Grey Literature Research Articles

Extended-duration work shifts among care workers: a scoping review protocol

IntroductionThe available literature reviews of shift work among care workers are almost exclusively focused on 8-hour shifts and 12-hour shifts or 24-hour on-call shifts for physicians. We do not yet know the scope of evidence regarding extended-duration work shifts (defined as on-duty shifts of 16 or more hours per shift) in diverse healthcare settings, such as the impact on care workers and recipients of care. In this proposed scoping review, we aim to provide an overview of the current research regarding extended-duration work shifts among care workers in various healthcare settings.Methods and analysisWe will conduct this scoping review in accordance with the Joanna Briggs Institute scoping review methodology. Comprehensive searches will be conducted in PubMed, Embase, MEDLINE, Web of Science and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases and grey literature sources. We will include empirical studies that focus on extended-duration work shifts among care workers working in different healthcare settings, including home care, community, acute care settings, long-term care homes and assisted living facilities. We will not apply language restrictions. We will conduct searches in August 2024, followed by screening of records. We will exclude research on on-call work shifts and investigations that solely focus on interns. The included literature will be screened independently by pairs of reviewers at the title and abstract review phase, followed by a full-text review for relevant literature. Any disagreement will be resolved by consensus or discussion with a third reviewer. The results will be extracted and summarised in the final report in tabular form, when possible, along with narrative synthesis.Ethics and disseminationAll data for this study will come from published literature, so an ethics review is not necessary. The findings will be disseminated through conference presentations and publication in peer-reviewed journals, with the expectation that they will guide future research and inform future management of work shifts in care workers.

Efficacy and acceptability of lurasidone for bipolar depression: a systematic review and dose–response meta-analysis

Question The optimal dose of lurasidone for bipolar depression is unclear. This study examined its dose–response relationship for efficacy, acceptability, and metabolic/endocrine profiles. Study selection and analysis Five databases and grey literature published until 1 August 2024, were systematically reviewed. The outcomes included efficacy (changes in depression, anxiety, clinical global impression, disability and quality of life), acceptability (dropout, manic switch, suicidality and side effects) and metabolic/endocrine profiles (changes in body weight, glucose, lipid and prolactin levels). Effect sizes were calculated using a one-step dose–response meta-analysis, expressed as standardised mean differences (SMDs), risk ratios (RRs) and mean differences (MDs) with 95% CIs. Findings Five randomised clinical trials (2032 patients, mean treatment duration 6 weeks) indicated that the optimal therapeutic dose of lurasidone (40–60 mg) improved depression (50 mg: SMD −0.60 (95% CI −0.30, –0.89)), anxiety (50 mg: −0.32 (95% CI −0.21, –0.42)), clinical global impression (50 mg: −0.67 (95% CI −0.30, –1.03)) and disability (50 mg: −0.38 (95% CI −0.08, –0.69)). Side effects increased with higher doses (50 mg: RR 1.15 (95% CI 1.05, 1.25); 100 mg: 1.18 (95% CI 1.02, 1.36)), but dropout, manic switch and suicidality did not show a dose–effect relationship. Weight increased at doses<60 mg (40 mg: MD 0.38 (95% CI 0.16, 0.60) kg), while blood glucose levels rose at doses>70 mg (100 mg: 3.16 (95% CI 0.76, 5.57) mg/dL). Prolactin levels increased in both males (50 mg: 3.21 (95% CI 1.59, 4.84) ng/mL; 100 mg: 5.61 (95% CI 2.42, 8.81)) and females (50 mg: 6.64 (95% CI 3.50, 9.78); 100 mg: 5.33 (95% CI 0.67, 10.00)). Conclusions A daily dose of 40–60 mg of lurasidone is a reasonable choice for bipolar depression treatment. Trial registration number INPLASY202430069.

Editorial policy and procedure

The Journal of Vocational, Adult and Continuing Education and Training (JOVACET) recognises the need for critical engagement through studies in TVET and Adult and Continuing Education and Training, and for encouraging critical scrutiny of this expansive knowledge area on the African continent. The voices and experiences of practitioners, reflecting on all aspects of teaching and learning within vocational education and adult education settings, should be heard through publication of empirical and robust research. While the journal clearly wishes to take forward academic scholarship, it also seeks to strengthen opportunities for reflective practice that makes a scholarly contribution to the field. New knowledge emerging out of complex developmental contexts has significant value and needs to be showcased beyond existing geographical and political boundaries. The journal is therefore committed to also supporting the development of emerging researchers by providing them with a space to present and defend their research among a network of global scholars. Within the field of vocational and continuing education there is substantive ‘grey literature’ that remains in project report form. The journal is potentially a vehicle for the translation of this important work into an academic contribution to a wider community of practice and thereby enhancing its value. The JOVACET will appear at least once a year. Unsolicited articles are welcome for consideration and should be uploaded onto the JOVACET’s website online journal or else emailed to the journal’s managing editor. The editors are accountable for everything published in the journal and should therefore:• work towards improving the contents of the journal;• adopt peer-review methods best suited for the journal and the research communityit serves;• ensure that all manuscripts have been reviewed by appropriate reviewers;• ensure quality assurance processes are in place for the material that is published; and• uphold the highest standards of integrity, intellectual rigour and ethics. The editors will not disclose any information about the submitted manuscripts or their authors to anyone other than the author(s) and reviewer(s), as appropriate. Submitted articles will be reviewed by two anonymous external referees in a ‘blind’ peer-review process. Appropriate papers will be reviewed according to their significance and soundness. Articles that have been submitted must not have been published or accepted for publication elsewhere. The editors are responsible for deciding which of the manuscripts submitted to the journal will be published. The editors’ decision to accept or reject a manuscript should be based on the importance of the manuscript, its originality and clarity, the validity of the study and its relevance to the journal’s scope. Considerations will also include current legal requirements regarding libel, copyright infringement and plagiarism. Submissions may not exceed the 8 000-word limit and must contain a title, abstract of not more than 200 words and be correctly and completely referenced according to the Harvard system of referencing. Footnotes should be kept to a minimum. Tables should be positioned where they are referred to and not be submitted separately. Authors are requested to consult the author’s guidelines on the website. The article should not contain any identification of the author and should be anonymised as far as possible. The name(s) and affiliations of the author(s), as well as their email address, should appear on a separate page. The Journal of Vocational, Adult and Continuing Education and Training (JOVACET) is an open access, peer-reviewed journal committed to disseminating the latest research in post-school education to the global community as widely as possible. The journal content is freely and openly available after publication on the website, www.jovacet.ac.za, and can be read, downloaded, copied, distributed and printed without asking prior permission from the publisher or the author.

Misinformation About Climate Change and Related Environmental Events on Social Media: Protocol for a Scoping Review.

Climate change and related environmental events represent major global challenges and are often accompanied by the spread of misinformation on social media. According to previous reviews, the dissemination of this misinformation on various social media platforms requires deeper exploration. Moreover, the findings reported applied mainly to the context of the United States, limiting the possibility of extending the results to other settings. This study aims to assess the current state of knowledge about misinformation concerning climate change and related environmental events that are circulating on social media. More specifically, we will explore past and current themes, actors, and sources, and the dissemination of this misinformation within the Canadian context. This scoping review protocol follows the methodological approach developed by Arksey and O'Malley and advanced by Levac, complemented by the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and the best practice guidance for the development of scoping review protocols. Following the identification of the research questions and assisted by a specialized librarian, we developed search strategies for selected bibliographic databases (MEDLINE, Embase, Web of Science, and GreenFILE) and for gray literature (Google and pertinent databases) searches. Bibliographic and gray literature will be searched to identify relevant publications. In total, 2 members of our team will use the review software Covidence (Veritas Health Innovation) to independently select publications to include in the review. Publications specifically addressing our research questions, peer-reviewed, evidence-based, and published from January 1, 2000, in the full-text version in English or French will be included. Data will be extracted from the included publications to chart, among other items, the years of publication, geographic areas, themes, actors, and sources of the climate change-related misinformation and conclusions reported. Our team will then synthesize the extracted data to articulate the current state of knowledge relating to our research inquiries. The research questions were identified in January 2024. The search strategies were developed from January to March 2024 for MEDLINE, Embase, and Web of Science and in July 2024 for GreenFILE and gray literature. MEDLINE, Embase, and Web of Science searches were launched on March 26, 2024. The first of 2 rounds of selection of publications identified through these databases was achieved in April 2024. This protocol will enable us to identify the evolution of themes, actors, and sources of misinformation regarding climate change and related environmental events on social media, including the latest platforms, and to potentially identify a context particular to Canada. As misinformation is known to undermine actions and public support in the fight against climate change, we intend to facilitate the targeting of efforts to combat misinformation related to climate change in an up-to-date and contextualized manner. DERR1-10.2196/59345.

Journal of Vocational, Adult and Continuing Education and Training, Volume 7, Issue 1 2024

The Journal of Vocational, Adult and Continuing Education and Training The Journal of Vocational, Adult and Continuing Education and Training (JOVACET) recognises the need for critical engagement through studies in technical and vocational education and training (TVET) and adult and continuing education and training, and for encouraging critical scrutiny of this expansive knowledge area on the African continent. The voices and experiences of practitioners, reflecting on all aspects of teaching and learning within vocational education and adult education settings, should be heard through the publication of empirical and robust research. While the journal wishes to take forward academic scholarship, it also seeks to strengthen opportunities for reflective practice that makes a scholarly contribution to the field. New knowledge emerging out of complex developmental contexts has significant value and needs to be showcased beyond existing geographical and political boundaries. The journal is therefore committed to also supporting the development of emerging researchers by providing them with a space to present and defend their research amongst a network of global scholars. Within the field of vocational and continuing education there is substantive ‘grey literature’ that remains in project report form. The journal is potentially a vehicle for the translation of this important work into an academic contribution to a wider community of practice, thereby enhancing its value. (c) 2024 Journal of Vocational, Adult and Continuing Education and Training

Toward a whole-of-virtual school framework for promoting student physical activity: a scoping review protocol

BackgroundThe advent of full-time virtual schooling presents unique challenges and opportunities for the promotion of physical activity (PA) among children and adolescents. Despite the recognized benefits of PA as an essential component for combating non-communicable diseases and ensuring holistic development, there is a notable gap in understanding how to effectively integrate PA within the digital learning environments of full-time virtual schools. Current efforts to promote student PA are targeted for implementation exclusively in contexts characterized by physical school campuses that are bound to their surrounding local communities. This is problematic given the digital, widely distributed, and contextually unmoored nature of virtual schooling. Our aim in this scoping review is to advance research on whole-of-school physical activity promotion within full-time virtual schools by examining the published literature on whole-of-school PA promotion within full-time virtual schools. Specifically, this review will map the literature, consolidate knowledge claims and practical implications, and identify evidence gaps that merit further investigation.Methods/designThis review will be conducted using evidence-informed scoping review methodology and reporting guidelines. Articles will be included if they are peer-reviewed English-language research, commentary, practical, or grey literature and relate to the participation, support, design, development, and/or provision of remote online PA interventions delivered through primary/elementary and/or secondary/middle school/high schools. Searches will be conducted in PsycInfo, ERIC, SportDiscus, and Web of Science. Additional hand-searching, reference scans, and grey literature searches will also be performed. Two trained research assistants will independently complete study screening and selection and data charting with guidance from a senior author. Charted data will be displayed in table form, and depending on the results, data will also be synthesized through qualitative content analysis using the Active Schools guiding framework as an analytical and interpretive lens.DiscussionThis scoping review will serve as a guidepost for the application and advancement of research on whole-of-school PA promotion through full-time virtual schools. The results will address the increased importance of equitable online learning and PA promotion due to the expanding virtual education landscape, with implications for public health and education policy.Systematic review registrationOpen Science Framework: https://osf.io/f6wau/.

Clinicopathological analysis of hybrid carcinomas of the salivary glands: A systematic review

Hybrid carcinomas (HC) are the association of two or more malignant neoplasms arising within the same topographical area. The present study is a systematic review of HC of the salivary glands. This study aimed to assess HC clinicopathological features and molecular profile. Observational studies, case series, and case reports were included. PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched until June 2024. A total of 18 articles including 34 patients were included. HC of the salivary glands is presented as a painless mass affecting mainly the parotid gland of adults with a preference for male patients. Histologically, adenoid cystic carcinoma and epithelial-myoepithelial carcinoma were the most prevalent association, being surgical excision with radiotherapy the most common treatment. It's seen that the most aggressive component might guide the patient's treatment and prognosis. Further molecular studies are necessary to determine if HC are distinct entities or biologically identical to the individual neoplasms. In conclusion, this systematic review may contribute to a better understanding of this rare lesion, their biological behavior, treatments employed, and the outcome of these patients.

Exploring Machine Learning Applications in Sports Injury Prediction Analysis

Abstract: Injuries, particularly those resulting from repetitive strain on the body, pose a significant challenge in athletics, where prevention has traditionally relied on historical data and human expertise. Existing methods for injury prevention have struggled to achieve higher precision in practice. However, technological advancements now enable artificial intelligence (AI) and machine learning (ML) to emerge as promising tools for enhancing both injury mitigation and rehabilitation strategies. This article provides a detailed overview of recent ML advances applied to sports injury prediction and prevention. A comprehensive literature review was conducted using databases such as PubMed/Medline, IEEE/IET, and Science Direct, with additional resources from Ovid Discovery and Google Scholar, including a grey literature search. Focus was placed on studies published between 2017 and 2022, examining algorithms including K-Nearest Neighbor (KNN), K-means, decision trees, random forest, gradient boosting, AdaBoost, and neural networks. A total of 42 original research papers were reviewed and their findings summarized. While the current lack of open-source, standardized datasets and the reliance on dated regression models limit strong conclusions about ML’s real-world efficacy in sports injury prediction, addressing these challenges could enable the deployment of advanced ML architectures, thereby accelerating progress in this field and supporting the development of validated clinical tools.

Nursing Care and Postgraduate Education of Nephrology and Dialysis Nurses in Italy.

Introduction. Patients with chronic kidney disease undergoing renal replacement therapy have complex care needs. To address this, nephrology and dialysis nurses must possess expertise in advanced specialist and disciplinary skills. The aim of this review is to analyze post-graduate academic training pathways and clinical-care training in the field of nephrology and dialysis nursing in the Italian context. Methodology. A narrative review of the literature was conducted in May 2024, using databases such as CINAHL and Medline-PubMed, with a selection criterion limited to primary and secondary studies published in Italian and English. To supplement the search, particularly within the Italian context, grey literature sources were consulted. Results. Post-graduate nephrology nursing education in Italy is mainly offered through First-Level Masters, as well as Second Level Masters and specialization courses, which are provided at various academic institutions. Analysis of the educational programs revealed the presence of common "core" teachings across all pathways, covering renal disease pathophysiology, hemodialysis, peritoneal dialysis, and dialysis nursing care, alongside significant heterogeneity in other proposed teachings. Clinical-care training emerged as a fundamental aspect in both post-graduate education, professional integration for newcomers, and continuous professional development. Conclusions. The growing healthcare need for specialist skills suggests the necessity of integrating field-based training with standardized post-graduate academic pathways, possibly in collaboration with relevant Nursing Scientific Societies. This synergy would not only promote the enhancement of nursing competencies but also ensure a high quality of care delivery.

Critical Analysis of Tools for Measuring Recovery-Oriented Practice in Mental Health Facilities: A Scoping Review

Background: To implement recovery-oriented practice, it is important to have instruments capable of evaluating such practice. A number of different questionnaires have been developed in recent years which measure recovery orientation in mental health services. Objective: To identify and analyze patient-reported experience measures (PREMs) reported in the literature that are related to recovery-oriented practice in mental health services. Methodology: This study followed the Joanna Briggs Institute methodology for scoping reviews. Searches were carried out in the Web of Science, CINAHL, Medline (via Pubmed), and SCOPUS databases and in grey literature repositories (Google Scholar, Opengrey, Dart-Europe, Teseo). Papers on recovery services for adults suffering from mental disorders (MDs) were included. Those focusing on addiction and intellectual disability care services were excluded. Results: Sixteen papers met the inclusion criteria. The selected PREMs mainly identified recovery-oriented systems, treatment, community integration and support as the dimensions addressed most frequently in questionnaires. The average number of items included in the questionnaires was found to be 54. With regard to psychometric properties, 62% of the papers evaluated reliability (internal consistency) and 56% provided some kind of evidence of validity. Conclusions: This review aims to give an overview of the existing instruments in the literature and to highlight the characteristics of each one of them. Several different PREMs exist which evaluate recovery-oriented practice. No instrument currently exists which could be described as a benchmark tool, but there are quite a few with good psychometric properties capable of producing data that are useful when evaluating clinical services.

Non-Invasive Therapeutic Approaches for Mechanical Low Back Pain: An Integrative Systematic Review

Background: Mechanical low back pain (LBP) is one of the most prevalent musculoskeletal conditions, affecting a significant portion of the global population at some point in their lives. It is characterized by pain in the lumbar region without an obvious inflammatory or infectious origin, typically exacerbated by movement, posture, or mechanical load. LBP, whether acute, subacute, or chronic, is a leading cause of temporary and permanent disability, with significant economic repercussions due to lost workdays and healthcare costs. Recent clinical guidelines, such as those from the American College of Physicians (ACP) and the National Institute for Health and Care Excellence (NICE), emphasize the importance of non-invasive interventions for managing mechanical LBP, particularly in acute and chronic cases. In this context, this systematic review aims to consolidate current evidence on available therapeutic interventions, focusing on non-invasive treatments. Objective: To evaluate the available evidence on non-invasive therapeutic interventions for the treatment of mechanical low back pain. The review aims to synthesize international clinical guideline recommendations and identify the most effective practices for reducing pain and improving functional outcomes. Methods: This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Randomized controlled trials, systematic reviews, and clinical guidelines published up to 2023 addressing the management of mechanical low back pain in adults were included. Databases such as PubMed, Cochrane Library, and grey literature sources, including guidelines from medical societies, were searched. The study selection process followed strict eligibility criteria, including publications in English and Portuguese focused on non-invasive treatments for LBP. The methodological quality of the studies was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool. A total of 15 studies met the inclusion criteria, covering a range of non-invasive interventions such as physical therapy, exercise, acupuncture, manual therapy, and pharmacological approaches. Results: Evidence suggests that exercise-based interventions, particularly programs focused on muscle strengthening and stretching, are effective in reducing pain and improving functional outcomes in patients with mechanical LBP. Manual therapies and acupuncture also demonstrated benefits, albeit with less robust evidence. Reviewed guidelines recommend caution in the use of pharmacological interventions, such as nonsteroidal anti-inflammatory drugs (NSAIDs), particularly in chronic cases. Conclusion: This review highlights that non-invasive therapies, especially supervised exercise programs, represent the most effective and safe treatment for mechanical low back pain. The revised international guidelines reinforce the importance of avoiding early invasive interventions, except in cases of persistent or refractory pain. Appropriate management of mechanical LBP should be individualized, integrating evidence-based interventions to promote functional rehabilitation and minimize the impact of pain on patients' quality of life.

Survival and Toxicity Outcomes with Radiotherapy Technique and Timing in the Management of Wilms Tumor: a Systematic Review to Inform a National Clinical Practice Guideline Development

Purpose: Wilms tumor (WT) management has evolved into a multimodality paradigm that includes radiotherapy (RT), usually as an adjuvant or consolidative modality. Protocols are refined to maximize cure and compliance while minimizing acute toxicity and long-term effects. RT technique and timing are two factors that could improve these outcomes. We reviewed the evidence on survival and toxicity outcomes among WT patients with conventional versus advanced RT techniques and early versus delayed RT to inform a Department of Health (DOH) commissioned guideline. Materials and Methods: We systematically searched PubMed, EuropePMC, EBSCOHost, HERDIN, systematic review and clinical trial registries and official websites of scientific societies for relevant publications and grey literature. Eligibility screening, risk-of-bias assessment and data extraction were performed using a single-reviewer approach. Given the study and data heterogeneity, only a qualitative synthesis was performed. Certainty of evidence assessment was done using the GRADE approach. Results: We screened 314 studies and included seven in the review, including a phase 1/2 trial and six retrospective studies, all from first-world countries (US, France, Netherlands), except one from a newly industrialized country (Brazil). The certainty of evidence on the survival and toxicity outcomes with advanced RT techniques was very low. Moderate-certainty evidence supports that giving RT >14 days after surgery leads to increased mortality. Conclusion: Current evidence does not support the routine use of advanced RT techniques; proper contextualization is necessary. Tertiary centers managing WT should strive to administer RT within 14 days after surgery whenever possible. Keywords: Wilms tumor, nephroblastoma, radiotherapy, intensity-modulated radiotherapy, survival, toxicity

Footwear and Foot Health: Unveiling the Role of Proper Shoe Fit in Preventing Podiatric Issues and Enhancing Well-Being

Background: The appropriate choice of footwear is crucial for foot health, yet its impact on different populations and medical conditions remains understudied. This review explores the effect of shoe fit on the prevention of podiatric disorders and overall well-being. Methods: The research included major academic databases such as MEDLINE, Cochrane Central, Scopus, and PEDro, using specific keywords. A scoping review was conducted following the Joanna Briggs Institute methodology, encompassing studies on shoe fit across diverse populations and conditions. Medical databases and grey literature were also included. Results: Five studies were included, covering topics such as footwear advice for women over 50, the effect of shoes in preventing calluses under the metatarsals, the effectiveness of a shoe-related intervention for gout patients, and the impact of custom-fitted shoes on physical activity in children with Down syndrome. Results showed that well-fitting shoes can prevent callus formation, but the efficacy of custom-fitted shoes for increasing physical activity requires further research. Conclusions: The choice of appropriate footwear should not be solely based on aesthetic considerations but rather on the specific needs of each individual. Physicians should consider providing advice on appropriate shoe characteristics as a primary intervention

Multi-stakeholder aged care research networks: A scoping review.

An ageing population worldwide has highlighted the need for improved care in long term aged care homes. In Australia, such homes are called Residential Aged Care homes, and reform is underway to improve the quality and safety of aged care. A key enabler of quality improvement is increasing evidence-based practice through creating a system to support research translation. Collaborative multi-stakeholder research networks offer a potential solution by bringing together stakeholders to identify evidence-to-practice gaps, co-design research and translate knowledge into practice. The aim of this scoping review was to understand the current evidence on the creation and maintenance of multi-stakeholder aged care research networks internationally, reported facilitators and barriers, and outcomes. An academic literature search in five databases to identify existing multi-stakeholder aged care research networks. A grey literature search was conducted using Google, Google Scholar, grey literature databases and a manual search of targeted websites. 10 papers and 19 web-based resources were identified, reporting on six multi-stakeholder research networks internationally. Enabling factors of successful networks included flexibility in structure, good governance, leveraging pre-existing research relationships, consistent and open communication, staff with dual roles in research and practice, and a focus on building long term partnerships independent of research projects. Collaborative multi-stakeholder research networks offer promise for improving research translation in aged care. Advancing the development of impactful multi-stakeholder aged care research networks requires internationally agreed terminology for network models, clear reporting and evaluation guidelines and dedicated infrastructure resources.

Parents' and guardians' experiences of barriers and facilitators in accessing autism spectrum disorder diagnostic services for their children: a qualitative systematic review.

The objectives of this review were to comprehensively identify the best available qualitative evidence about parents' and guardians' experiences of barriers and facilitators in accessing autism spectrum disorder (ASD) diagnostic services for their children; and to develop recommendations based on the review for addressing barriers to timely diagnosis and early intervention. Early identification of ASD is a priority because the best chance for improving symptoms occurs through early and intensive intervention. A definitive ASD diagnosis is often a prerequisite for children to access publicly funded services, yet obtaining a diagnosis in itself can be stressful, frustrating, and time-consuming for many families. It is essential to understand the barriers and facilitators parents and guardians face in accessing ASD diagnostic services for their children. This qualitative systematic review considered studies conducted worldwide that included parents and guardians of children up to 18 years of age who had accessed or who were attempting to access ASD diagnostic services for their children. This review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. A literature search included CINAHL (EBSCOhost), CINAHL Plus (EBSCOhost), MEDLINE (EBSCOhost), APA PsycINFO (EBSCOhost), Social Services Abstracts (ProQuest), ERIC (EBSCOhost), and Embase. Gray literature sources included ProQuest Dissertations and Theses, Google Scholar, Google, OpenGrey, other online resources (government and organizational websites), and reference lists of retrieved records. No language, date, or country limits were applied to the searches. Retrieved records from the academic databases, gray literature, and reference lists of retrieved records were screened, with potentially relevant records examined in full against the inclusion criteria. Eligible studies were critically appraised for methodological quality and those included in this review were subjected to data extraction of descriptive details and study findings relevant to the review question. Study findings were synthesized and assigned confidence scores. All reviewers agreed upon the categories and finalized synthesized findings. The 36 included studies varied in qualitative research designs with high methodological quality. There were approximately 661 eligible participants, and 55 credible and unequivocal research findings. The research findings yielded 6 categories and 3 synthesized findings with moderate confidence scores. Parents' and guardians' ability to access ASD diagnostic services for their children is affected by i) encountering health care providers who actively listened to and addressed parents' and guardians' concerns instead of dismissing them, providing a sense of support and validation; ii) facing extended waiting times and associated financial burdens resulting in frustration and associated financial impact when delays occurred; and iii) encountering health care providers lacking specialized knowledge about ASD contributing to parents' and guardians' confusion due to inaccurate or conflicting diagnoses related to ASD comorbidities. Many parents described their journey in accessing ASD assessment and diagnostic services for their children as cumbersome. Parents' and guardians' experiences were affected by the level of perceived support by and knowledge of health care providers; confusion surrounding inaccurate/mixed diagnoses related to ASD; lengthy delays; and systemic and contextual barriers in navigating the pathway to ASD assessment and diagnosis that included socioeconomic and cultural disparities. PROSPERO CRD42018100127.

Expert Consensus Recommendations on a Biosimilars Value Framework for the Gulf Cooperation Council Countries.

This paper aims to develop a biosimilar value framework with local stakeholders in Gulf Cooperation Council (GCC) countries. A convenience sample of ten key opinion leaders from the United Arab Emirates, Kingdom of Saudi Arabia, Kuwait, Oman and Qatar participated in an expert panel meeting in November 2022 that examined factors positively influencing biosimilar adoption in these countries. The discussion was structured around a conceptual biosimilar value framework and an overview of biosimilar policies as derived from a targeted review of the peer-reviewed and grey literature. The expert panel agreed on a biosimilar value framework for the GCC countries that is founded on trust, cost savings and contextual considerations. They emphasized the importance of launching educational initiatives that build trust in and expand knowledge of all stakeholders about biosimilars. This also includes making stakeholders aware of the various value propositions of biosimilars as an instrument to produce, for example, cost savings. Finally, they stressed that biosimilar adoption is influenced by contextual factors such as incentives and implementation efforts. Our proposed biosimilars value framekwork is the first set of recommendations in the Arab countries designed to help policymakers and decision-makers promote biosimilar adoption, both in high-income GCC countries and in low- and middle-income countries.

Critical Evaluation of Neglected Consensus Risk Factors Causing the Recurrent Upsurge of Cholera Outbreaks in Some Regions in Cameroon: A Systematic Review

Background: Cameroon is a developing nation and has been enlisted amongst the several countries in sub-Sahara Africa situated in West and Central Africa to be experiencing the recurrent cholera outbreaks. The World Health Organization (WHO), Cameroon health authorities and others researchers have considered a few risk factors that are believed to be contributing to the current and on-going cholera outbreaks in Cameroon. These risk factors include the wide circulation of Vibrio cholerae in the country, limited access to safe-drinking water in some areas, a seasonal pattern of cholera re-occurrence and inadequate water, sanitation and hygienic (WASH) conditions, unstable political atmosphere that have resulted to internally displayed persons, very poor and vulnerable persons, refugees and humanitarian crises and continued unnecessary imposed lock-downs and road-blocks. However, despite these enormous efforts made by Cameroon health authorities so far and its partners over the past decades in responding and tackling all these risk factors, the recurrent outbreak of cholera in Cameroon still remained a great challenge and potential humanitarian crisis, an unendingly reality with bewilderment amid uncertainty, threatening and vulnerability to many affected regions. Aim: This systematic review seeks to critically evaluate, identify and classify some previously overlooked consensus risk factors driving cholera endemicity, pandemicity or epidemicity in Cameroon. By highlighting these neglected factors, this review hopes to inform evidenced -based intervention to finally combat the persistence recurrent upsurge and burden of future outbreaks of cholera in Cameroon. Methodology: The current Systematic reviews gathered information from various sources using different search engines provide a comprehensive overview of existing research. These include Academic Search Engines, Specialized Search Engines, Grey Literature, Primary Sources, Secondary Sources, Registers and Repositories, Open Access Sources, Hand Searching and Other Sources. Results: The current systematic review gathered information from diverse sources and identified and classified six groups of neglected consensus risk factors, along with their associated variables, contributing to cholera outbreaks in Cameroon. Additionally, the review assessed the level of intervention and preventive measures offered by the Cameroon health authorities and other stakeholders, categorizing them as either low or high, for both documented and undocumented strategies. All data sources were thoroughly referenced accordingly ensuring transparency and accountability. Conclusion: In spite of extensive research by the World Health Organization and Cameroonian health authorities identifying and documenting numerous risk factors contributing to Cameroon's ongoing cholera outbreaks, these efforts have not prevented or eradicated recurring episodes. Decades of enormous work and efforts by Cameroonian health authorities have been incapable to eradicate cholera. This systematic review unequivocally shows that without addressing the neglected consensus risk factors and variables, Cameroon could face a high likelihood of continued cholera outbreaks. Therefore, this review underscores the urgent need for Cameroon health authorities to adopt a multifaceted approach, addressing the identified neglected consensus risk factors and variables. Implementation of targeted interventions, strengthened health infrastructure, and community engagement are crucial to prevent future cholera outbreaks. Future research should focus on developing context-specific solutions, enhancing existing strategies, and evaluating the effectiveness of interventions.

Farmers market food safety: A comprehensive review of training needs in the U.S.

Farmers markets offer an apparently easy way for small-scale or hobbyist food producers to sell fresh produce, meat, and poultry from their farms or dis­tribute value-added products, but they may be unaware of the foodborne illness risks associated with both fresh produce and derivative products, as well as of their local food safety requirements. Food guidance and rules vary from state to state and market to market, making it difficult for indi­viduals to navigate the various regulatory levels. Even if a local food producer is exempt from these rules due to their amount of sales, they will still benefit greatly from resources and educational tools that increase awareness and knowledge of food safety best practices. This review discusses current knowledge of and guidelines for food safety in farmers markets based on peer-reviewed and grey literature as well as published guidelines and recommendations. We examine facilities and supplies, regulatory measures, education and train­ing, and Good Farmers Market Practices as pre­ventive measures to enhance food safety in farmers markets, which are critical to local and regional food systems. Overall, we identified various barri­ers to implementing farmers market food safety standards and practices in this scoping review; removing these barriers will require the participa­tion of local regularity authorities, market managers, vendors, and consumers.

Strategic leadership and management within non-profit organizations: An in-depth review of practices contributing to sustainable impact

This study provides an in-depth review of strategic leadership and management practices within non-profit organizations (NPOs) and their contribution to sustainable impact. Employing a systematic literature review and content analysis, the research aims to explore the evolving landscape of strategic leadership, define the scope of leadership and management in achieving sustainable impact, and identify innovative management practices that enhance organizational sustainability. The methodology involved a comprehensive search across peer-reviewed journals, conference proceedings, and grey literature from 2013 to 2023, focusing on empirical evidence, theoretical frameworks, and case studies relevant to NPOs' strategic leadership and management. Key findings reveal that adaptive leadership, innovative management practices, stakeholder engagement, and technology integration are crucial for NPOs to navigate operational complexities, engage stakeholders effectively, and achieve mission-driven objectives. The study proposes strategic recommendations for NPOs to enhance their sustainable impact, including adopting adaptive leadership styles, fostering innovation, integrating technology, and building resilient organizational frameworks. The study underscores the importance of policy development to guide non-profit leaders towards best practices in strategic leadership and management. It also highlights future research directions, emphasizing the need to explore the impact of emerging technologies, globalization, and cross-cultural dynamics on NPOs. Conclusively, the research affirms that effective strategic leadership and management are indispensable for enhancing the sustainable impact of NPOs, advocating for continuous innovation and adaptability in the non-profit sector.

Patient controlled epidural analgesia during labor: Protocol for a scoping review.

Childbirth remains one of the most painful experiences for women. Patient-controlled epidural analgesia provides the women in labor with self-control and thereby a shorter time interval between onset of pain and administration of analgesia, thus potentially improving the childbirth experience. This scoping review aims to investigate PCEA during labor involving maternal satisfaction, risks of adverse effects and obstetric interventions by mapping the evidence and identifying gaps in the current evidence base. The forthcoming review will adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) and the JBI methodology for scoping reviews. A systematic search will be carried out across major peer-reviewed databases and gray literature will be sought. All study types involving women in labor receiving PCEA will be eligible for inclusion. The extracted data will be charted regarding trial characteristics, population/participation characteristics, interventions, outcomes, and key findings. The results will be presented through relevant tables, figures, and graphs when appropriate. Alongside this, we present the data descriptively to explain how the results align with the objectives of the review. PCEA offers women greater autonomy during childbirth, making it essential to examine its effects and potential risks. By mapping current evidence regarding PCEA, this review aims to identify knowledge gaps and provide insights to enhance maternal care and improve childbirth experiences.