesize knowledge on the diversity, isolation, and bioactivity of metabolites produced by grass endophytic fungi. Additionally, this approach aids in the conservation of rare and endangered plant species. Advanced analytical techniques such as high-performance liquid chromatography, liquid chromatograpy-mass spectrometry and gas chromatography are discussed as critical tools for metabolite identification and characterization. The review also highlights significant bioactive metabolites discovered to date, emphasizing their antimicrobial, antioxidant, and insecticidal activities and plant growth regulation properties. Besides address the challenges and future prospects in harnessing grass endophytic fungi for sustainable biotenological applications. By consolidating recent advancements and identifying agaps in the current research, this paper provides a comprehensive overview of the potential grass endophytic fungi as a valuable resource for novel bioactive compounds.

CDC Program Evaluation Framework, 2024.

Program evaluation is a critical tool for understanding and improving organizational activities and systems. This report updates the 1999 CDC Framework for Program Evaluation in Public Health (CDC. Framework for program evaluation in public health. MMWR Recomm Rep 1999;48[No. RR-11];1-40) by integrating major advancements in the fields of evaluation and public health, lessons learned from practical applications of the original framework, and current Federal agency policies and practices. A practical, nonprescriptive tool, the updated 2024 framework is designed to summarize and organize essential elements of program evaluation, and can be applied at any level from individual programs to broader systems by novices and experts for planning and implementing an evaluation. Although many of the key aspects from the 1999 framework remain, certain key differences exist. For example, this updated framework also includes six steps that describe the general process of evaluation planning and implementation, but some content and step names have changed (e.g., the first step has been renamed Assess context). The standards for high-quality evaluation remain central to the framework, although they have been updated to the five Federal evaluation standards. The most substantial change from the 1999 framework is the addition of three cross-cutting actions that are core tenets to incorporate within each evaluation step: engage collaboratively, advance equity, and learn from and use insights. The 2024 framework provides a guide for designing and conducting evaluation across many topics within and outside of public health that anyone involved in program evaluation efforts can use alone or in conjunction with other evaluation approaches, tools, or methods to build evidence, understand programs, and refine evidence-based decision-making to improve all program outcomes.

Revolutionizing the Banking Industry: The Impact of Blockchain Technology on Financial Services

Blockchain technology represents a significant innovation with far-reaching implications across multiple industries, having initially emerged as the backbone of Bitcoin to enable secure, decentralized digital transactions. Its decentralized structure, which replaces centralized databases with multiple shared copies across nodes, enhances security and reduces the risk of data breaches. Despite its growing use in banking, finance, supply chains, and other sectors, a gap exists in fully understanding its transformative potential in improving business processes. This research aims to analyze blockchain’s impact on the security, efficiency, and transparency of digital transactions. By employing a comparative analysis of blockchain applications across industries, we find that its decentralized, encrypted ledger system significantly reduces fraud risk and improves transactional efficiency. These results highlight blockchain’s role as a critical tool for future digital economies, with broader implications for enhancing trust and security in various sectors.

MRI for Rectal Cancer: Updates and Controversies-AJR Expert Panel Narrative Review.

Rectal MRI is a critical tool in the care of patients with rectal cancer, having established roles for primary staging, restaging, and surveillance. The comprehensive diagnostic and prognostic information provided by MRI helps to optimize treatment decision-making. However, challenges persist in the standardization and interpretation of rectal MRI, particularly in the context of rapidly evolving treatment paradigms, including growing acceptance of nonoperative management. In this AJR Expert Panel Narrative Review, we address recent advances and key areas of contention relating to the use of MRI for rectal cancer. Our objectives include: to discuss concepts regarding anatomic localization of rectal tumors; review the evolving rectal cancer treatment paradigm and implications for MRI assessment; discuss updates and controversies regarding rectal MRI for locoregional staging, restaging, and surveillance; review current rectal MRI acquisition protocols; and discuss challenges in homogenizing and optimizing acquisition parameters.

In Defense of Democratic Qualitative Research Teams: A Bourdieusian Approach to Critical Reflexivity

In this article, we provide a critical reflexive tool developed to interrogate hierarchical research team structures. As members of a qualitative research team working on a large-scale federally funded project, we aim to provide guidance for scholars interested in working against established hierarchies toward more democratic team practices. Our approach is guided by critical scholarship that employs Bourdieu’s conceptualization of reflexivity to move beyond individual-level positionality, toward the critical analysis of the larger academic field and intellectual bias produced through the neoliberal academic field. Though some have argued for the need to preserve hierarchy, we stand in defense of democratic teams.

Global rapid review of interventions to tackle the harms of illicit tobacco

ObjectiveThis review aimed to assess interventions designed to reduce harm from illicit tobacco (IT). We evaluated health outcomes, cost-effectiveness, the advantages and disadvantages of interventions, and contextual factors affecting implementation.Data...

A quantitative approach to measure and predict microbiome response to antibiotics.

Antibiotics are potent influencers of the human microbiome and can be a source for enduring dysbiosis and antibiotic resistance in healthcare. Existing microbiome data analysis methods can quantify perturbations of bacterial communities but cannot evaluate whether the differences are aligned with the expected activity of a specific antibiotic. Here, we present a novel method to quantify and predict antibiotic-specific microbiome changes, implemented in a ready-to-use software package. This has the potential to be a critical tool to broaden our understanding of the relationship between the microbiome and antibiotics.

A compressible high-sensitivity flexible sensor array for real-time motion artifact detection in magnetic resonance imaging

Magnetic Resonance Imaging (MRI) serves as a critical tool in modern medical diagnosis, and its accuracy is directly linked to patient treatment and recovery. However, unintentional patient movement during MRI scans often results in motion artifacts on the images, significantly compromising the precision of diagnosis. Traditional solutions typically involve identifying and addressing these issues after the scanning sequence is completed, leading to significant resource waste and delays in patient treatment. Here, we propose a flexible tactile sensor array system based on triboelectric nanogenerators (TENGs) for real-time monitoring of head motion artifacts in MRI. The unique design of the tactile sensor structure, operating in a dual-electrode mode, maintains high sensitivity and a wide response range, even with a minimal surface area. The advantage of TENG is the wide range of material choices, ensuring that a proper selection will not interfere with MRI during application. By integrating TENG sensor technology and control program systems, this solution provides a novel approach for monitoring head motion artifacts in MRI. On the basis of ensuring patient comfort, it has saved the time and money costs of monitoring, improved the efficiency of detection, and demonstrated significant potential in the field of medical imaging.

Factors Related to Rehabilitation Adherence in Pediatric Cancer: A Systematic Review

Background: Rehabilitation is crucial for improving the functional outcomes of children and adolescents with cancer. An understanding of factors related to rehabilitation adherence is needed to improve intervention design and effectiveness, and decrease healthcare costs. Therefore, this systematic review aims to identify factors related to pediatric cancer rehabilitation adherence. Methods: Based upon the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a search of MEDLINE and CINAHL was completed in January 2023, including terms of pediatrics, cancer, rehabilitation, and adherence. Study eligibility included: (1) published after 2011, (2) English language, (3) a physical therapy, occupational therapy, speech-language pathology, cognitive or exercise intervention or service, (4) mean age ≤18 years old, within 5 years of a cancer diagnosis, and (5) measurement and reporting of adherence factors. Study quality was evaluated using the Joanna Briggs Critical Appraisal Tools. Results: The review included 13 studies providing interventions to 318 children. Most of the interventions were related to exercise. Adherence levels of supervised sessions ranged from 61% to 91%. Unsupervised intervention adherence was not a common outcome, but the reported measurements ranged widely (<1-72%). The classification of factors associated with adherence included organizational, treatment, and personal factors. Common barriers to adherence were fatigue, illness, time and motivation. Facilitators of adherence included peer or caregiver support and supervision. Conclusion: Additional research is needed to investigate the factors related to rehabilitation intervention adherence, especially factors beyond exercise and those associated with unsupervised interventions. Standardized measures are crucial to ensure the reliability and comparability of findings.

Modelling what matters: How do current models handle environmental limits and social outcomes?

Models that represent the economy, society, and environment are critical macroeconomic policy tools. However, economic output as measured by Gross Domestic Product (GDP) is increasingly being seen as an unreliable and undesirable economic indicator and policy goal. Instead, multiple indicators of environmental impacts and social outcomes are needed to make decisions about sustainable development.Drawing on the Doughnut of social and planetary boundaries, and the Sustainable Development Goals, we analyse 50 models to assess the state of the art in modelling the environment, society, and economy. We categorise models according to their economic foundation and modelling approach, assess their coverage of 15 environmental and 21 social indicators, and identify feedbacks between different model parts. We further construct a targeted sample of 15 models that represents the diversity in modelling approaches and indicator coverage, and use this sample to investigate how environmental and social indicators are linked to macroeconomic drivers.For the environment, indicator coverage is best for climate change, energy use, and land conversion. Within current models, environmental impact is largely driven by GDP and agricultural production. For society, coverage is best for jobs, income (wages and inequality), and productivity. Within current models, social outcomes are largely driven by income per capita, government spending, and governance. Models rarely contain feedbacks from the environment and society to the economy, and few include any biophysical limits.The current focus on monetary flows limits understanding of the interconnections between environmental, social, and economic systems. We argue that modellers should rely less on economic variables as determinants of social and environmental outcomes. Specific provisioning systems could be modelled in more detail to allow models to explore growth-agnostic ways of achieving a good life for all within environmental limits.

‘A Necessary Evil?’: (Southern) Rhodesia’s Diplomatic and Economic Relations with Zambia, 1963 to 1973

This paper historicises the diplomatic and economic relations of Southern Rhodesia and Zambia between 1963 and 1973. While there has been comprehensive scholarship delineating the relations between, for instance, Zimbabwe and South Africa over the years, neighbouring Zambia has hitherto been given little attention by historians. Where the relations of Zimbabwe and Zambia have been examined, this has been in the context of political and military connections between Zambia’s United National Independence Party-led government and the Zimbabwean liberation movements the Zimbabwe African National Union and the Zimbabwe African People’s Union. In terms of Zambia–Rhodesia economic and diplomatic interactions, much has been written on how Zambia fared against the backdrop of Rhodesia’s Unilateral Declaration of Independence and the sanctions that followed, from the point of view of Zambia. We shift the focus because there is very little scholarship on the Rhodesian point of view, particularly its relations with Zambia in the period covered by this article. Using archival sources, newspapers and secondary literature, we contend that until the closure of the Rhodesia–Zambia border, the connection between the two countries was characterised by a cautious partnership marked by both covert and overt hostility, which escalated to an outright breakdown of border relations in 1973. Essentially, economic diplomacy became a critical tool deployed by Rhodesia towards Zambia to survive times of financial challenges precipitated by sanctions imposed by Britain and the United Nations, as well as the context of wars of liberation waged in Rhodesia since 1966.

The outcomes of imagery-focused interventions in relation to distress in people with delusions: a systematic literature review

Abstract Background: Imagery-focused therapies within cognitive behavioural therapy are growing in interest and use for people with delusions. Aims: This review aimed to examine the outcomes of imagery-focused interventions in people with delusions. Method: PsycINFO, PubMed, MEDLINE, Web of Science, EMBASE and CINAHL were systematically searched for studies that included a clinical population with psychosis and delusions who experienced mental imagery. The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and quality appraisal of all included papers was completed using the Crowe Critical Appraisal Tool. Information from included texts was extracted and collated in Excel, which informed the narrative synthesis of results. Results: Of 2,736 studies identified, eight were eligible for inclusion and rated for quality with an average score of 70.63%. These studies largely supported their aims in reducing levels of distress and intrusiveness of imagery. Four of the eight studies used case series designs, two were randomised controlled trials, and two reported single case studies. It appears that interventions targeting mental imagery were acceptable and well tolerated within a population of people experiencing psychosis and delusions. Conclusions: Some therapeutic improvement was reported, although the studies consisted of mainly small sample sizes. Clinical implications include that people with a diagnosis of psychosis can engage with imagery-focused therapeutic interventions with limited adverse events. Future research is needed to tackle existing weaknesses of design and explore the outcomes of imagery interventions within this population in larger samples, under more rigorous methodologies.

Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2024 edition)

To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical Diagnosis and Treatment Guidelines for Lung Cancer (2024 edition). This consensus resulted in several updates from the 2023 version. The 2024 guidelines highlight that the risk of lung cancer in smokers remains higher than that of non-smokers even 15 years after quitting. Additionally, a new lung cancer incidence risk model is expected to become a critical tool for screening high-risk groups. In pathology, the guidelines now include pathological evaluation of surgically resected lung cancer specimens following neoadjuvant therapy and suggest that immunohistochemical staining of certain transcription factors may aid in the classification of small cell lung cancer (SCLC). In molecular detection, the guidelines propose simultaneous detection of driver gene variations based on both RNA and DNA from specimens. The new edition also provides detailed descriptions of patient selection and surgical requirements for thoracic sub-lobectomy, aligned with the 9th TNM staging. Moreover, the guidelines expand treatment options, approving more therapies for immunoadjuvant and EGFR-TKI resistant lung cancer patients, as well as additional drug options for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations, EGFR 20 insertions, ALK fusions, and MET exon 14 skipping. These recommendations are based on state-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, rehabilitation professionals, and other medical staff at all levels.

Zooming in and out: Exploring RNA Viral Infections with Multiscale Microscopic Methods.

RNA viruses, being submicroscopic organisms, have intriguing biological makeups and substantially impact human health. Microscopic methods have been utilized for studying RNA viruses at a variety of scales. In order of observation scale from large to small, fluorescence microscopy, cryo-soft X-ray tomography (cryo-SXT), serial cryo-focused ion beam/scanning electron microscopy (cryo-FIB/SEM) volume imaging, cryo-electron tomography (cryo-ET), and cryo-electron microscopy (cryo-EM) single-particle analysis (SPA) have been employed, enabling researchers to explore the intricate world of RNA viruses, their ultrastructure, dynamics, and interactions with host cells. These methods evolve to be combined to achieve a wide resolution range from atomic to sub-nano resolutions, making correlative microscopy an emerging trend. The developments in microscopic methods provide multi-fold and spatial information, advancing our understanding of viral infections and providing critical tools for developing novel antiviral strategies and rapid responses to emerging viral threats.

PRIORITY DIRECTIONS OF ENTERPRISES DEVELOPMENT IN THE WAR CONDITIONS BASED ON THE IMPLEMENTATION OF INFORMATION TECHNOLOGIES AND DIGITAL TOOLS

The article examines the modern challenges faced by Ukrainian enterprises in war conditions and the strategic approaches to adapting to these challenges. As business leaders, policymakers, and analysts, your understanding and support are crucial. The current stage of Ukraine's economic development, characterized by high instability due to the full-scale invasion of Russia, dictates new conditions for the functioning of domestic enterprises. In these conditions, implementing information technologies and digital tools becomes critically important for ensuring sustainable development and adaptation of enterprises to new realities. The influence of the war on the strategic behavior of enterprises is considered in detail, emphasizing the need to adapt to rapid changes in the external environment. In constant uncertainty and risks, enterprises are forced to look for new development opportunities, actively implement information technologies, and diversify their activities. The main challenges and barriers faced by enterprises during the war are also analyzed. Among them are the lack of sufficient capital, limited access to credit funds, the unpredictability of the situation in Ukraine, the negative impact of government decisions on business, and others. To overcome these problems, enterprises must look for development directions and develop appropriate development strategies that consider internal opportunities and external threats. Digitization and the use of information technologies are becoming critical tools for achieving these goals, allowing enterprises to adapt to changes in the external environment quickly, increase the efficiency of their activities, and maintain competitiveness. Special attention is paid to such promising development directions as DefenseTech, FinTech and cyber security. These directions, with their significant potential for development in wartime, provide the necessary technological solutions to improve the security and efficiency of enterprises, offering a beacon of hope for the future. Thus, the article provides a comprehensive analysis of the priority directions of enterprise development in wartime conditions, with an emphasis on implementing information technologies and digital tools.

Organisational models for managing Public Health Emergencies of International Concern (PHEICs) in the South-East Asia Region (SEAR) nations: protocol for a systematic review

IntroductionThe current literature suggests that the frequency and complexity of public health emergencies are rising and this trend will likely continue. From 2000 to 2023, seven events have been declared...

OLD WINE IN A NEW WINESKIN: ACHEBE’S OKONWO A CHARACTER ARCHETYPE OF ADICHIE’S EUGENE ACHIKE

The investigation and establishment of character types in literary texts is a cardinal thrust of archetypal criticism as a critical tool. Achebe’s Okonkwo in Things Fall Apart (1958) and Adichie’s Eugene otherwise referred to as Papa in Purple Hibiscus (2003) are character types in two canonical African fictions not only because both are male protagonists but also due to a number of other remarkable characterizations which they share in common. In fact, Eugene can he said to be a modern Okonkwo in various ways. Utilizing the vital tools and tenets of archetypal criticism, a critical juxtaposition of the two major characters in the two novels unveils that both characters are caring but cruel, and indeed unleashed multidimensional phallocentric violence in monumental proportions to their immediate family members, particularly to their women. Both characters are unsympathetic to their wives and possess similar volcanic temperaments. Also, both men have “no patience” with their biological fathers and maintain frosty relationships with them on account of certain grievances and grudges borne in their hearts against them over a protracted period of time. Indeed, both men can be said to be ashamed of their own fathers. But their disgusts for their fathers transform them into men of actions rather than of words and leisure, even as both characters become diligent creators and managers of wealth by their personal determination, courage and hardworking attitude as opposed to the indigent backgrounds they germinated from. Unfortunately, both characters encounter tragic ends in their seemingly unguarded pursuit for preservation and perfection.