Quality Appraisal Research Articles (Page 1)

Suicide is the fourth leading cause of death in adolescents globally. Post-primary school-based suicide prevention (PSSP) interventions are an evidence-based suicide prevention strategy. However, adolescents' experiences with PSSP interventions are not well understood but are arguably critical to ensuring PSSP interventions have their intended impacts on adolescent mental health. No known review synthesising adolescents' PSSP intervention experiences exists. The objective of the meta-ethnography review is to explore the perspectives and experiences of adolescents engaging with PSSP interventions, as participants/end-users, intervention advisors, facilitators, co-designers and co-researchers. A peer-reviewed meta-ethnography protocol has been published. The meta-ethnographic approach followed Noblit and Hare's seven-stage process for conducting meta-ethnography and adhered to the eMERGe reporting and the PRISMA statement guidelines. Searches of nine databases identified journal articles and dissertations. Study quality appraisal was undertaken in duplicate using the CASP checklist. Sixteen journal articles and dissertations were retained for analysis. Adolescents were engaged in PSSP interventions as end-users, co-creators and peer helpers. Reciprocal translations and lines of argument (LOA) synthesis reveal the importance of the following aspects of engaging with PSSP interventions: (1) how adolescents were engaged; (2) trust in facilitators, peers, school personnel and schools; and (3) personal experience sharing for connection and engagement. Our findings demonstrate the intersection between school contexts and adolescents' experiences with PSSP interventions. To our knowledge, this is the first review to synthesise qualitative findings of adolescents' experiences with engaging with PSSP interventions. Understanding and harnessing adolescents' perspectives is key for enhancing PSSP intervention effectiveness and implementation. Our findings are relevant to broader health-related fields and practice, particularly given the increasing calls for youth voice.

Neonatal transports are essential for providing access to advanced intensive care treatment for sick and premature neonates. There is a lack of consensus of which core physiological variables, clinical parameters and quality metrics to report for clinical guidance during transport and clinical governance of transport systems. We performed a systematic literature review to identify which data variables are reported during neonatal transports and assess whether these variables are uniform and transferable across studies. In the final data extraction and quality appraisal, 108 studies were included. The studies were heterogenous, presented a large variation of registered variables and frequently lacked uniform definitions. Reaching consensus on a set of defined variables for registration and implementation internationally will enhance the opportunity to improve the safety, effectiveness and quality of care for these vulnerable neonates.

Background/Objectives: This systematic review explores the evolving landscape of ethical dilemmas and legal responsibilities in hospital-based patient care, with particular attention to how they intersect with institutional safety. Drawing from 40 studies published within the last decade and supplemented by seminal theoretical works, the review examines clinical, technological, legal, and policy-driven challenges that compromise ethical clarity and organisational accountability. Methods: Methods included a structured literature search across major academic databases, guided by inclusion and exclusion criteria aligned with PRISMA guidelines and a quality appraisal ensuring inclusion of only medium- and high-quality studies. Results: Findings reveal that ethical complexity has shifted from individual decision-making to system-level vulnerabilities, particularly in contexts involving artificial intelligence (AI), data governance, consent procedures, and end-of-life care. Moreover, hospitals often lack sufficient protocols for disclosure, cross-border telemedicine accountability, and ethically responsive infrastructure. The results support a growing call for ethics-by-design approaches, where ethical reflexivity is embedded into institutional processes and digital systems. Conclusions: Overall, ethical resilience in hospital care depends not only on clinical training but on proactive organisational structures that support transparency, equity, and patient dignity.

Introduction: Peripheral artery disease (PAD) is associated with high morbidity and mortality, yet palliative care (PC), a supportive, team-based approach integrated remains underutilized. This review contrasted PC components, patient-level and program outcomes, and patient-reported outcomes across heart failure (HF), coronary artery disease (CAD), and peripheral artery disease (PAD). Methods: We searched PubMed and Cochrane databases for English-language studies published from January 1, 2014, to December 19, 2024. Studies included systematic reviews and original investigations of PC interventions in HF, CAD, and PAD. The ROBIS tool was used for quality appraisal. Data were synthesized across seven domains: (1) symptom management, (2) advance care planning (ACP), (3) psychosocial/spiritual support, (4) quality-of-life measurement (QoL), (5) interdisciplinary team integration, (6) referral timing and triggers, and (7) sustainability of care. Results: Fifty-six studies were included (HF: n=48; PAD: n=5; CAD: n=2; HF+CAD: n=1), including randomized trials, meta-analyses, and observational studies. HF studies focused on patients with New York Heart Association (NYHA) Class II–IV and high comorbidity burden, across in- and outpatient settings. PAD studies included patients with chronic limb-threatening ischemia; CAD populations were post-MI or post-revascularization. HF programs used validated QoL tools (e.g., ESAS, KCCQ, EQ-5D) to guide symptom management and referrals. ACP was a central feature of HF interventions, contributing to improved documentation, reduced hospital utilization, and care alignment. In contrast, PAD studies mostly lacked standardized assessment tools and relied on clinical outcomes (e.g., readmissions, complications, mortality). ACP was limited to end-of-life contexts without continuity. Psychosocial and spiritual support services were rarely addressed. CAD studies utilized general and disease-specific QoL instruments (SF-36, Seattle Angina Questionnaire), and focused on education and rehabilitation with minimal PC integration. ACP was rarely emphasized, psychosocial/spiritual support was excluded, and PC referrals for CAD patients were late and lacked continuity. Conclusion: HF programs provide a transferable template for PAD, based on an early, structured and multidisciplinary PC. This could lead to a PAD-specific care model that integrates best practices from HF and that helps address underuse in a vulnerable and overlooked population.

Exercise is a potentially effective treatment for depression, but some evidence suggests that women with depression are less likely than men to engage in exercise as a treatment. This review aims to identify barriers and enablers to women engaging in exercise and/or physical activity as a treatment for depression. MEDLINE (OVID), PsycINFO (OVID), CINAHL (EBSCOhost) and SportDISCUS were searched until February 2025. Studies of any design that examine barriers and enablers to women participating in exercise interventions for treatment of depression that were published from 2004 (the year clinical practice guidelines first recommended exercise as a standard treatment for depression) were included. Studies that did not report findings separately for women were excluded. Quality appraisal tools were used to assess the methodological quality according to study design. Six studies (four qualitative and two observational) involving 139 participants were included. Lack of time, symptoms of depression, weather conditions and low self-efficacy were identified as barriers to women engaging in exercise as treatment for depression. Barriers unique to women included caregiving responsibilities, safety concerns and, in some cases, the need for permission. Support from family and friends, exercise related to weight loss and perceived impact on health and wellbeing were reported as enablers. Critical appraisal identified important sources of bias in all but one of the included studies. Exercise has potential as a treatment for depression in women, but barriers like time constraints and depressive symptoms can hinder adoption, while factors such as support from others can encourage it.

Hereditary breast cancer, primarily linked to pathogenic BRCA1 and BRCA2 mutations, accounts for 5%-10% of all breast cancer cases in the United States. Despite national guidelines recommending genetic testing for individuals at elevated hereditary risk, uptake remains disproportionately low among African American and Hispanic/Latina women. Despite elevated risk in Black women data on genetic testing uptake in St. Louis is absent. This systematic review aimed to address three research questions: (1) Are there racial and ethnic disparities in the utilization of BRCA genetic testing in Saint Louis? (2) What individual, provider, and systemic factors influence testing uptake among diverse populations? (3) What policy-level interventions are feasible and effective to improve BRCA testing rates in the city? A systematic search of MEDLINE, EMBASE, APA PsycInfo, CINAHL Plus, Scopus, and Web of Science yielded 264 unique records. Twenty-five peer-reviewed studies published between 1996 and 2024 were included after applying inclusion criteria and quality appraisal. The studies span quantitative, qualitative, and mixed methods research on high-risk populations. BRCA awareness among African American women was significantly lower (12%-32%) than among White women (65%-75%). Fear of results (54%), mistrust, and concern over genetic discrimination (60%) were major barriers. Referral disparities were also stark-African American women were 50% less likely to receive provider referrals. Only 5% of genetic counselors identified as Black or Hispanic. No studies specifically examined BRCA testing disparities in Saint Louis. Findings from similar Midwestern cities suggest urgent need for locally informed, equity-focused interventions.

Treatment decision-making and quality of life versus length of life preferences of older patients with early stage cancer: A systematic review.

Women's choices and preferences for subsequent mode of birth following an obstetric anal sphincter injury (OASI): A scoping review.

Atypical complications and co-morbidities of type 1 diabetes in young adults.

Best Practices of Emergency Department Triage Training: A Systematic Review and Meta-Analysis Protocol.

Addressing housing insecurity as a social determinant of health: A systematic review of interventions in healthcare settings.

Groundwater usage characterization in a tribal stretch infected with chronic kidney disease of unknown etiology (CKDu).

Building healthier and sustainable cities: A scoping review to establish the cost-effectiveness of place-based interventions.

Hydrochemistry, quality, and potential health risk appraisal of arsenic-enriched groundwater in central-west Bangladesh using the integrated water quality index and Monte Carlo simulation.

IntroductionBeing able to talk about the anticipated course of living with an illness is essential to delivering and receiving person-centred care. Despite clinical heart failure guidance encouraging these prognostic conversations at all stages of disease, they occur infrequently or very late in the disease course. This qualitative synthesis will use the Joanna Briggs Institute (JBI) meta-aggregation approach to explore how prognostic conversations are currently taking place, what people think about prognostic conversations, and how people experience them.Methods and analysisThis systematically conducted qualitative synthesis, using JBI meta-aggregation, considers qualitative evidence that explores the prognostic communication experiences, attitudes or practices of people with heart failure and their healthcare professionals. Prognostic communication is defined as a verbal interaction about anticipated changes to symptoms or function, possibility of unpredictable events, potential future treatments or care, expression of wishes about the future, or estimates of life expectancy. It will include interactions occurring in any setting (inpatient, outpatient, community). Exclusion criteria include studies of carer perspectives, discussion about implantable cardiac defibrillator deactivation, assisted dying and/or euthanasia, and those not published in the English language. Medical Literature Analysis and Retrieval System Online (MEDLINE) (Ovid), Excerpta Medica Database (EMBASE) (Ovid), PsycInfo (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus (EBSCOhost), Web of Science Core, Overton, ProQuest Dissertations and Theses Global, and Google Scholar databases will be searched for eligible studies. Reference screening of relevant systematic reviews will also be conducted. Two independent reviewers will screen, quality assess included studies and perform data extraction. JBI tools will be used for quality appraisal, data extraction, synthesis and assessing confidence of summarised findings.Ethics and disseminationEthical approval is not required for the study since it is based on available published literature. Findings from the review will be disseminated through publication in a peer-reviewed journal.Trial registration numberInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42024605240.

Many barriers exist in the literature related to the implementation of the Clinical Practice Guidelines for the Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in the intensive care unit (ICU). The objective of this integrative review was to identify barriers to and facilitators of nurses' PADIS delirium guideline implementation in adult ICU settings. We followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines as a framework for this review and the Joanna Briggs Institute quality appraisal guidelines. The inclusion criteria led to the identification of quantitative and qualitative studies, quality improvement projects, and review studies published in English between 2013 and 2023 that addressed adult ICU patients and explored facilitators and barriers regarding nurses' delirium guideline implementation in a variety of countries. The 15 selected studies were 5 cross-sectional studies, 2 mixed-methods studies, 1 cohort report, 3 qualitative studies, 3 quality improvement projects, and 1 systematic review. The most commonly reported barriers concerned a lack of interdisciplinary collaboration and support, a workload burden, and knowledge deficits among nurses. The most commonly reported facilitators were related to interdisciplinary collaboration and education on delirium, PADIS guideline, and ABCDE bundle. Delirium is crucial to address in critically ill patients, and nurses' implementation of PADIS guidelines is vital for better outcomes. This review identified barriers and facilitators at individual, educational, and institutional levels. The review findings emphasize the need for routine and structured education for nurses on delirium risk factors, prevalence, outcomes, complications, management, and assessment to combat the educational deficits that inhibit guideline implementation. The review findings also highlight the need for interdisciplinary collaboration and education to effectively support nurses. Hospitals and other institutions can leverage these insights to develop strategic interdisciplinary education planning, including delirium-focused rounds and routine interdisciplinary discussions about incorporating delirium guidelines into the care of ICU patients.

Enhancing maternal and infant health: A systematic review of breastfeeding interventions among refugee, migrant, and asylum seeker populations.

ABSTRACT This systematic review aimed to identify interventions that support and facilitate professionals’ transition from health and social care practice to higher education. It was prospectively registered with PROSPERO (CRD42023404825). AMED, CINAHL, MEDLINE, and Research Education Complete were searched from inception up until 26/02/2025. Included studies described interventions that support health and social care practitioners transitioning into higher education teaching jobs and involved 2-3 years retainment. Transitions of doctoral students were excluded as well as literature reviews and theses. Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis of the included studies was conducted. Nine papers were included in the review. Studies were predominantly conducted in the USA and involved surveys of nursing staff. Mentoring and onboarding were identified as interventions supporting the transition from health and social care to higher education. A structured, formalised mentoring programme with clearly defined boundaries and guidelines, strengthened staff acclimatisation to the new role. Onboarding programmes should be formalised as well, commencing prior to an individual starting in their new role, and individualised to the professionals’ skills and development requirements. Onboarding programmes contributed to feelings of satisfaction and retention. Mentoring and onboarding need to be individualised, formal, and facilitated by expert academics to enable novice healthcare academics to bridge the gap from practice to academia. There is a need for more research within this field globally, presenting methodologically sound findings regarding interventions supporting the transition from health and social care to higher education and their impact.

Brainstem cavernous malformations (BSCMs) are clusters of dilated, thin-walled, sinusoidal vessels prone to hemorrhage, often leading to life-threatening neurological deficits. Despite their rarity, prompt intervention is frequently required. Advances in diagnostics and treatment, including microsurgery and stereotactic radiosurgery, have improved management, yet no clear consensus exists due to considerable variability and lack of standardization across studies. Inadequate reporting further limits the generation of high-quality evidence. This study aims to evaluate publishing rigor and propose a reporting guideline for BSCMs based on observed gaps.A systematic review was conducted following PRISMA guidelines, identifying studies from the past ten years in PubMed, Embase, and Web of Science. Studies were evaluated using EQUATOR-based criteria (STROBE, CONSORT) across seven domains: (1) patient baseline characteristics; (2) lesion characteristics; (3) definition of key concepts; (4) neurosurgeon/staff attributes; (5) anesthesia protocols; (6) procedural details; and (7) clinical outcomes and complications.Forty-two studies (3,566 patients) were included. Most consistently reported items were patient inclusion criteria (100%), radiosurgery procedural details (100%), surgical case identification (95.2%), and outcome definitions (93.3%). Less commonly reported were anesthesia protocols (2.4%), use of reporting guidelines (7.1%), surgeon experience (9.5%), patient comorbidities (11.9%), and definitions for radiosurgical lesion reduction (14.3%) or complication criteria (14.7%).Methodological and reporting shortcomings are prevalent in BSCM literature, undermining evidence synthesis. We propose a 58-item BSCM Reporting Guideline to address these deficiencies and improve study quality and comparability.

The role of illness perceptions in epilepsy throughout the lifespan: A systematic review.