Inclusion In Review Research Articles

Advocating for Action: Exploring the Potential of Virtual Reality in Breathing Exercise - A Review of The Clinical Applications.

The emergence of virtual reality (VR) technologies is currently shaping the healthcare system and is now being employed in various healthcare interventions. Pulmonary rehabilitation remains one such area in which VR is currently thriving to ensure overall health and well-being. While the importance of these novel technologies is being primarily researched in pulmonary rehabilitation, especially over passive conventional breathing exercise training, there seems to be a limited number of studies that have comprehensively put together these findings. This study utilizes a scoping review methodology to review VR exercises in clinical settings related to pulmonary rehabilitation. To achieve this objective, three electronic databases (Web of Science, PubMed, and Cochrane Library) were searched using a formulated search string related to the research objective. Following the database search, a total of 236 references were retrieved and managed using the reference manager. The screening of references was conducted according to the PRISMA 2020 screening process, and their quality was assessed using the JBI checklist. Ultimately, a total of eight publications of high quality were selected for inclusion in the scoping review. The results of the synthesis validate the importance of utilizing VR in the context of breathing exercise in rehabilitation. The effectiveness and rapid development of VR breathing exercises are primarily attributed to the engaging and immersive experience they provide. The use of biofeedback and self-regulation techniques into VR exercise systems was also seen to have a notable impact on the effectiveness of the breathing exercise system.

Salmonellosis outbreak archive in China: data collection and assembly

Infectious disease outbreaks transcend the medical and public health realms, triggering widespread panic and impeding socio-economic development. Considering that self-limiting diarrhoea of sporadic cases is usually underreported, the Salmonella outbreak (SO) study offers a unique opportunity for source tracing, spatiotemporal correlation, and outbreak prediction. To summarize the pattern of SO and estimate observational epidemiological indicators, 1,134 qualitative reports screened from 1949 to 2023 were included in the systematic review dataset, which contained a 506-study meta-analysis dataset. In addition to the dataset comprising over 50 columns with a total of 46,494 entries eligible for inclusion in systematic reviews or input into prediction models, we also provide initial literature collection datasets and datasets containing socio-economic and climate information for relevant regions. This study has a broad impact on advancing knowledge regarding epidemic trends and prevention priorities in diverse salmonellosis outbreaks and guiding rational policy-making or predictive modeling to mitigate the infringement upon the right to life imposed by significant epidemics.

Embodied decisions unfolding over time: a meta-ethnography systematic review of people with cancer’s reasons for delaying or declining end-of-life care

BackgroundBarriers to accessing hospice and palliative care have been well studied. An important yet less researched area is why people approaching the end-of-life decline a referral when they are offered services. This review focused on synthesising literature on patients in the last months of life due to a cancer diagnosis who have declined a referral to end-of-life care.MethodsSix academic databases were systematically searched for qualitative literature published between 2007 and 2021. Two researchers independently reviewed and critically appraised the studies. Using meta-ethnographic methods of translation and synthesis, we set out to identify and develop a new overarching model of the reasons patients decline end-of-life care and the factors contributing to this decision.ResultsThe search yielded 2060 articles, and nine articles were identified that met the review inclusion criteria. The included studies can be reconceptualised with the key concept of ‘embodied decisions unfolding over time’. It emphasises the iterative, dynamic, situational, contextual and relational nature of decisions about end-of-life care that are grounded in people’s physical experiences. The primary influences on how that decision unfolded for patients were (1) the communication they received about end-of-life care; (2) uncertainty around their prognosis, and (3) the evolving situations in which the patient and family found themselves. Our review identified contextual, person and medical factors that helped to shape the decision-making process.ConclusionsDecisions about when (and for some, whether at all) to accept end-of-life care are made in a complex system with preferences shifting over time, in relation to the embodied experience of life-limiting cancer. Time is central to patients’ end-of-life care decision-making, in particular estimating how much time one has left and patients’ embodied knowing about when the right time for end-of-life care is. The multiple and intersecting domains of health that inform decision-making, namely physical, mental, social, and existential/spiritual as well as emotions/affect need further exploration. The integration of palliative care across the cancer care trajectory and earlier introduction of end-of-life care highlight the importance of these findings for improving access whilst recognising that accessing end-of-life care will not be desired by all patients.

Cochlear Implantation After Head and Neck Radiation: A Case Series, Systematic Review, and Meta-analysis.

To determine if cochlear implant (CI) is safe and effective in patients with radiation therapy (XRT)-induced sensorineural hearing loss and to discuss considerations in this population through a retrospective cohort review, systematic review, and meta-analysis. PubMed, Cochrane Library, and Embase. We retrospectively reviewed all CI cases after head and neck (HN) XRT at our institution, noting intraoperative findings, postoperative complications, and hearing outcomes. Change in speech discrimination scores (SDSs) was the primary outcome measure. Systematic review was performed to identify all cases of CI after HNXRT. A meta-analysis was performed to assess SDS change. The retrospective cohort review identified 12 patients who underwent CI after HNXRT. One patient with HN cancer (HNC) and one with central nervous system pathology (CNSP) received bilateral implants. Six had HNC, three had CNSP, and one had Langerhans cell histiocytosis. Eleven had abnormal findings during CI. There were no postoperative complications. Twenty articles with an additional 97 patients were suitable for systematic review inclusion. Of the 109 patients, 67 (61.5%) had HNC and 18 (16.5%) had CNSP. Abnormal intraoperative findings were common (30.3%), most frequently in the mastoid (66.7%). Postoperative complications, including wound dehiscence and infection with some requiring explantation, occurred in 10.1% of patients. Sixty-six patients were included in the meta-analysis. All demonstrated SDS improvement (mean increase, 56.2%). Patients with prior HNXRT benefit from CI. Paying careful attention to surgical planning and technique, postoperative care, and patient expectations is imperative, as complications are not uncommon.

A105 PILOT STUDY ON THE ACCURACY OF CHATGPT IN ARTICLE SCREENING FOR SYSTEMATIC REVIEWS IN GASTROENTEROLOGY

Abstract Background Systematic reviews synthesize extant research to answer a research question in a way that minimizes bias. After articles for potential inclusion are identified by sensitive searches, screening requires human expert review, which may be time-consuming and subjective. Large language models such as ChatGPT may have potential for this application. Aims This pilot study aims to assess the accuracy of ChatGPT 3.5 in screening of articles for systematic reviews in gastroenterology by (1) identifying if articles were correctly included and (2) excluding articles reported by authors as difficult to assess. Methods We searched the Cochrane Library for gastroenterology systematic reviews (January 1, 2022 to May 31, 2023) and selected the 10 most cited studies. The test set used to determine the accuracy of Open AI’s ChatGPT 3.5 model for included studies was the final list of included studies for each Cochrane review. The test set used for studies challenging to assess was the “excluded studies” list as defined in the Cochrane Handbook. Figure 1 shows the prompt used for the screening query. Articles were omitted if they did not have digital sources, abstracts or methods. Each article was screened 10 times to account for variability within ChatGPT’s outputs. Articles with ≥5 inclusion results were counted as an included study. Results ChatGPT correctly identified included studies at rates ranging from 60% to 100%. ChatGPT correctly identified exlcuded studies at rates ranging from 0% to 50% (Table 1). A total of 265 articles were screened. Conclusions In this pilot study, we demonstrated that ChatGPT is accurate in identifying articles screened for inclusion in Cochrane reviews; however, it is inaccurate in excluding articles described by the authors as being difficult to assess. We hypothesize that the GPT 3.5 model can read for keywords and broad interventions but is unable to reason cognitively, as an expert would, as to why a study may be excluded. We aim to review reasons for exclusion in future work. Table 1. Screening Results of ChatGPT Figure 1. ChatGPT Screening Prompt Funding Agencies None

Cerebral palsy in African paediatric populations: A scoping review.

To review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21-year period. The PubMed, Scopus, and Web of Science online databases were searched for original research on African children with CP aged 18 years and younger published from 2000 to 2021. A total of 1811 articles underwent review against explicit criteria; 93 articles were selected for inclusion in the scoping review. The reported prevalence of CP ranged from 0.8 to 10 per 1000 children. Almost half had perinatal risk factors, but up to 26% had no identifiable risk factor. At least one-third of children with CP had one or more comorbidities, most commonly epilepsy, intellectual disability, and malnutrition. African children with CP demonstrated excess premature mortality approximately 25 times that of the general population, predominantly from infections. Hospital-based and younger populations had larger proportions of children with severe impairments. African children with CP had inadequate access to care and education, yet showed functional improvements compared to controls for all evaluated interventions. The prevalence of CP in Africa remains uncertain. African children with CP have different risk profiles, greater premature mortality, and more severe functional impairments and comorbidities compared to the Global North. Several barriers prevent access to optimal care. Larger African studies on validated and effective interventions are needed.

Systematic review of the patient burden of generalised myasthenia gravis in Europe, the Middle East, and Africa

BackgroundMyasthenia gravis (MG) is a rare autoimmune disease characterised by muscle weakness, and progression from ocular (oMG) to generalised (gMG) symptoms results in a substantial negative impact on quality of life (QoL). This systematic review aimed to provide an overview of the patient burden experienced by people living with gMG.MethodsElectronic database searches (conducted March 2022), supplemented by interrogation of grey literature, were conducted to identify studies reporting patient burden outcomes in patients with gMG in Europe, the Middle East and Africa. Results were synthesised narratively due to the heterogeneity across trials.ResultsIn total, 39 patient burden publications (representing 38 unique studies) were identified as relevant for inclusion in the systematic review, consisting of 37 publications reporting formal patient-reported outcome measures (PROMs), and two publications describing alternative qualitative assessments of patient experience. The studies included a variety of measures including generic and disease-specific PROMs, as well as symptom-specific PROMs focusing on key comorbidities including depression, anxiety, fatigue and sleep disturbance. The findings showed some variation across studies and PROMs; however, in general there was evidence for worse QoL in patients with gMG than in healthy controls or in patients with oMG, and a trend for worsening QoL with increasing MG severity.ConclusionsThis review highlights the importance of considering patient QoL when developing and assessing treatment and management plans for patients with gMG. However, the heterogeneity identified across studies illustrates the need for further representative and well-powered studies in large cohorts administering consistent, validated questionnaires.Trial registrationThe protocol for this systematic review was registered in PROSPERO: CRD42022328444.

Maslach Burnout Inventory – General Survey

Abstract: This study sought to investigate the measurement properties of a “gold standard” instrument for measuring burnout, the Maslach Burnout Inventory – General Survey (MBI-GS), with a systematic literature review and meta-analysis of studies that had as the primary aim its psychometric validation. The search spanned from January 1996 to December 2022 using the following databases: Web of Science, Scopus, PubMed, APA PsychINFO, ScienceDirect, and ProQuest Dissertations and Theses Global. Our search identified 35 eligible studies for inclusion in the systematic review. Of these, 17 were included in the meta-analysis. The meta-analysis of the original 16-item version studies supported a three-dimensional representation of burnout with modest internal consistencies. However, similar to the narrative findings, it also indicated the viability of a two-factor solution. Consequently, the structural validity of the MBI-GS remains unclear, and so does its cross-cultural validity. The criterion validity of the cynicism and personal efficacy scales also raised a few questions. Overall, the findings provided some support for the adequacy of the measurement properties of the MBI-GS as a research tool measuring exhaustion, cynicism, and professional efficacy. However, we also identified challenges and practices of which researchers should be cognisant and that they should consider in future burnout projects.

Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the “see and treat” approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452). Results: Eight studies were included in the qualitative analysis for a total of 474 patients undergoing laser hysteroscopic surgery. Eighty-three patients had female genital tract abnormalities, 63 had submucosal leiomyomas, 327 had endometrial polyps, and one patient had a scar pregnancy. Except for leiomyomas, whose technique already included two surgical times at the beginning, only seven patients required a second surgical step. Cumulative rates of intraoperative and postoperative complications of 2.7% and 0.6%, respectively, were reported. Conclusions: Diode laser through “see and treat” hysteroscopy appears to be a safe and effective method. However, additional studies with larger sample sizes and improved designs are needed to consolidate the evidence currently available in the literature.

Differences in the Impact of Various Types of Exercise on Irisin Levels: A Systematic Review and Meta-Analysis.

Irisin, a myokine that is responsive to exercise, induces significant changes in subcutaneous adipose tissue. By promoting the browning of white fat tissue, it enhances energy expenditure, thereby addressing overweight and obesity. This systematic review and meta-analysis aimed to compare the effects of different types of physical exercises on irisin levels in overweight and obese adults. Specifically, the review focused on studies involving obese or overweight individuals who participated in exercise training for a minimum of 8 weeks, with measured and reported changes in serum irisin levels compared to a control group. Data were collected from four databases (Google Scholar, ISI Web of Science Core Collection, PubMed, and Scopus). The risk of bias was assessed using the Begg and Egger tests, and the results were synthesized. Initial searches identified 560 titles, out of which only seven met the criteria for inclusion in the systematic review. Statistical analysis demonstrated a significant increase in serum irisin concentration (SMD = 0.957, P = 0.005) among obese and overweight individuals who engaged in exercise, compared to the passive control group. High-intensity interval training (HIIT) (SMD = 1.229, P < 0.001) had a more pronounced effect on increasing serum irisin levels than other exercise protocols. Furthermore, the effectiveness of exercise varied based on the participants' weight status (significant changes for overweight individuals; P < 0.001 and insignificant changes for obese individuals; P = 0.1), age (significant changes for those under 40 years old; P < 0.001 and insignificant changes for those over 40 years old; P = 0.322), and gender (significant changes for men; P < 0.001 and insignificant changes for women; P = 0.285). Consequently, exercise can elevate serum irisin levels, leading to alterations in adipose tissue phenotype and thermogenesis, ultimately contributing to weight reduction in obese and overweight individuals.

A Systematic Literature Review on the Relationship Between Quality of Work and Intentions to Retire Among Individuals Aged 50 and Older

Europe, notably in countries like Lithuania, is facing substantial demographic shifts due to aging, impacting various systems, including the labor market. In this context understanding retirement intentions is crucial. Quality of work is a key determinant of retirement intentions, yet other factors such as financial situation, health, or family pressures also play a role, and a comprehensive understanding of their interactions remains a research gap. Therefore, the aim of this study was to conduct a systematic literature review of research on the relationship between retirement intentions and quality of work, with a specific focus on potential control factors, moderators and mediators of this relationship. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Articles were electronically retrieved from Scopus, Web of Science, ScienceDirect, and EBSCO databases. Studies selected were full-text, peer-reviewed articles in English from 2003 to 2023, which used quantitative methodologies and focused on the relationship between retirement intentions and quality of work for workers aged 50+. The quality of the selected publications was assessed using the Appraisal Tool for Cross-Sectional Studies – AXIS tool. Of the initial 776 sources, after removing duplicates and irrelevant articles, 91 were fully screened, and 17 met the criteria for inclusion in the systematic review. This systematic literature review provided further insights into the relationship between retirement intentions and quality of work, highlighting the roles of moderators, mediators, and control factors in this relationship.

How is digital health suitability measured for communities? A systematic review.

Digital health services continue growing in usage and popularity, with patients and healthcare organizations benefiting from their use. Despite this, no mechanism exists to measure a patient's and community's suitability to leverage these services. This systematic review aims to evaluate the extent and nature of measuring the overall suitability of individuals and communities within the digital health landscape. Database searches in February 2024 across PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, and IEEE Xplore yielded 1044 unique references. Two screening stages resulted in 10 articles that met all evaluation criteria for review inclusion. This systematic review found a gap in the ability to holistically assess a patient's and community's suitability to access digital health services. Myriad indices and tools identify isolated factors contributing to digital health accessibility (e.g., broadband availability); however, no comprehensive mechanism adequately informs providers, policymakers, and researchers. A comprehensive index that accurately reflects suitability for digital health services is needed. Index factors should include a combination of indicators related to socioeconomic status, digital accessibility, such as device and internet access, and social determinants of health. Together, these form the predominant driving factors related to one's ability to participate in digital health services.

Tackling complex thoracic surgical operations with robotic solutions: a narrative review.

The adoption of robotic surgery for general thoracic surgery has rapidly progressed over the last two decades from its application in basic operations to complex pathologies. As such, the purpose of this narrative review is to highlight the collective experience of tackling complex thoracic surgical operations with minimally invasive robotic solutions. Electronic searches of PubMed were conducted for each subtopic, using specific keywords and inclusion criteria. Once identified, the articles were screened through the abstract, introduction, results and conclusion for relevancy, and included based on a standard narrative review inclusion criteria. The role of the robotic approach has increased in thoracic outlet syndrome, chest wall resection, tracheobronchomalacia, airway and sleeve lung surgery, lobectomy after neoadjuvant therapy, complex segmentectomy, giant paraesophageal hernia repair, esophagectomy and esophageal enucleation, mediastinal masses and thymectomy and lung transplantation. Robotic surgery has several advantages when compared to video-assisted and open thoracoscopic surgery. These include better pain control and aesthetic outcome, improved handling of complex anatomy, enhanced access to lymph nodes, and faster recovery rates. Although it is associated with longer operative time, robotic surgery has comparable morbidity rates. The robotic approach to complex thoracic problems is safe, effective, and associated with improved patient outcomes. To encourage wider adoption of robotic technology, increased training and expanded research efforts are essential, alongside improved worldwide access to this technology.

Role of Platelet-Rich Plasma in Genitourinary Syndrome of Menopause.

The genitourinary syndrome of menopause (GSM) encompasses a range of symptoms linked to the genitourinary tract stemming from the reduction in estrogen levels following menopause. These symptoms may endure throughout a woman's lifetime. Platelet-rich plasma (PRP), known for its capacity to induce angiogenesis and the restoration effects of growth factors, has been widely employed in various disorders, including GSM. This article aims to comprehensively review the existing literature on the utilization of PRP for managing GSM. The search was executed in electronic databases, specifically PubMed, Scopus, and Google Scholar, up until April 2023. Eligible studies were meticulously chosen for inclusion in this systematic review. PRP emerges as a viable alternative for addressing vaginal atrophy, exhibiting favorable outcomes. Notably, it can be considered for patients with contraindications to hormonal therapy. However, the available body of evidence supporting the use of PRP for GSM remains limited. PRP presents itself as a promising agent, offering a patient-friendly, cost-effective alternative modality. To establish the efficacy of PRP in treating GSM definitively, future randomized trials are imperative.

Does Mindfulness Training Have an Effect on Brain Tumor Patients? A Literature Review

Aims: The purpose of this research was to examine into the recent spike in curiosity regarding mindfulness-based therapy and their benefits on patients with brain tumors. Methods: The approach to searching was implemented by using certain keywords in an online database. This review's inclusion criteria were: (1) study of experimental design, (2) only brain tumor patients, and (3) Mindfulness-based therapy. The search was limited to English and Indonesian literature published between 2017 and 2023. To assess the quality of the included studies, the Critical Appraisal Skills Program (CASP) tool, which is available for intervention research, was employed. Results: For this investigation, the original search method returned 581 documents. After a comprehensive study of these papers and application of the inclusion and exclusion criteria, four papers met the inclusion criteria. The programs lasted between 8 and 12 weeks. While mindfulness-based therapies revealed a good benefit for brain tumor patients, one study found a negative effect on family well-being. Conclusions: According to the journals reviewed, this study intends to evaluate the benefits of mindfulness training for improving the condition of brain tumor patients. The biological factors of the tumor or the participant's cognitive profile may influence improvement.

The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis

BackgroundGardening and horticultural therapy (HT) has been widely recognised as a multicomponent approach that has affected a broad range of health and well-being outcomes. The aim of this umbrella review and meta-analysis was to compare the findings of previous reviews on the impact of multiple gardening interventions and gardening attributes on different well-being constructs.MethodsElectronic databases including PubMed, Web of Science, Science Direct, the Cochrane Library, and Google Scholar were searched from inception to December 2022. Interventional and observational reviews were eligible for inclusion in this umbrella review. Outcome measures included mental well-being, health status and quality of life. The key exposure variables were gardening and horticultural therapy. Narrative synthesis was used to evaluate the overall impact of gardening and HT on study outcomes. For a subsample of studies with available quantitative data, a random effect meta-analysis was conducted.ResultsThis umbrella review included 40 studies (10 interventional studies, 2 observational studies, and 28 mixed interventional and observational studies). The reviewed studies reported an overall positive impact of gardening activities on several measures of mental well-being, quality of life, and health status. Meta-analysis showed a significant and positive effect of gardening and HT activities on well-being (effect size (ES) 0.55, 95% confidence interval (CI) 0.23, 0.87, p < 0.001).ConclusionsEvidence from observational and interventional studies supports a positive role for gardening and HT activities on well-being and general health. Interventional studies with horticultural-based therapies were effective in improving well-being and quality of life both in the general population and vulnerable subgroups. The high degree of heterogeneity in the included studies cautions against any direct clinical implications of the study findings.

Language inclusion in ecological systematic reviews and maps: Barriers and perspectives.

Systematic reviews and maps are considered a reliable form of research evidence, but often neglect non-English-language literature, which can be a source of important evidence. To understand the barriers that might limit authors' ability or intent to find and include non-English-language literature, we assessed factors that may predict the inclusion of non-English-language literature in ecological systematic reviews and maps, as well as the review authors' perspectives. We assessed systematic reviews and maps published in Environmental Evidence (n = 72). We also surveyed authors from each paper (n = 32 responses), gathering information on the barriers to the inclusion of non-English language literature. 44% of the reviewed papers (32/72) excluded non-English literature from their searches and inclusions. Commonly cited reasons included constraints related to resources and time. Regression analysis revealed that reviews with larger author teams, authors from diverse countries, especially those with non-English primary languages, and teams with multilingual capabilities searched in a significantly greater number of non-English languages. Our survey exposed limited language diversity within the review teams and inadequate funding as the principal barriers to incorporating non-English language literature. To improve language inclusion and reduce bias in systematic reviews and maps, our study suggests increasing language diversity within review teams. Combining machine translation with language skills can alleviate the financial and resource burdens of translation. Funding applications could also include translation costs. Additionally, establishing language exchange systems would enable access to information in more languages. Further studies investigating language inclusion in other journals would strengthen these conclusions.

RELATIONSHIP BETWEEN BCG VACCINATION HISTORY AND THE INCIDENCE OF LEPROSY IN CHILDREN: A LITERATURE REVIEW

Background: Globally, 9,052 new cases of leprosy in children were reported, with a corresponding rate of 4.5 per million child population. Children are believed to be the most vulnerable group to M. leprae infections due to their immature immunity. Purpose: This study aims to determine the relationship between the history of BCG vaccination and leprosy incidence in children. Methods: This study used a literature review method that involved a systematic search. The data sources were obtained using several databases, namely Google Scholar, Proquest, Science Direct, and Pubmed. Keywords were built using the PICOS protocol and Boolean Operators, so the keywords used were "relationship" AND "BCG vaccine" AND "leprosy" AND "children". The research selection and search procedures were explained using the PRISMA 2020 method and research included in this study following the inclusion and exclusion criteria that have been set. Results: There were eight studies suitable for inclusion in this literature review. Five articles concluded that there was a relationship between the history of BCG vaccine and the incidence of leprosy in children, while three articles concluded that there was no relationship between the two variables. Conclusion: The BCG vaccine is useful as an effort to prevent the transmission and spread of leprosy in children. Children who do not receive BCG immunization are more susceptible to leprosy than those who receive immunization. The BCG vaccine has a protective effect to prevent children from contracting and transmitting leprosy to other people.

Rural Patients' Experiences with Synchronous Video Telehealth in the United States: A Scoping Review.

Background: Telehealth can help increase rural health care access. To ensure this modality is accessible for rural patients, it is necessary to understand rural patients' experiences with telehealth. Objectives of this scoping review were to explore how rural patients' telehealth experiences have been measured, assess relevant research, and describe rural telehealth patient experiences. Methods: We searched five databases for articles published from 2016 through 2022. Primary research reports assessing rural adult patient experiences with synchronous video telehealth in the United States in any clinical area were included. Data collected pertained to study characteristics and patient experience assessment characteristics and outcomes. Quality of included studies was assessed using the Quality Assessment with Diverse Studies tool. Review findings were presented in a narrative synthesis. Results: There were 740 articles identified for screening, and 24 met review inclusion criteria. Most studies (70%, n = 16) assessed rural telehealth patient experience using questionnaires; studies employed interviews (n = 11) alone or in combination with surveys. The majority of surveys were study developed and not validated. Quantitative patient experience outcomes fell under categories of patient satisfaction, telehealth care characteristics, patient-provider rapport, technology elements, and access. Qualitative themes were most often presented as telehealth benefits or facilitators, and drawbacks or barriers. Conclusions: Available research indicates positive patient experiences with rural telehealth services. However, study weaknesses limit generalizability of findings. Future research should apply established definitions for participant rurality and clearly group samples by rurality. Efforts should be made to use validated telehealth patient experience measures.

Regional Agriculture and Food Systems Amid the COVID-19 Pandemic: The Case of the Near East and North Africa Region.

The COVID-19 pandemic affected agri-food systems worldwide. However, while the impacts differed from one country/region to another, the scholarly literature seems to focus on developed countries in the Global North. Consequently, this review scrutinizes the literature on the pandemic's impacts in the Near East and North Africa (NENA) region. A search on the Web of Science in March 2023 generated 334 documents, of which 151 were eligible for inclusion in the systematic review. According to the bibliometric analysis, the most active nations are Saudi Arabia, Egypt, Jordan, the United Arab Emirates, and Lebanon. In general, the coverage of studies is better in the Gulf region than in the less developed countries of North Africa and those suffering from wars (cf. Libya, Syria, and Yemen). Studies generally focus on crop production and the downstream food chain (cf. distribution and consumption). While the pandemic influenced every pillar of food security, this research concentrates on access and utilization. Meanwhile, the lion's share of the literature deals with the pandemic's socio-economic effects, especially those linked to food (in)security and health. The pandemic, which laid bare the agri-food system vulnerabilities, should be seized to foster the transition towards more resilient agri-food systems in the NENA region.