Qualitative Systematic Review Research Articles

Hope as experienced by people with acquired brain injury in a rehabilitation—or recovery process: a qualitative systematic review and thematic synthesis

Hope as experienced by people with acquired brain injury in a rehabilitation—or recovery process: a qualitative systematic review and thematic synthesis

Identifying Best Practices for Increasing HIV Pre-exposure Prophylaxis (PrEP) Use and Persistence in the United States: A Systematic Review.

A qualitative systematic review was conducted to evaluate pre-exposure prophylaxis (PrEP) interventions, describe characteristics of best practices for increasing PrEP use and persistence, and explore research gaps based on current PrEP interventions. We searched CDC's Prevention Research Synthesis (PRS) Project's cumulative HIV database (includes CINAHL, EMBASE, Global Health, MEDLINE, PsycInfo, and Sociological Abstracts) to identify PrEP intervention studies conducted in the U.S., published between 2000 and 2022 (last searched January 2023). Eligibility criteria include studies that evaluated PrEP interventions for persons testing negative for HIV infection, or for healthcare providers who prescribed PrEP; included comparisons between groups or pre/post; and reported at least one relevant PrEP outcome. Each eligible intervention was evaluated on the quality of study design, implementation, analysis, and strength of evidence (PROSPERO registration number: CRD42021256460). Of the 26 eligible interventions, the majority were focused on men who have sex with men (n = 18) and reported PrEP adherence outcomes (n = 12). Nine interventions met the criteria for Best Practices (i.e., evidence-based interventions, evidence-informed interventions). Five were digital health interventions while two implemented individual counseling, one offered motivational interviewing, and one provided integrated medical care with a PrEP peer navigator. Longer intervention periods may provide more time for intervention exposure to facilitate behavioral change, and engaging the community when developing, designing and implementing interventions may be key for effectiveness. For digital health interventions, two-way messaging may help participants feel supported. Research gaps included a lack of Best Practices for several populations (e.g., Black persons, Hispanic/Latino persons, persons who inject drugs, and women of color) and evidence for various intervention strategies (e.g., interventions for promoting provider's PrEP prescription behavior, peer support). These findings call for more collaborative work with communities to develop interventions that work and implement and disseminate Best Practices for increasing PrEP use and persistence in communities.

Women's perspectives on mHealth behavior change interventions for the management of overweight, obesity, or gestational diabetes: A qualitative meta-synthesis.

mHealth interventions play an increasingly important role in health behavior change for gestational diabetes or peripartum obesity management. This qualitative systematic review and meta-synthesis aims to explore women's perceptions of mHealth behavior change interventions for gestational diabetes and/or overweight/obesity management during pregnancy and the postpartum period. Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, Excerpta Medica Database (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Psychological Information Database (PsycINFO) databases were searched using a Sample, Phenomenon of Interest, Design, Evaluation and Research type (SPIDER) concept framework through to February 2024. Included studies were quality assessed using the Critical Appraisal Skills Programme checklist. Study findings were evaluated using reflexive thematic analysis and GRADE-Confidence in the Evidence from Reviews of Qualitative Research (CERQual) checklist. We identified 29 studies, representing 604 women's views from one upper middle-income and nine high-income countries. Two themes were generated: mHealth as a supportive tool; and mHealth as a personalizable tool. Women highlighted the importance of self-monitoring, information trustworthiness, peer support, motivational tools (goal setting, risk awareness, and problem solving) and convenience in achieving behavior change using mHealth technology. They suggest mHealth programs incorporate these elements to support user engagement and improved health outcomes. Understanding what women want as mHealth users is particularly important for effective interventions in gestational diabetes, weight management, and chronic disease prevention. Creating a better, more woman-centered experience by addressing central engagement issues should result in improved maternal health outcomes.

On the advantages and disadvantages of choice: future research directions in choice overload and its moderators

Researchers investigating the psychological effects of choice have provided extensive empirical evidence that having choice comes with many advantages, including better performance, more motivation, and greater life satisfaction and disadvantages, such as avoidance of decisions and regret. When the decision task difficulty exceeds the natural cognitive resources of human mind, the possibility to choose becomes more a source of unhappiness and dissatisfaction than an opportunity for a greater well-being, a phenomenon referred to as choice overload. More recently, internal and external moderators that impact when choice overload occurs have been identified. This paper reviews seminal research on the advantages and disadvantages of choice and provides a systematic qualitative review of the research examining moderators of choice overload, laying out multiple critical paths forward for needed research in this area. We organize this literature review using two categories of moderators: the choice environment or context of the decision as well as the decision-maker characteristics.

Curriculum Making Across Sites of Activity in Upper Secondary School Vocational Education and Training: A Review of the Research in Sweden

Purpose: This paper presents a qualitative systematic review of Swedish research on vocational education and training (VET) at the upper secondary school level over the past 20 years. The review is based on a theoretical model on curriculum making as social practice that may serve as model for comparative studies between countries. By introducing the model, the ambition is to open for new perspectives on VET curriculum in policy and practice. Questions regarding key themes and the interplay of discourses and processes across multiple sites in the education system have not been addressed in previous systematic reviews of Swedish VET research. Methods: The methodological approach in the present paper is a qualitative systematic research review with an integrative and interpretative purpose and research design. The qualitative review is based on the conceptual model of curriculum making as social practice, seeking to capture the inherent complexity and porous boundaries of education systems and movements of ideas, discourses and actors between sites of activity. The model is used for mapping the research, and a content analysis for identifying main themes and emphases and exploring and discussing the potential gaps that may inform future international research studies. Findings: The results show that the research is focused on the micro and nano sites of curriculum making, with connections to macro site activities of national curriculum policy enactment. Research focusing on the macro site of activity has an emphasis on national policy and policymaking regarding the relationship between academic and vocational knowledge/programmes and apprenticeship and employability. In the micro and nano sites of activity – which comprise the majority of the research – the main themes are vocational knowing and identity, teaching, learning and assessment practices and work-based learning. Conclusion: An observation is the absence of principals and middle leaders as actors and informants in the studies. There is little evidence of actors moving between sites of activity and the meso site of activity only comprise a very small part of the research. In this respect, there is a potential gap to be explored, not least regarding how local curricula and syllabi are made and shaped in terms of the influence of representatives from local authorities, companies, trade unions, employer associations, universities and regional agencies. Curriculum making as social practice has the potential to be used for comparative international studies and as a framework that takes national differences in VET education systems into account.

Older people's experiences of participation in mindfulness-based intervention programmes: A qualitative systematic review.

This systematic review aimed to synthesise the qualitative evidence of mindfulness-based interventions and focused on the perceptions and experience of older people. A literature search was conducted using electronic databases including CINAHL, EMBASE, EMCare, and MEDLINE. The inclusion criteria for the review were an original study that includes qualitative data on experience and perceptions of mindfulness interventions, a study population involving older people aged 60 years and above, and articles published in English. Eleven articles are included in this review. Four major descriptive themes were generated from the data synthesis: benefits on physical health, improved psychosocial well-being, development of new perspectives, and motivators and challenges of mindfulness practice. Mindfulness practice provided health benefits for pain management, promoting sleep quality, psychosocial well-being, and development of positive strategies such as a new way of coping in negative situations, acceptance, and a sense of freedom. Health benefits and positive reinforcement were reported as motivators, whereas time commitment and an easily distracted mind were barriers to continued mindfulness practice. In addition to the descriptive themes, two analytical themes were derived: inner peace and well-being through mindfulness and development of acceptance-based coping. The positive outcomes indicated in this review suggest that mindfulness-based interventions could be an effective therapeutic tool for the well-being of older people.

Critical care nurses' role in rapid response teams: A qualitative systematic review.

To analyse the qualitative evidence on the role of critical care nurses in rapid response teams. Qualitative systematic review. This qualitative systematic review employed Bettany-Saltikov and McSherry's guidelines and is reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist. Two pairs of blinded researchers screened the articles. The data were synthesised using a thematic analysis approach. A systematic literature search was conducted using the CINAHL, Embase and MEDLINE databases. Seven studies were included, and three main roles were identified: (1) balancing between confidence and fear in clinical encounters, (2) facilitating collaboration and (3) managing challenging power dynamics in decision-making. Critical care nurses possess extensive knowledge and skills in providing critical care to patients experiencing deterioration on general wards. They play a vital role in facilitating collaboration between team members and ward staff. Furthermore, within the rapid response team, critical care nurses assume leadership responsibilities by overseeing the comprehensive coordination of patient care and actively engaging in the decision-making process concerning patient care. Highlighting the central role of critical care nurses in rapid response teams as well such a team's benefits in healthcare organisations can promote applications for funding to support further quality assurance of rapid response teams and thus enhance patient safety. Health care organisations can assure the quality of rapid response team by providing economical resources and training. The education providers should facilitate and standardise curriculum for critical care nursing students to achieve necessary knowledge and skills as members in rapid response teams. No patient or public contribution.

Designing and Psychometric Evaluation of a Questionnaire for Assessing Society's Perception of Flash Flood Risk

Background: Public perception of risks associated with natural disasters like flash floods significantly influences disaster management effectiveness. Flash floods pose a major threat to life and property, and a lack of tools to evaluate societal risk perception creates a critical gap. Objectives: This study aimed to design and evaluate the psychometric properties of a questionnaire specifically assessing society's perception of flash flood risk. Methods: A two-stage approach was employed. The first stage involved collecting questionnaire items through a systematic literature review and a qualitative study. In the second stage, a comprehensive psychometric evaluation was conducted, including assessments of face validity, content validity, and construct validity. Reliability was established using Cronbach's alpha. Confirmatory factor analysis was further conducted with data collected from 136 community members who had experienced flash floods. Data analysis was performed using SPSS version 20 and AMOS software. Results: A combination of qualitative data and systematic review findings facilitated the development of 36 initial questionnaire items. Applying quantitative and qualitative construct validity measures led to the refinement of the instrument, resulting in 29 final items categorized into three domains: Risk perception (12 items), awareness (10 items), and preparedness (7 items). The internal consistency of the instrument was confirmed by a Cronbach's alpha coefficient of 0.88. Factor analysis further supported the good fit of the hypothesized model to the data. Conclusions: This study successfully developed and rigorously evaluated a questionnaire to assess society's perception of flash flood risk. This instrument offers valuable insights for informed decision-making and identification of factors influencing risk perception, ultimately contributing to improved disaster preparedness and management.

The Ethical Principles in Ethical Guidance Documents during the COVID-19 Pandemic in the United Kingdom and the Republic of Ireland: A Qualitative Systematic Review.

The sudden onset of the coronavirus disease 2019 (COVID-19) pandemic was accompanied by a myriad of ethical issues that prompted the issuing of various ethical guidance documents for health care professionals in clinical, research, and public health settings throughout the United Kingdom (UK) of Great Britain and Northern Ireland and the Republic of Ireland. The aim of this review was to identify the main principles in ethical guidance documents published in the UK and Ireland during the COVID-19 pandemic. This review used a qualitative systematic review methodology with thematic synthesis to analyze the included ethics-related guidance documents, as defined in this review, published in the UK and Ireland from March 2020 through March 2022. The search included a general search in Google Scholar and a targeted search on the websites of the relevant professional bodies and public health authorities in the two countries. The ethical principles in these documents were analyzed using the constant comparative method (CCM). Forty-four guidance documents met the inclusion and exclusion criteria. Ten main ethical principles were identified, namely: fairness, honesty, minimizing harm, proportionality, responsibility, autonomy, respect, informed decision making, duty of care, and reciprocity. The guidelines did not present the ethical principles in equal detail. Some principles lacked definitions, leaving them vulnerable to misinterpretation by the documents' end users. Priority was frequently given to collectivist ethics over individualistic approaches. Further clarity is required in future ethical guidance documents to better guide health care professionals in similar situations.

Understanding Fall Perceptions Among People with Parkinson’s Disease: A Systematic Qualitative Review

Understanding Fall Perceptions Among People with Parkinson’s Disease: A Systematic Qualitative Review

PERSPECTIVES OF PEOPLE WITH CHRONIC KIDNEY DISEASE REGARDING DIGITAL HEALTH INTERVENTIONS THAT PROMOTE A HEALTHY LIFESTYLE: QUALITATIVE SYSTEMATIC REVIEW

Chronic kidney disease (CKD) is a life-limiting condition that affects 1 in 10 adults and accounts for 12% of all deaths in Australia. Diet and physical activity are crucial to attenuate disease progression and reduce mortality risk. Digital health interventions have been proposed as a feasible model to deliver lifestyle interventions. Users’ perspectives are key to ensure the intervention is aligned with their needs and goals. As such, this systematic review aimed to synthesise the perspectives of people with CKD and develop higher order concepts that elucidate users’ preferences regarding digital health interventions that promote heathy lifestyle. This was a qualitative systematic review. A database search was conducted on CENTRAL, Scopus, MEDLINE, CINAHL and SPORTDiscus between 2000-2023. Eligibility criteria included primary research that reported the preferences of adults with CKD regarding digital lifestyle interventions. Two independent reviewers completed title, abstract and full text screening. Quotes were extracted verbatim, coded and categorised. Categories were then used to generate themes. Database search identified 5,761 records. One additional record was included following communication with a primary author. Fifteen papers were eligible, including 197 participants (age 51.0±7.2 years; 47% female). There were 83 people with CKD 1-5; 61 transplant recipients; and 53 people receiving maintenance dialysis. The overarching theme identified was that people with CKD considered digital interventions to be important platforms to access lifestyle interventions. There were five underlying themes that elucidated users’ preferences for digital interventions, including simple instruction and engaging design; individualised interventions; virtual communities of care; education and action plans; and timely reminders and automated behavioural monitoring. Digital health interventions were considered important platforms to deliver lifestyle interventions. Future research may apply users’ preferences in this review to inform the development and conduct of a digital lifestyle intervention for people with CKD.

Nurses' experiences and perceptions of unfinished nursing care: a qualitative systematic review protocol.

The aim of this review is to synthesize the findings of qualitative studies about the experiences and perceptions of nurses regarding unfinished nursing care. The issue of unfinished nursing care is a widespread challenge globally, causing detrimental effects to both patients and health care practitioners. Despite its prevalence, there is a dearth of qualitative evidence synthesis summarizing the reasons for unfinished nursing care, as well as the experiences of nurses. This review will include studies exploring registered nurses' and nurse managers' experiences and perceptions of unfinished nursing care, utilizing qualitative methods. Our approach to qualitative methodology will be unrestricted, allowing for various designs, such as phenomenology, ethnography, grounded theory, action research, and feminist research. Only articles published in English or Chinese from 2001 onward will be included. Our search will encompass the following electronic databases for published and unpublished literature: MEDLINE (PubMed), PsycINFO (APA PsycNET), CINAHL (EBSCOhost), Web of Science, Embase, ScienceDirect, ProQuest Dissertations and Theses, GreyNet International, Google Scholar, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Biomedicine Literature Database (CBM). To ensure thoroughness, manual searches of reference lists and citations of included studies will also be conducted. Two reviewers will extract relevant information, and quality validation will be conducted using the JBI critical appraisal checklist for qualitative research. Similar findings will be categorized through meta-aggregation to establish synthesized findings. Finally, each synthesized finding will be graded according to the JBI ConQual approach. PROSPERO CRD42022368041.

Experiences and attitudes of task-shifting and task-sharing of physicians, nurses, and nursing assistants in hospitals: a qualitative systematic review protocol.

The objective of this review is to explore the experiences and attitudes of physicians, nurses, and nursing assistants regarding task-shifting and task-sharing in hospitals. Despite multiple health care professionals performing overlapping tasks, the need for effective task-shifting and task-sharing remains a concern. Understanding task-shifting and task-sharing experiences, as well as the attitudes of health care providers in hospitals, is essential for providing safe and patient-appropriate care with limited human resources. Qualitative studies that examine the experiences and attitudes of physicians, nurses, and nursing assistants in hospitals regarding task-shifting and task-sharing will be included. The review will include physicians, advanced practice nurses who are nurse practitioners or clinical nurse specialists, registered nurses, and nursing assistants. Midwives, pharmacists, occupational therapists, physical therapists, and students will be excluded. PubMed, MEDLINE, CINAHL, PsycINFO, Cochrane Database, and Web of Science will be searched as part of a 3-step search strategy. We will search for unpublished research and gray literature using Google Scholar and ProQuest Dissertations and Theses. Studies published in English or Japanese from the time each database was established to the present will be considered for inclusion. The methodological quality of all studies will be evaluated by screening against the inclusion criteria and by at least 2 critical evaluations using the standardized JBI checklist. Synthesized results will be pooled by meta-aggregation and published as a ConQual Summary of Findings. PROSPERO CRD42023409612.

Nurses’ experiences of caring for COVID-19 patients: A systematic review of qualitative studies

Background & Aim: Nurses are considered one of the most important members of the healthcare system in facing pandemics, including COVID-19. This study was conducted to explain the nurses' experiences in caring for patients diagnosed with COVID-19. Methods & Materials: This study was a qualitative systematic review. A structured search was conducted using CINAHL, MEDLINE, EMBASE, Pub Med, Google Scholar, Cochrane Library, MedNar, and ProQuest. All qualitative studies describing nurses’ experiences of caring for patients with Covid-19 were included. This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. Themes and narrative statements were extracted from included papers using the JBI SUMARI data extraction tool. Results: The findings of 46 qualitative studies were included in this systematic review. From the data analysis, four themes "Professional Development", "Psychological exhaustion", "Care Challenges" and "Work-family conflict" were extracted. Conclusion: Nurses have experienced conflicts between their work and family and challenges when caring for patients with COVID-19. Hence, they were psychologically under pressure but professionally developed. To ensure the survival of nurses in critical situations, all their needs must be carefully monitored and the necessary support provided to them.

Perceptions of Patients and Nurses about Bedside Nursing Handover: A Qualitative Systematic Review and Meta-Synthesis.

Bedside nursing handover is a recognized nursing practice that involves conducting shift change communication at the patient's bedside to enhance communication safety. Understanding the perceptions of both patients and nurses regarding bedside handover is crucial in identifying the key principles for developing and implementing effective bedside handover protocols. However, there is currently a lack of comprehensive evidence that summarizes and evaluates studies focused on qualitative approaches for gaining insights into the perceptions of both nurses and patients. This meta-synthesis review aims to identify, synthesize, and evaluate the quality of primary qualitative studies on the perceptions of patients and nurses about bedside nursing handover. A meta-synthesis review was conducted to identify qualitative studies that reported patients and nurses' perceptions about bedside handover using seven electronic databases, including CINAHL, PsycINFO, Embase, Education Database (ProQuest), Web of Science, The Cochrane Library, and PubMed, from January 2013 to November 2023. The authors independently selected reviews, extracted data, and evaluated the quality of included studies using the 10-item JBI Qualitative Assessment and Review Instrument tool. A total of 871 articles were retrieved, of which 13 met the inclusion and exclusion criteria. These studies identified three main themes: (1) facilitators of bedside nursing handover, (2) barriers to bedside nursing handover, and (3) strategies to maintain confidentiality during bedside handover. This study systematically reviewed and integrated the perceptions of patients and nurses about bedside handover. Based on nurses' perceptions, the combined findings highlight the facilitators of bedside handover, including developing partnership interaction between nurses and patients, promoting professionalism, and enhancing emotional communication among nurses. From the patients' viewpoint, the synthesized findings emphasize the facilitators of bedside handover, including acknowledging the expertise, professionalism, and humanity of the nursing profession, ensuring a sense of safety, satisfaction, and confidence in the care received, as well as promoting individualized nursing care. In the context of barriers to bedside handover, both nurses and patients perceive breaches of confidentiality and privacy violations as significant barriers. When it comes to maintaining confidentiality during bedside handovers, it is important to consider patients' preferences. Patients often prefer handovers to take place in a private setting. From the nurses' perspective, it is important to inquire with patients about their preference for the presence of caregivers, and to conduct private handovers for sensitive issues away from the bedside. Relevance to Clinical Practice. Clinicians should carefully evaluate the barriers and facilitators in this meta-synthesis prior to implementing bedside handover. Study Registration. This study is registered in PROSPERO with Protocol registration ID: CRD42024514615.

Experiences of dental behaviour support techniques: A qualitative systematic review.

Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences. To explore and synthesize qualitative literature related to patient experience of dental behaviour support. A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified. Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision. Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.

A Qualitative Systematic Review of Trust in Technology

Although many information systems (IS) scholars have researched the antecedents and consequences of trust in technology, the sheer amount of work published, authors’ use of inconsistent construct terms, and variations in conceptualization and measurement make it difficult to compare and aggregate findings across studies. To provide scholars with an overview of the literature, we performed a systematic qualitative review of the IS literature. The goal of our review was to identify the antecedents and consequences of trust in technology that have received frequent empirical support, as well as those for which the evidence is not yet conclusive. To that end, we curated a glossary of unique construct terms and summarized the results of 241 relationships tested in 62 empirical research articles (both quantitative and qualitative) from the AIS “Basket of Eight” journals. From these, we identified 62 unique relationships: 22 are well-supported, six are supported by suggestive evidence, and 34 have received little support. These relationships summarize what is well-known and less well-known within the literature. By taking stock, we prepare a path for future research on the phenomenon of trust in the context of emerging technologies (e.g., artificial intelligence, blockchain). We conclude the paper with opportunities and directions for future research.

Sensor Technologies for Safety Monitoring in Mine Tailings Storage Facilities: Solutions in the Industry 4.0 Era

The recent tailings storage facility (TSF) dam failures recorded around the world have concerned society in general, forcing the mining industry to improve its operating standards, invest greater economic resources, and implement the best available technologies (BATs) to control TSFs for safety purposes and avoid spills, accidents, and collapses. In this context, and as the era of digitalization and Industry 4.0 continues, monitoring technologies based on sensors have become increasingly common in the mining industry. This article studies the state of the art of implementing sensor technologies to monitor structural health and safety management issues in TSFs, highlighting advances and experiences through a review of the scientific literature on the topic. The methodology applied in this article adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and utilizes scientific maps for data visualization. To do so, three steps were implemented: (i) a quantitative bibliometric analysis, (ii) a qualitative systematic review of the literature, and (iii) a mixed review to integrate the findings from (i) and (ii). As a result, this article presents the main advances, gaps, and future trends regarding the main characteristics of the sensor technologies applied to monitor TSF structural health and safety management in the era of digitalization. According to the results, the existing research predominantly investigates certain TSF sensor technologies, such as wireless real-time monitoring, remote sensors (RS), unmanned aerial vehicles (UAVs), unmanned survey vessels (USVs), artificial intelligence (AI), cloud computing (CC), and Internet of Things (IoT) approaches, among others. These technologies stand out for their potential to improve the safety management monitoring of mine tailings, which is particularly significant in the context of climate change-related hazards, and to reduce the risk of TSF failures. They are recognized as emerging smart mining solutions with reliable, simple, scalable, secure, and competitive characteristics.

The molecular characteristics of recurrent/metastatic HPV-positive head and neck squamous cell carcinoma: A systematic review of the literature.

About 17% of patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC), which is mainly comprised of oropharyngeal SCC (OPSCC), will experience disease recurrence, which is often considered incurable when manifested at a metastatic and/or recurrent stage. We conducted a critical qualitative systematic review. Our objectives were to provide an overview of the molecular landscape of recurrent/metastatic HPV-positive HNSCC as well as novel molecular biomarkers. A literature review was conducted to identify studies reporting on the molecular characteristics of recurrent/metastatic HPV-positive HNSCC, novel molecular biomarkers and treatment options. The reviews of abstracts, full articles, and revision of the included studies, followed by data extraction and quality assessment were performed by three independent assessors. All primary literature, such as retrospective, prospective, and clinical trials as well as basic research studies were considered, and the final search was conducted at the end of February 2023. The level of evidence was rated using the guidelines published by the Oxford Centre for Evidence-based Medicine and quality was assessed using the Newcastle-Ottawa Scale criteria. The literature search resulted in the identification of 1991 articles. A total of 181 full articles were screened, and 66 articles were included in this analysis. Several studies reported that recurrent/metastatic HPV-positive HNSCC had higher rates of TP53 mutation and were genomically similar to HPV-negative HNSCC. The detection of circulating tumour tissue-modified HPV DNA (ctHPVDNA) as a specific biomarker has shown promising results for monitoring treatment response and recurrence in the subset of HPV-positive HNSCC. In addition, evidence for targeted therapy in recurrent/metastatic HPV-positive HNSCC has emerged, including agents that inhibit overexpressed EGFR. Studies of combination immunotherapy are also underway. Our review outlines the latest evidence on the distinct molecular profiles of recurrent/metastatic HPV-positive HNSCC as well as the clinical potential of ctHPVDNA testing in routine practice. More controlled and longitudinal studies are needed to identify additional molecular targets and to assess the performance and benefits of novel molecular biomarkers in clinical practice.

Systematic Review of Cocaine-Treatment Interventions for Black Americans

Evidence-based drug-treatment studies that have shaped best practice in the United States demonstrate racial differences in effectiveness, with Black participants reporting worse outcomes compared with White participants. There are disproportionate cocaine-related overdose deaths affecting Black Americans, with limited information about interventions that serve them best. Culturally tailored treatment approaches, which incorporate participants’ salient identities and experiences, have shown effectiveness in meta-analyses. Thus, in this qualitative systematic review, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify both culturally universal and culturally tailored treatment-intervention studies that addressed cocaine outcomes among Black Americans. Four hundred two articles met initial criteria, 330 were reviewed by independent coders, and k = 30 treatment approaches are described in the article. Results indicate 72% of culturally tailored interventions were effective at reducing cocaine use compared with 47% of culturally universal interventions. Implications for provision and funding of effective cocaine-treatment interventions for Black Americans are critical to researchers, practitioners, and policymakers alike.