Interpretive Synthesis Research Articles

Good quality end-of life care for people with an intellectual disability: A critical interpretive synthesis protocol.

People with an intellectual disability face inequality accessing healthcare that extends to end-of-life care. Furthermore, end-of-life care for people with an intellectual disability is more complex than that for the general population. This protocol sets out how our review will explore the available evidence and identify the key characteristics of care that are required for people with an intellectual disability to have a good end-of-life experience. A critical interpretive synthesis approach will be adopted, combining some elements of a systematic review with interpretive synthesis. This approach has been selected as it allows a diverse body of literature to be considered. Furthermore, it is compatible with theory generation allowing new insights to emerge in an iterative process. Electronic databases and grey literature sources will be searched using pre-defined search terms. Following initial title and abstract screening, eligible papers will undergo full text screening. Papers that are deemed to be 'fatally flawed' will be excluded and remaining papers appraised for relevance. Resultant papers will be included in the sampling frame from which data extraction will occur. An existing framework outlining key factors in the provision of excellent end-of-life care to people with an intellectual disability will be used to support data extraction and synthesis. Data extracted will be integrated into a synthesising argument in the form of a theoretical framework. This will identify the key characteristics in the provision of care that are required for people with an intellectual disability to have a good end-of-life experience. The developing theoretical framework will guide further selection of relevant literature to fill any conceptual gaps until saturation is reached. Our review will add to the existing body of evidence, shedding light on the key factors necessary in the provision of care to ensure that people with an intellectual disability have a good end-of-life experience.

Suspect, Officer, and Situational Dynamics Underlying Violent Resistance Against Police: A Critical Interpretative Synthesis

ABSTRACT Assaults against police officers pose a significant challenge to law enforcement safety, yet the factors driving such violence remain complex and underexplored. This critical interpretative synthesis (CIS) is the first literature review to examine violent resistance from an interpretative perspective. By reviewing 38 studies from 2000 to 2024, identified through various methods, we develop a theoretical framework to better understand and contextualize factors linked to assaults against officers. Results indicate that certain suspect, officer, and situational characteristics are linked to violent resistance, both independently and through their interactions. These interactions between predictors help explain inconsistencies across studies. Additionally, we note a lack of diversity in how risk and protective factors of violent resistance have been studied. We suggest areas for future research and offer recommendations to inform police practices and improve officer safety.

One health governance of antimicrobial resistance seen through an Urban Political Ecology lens: a critical interpretive synthesis

ABSTRACT Antimicrobial resistance (AMR) is a threat to animal and ecosystem health, agriculture, water, and sanitation systems, posing risks not only to human health, but also to society and the systems upon which it depends. Global health governance draws on the One Health (OH) approach to combat AMR. However, the effective implementation of these approaches faces several constraints, including governance and implementation challenges arising from the interconnected nature of AMR with other global health threats, as well as local and structural socioecological factors that affect policy outcomes, that are often overlooked in governance approaches. This article aims to clarify how scientific literature has situated OH-AMR governance responses in relation to six socioecological dimensions: global health threats, broader concerns, governance frameworks, socioeconomic factors, health equity, and environmental justice. Informed by an Urban Political Ecology (UPE) lens and guided by the Critical Interpretive Synthesis (CIS) methodology of Dixon-Woods et al., our critical interpretive synthesis identified 18 articles situating OH-AMR arrangements within these socioecological dimensions. The role of global governance frameworks in shaping state governance arrangements has rarely been the object of analysis in the selected studies. The synthesis highlights the connections between urbanization, AMR risks, global health threats, and broader ecological challenges, calling for a reassessment of current global and state governance approaches. The study also offers a case for the adoption of a UPE lens to address AMR and related global health challenges.

The Unintended Consequences of Telehealth in Australia: Critical Interpretive Synthesis.

Despite more than 2 decades of telehealth use in Australia and the rapid uptake during the COVID-19 pandemic, little is known about its unintended consequences beyond its planned and intended outcomes. The aim of this review was to synthesize evidence on the unintended consequences of telehealth use in Australia to clarify its impact beyond its planned and intended outcomes. We conducted a search of 4 electronic databases: Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, and Scopus. A critical interpretive synthesis approach was adopted for its flexibility and interpretive nature. We extracted data about study characteristics and the types and models of telehealth services. The extracted unintended consequences were coded and mapped into the domains and dimensions of the Australian Health Performance Framework. Of the 4241 records identified by the search, 94 (2.22%) studies were eligible for data extraction and analysis. Of these 94 studies, 23 (24%) reported largely positive unintended consequences of telehealth associated with health status, while 6 (6%) noted a potential negative impact of telehealth on socioeconomic status. The findings of 4 (4%) of the 94 studies highlighted societal and financial consequences of telehealth beyond the health system. Almost all studies (93/94, 99%) reported unintended consequences under the 5 dimensions of the Australian Health Performance Framework. Our synthesis offers a framework for understanding the unintended consequences of the use of telehealth as an alternative to in-person care in Australia. While we have documented many unintended benefits of telehealth use, our findings also shed light on many challenges of delivering care via telehealth across different domains and dimensions. These findings hold significant practice and policy-making implications for ensuring safe and high-quality care delivery via telehealth.

Childbearing Women's Experiences of and Interactions With the Health System in Vietnam: A Critical Interpretive Synthesis.

Scholars have long argued that the care experience is shaped by context, and by evolutions in this context. Using Vietnam as a case, we critically interrogate the literature on women's experiences with maternity care to unpack whether and if it engages with the major social, economic, and health system impacts of the Doi Moi reforms in Vietnam and with what consequences for equity. We conducted a critical interpretive synthesis of this literature in light of the social, economic, and health system transformations driven by the Doi Moi reforms. We offer three critiques: (1) an overwhelming focus on public maternity care provision in rural/mountainous regions of Vietnam, (2) a narrow focus on women's ethnic identity, and (3) a misplaced preoccupation with women's limited autonomy and agency. We argue that future research needs to consider the impact of Vietnam's shift towards market-oriented care provision, and the broader societal and health system changes impacting both rural and urban areas, as well as ethnic minority and Kinh majority populations.

"I don't wanna die, but my brain insists that I should": a big qualitative data approach to the lived experiences of suicidal thoughts.

There remains a dearth of knowledge concerning the phenomenology of suicidal thoughts, with research focusing on reasons for feeling suicidal rather than their mental expression. While clinical interviews remain the standard phenomenological approach, such exploration of lived experiences may prove challenging for this sensitive topic. As a complementary alternative, the use of naturally-occurring online data is opportune for capturing elaborations on tabooed phenomena. In this phenomenological study, we present a thematic analysis on lived experiences of suicidal thoughts as spontaneously reported by non-identified users of a Reddit online board (r/Depression), collecting 668 posts using the search terms "suicidal ideation," "suicidal thoughts," and "suicide." Codes were grouped into descriptive categories summarizing the properties of thoughts, their effects, and their relation to suicide. Then, an interpretative synthesis yielded global themes connecting salient meanings on the experience of suicidal thoughts. With a long-term and recurring nature, thoughts of suicide appear in the form of vivid imagery and daydreaming's, initially bringing relief to adverse feelings but eventually becoming conditioned and all-consuming. Rather than a wonderment, they are experienced as intrusive thoughts by people struggling to make meaning of their occurrence. When conciliating the presence of unwanted thoughts, users express intricate relations to wishing or not to die, as well as varying perceptions of control over actions or fear of suicidal behavior. With an innovative application of big qualitative data into phenomenological analysis, this study contributes to an initial characterization of suicidal thoughts, uncovering findings that are not contemplated into current conceptualizations of suicidality. The analysis is limited by a restricted context of posts and unknown demographics, and further research with clinical interviews is warranted for in-depth exploration of suicidal thoughts.

Candidacy 2.0 (CC) – an enhanced theory of access to healthcare for chronic conditions: lessons from a critical interpretive synthesis on access to rheumatoid arthritis care

BackgroundThe Dixon-Woods et al. Candidacy Framework, a valuable tool since its 2006 introduction, has been widely utilized to analyze access to various services in diverse contexts, including healthcare. This social constructionist approach examines micro, meso, and macro influences on access, offering concrete explanations for access challenges rooted in socially patterned influences. This study employed the Candidacy Framework to explore the experiences of individuals living with rheumatoid arthritis (RA) and their formal care providers. The investigation extended to assessing supports and innovations in RA diagnosis and management, particularly in primary care.MethodsThis systematic review is a Critical Interpretive Synthesis (CIS) of qualitative and mixed methods literature. The CIS aimed to generate theory from identified constructs across the reviewed literature. The study found alignment between the seven dimensions of the Candidacy Framework and key themes emerging from the data. Notably absent from the framework was an eighth dimension, identified as the “embodied relational self.” This dimension, central to the model, prompted the proposal of a revised framework specific to healthcare for chronic conditions.ResultsThe CIS revealed that the eight dimensions, including the embodied relational self, provided a comprehensive understanding of the experiences and perspectives of individuals with RA and their care providers. The proposed Candidacy 2.0 (Chronic Condition (CC)) model demonstrated how integrating approaches like Intersectionality, concordance, and recursivity enhanced the framework when the embodied self was central.ConclusionsThe study concludes that while the original Candidacy Framework serves as a robust foundation, a revised version, Candidacy 2.0 (CC), is warranted for chronic conditions. The addition of the embodied relational self dimension enriches the model, accommodating the complexities of accessing healthcare for chronic conditions.Trial RegistrationThis study did not involve a health care intervention on human participants, and as such, trial registration is not applicable. However, our review is registered with the Open Science Framework at https://doi.org/10.17605/OSF.IO/ASX5C.

Applied qualitative methods for social life cycle assessment: a case study of Canadian beef

PurposeThis paper presents a transparent and rigorous methodological approach to conducting a case study of social performance (SP) within the conventional life cycle of Canadian beef. The objective was to explore the potential benefits and risks (or hotspots) of practices on Canadian beef farm businesses (BFBs) and slaughter operations (BSOs) to establish valid benchmarks and a social sustainability roadmap for decision-makers to improve SP.MethodsThis study undertook a novel and participatory approach to social life cycle assessment (S-LCA). Respondents from both within and at-arms-length to the beef value chain were engaged to identify SP practices and perceptions and develop the life cycle inventory. The goal and scope, inventory, assessment, and interpretation were conducted in a three-phased approach: (i) scoping; (ii) practice-based assessment; and (iii) deep-dive assessment. Data collected through mixed methods, including Q method, interviews, surveys, and literature review, were assessed using a type I (reference scale) approach and interpreted through critical interpretive synthesis. Organizational SP was explored at BFBs and BSOs, considering the following stakeholders: value chain actors, farmers, employees, and cattle.Results and discussionOutcomes from the applied approach explore the interrelations between organizations and stakeholders along the value chain. Impact categories concerning labour management, people’s health and safety, and animal care were prioritized for deep-dive assessment. Subcategories included novel topics, like recruitment and retention and access to mental health resources. A range of potential benefits and areas for improving SP were identified at BFBs and BSOs. Potential risks from SP were identified for stakeholders from working hours, communication and dispute resolution, animal transport, and personal protective equipment practice areas. Results informed strategic activities for the National Beef Sustainability Strategy.ConclusionThis study contributes to the social sustainability discourse in livestock systems by demonstrating a qualitative approach to S-LCA that can be replicated by practitioners to explore valid and locally specific social dimensions of sustainability. Practitioners may consider the approach and results in future studies to better capture and manage the complex and dynamic nature of livestock systems, leading to more effective social sustainability decisions that incorporate diverse stakeholder perspectives.

Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis

BackgroundTriage and clinical consultations increasingly occur remotely. We aimed to learn why safety incidents occur in remote encounters and how to prevent them.Setting and sampleUK primary care. 95 safety incidents...

Defining contemporary outdoor physical activity: A critical interpretive synthesis

Outdoor physical activities (OPAs) are known to provide economic and social benefits across a number of sectors and industries (Buckley, 2007; Carpenter, 2013; Clough et al., 2016). However, the loosely constructed meanings attached to its various typologies create an ambiguity impacting our understanding of OPA as a holistic term. This study aimed to construct a new, unified definition of OPA, as experienced by adult participants, and develop a conceptual model of shared characteristics that provides clarity and informs practice. Through conducting a Critical Interpretive Synthesis (Dixon-Woods et al., 2006) of existing definitions within academic literature (N = 133), three arguments were established. These suggest that all OPAs share characteristics relating to sensation seeking, emphasise the importance of the settings in which they take place, as well as the wellbeing outcomes they offer. A model detailing these arguments is presented and each argument is critically discussed. Management implicationsThe management implications of this research are fourfold and can be summarised by the following points.1)Through understanding the three characteristic elements of OPA, leisure, tourism and recreational managers can be better informed as to the allocation of resources for the provision of services to meet the needs of participants.2)Through a greater understanding of OPA, interested parties who are marketing products and services to end users can ensure that the relationships they build are based on the evidenced characteristics described in the MOPAC model.3)A renewed understanding of OPA attributes can improve efficiency in the management of through better informed policy decision making.4)With OPA increasingly being used by healthcare professionals, this research can enable more informed and targeted activities that increase the efficacy of interventions using OPA.

KONSEP DALAM MERUMUSKAN VISI, MISI, TUJUAN DAN PROGRAM LEMBAGA PENDIDIKAN ISLAM

The era of Society 5.0 and Industrial Revolution 4.0 brought fundamental changes to the educational landscape, requiring Islamic educational institutions to adapt without losing their identity. This article examines the concept of formulating the vision, mission, goals and programs of Islamic educational institutions in the context of the digital era. This research uses a library research method with a descriptive-analytical approach. Data was obtained from primary sources in the form of the Al-Qur'an, Hadith, and the latest publications from reputable Islamic education journals, as well as relevant secondary sources. Data analysis was carried out through the stages of categorization, contextual interpretation and conceptual synthesis. The research results show that these four elements must be formulated based on the integration of modern management and Islamic values ​​interpreted contextually. The main finding is the concept of "technological ijtihad", namely an effort to reinterpret classical Islamic concepts to make them relevant to the digital era. The vision must respond to global issues, the mission includes Islamic "digital citizenship", the goals are formulated using SMART and VUCA Prime principles, while the program integrates Islamic boarding school values ​​with technology. This approach resulted in a creative synthesis between tradition and modernity, which gave birth to a "techno-spiritual" generation. This article contributes to providing a conceptual framework for Islamic educational institutions to formulate strategic directions that are in line with Islamic identity and the demands of the times, so that they can produce graduates who are superior intellectually, technologically and spiritually.

A critical and interpretive synthesis of arts-based methods used by dance therapy researchers: A perspective from the creative arts therapies

The creative arts therapies are a group of modality specific disciplines that include dance, music, drama and art. Creative arts therapists take an arts-based approach to practice which often results in the privileging of alternate ways of knowing, such as non-verbal, artistic, and embodied forms of expression and meaning-making. The rising interest in arts-based research in our field, as well as within psychology, has prompted us – a dance therapist and music therapist - to take a closer look at the research literature to ascertain the function and purpose of existing arts-based research approaches in the creative arts therapies. Using dance therapy as an example, we conducted a rigorous interpretive review of 12 dance therapy arts-based research articles to help answer the question - ‘what is the function and purpose of arts-based research in dance therapy?‘. As part of our review, we used an arts-based process to synthesise data and to strengthen our analytic process in a manner congruent with artistic ‘ways of knowing.’ Our exploration led us to recognise that arts-based processes appear to enable the ‘illustration’ and ‘illumination’ of novel understanding in ways that are often more difficult to arrive at when using other qualitative research methods. Furthermore, arts-based research can be useful for facilitating researcher reflexivity, which may be used in service of deepening the interpretive process in qualitative research. However, our involvement with the dance therapy publications also revealed a clear shortcoming for the field: at present there appears to be a clear lack of focus on direct client engagement in the arts-based research literature. As such, arts-based research in the field of dance therapy seems to be somewhat removed from professional practice and appears to instead fulfil a more scholarly or self-reflective purpose. Based on this discovery, we offer some recommendations for those interested in pursuing arts-based research within both psychology as well as creative arts therapies, and in doing so highlight the importance of client voice and experience in health-focused research.

Bleeding beyond binaries: a critical interpretive review of trans, non-binary and gender non-conforming experiences with menstruation

While some barriers for managing menstruation have been mitigated for cisgender women, trans, non-binary, and gender non-conforming people still struggle to navigate menstruation in a gendered society. With an increasing number of young people identifying outside of the gender binary, there is an immediate need to identify and address the barriers to managing menstruation. This review sets out to explore how trans, non-binary, and gender non-conforming people experience and navigate menstruation. Using critical interpretive synthesis methodology, nine pieces of literature including peer-reviewed journal articles, graduate theses, a book chapter, and a conference poster presentation were reviewed using thematic analysis. Four primary themes were identified: (1) menstruation is strongly gendered; (2) there exists inadequate trans, non-binary, and gender non-conforming education and healthcare training; (3) the gendering of public toilets/washrooms poses a barrier to the management of menstruation; and (4) there exists a lack of diverse participants and attention to intersectional menstruation concerns. A set of recommendations, specific to a variety of stakeholders is provided, and implications for future research are discussed.

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis.

The perinatal period is known as time of transition and anticipation. For women with social risk factors, child protection services may become involved during the perinatal period and this might complicate their interactions with healthcare providers. To systematically review and synthesise the existing qualitative evidence of healthcare experiences of women and healthcare professionals during the perinatal period while facing child protection involvement. A systematic search of databases (Web of Science, MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, MIDIRS, Social Policy and Practice and Global Health) was carried out in January 2023, and updated in February 2024. Quality of studies was assessed using the Critical Appraisal Skills Programme. A Critical Interpretative Synthesis was used alongside the PRISMA reporting guideline. A total of 41 studies were included in this qualitative evidence synthesis. We identified three types of healthcare interactions: Relational care, Surveillance and Avoidance. Healthcare interactions can fluctuate between these types, and elements of different types can coexist simultaneously, indicating the complexity and reciprocal nature of healthcare interactions during the perinatal period when child protection processes are at play. Our findings provide a novel interpretation of the reciprocal interactions in healthcare encounters when child protection agencies are involved. Trust and transparency are key to facilitate relational care. Secure and appropriate information-sharing between agencies and professionals is required to strengthen healthcare systems. Healthcare professionals should have access to relevant training and supervision in order to confidently yet sensitively safeguard women and babies, while upholding principles of trauma-informed care. In addition, systemic racism in child protection processes exacerbate healthcare inequalities and has to be urgently addressed. Providing a clear framework of mutual expectations between families and healthcare professionals can increase engagement, trust and accountability and advance equity.

Meta-Ethnography, a Method for the Synthesis of Qualitative Research: A Narrative Review

Background: Synthesis studies are used for the retrieval, review, synthesis, analysis, and integration of the findings of original studies. The purpose of this review was to shed more light on how meta-ethnography works as a method of inductive and interpretative knowledge synthesis, and on its application and implementation in medical sciences. Methods: This was a narrative review study and the statistical population included all scholarly publications on the synthesis of qualitative studies and meta-ethnography published from 1998 to 2022. The search in international and domestic databases led to the extraction of 118 books and articles. After reviewing the titles, abstracts, and full texts of these publications, we included 2 books and 8 articles in the review. Results: Meta-ethnography is used for synthesizing the knowledge obtained from qualitative studies to re-conceptualize their findings. There are seven phases in the process of meta-ethnography: Getting started; Deciding on what is of initial interest; Reading the studies; Determining how the studies are related; Translating the studies to each other; Synthesizing the translations; and expressing the synthesis. The number of studies required to perform meta-ethnography has been recently suggested to be 40. Strategies for updating meta-ethnography include repeating the previous strategy and reformulating the strategy according to a new objective, a revised review question, or new inclusion criteria. Conclusion: Noblit and Hare introduced meta-ethnography in 1988 as a qualitative research method for the synthesis of educational ethnographies. Today, it is widely used in healthcare research.

Association of dietary habits with non-communicable diseases: a qualitative review

PurposeKerala, a southern state in India, is acknowledged for its socio-economic reforms such as quality health care, gender parity, high literacy rate and more. However, recent trends show that the state has the highest incidence of various noncommunicable diseases in the country, including diabetes, hypertension and heart coronary artery disease. This research paper aims to examine the link between the Kerala population’s lifestyle, diet and genetic factors and its correlation with a heightened cardio-metabolic risk.Design/methodology/approachUsing Dixon Wood’s interpretive synthesis, this qualitative literature review is systematically used by searching, gathering articles, theme building, comparing and criticising the evidence.FindingsThe result shows that only minimal evidence is available regarding the genetic makeup of the Kerala community, food patterns and its link to the high prevalence of non-communicable diseases (NCDs). However, limited and contradicting evidence and studies restricted to a particular region in the state demand more research on this domain.Originality/valueIt is vital to review the diet habits of Keralites due to the alarmingly high prevalence of NCDs. To the best of the authors’ knowledge, this is the first comprehensive review of the diet habits of Kerala and their link to NCDs.

Suggesting a holistic framework for understanding healthcare services leadership competence – a critical interpretive synthesis

PurposeHealthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.Design/methodology/approachIn the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.FindingsForty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.Research limitations/implicationsThis literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.Practical implicationsThe holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.Originality/valueThis study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

Applications of Artificial Intelligence in Emergency Departments to Improve Wait Times: Protocol for an Integrative Living Review.

Long wait times in the emergency department (ED) are a major issue for health care systems all over the world. The application of artificial intelligence (AI) is a novel strategy to reduce ED wait times when compared to the interventions included in previous research endeavors. To date, comprehensive systematic reviews that include studies involving AI applications in the context of EDs have covered a wide range of AI implementation issues. However, the lack of an iterative update strategy limits the use of these reviews. Since the subject of AI development is cutting edge and is continuously changing, reviews in this area must be frequently updated to remain relevant. This study aims to provide a summary of the evidence that is currently available regarding how AI can affect ED wait times; discuss the applications of AI in improving wait times; and periodically assess the depth, breadth, and quality of the evidence supporting the application of AI in reducing ED wait times. We plan to conduct a living systematic review (LSR). Our strategy involves conducting continuous monitoring of evidence, with biannual search updates and annual review updates. Upon completing the initial round of the review, we will refine the search strategy and establish clear schedules for updating the LSR. An interpretive synthesis using Whittemore and Knafl's framework will be performed to compile and summarize the findings. The review will be carried out using an integrated knowledge translation strategy, and knowledge users will be involved at all stages of the review to guarantee applicability, usability, and clarity of purpose. The literature search was completed by September 22, 2023, and identified 17,569 articles. The title and abstract screening were completed by December 9, 2023. In total, 70 papers were eligible. The full-text screening is in progress. The review will summarize AI applications that improve ED wait time. The LSR enables researchers to maintain high methodological rigor while enhancing the timeliness, applicability, and value of the review. DERR1-10.2196/52612.

Creating or destroying value for users? Lessons about activation from qualitative studies in Norway and Denmark

ABSTRACT This article contributes to a growing stream of research on service co-creation and users’ experiences and use of activation services. In public management research, the idea of a public service logic has gained increasing prominence. A key point is that a better understanding of what a service genuinely is, has implications for how to develop more user-centric and efficient services. This article applies a public service logic in a critical interpretive synthesis of qualitative research findings regarding users’ experiences with activation services in Denmark and Norway. It shows that activation services are necessarily co-created, as users contribute resources to co-create services. Only users can transform these services into individual value, helping them in their process towards work. Services made by utilizing users’ resources but not answering to users’ needs may destroy individual value. Some activation services tend to contribute more to individual value creation than other services, but most services can contribute to both value creation and destruction, depending on users’ needs and circumstances. Public services must also create public value. Services users are obliged to participate in co-creating and which give priority to the creation of public value, such as clarifying eligibility for long term benefits often lead to the destruction of individual value. Taking users’ co-creation of service as a starting point in the design of and research on activation services will contribute to provide more user-centric services, increase the priority given to creation of individual over public value and thereby improve the outcome of activation policy.

Unraveling Gender and Non-Accidental Violence in Women’s Gymnastics Research: A Critical Interpretive Synthesis

ABSTRACT Non-accidental violence in women’s gymnastics has gained significant attention, and is a sport where gender is clearly differentiated. Despite the volume of gymnastics research on these themes it seemingly had little impact in preventing harm. We conducted a critical interpretative synthesis of 45 articles to reexamine the literature for understanding of, and connections between, gender and violence. We found that where gender viewed as a structure was explicit, violence was not. Conversely where violence was explicit, gender was implicit and viewed in individualist terms. Only one article explicitly connected gender and violence recognizing violence as a gendered outcome. We encourage researchers to incorporate gender as a structure in analytical inquiries and identify the wider contexts and associated mechanisms through which gender intersects with violence. Doing so can help to develop prevention measures that align with international definitions of gender-based violence.