Systematic Integrative Review Research Articles

ESG practices: the key to organizational sustainability

The study addresses the relevance of ESG practices as key to organizational sustainability, generating long-term value, improving efficiency, and managing risks. The research focuses on the question of how ESG practices contribute to organizational sustainability, requiring an understanding of the integration of ESG dimensions into corporate strategies and their impact on sustainability. Using an integrative systematic review, the study provides a comprehensive view of research on ESG practices and organizational sustainability, highlighting a growing academic and corporate interest in this area. The analysis reveals that, despite the recognition of the benefits of ESG practices, there is a gap in understanding how these are implemented daily and the challenges faced by organizations. Furthermore, the absence of studies on the ideal balance between ESG practices to optimize organizational sustainability is emphasized. It concludes with the need for more research to elucidate the specific contribution of ESG practices to organizational sustainability, suggesting a positive movement towards their integration into business strategies, under the aegis of greater regulatory guidance and transparency in ESG reporting.

Core Competencies for Serious Illness Conversations: An Integrative Systematic Review.

Objective: The Serious Illness Care Program was developed to support goals and values discussions between seriously ill patients and their clinicians. The core competencies, that is, the essential clinical conversation skills that are described as requisite for effective serious illness conversations (SICs) in practice, have not yet been explicated. This integrative systematic review aimed to identify core competencies for SICs in the context of the Serious Illness Care Program. Methods: Articles published between January 2014 and March 2023 were identified in MEDLINE, PsycINFO, CINAHL, and PubMed databases. In total, 313 records underwent title and abstract screening, and 96 full-text articles were assessed for eligibility. The articles were critically appraised using the Joanna Briggs Institute Critical Appraisal Guidelines, and data were analyzed using thematic synthesis. Results: In total, 53 articles were included. Clinicians' core competencies for SICs were described in 3 themes: conversation resources, intrapersonal capabilities, and interpersonal capabilities. Conversation resources included using the conversation guide as a tool, together with applying appropriate communication skills to support better communication. Intrapersonal capabilities included calibrating one's own attitudes and mindset as well as confidence and self-assurance to engage in SICs. Interpersonal capabilities focused on the clinician's ability to interact with patients and family members to foster a mutually trusting relationship, including empathetic communication with attention and adherence to patient and family members views, goals, needs, and preferences. Conclusions: Clinicians need to efficiently combine conversation resources with intrapersonal and interpersonal skills to successfully conduct and interact in SICs.

Identifying the supportive care needs of people affected by non-muscle invasive bladder cancer: An integrative systematic review.

To understand supportive care needs among people with non-muscle invasive bladder cancer (NMIBC). An integrative systematic review was reported using the Preformed Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Seven electronic databases were searched for relevant studies, including all quantitative, qualitative, and mixed methods studies, irrespective of research design. The review process was managed by Covidence systematic review software. Two reviewer authors independently performed data extraction using eligibility criteria. Quality appraisal was conducted, and a narrative synthesis was performed. A total of 1129 articles were screened, of which 21 studies met the inclusion criteria. The findings revealed that the frequency of supportive care needs reported by NMIBC participants included psychological/emotional (16/21:76%), physical (16/21:76%), practical (8/21:38%), interpersonal/intimacy (7/21:33%), family-related (7/21:33%), health system/information (5/21:23%), social (4/21:19%), patient-clinician communication (3/21:14%), spiritual (1/21:5%) and daily needs (1/21:5%). People affected by NMIBC experience anxiety, depression, uncertainty, and fear of recurrence. The physical symptoms reported included urinary issues, pain, sleeping disorders and fatigue. These supportive care needs persist throughout the participants' treatment trajectory and can impact their quality of life. Identifying supportive care needs within the NMIBC population will help inform future interventions to provide patient-centred care to promote optimal well-being and self-efficacy for people diagnosed with NMIBC.

Delivering Patient Education in Healthcare Organizations: An Integrative Review of the Nursing Administrative Actions

Aim. To analyze the literature on nursing administrative actions related to patient education to inform healthcare organizations for the development of patient education and identify the knowledge gaps for future research. Background. Patient education is a patient’s right, yet numerous organizational factors can hinder the effective delivery of patient education. Nursing administrative actions can mediate these factors, but little is known about nursing administration in patient education. Evaluation. A systematic integrative review was conducted in October 2022 on five databases (CINAHL (Ebsco), PubMed, Web of Science, ABI/Inform, and Business Source Complete). No time limitations were set. Empirical research articles reporting nursing administrative actions related to educational actions as a main topic were screened and evaluated. The data analysis was based on a constant comparison method. Key Issues. There were 3,110 studies identified, of which five quantitative and four qualitative studies were included. Three main themes were generated from the data describing nursing administrative actions related to patient education: (1) strengthen the commitment to patient education, (2) ensure the necessary resources for patient education, and (3) enhance patient education policies. Conclusion. This review provides insights into nursing administration in patient education, focusing on commitment, resources, and policies. It not only highlights the critical role of nurse administrators but also calls for further research to assess the impact of these actions. Implications for Nursing Management. The findings of this review will be useful for nurse administrators by providing knowledge about nursing administrative actions in patient education and underlining the need for them to pay more attention to it. The implications for nursing management also include supporting further research in the field.

Internationalization of higher education in Central Asia: a systematic review

ABSTRACT Despite the growing literature on higher education internationalization in Central Asia, such literature remains unexamined for its criticality. Our systematic integrative literature review helps address this lacuna. The article utilizes critical internationalization perspectives to examine the extent to which the literature on internationalization in the region addresses the critical questions currently dominating the internationalization discourse globally. We analysed 56 peer-reviewed journal articles published in English between 2012 and 2022 to address the following themes: (1) internationalization as Westernization, (2) internationalization and the modernization of the university, (3) internationalization equals Englishization and (4) internationalization and the recreation of unequal relations. We assert that the published work does not promote the reimagination of dominant patterns of relationship, representation and resource distribution. By providing a systematic review, we hope to have helped academics, researchers, students, administrators and policymakers reflect upon and reimagine internationalization practice.

A Deep Dive into Robot Vision - An integrative Systematic Literature Review Methodologies and Research Endeavor Practices

Novel technological swarm and industry 4.0 mold the recent Robot vision research into innovative discovery. To enhance technological paradigm Deep Learning offers magical pace to get into diversified advancement. This research considers most topical, recent, related and state of the art research review revolves around Robot vision, shapes the research into Systematic Literature Survey – SLR. The SLR considers a combo of more than 100 reviews and empirical studies to perform a critical categorical study and shapes findings against Research Questions. The research study contribution is span over multiple categories of Robot vision and tinted along with technical limitations and future research endeavor. Previously multiple researches have been observed to leverage Robotic vision technique. Yet, there is none alike SLR summarizing recent vision techniques for all targeted Robotic fields. This research SLR could be a precious mile stone in Robot vision for each glimpse of Robotics.

REVISÃO INTEGRATIVA E SISTEMÁTICA SOBRE PARCERIAS PÚBLICO-PRIVADAS NA ADMINISTRAÇÃO PÚBLICA

Public Administration is the set of activities undertaken by the State with the objective of promoting the common good, through the use of authority powers and the implementation of public policies, programs and services. Public Administration management in Brazil faces a series of challenges that compromise the efficiency and effectiveness in the use of public resources, including problems such as excessive bureaucracy, the lack of strategic planning, corrupt practices and the phenomenon of clientelism. Therefore, the present study, undertaken an Integrative Systematic Review (RSI), had the purpose of examining articles related to public-private partnerships in public administration, which were published in the Scientific Electronic Library Online (SCIELO) database in the period time between 2012 and 2022. The main findings were that the most published articles are mostly related to health and education, which together represent a total of 15 articles. The presence of literature reviews on the topic was observed; public-private partnerships in the Brazilian public sectors and the main themes found in relation to this topic include: studies presented a single health system, government regulation, education policies, urban mobility, educational governance, health service reforms/health policy.

How clinicians make decisions for patient management plans in telehealth.

This systematic integrative literature review explores how clinicians make decisions for patient management plans in telehealth. Telehealth is a modality of care that has gained popularity due to the development of digital technology and the COVID-19 pandemic. It is recognized that telehealth, compared to traditional clinical settings, carries a higher risk to patients due to its virtual characteristics. Even though the landscape of healthcare service is increasingly moving towards virtual systems, the decision-making process in telehealth remains not fully understood. A systematic integrative review. Databases include CINAHL, APA PsycInfo, Academic Search Complete, PubMed, Web of Science and Google Scholar. This systematic integrative review method was informed by Whittemore and Knafl(2005). The databases were initially searched with keywords in November 2022 and then repeated in October 2023. Thematic synthesis was conducted to analyse and synthesize the data. The search identified 382 articles. After screening, only 10 articles met the eligibility criteria and were included. Five studies were qualitative, one quantitative and four were mixed methods. Five main themes relevant to decision-making processes in telehealth were identified: characteristics of decision-making in telehealth, patient factor, clinician factor, CDSS factor and external influencing factor. The decision-making process in telehealth is a complicated cognitive process influenced by multi-faceted components, including patient factors, clinician factors, external influencing factors and technological factors. Telehealth carries higher risk and uncertainty than face-to-face encounters. CDSS, rather than bringing unification and clarity, seems to bring more divergence and ambiguity. Some of the clinical reasoning processes in telehealth remain unknown and need to be verbalized and made transparent, to prepare junior clinicians with skills to minimize risks associated with telehealth. Not applicable.

A systematic integrative review of specialized nurses' role to establish a culture of patient safety: A modelling perspective.

To understand specialized nurses' role in the culture of patient safety and their ability to promote and enforce it within healthcare. A systematic integrative review using the approach of Whittemore and Knafl. Systematic literature search for qualitative, quantitative and mixed-methods studies, followed by data evaluation, quality assessment, analysis and research synthesis with a narrative perspective. Findings were contextualized within a 'framework for understanding the development of patient safety culture'. Searches were conducted in PubMed [including MEDLINE], Scopus, CINAHL, Web of Science and EMBASE from Jan 2013 until Sep 2023. Sixteen studies published in English from six different countries were selected and used for research synthesis. Diverse enabling factors and enacting behaviours influencing specialized nurses' roles to promote patient safety culture were identified, mainly focusing on nurses' workload, professional experiences and organizational commitment. Patient safety outcomes focused on medication management, infection prevention, surveillance process in critical care, oversight on quality and safety of nurses' practice, patient care management, continuity of care, adherence to the treatment plan and implementation of a specialized therapeutic procedure. Specialized nurses can make a significant contribution to promote patient safety culture and support organizational initiatives to prevent adverse events. Stronger participation and leadership of specialized nurses in initiatives to improve patient safety culture requires appropriate investments and support by policy makers and managers in terms of resources and training. There is a gap in existing literature on the contribution that specialized nurses can make in promoting patient safety culture. Review results highlight the importance of interprofessional collaboration and teamwork by involving specialized nurses. They inform healthcare policy makers about recognizing their roles and competencies in patient safety culture. Preferred reporting items for systematic reviews and meta-analysis. No patient or public contribution.

Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review

BackgroundIn recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging.MethodsThis study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT).ResultsTwenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors.ConclusionThe study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.

STRATEGIES TO PROMOTE THE MENTAL HEALTH OF PATIENTS IN PALLIATIVE CARE: INTEGRATIVE REVIEW

The respective research aims to analyze national and international publications that investigate mental health promotion strategies carried out by the nursing team for patients in palliative care. It is understood that palliative care is a methodology developed to provide differentiated assistance to patients with advanced illness until the end of life, in the hospital and home environment, based on the patient-family binomial, called the hospice movement. To this end, a bibliographical research was carried out, using a qualitative descriptive approach using the techniques of systematic integrative literature review. Focusing on the results, 7 articles were selected and after analyzing the studies, the categories emerged: 1) Strategies for promoting the mental health of patients in palliative care: caring for patients, family members and workers; 2) Necessary requirements for humanized nursing care for patients in palliative care: Professional training and continuing education. The study concludes that it is extremely important that nursing professionals are equipped with skills and qualifications to develop strategies that promote the mental health of patients and their families, as well as health professionals. To achieve this, it is necessary to disseminate good practices in palliative care through humanized care with a focus on promoting the mental health of everyone involved using as strategies the insertion of empathy, solidarity, spirituality, effective communication, as well as investing in professional training and ongoing in-service education.

Motivating factors for blockchain technology adoption: a theoretical analysis from the perspective of supply chain collaboration

Purpose This study aims to identify the driving factors that influence blockchain technology adoption in the context of a supply chain (SC), considering three dimensions: technology, transactions and collaboration. Design/methodology/approach An integrative systematic literature review of previous studies was conducted. Using three main dimensions: technology, transactions and SC collaboration, supported by the unified theory of acceptance and use of technology, transaction cost economics (TCE) and concepts of SC collaboration, the authors categorized factors that contributed to blockchain technology in SC in the extant literature and proposed a theoretical model that covers these three dimensions. Findings The findings reveal that the information sharing category – related to the SC collaboration dimension – is the category with the greatest number of motivating factors for blockchain adoption in the SC context, followed by performance expectancy and behavioral uncertainty. Research limitations/implications The review considers papers published until 2021 obtained from a specific database. Originality/value This study focuses on filling the research gap concerning technology adoption as it considers the interconnection formed by two organizations, interorganizational transactions and SC collaboration, using complementary theories to explain the phenomenon.

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Medical knowledge in Brazil about palliative care: Integrative systematic review

This study aims to show medical knowledge about palliative care in Brazil. Palliative care (PC) is a term used to designate a set of actions employed by a highly skilled multidisciplinary team in order to alleviate the suffering of patients and families facing terminal illnesses. This is bibliographical research, of the integrative review type, through a search in the databases: SCIELO, MEDLINE and LILACS. The present study used the following descriptors: “Palliative care”, “Medical education”, “Patient care” in association with Boolean operators AND and OR. Data collection was carried out following six methodological steps: The first step was related to the proposed objectives. The second step was to determine the inclusion or exclusion criteria for articles. The third stage was collecting information from the selected studies and stratifying them. The fourth stage was the evaluation of the methods used in the studies. The fifth stage was the interpretation and discussion of the results, and the last stage was the presentation, argumentation and conclusion. 150 articles were identified, of which only 100 met the eligibility criteria, however, 85 of them did not meet the project regulations. Thus, 5 articles were selected that relate medical knowledge about palliative care. The discussion was conducted on the results, respecting comparative criteria between objective, thematic associations and conclusion. In conclusion, it appears that the inclusion of CP teaching in undergraduate courses is deficient in Brazil, and all studies reveal the need to address the topic to improve students’ comprehensive vision.

Acurácia do método eletrónico versus método radiográfico na determinação do comprimento de trabalho: revisão sistemática integrativa

Introduction: The radiographic method is widely used to calculate the working length (CT). However, it presents limitations that, to overcome them, apical electronic locators (LEAs) were developed to allow greater accuracy and reliability in determining the CT. Objective: The present study aims to perform an integrative systematic review and gather the available scientific evidence on the method that allows greater accuracy in determining the CT between the radiographic method and the electronic localisation method (LEA). Materials and Methods: The literature search was performed on the PubMed platform using keywords combined through the Boolean operator AND as follows: ("endodontics" AND "electronic apex locator" AND "radiographic measurement") and ("endodontics" AND "electronic apex locator" AND "radiographic measurement" AND "odontometry"). Results: 68 articles reporting comparative studies performed between the methods, radiographic and LEA, were identified. Eleven studies were included, of which, in some cases, LEAs showed better results than non-digital periapical radiographs. The studies indicate that although there are differences between the two methods, with greater accuracy in determining LEA, the differences did not prove to be statistically significant. In the presence of irrigating solutions, sodium hypochlorite revealed more significant discrepancies in CT determination with the LEA method. Conclusion: The two methods, radiographic and LEA, should be used in association since each has particularities that present more significant benefits enhancing the success of endodontic treatment and a better and more complete treatment for patients.

Built to last? Barriers and facilitators of healthcare program sustainability: a systematic integrative review.

To identify barriers and facilitators associated with the sustainability of implemented and evaluated improvement programs in healthcare delivery systems. Six academic databases were searched to identify relevant peer-reviewed journal articles published in English between July 2011 and June 2022. Studies were included if they reported on healthcare program sustainability and explicitly identified barriers to, and facilitators of, sustainability. A systematic integrative review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Study quality was appraised using Hawker's Quality Assessment Tool. A team of reviewers screened eligible studies against the inclusion criteria and extracted the data independently using a purpose-designed Excel spreadsheet. Barriers and facilitators were extracted and mapped to the Integrated Sustainability Framework (ISF). Frequency counts of reported barriers/facilitators were performed across the included studies. Of the 124 studies included in this review, almost half utilised qualitative designs (n = 52; 41.9%) and roughly one third were conducted in the USA (n = 43; 34.7%). Few studies (n = 29; 23.4%) reported on program sustainability beyond 5years of program implementation and only 16 of them (55.2%) defined sustainability. Factors related to the ISF categories of inner setting (n = 99; 79.8%), process (n = 99; 79.8%) and intervention characteristics (n = 72; 58.1%) were most frequently reported. Leadership/support (n = 61; 49.2%), training/support/supervision (n = 54; 43.5%) and staffing/turnover (n = 50; 40.3%) were commonly identified barriers or facilitators of sustainability across included studies. Forty-six (37.1%) studies reported on the outer setting category: funding (n = 26; 56.5%), external leadership by stakeholders (n = 16; 34.8%), and socio-political context (n = 14; 30.4%). Eight studies (6.5%) reported on discontinued programs, with factors including funding and resourcing, poor fit, limited planning, and intervention complexity contributing to discontinuation. This review highlights the importance of taking into consideration the inner setting, processes, intervention characteristics and outer setting factors when sustaining healthcare programs, and the need for long-term program evaluations. There is a need to apply consistent definitions and implementation frameworks across studies to strengthen evidence in this area. https://bmjopen.bmj.com/content/7/11/e018568 .

RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Evaluation of the Use of Activity Trackers in the Clinical Care of Adults Diagnosed With a Chronic Disease: Integrative Systematic Review.

Chronic diseases are a leading cause of adult mortality, accounting for 41 million deaths globally each year. Low levels of physical activity and sedentary behavior are major risk factors for adults to develop a chronic disease. Physical activity interventions can help support patients in clinical care to be more active. Commercial activity trackers that can measure daily steps, physical activity intensity, sedentary behavior, and distance moved are being more frequently used within health-related interventions. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a planning and evaluation approach to explore the reach, effectiveness, adoption, implementation, and maintenance of interventions. The objective of this study is to conduct an integrative systematic review and report the 5 main RE-AIM dimensions in interventions that used activity trackers in clinical care to improve physical activity or reduce sedentary behavior in adults diagnosed with chronic diseases. A search strategy and study protocol were developed and registered on the PROSPERO platform. Inclusion criteria included adults (18 years and older) diagnosed with a chronic disease and have used an activity tracker within their clinical care. Searches of 10 databases and gray literature were conducted, and qualitative, quantitative, and mixed methods studies were included. Screening was undertaken by more than 1 researcher to reduce the risk of bias. After screening, the final studies were analyzed using a RE-AIM framework data extraction evaluation tool. This tool assisted in identifying the 28 RE-AIM indicators within the studies and linked them to the 5 main RE-AIM dimensions. The initial search identified 4585 potential studies. After a title and abstract review followed by full-text screening, 15 studies were identified for data extraction. The analysis of the extracted data found that the RE-AIM dimensions of adoption (n=1, 7% of studies) and maintenance (n=2, 13% of studies) were underreported. The use of qualitative thematic analysis to understand the individual RE-AIM dimensions was also underreported and only used in 3 of the studies. Two studies used qualitative analysis to explore the effectiveness of the project, while 1 study used thematic analysis to understand the implementation of an intervention. Further research is required in the use of activity trackers to support patients to lead a more active lifestyle. Such studies should consider using the RE-AIM framework at the planning stage with a greater focus on the dimensions of adoption and maintenance and using qualitative methods to understand the main RE-AIM dimensions within their design. These results should form the basis for establishing long-term interventions in clinical care. PROSPERO CRD42022319635; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=319635.

Interventions to reduce interpersonal stigma towards patients with a mental dysregulation for ambulance and emergency department healthcare professionals: review protocol for an integrative review

IntroductionWorldwide, there is an increase in the extent and severity of mental illness. Exacerbation of somatic complaints in this group of people can result in recurring ambulance and emergency department...

The role of aspirin, statins, colchicine, and IL-1 inhibitors in prevention of cardiovascular events: a systematic integrative review.

Cardiovascular disease (CVD) is the leading cause of death in the United States. As such, an unmet need exists in the primary and secondary prevention of adverse cardiovascular events (CVEs). Specifically, identifying drugs that can reduce the progression of CVD and serious adverse events is much needed. Drugs that work by reducing platelet aggregation, blocking cholesterol formation (3-hydroxy-3-methyl-glutaryl-coenzyme A [HMG-CoA] reductase inhibitors), and/or blocking inflammation pathways (mainly interleukin-1b [IL-1b]) have been linked to preventing adverse CVEs, including acetylsalicylic acid (ASA, aspirin), statins, colchicine, and IL-1 inhibitors (interleukin-1 receptor antagonists). This systematic review aims to provide insight into utilizing these four agents for the primary and/or secondary prevention of CVD. In this systematic review, we opted to review the efficacy of aspirin, statins, colchicine, and IL-1 inhibitors in the primary and secondary prevention of CVE to provide clinical practitioners with evidence-based practice approaches and determine any unmet needs in their utilization. Between October 1 and 12, 2021, a search was conducted and completed on five databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Biomedical Reference Collection: Comprehensive. A total of 13 researchers (V.A., A.H., S.B., V.G., D.C., C.C., C.B., C.A., S.K., J.H., A.K., S.F., and S.E.) were involved in the search and screening of the articles. Search terms included "aspirin, statins, colchicine, IL-1 inhibitors, and primary, secondary, myocardial infarction (MI)." Inclusion criteria included clinical study design, English language articles, all genders older than 50 years old, and established patient history of CVD, including MI. In addition, articles were excluded if they were animal models, invitro studies, pharmacokinetic studies, systematic reviews, literature reviews, and studies exploring therapies other than those listed in the inclusion criteria. First, five individuals independently sorted through abstracts or articles based on the inclusion and exclusion criteria. Then, a team of 13 individuals sorted through full-text articles of selected abstracts based on the same criteria. A separate researcher resolved conflicts between the team. A total of 725 articles were identified from all databases, from which 256 duplicated articles were removed. Thus, a total of 469 articles abstracts were screened, of which 425 articles either did not meet the inclusion criteria or met the exclusion criteria. A total of 42 articles were retrieved and assessed for full-text review, from which 15 articles were retrieved for analysis. Statins may prevent primary CVEs based on their role in preventing cholesterol formation. Aspirin, canakinumab, and colchicine may be helpful in the secondary prevention of CVEs due to their blocking of various steps in the inflammation pathway leading to CVD. Future research should primarily focus on the use of canakinumab and colchicine in preventing CVD due to the limited number of studies on these drugs.

Content validation of a mental wellness measuring instrument for adolescents living with HIV: a modified delphi study

A growing body of evidence suggests that improving the mental wellness of adolescents living with HIV (ALHIV) will also result in improved adherence to antiretroviral therapy (ART), as well as improving their general health and wellbeing as they age into adulthood. However, to develop effective strategies and interventions aimed at improving mental wellness, we require age and culturally appropriate instruments to build an evidence base. Currently, there is a lack of mental wellness measures developed for ALHIV, especially in the African context. To address this gap, we developed a measure of mental wellness following modified guidelines set out by DeVellis [1] and Godfred et al. as a guiding framework [2]; (1) Identifying the gap, (2) Set the theoretical foundations and identify domains and (3); Instrument development and initial validation. For the first two steps, we conducted a systematic review, photovoice study and integrative review – which we briefly describe as the findings have been published. Following this we describe the processes to develop the instrument and to establish content validity through a modified Delphi Study. Through this process we were able to refine the instrument which will be subject to further testing.Implications and Contribution: This study aims to add to the body of knowledge on promoting mental health (mental wellness) among adolescents living with HIV in South Africa through developing an appropriate and valid measure of mental wellness for this population. This study reports on the results of a Delphi Study aimed at improving the content validity of the instrument Mental Wellness Measure for Adolescents Living with HIV (MWM-ALHIV).