Quantitative Systematic Review Research Articles

Organizational Change Management for Sustainability in Higher Education Institutions: A Systematic Quantitative Literature Review

Higher education institutions (HEIs) have been urged to integrate sustainability across all their structural and organizational dimensions. A promising area of research and practice that can help to deliver this is organizational change management for sustainability. While this field has received increasing attention over the past decade, a comprehensive assessment is still lacking. Therefore, a systematic quantitative review was carried out to summarize and synthesize the academic literature on organizational change management approaches that aim to holistically embed sustainability in HEIs. Furthermore, this review aims to illustrate what change factors have been observed and how they have been analyzed, and from this highlight implications for practice and pathways for future research. The literature reviewed puts strong emphasis on change processes and human factors, as well as elements of the institutional framework, such as vision and strategy. The findings highlight the value of strategic and reflective actions, the importance of understanding and actively shaping change processes, and that change towards sustainability requires broad stakeholder input and commitment. This review serves as an important reference point for future research and practice.

Determinan Gangguan Fungsi Paru Pekerja Terpapar Silika: Systematic Review

Background: Chronic obstructive pulmonary disease is the third leading cause of death in the world. At least 10-20% of chronic obstructive pulmonary disease cases are found in the work environment. One of the causes of lung function disorder suffered by workers is due to inhalation of silica dust.
 Objectives:To identify the determinants of lung function disorder in workers exposed to silica dust.
 Research Metodes: Systematic quantitative review that was implemented through a meta-analysis study with initial search results for articles matched to the title and abstract was 44 articles and it was eliminated by using inclusion criteria resulting 20 articles. The publication year of the articles was 2007-2020 and has been indexed by Garuda Dikti, SINTA, DOAJ and Scopus.
 Results: The number of samples from the combined study of 20 articles was 2.561 workers that 33% of the sample had lung function disorder. The p value for each variable included age p= 0,001, sex p= 0,854, nutritional status p= 0,033, inhaled dust level p= 0,007, working period p= 0,000, length of exposure p= 0,027, history of lung disease p= 0,880, exercise habit p= 0,098, PPE use p= 0,004, and smoking habit p= 0,014.
 Conclusion: The variables as determinant with the greatest risk of pulmonary function disorder were individual smoking habit and work environment factors.

The use of story to teach religious education in the early years of primary school: a systematic review of the literature

This systematic quantitative literature review explores the use of story in early childhood religious education to inform the research question “What are the pedagogical benefits of using story in religious education in the early years of primary school?” Searches were conducted across multiple databases and individual journals for publications dated from 1970 to 2019. Literature on the key areas of (1) early childhood, (2) story and (3) religious education were analysed to understand their unique perspectives and ways they overlap and connect, with an emphasis on seeking literature which connected all three areas. The study revealed the areas of religious education, the use of story and the field of early childhood as three distinct areas of research with connection points, and gaps in the literature connecting the pedagogical use of story for religious education in early primary education. The literature identifies the use of story as effectively engaging and connecting children to religious education in a pedagogically appropriate way for the early childhood age group. Further to this, benefits were found not only in faith development and biblical literacy, but also in learning, literacy development, empathy, and engagement with differing worldviews. The Australian context was a focus of the literature review providing insight for religious education in Christian schools which may be applied to other contexts in public schools, or internationally.

The Use of Magnesium Sulfate and Peripheral Nerve Blocks: An Updated Meta-analysis and Systematic Review.

With the popularization of ultrasound, nerve blocks have been widely implemented in current clinical practice. Although, they have seen limited success due to their shorter duration and suboptimal analgesia. Magnesium sulfate as a local anesthetic adjuvant for peripheral nerve blocks could enhance the effects of local anesthetics. However, previous investigations have not thoroughly investigated the analgesic efficacy of magnesium sulfate as an adjunct to local anesthetics for peripheral nerve blocks. Thus, we attempted to fill the gap in the existing literature by conducting a meta-analysis. We performed of a quantitative systematic review of randomized controlled trials published between May 30, 2011 and November 1, 2018. Inclusion criteria were: (1) magnesium sulfate used as adjuvant mixed with local anesthetic for nerve blockade, (2) complete articles and published abstracts of randomized controlled trials, (3) English language. The primary outcome measures were time of onset, total duration of the sensory blockade, and Visual Analog Scale pain scores. The secondary outcomes were postoperative oral and intravenous analgesics consumption and the incidence of nausea and vomiting. The 21 trials analyzed in this study included 1323 patients. Magnesium sulfate effectively prolonged the total duration of sensory blockade (mean difference [MD]=114.59 min, 95% confidence interval [CI]: 89.31-139.88), reducing Visual Analog Scale pain scores at 6 hours (MD=1.36 points, 95% CI: -2.09 to -0.63) and 12 hours (MD=1.54 points, 95% CI: -2.56 to -0.53) postsurgery. Magnesium sulfate also effectively reduced postoperative analgesic use within 24 hours postsurgery (standard MD=-2.06, 95% CI: -2.67 to -1.35). Furthermore, adjuvant magnesium sulfate significantly reduced the incidence of nausea and vomiting after transversus abdominis plane blockade (odds ratio: 0.39, 95% CI: 0.18-0.81). Adjuvant magnesium sulfate enhanced the anesthetic effects of local anesthetics and improved postoperative analgesia following the perineural blockade.

Validation of growth standards and growth references: A review of literature.

The World Health Organization (WHO) growth standards provide the most recognized and widely accepted way of assessing child growth. To ensure its applicability, accuracy, and reliability, studies have validated WHO growth standards against local populations and other internationally recognized growth references. We reviewed outcomes of evaluations done on WHO growth standards and assess the appropriateness of using these growth standards on a global level. We undertook a systematic quantitative review of studies published from 2011 to 2020 from multiple databases. Studies were included if they considered children aged 59months and below and reported on validation of growth standards. There was an agreement in studies that validated WHO growth standards against international growth references of its superiority in identifying stunted, overweight, and obese children. However, they were less likely to identify underweight children. None of the studies reviewed reported similar growth trajectories to WHO standards in all indicators considered. Regional differences in child growth were observed in comparison to WHO growth standards. Adoption of regional-specific standards increases the sensitivity of identifying children with adverse nutrition outcomes.

Pharmacotherapy for Anxiety Disorders: From First-Line Options to Treatment Resistance.

In this review, the author examines the evidence for psychopharmacologic treatments among adults for generalized anxiety disorder, panic disorder, and social anxiety disorder derived from clinical trials. For each disorder, major categories of drugs are reviewed, and then the evidence-based medications in each category are discussed. The author reviews key safety and tolerability considerations for each of the medications or classes. Evidence-based dosing for most specific agents is displayed in a comprehensive reference table. Subsequently, the author synthesizes the available information to suggest a pragmatic stepwise approach to treatment that accounts for patient-specific factors. To inform the guidance, the author incorporates and refines perspectives from treatment guidelines already written by clinical professional organizations. The author also briefly reviews the relatively new quantitative systematic review methodology of network meta-analysis (NMA) and discusses how NMA may help guide pharmacologic treatment sequencing decisions in the future by way of ranking treatments according to effect size and the relative amount of study to which treatments have been subject. Caveats of NMA studies are briefly discussed, as are results of recent NMAs regarding the pharmacologic treatment of anxiety disorders.

Intervention Planning for the Tinnitus E-Programme 2.0, an Internet-Based Cognitive Behavioral Intervention for Tinnitus.

Purpose The purpose of this study is to comprehensively describe the intervention planning process for the Tinnitus E-Programme 2.0, an Internet-based cognitive behavioral intervention for tinnitus. Method Theory-, evidence-, and person-based approaches to intervention development were used. In Phase 1, quantitative systematic reviews were used to identify potentially effective intervention techniques and design features. Primary mixed-methods research involving adults with tinnitus explored the acceptability of the first version of the intervention. In Phase 2, person-based guiding principles highlighted key intervention design objectives and features to address needs of the intervention's target group (identified in Phase 1) to maximize its acceptability, feasibility of delivery, and effectiveness. Theory-based "behavioral analysis" and "logic modeling" comprehensively described intervention content and potential mechanisms of action. From this planning work, a prototype intervention was developed. Results The intervention design objectives outlined in the guiding principles were to (a) normalize tinnitus, (b) support users to maintain a regular relaxation practice, (c) minimize the worsening of users' tinnitus sensation, and (d) ensure the intervention is accessible to those with hearing loss. Behavioral analysis and logic modeling identified intervention processes (e.g., illness perceptions, beliefs about consequences, skills, goals) and purported mediators (acceptance of tinnitus, negative thinking, use of the cognitive skills tools for managing negative thoughts, and practicing regular relaxation) hypothesized to facilitate reductions in tinnitus symptom severity. Conclusions The guiding principles highlight key design objectives and features to consider when developing interventions for tinnitus. The logic model offers hypothesized mechanisms of action that can be tested in future process analyses.

Thoracolumbar interfascial plane block for postoperative analgesia in spine surgery: A systematic review and meta-analysis.

IntroductionThoracolumbar interfascial plane (TLIP) block has been discussed widely in spine surgery. The aim of our study is to evaluate analgesic efficacy and safety of TLIP block in spine surgery.MethodWe performed a quantitative systematic review. Randomized controlled trials that compared TLIP block to non-block care or wound infiltration for patients undergoing spine surgery and took the pain or morphine consumption as a primary or secondary outcome were included. The primary outcome was cumulative opioid consumption during 0-24-hour. Secondary outcomes included postoperative pain intensity, rescue analgesia requirement, and adverse events.Result9 randomized controlled trials with 539 patients were included for analysis. Compared with non-block care, TLIP block was effective to decrease the opioid consumption (WMD -16.00; 95%CI -19.19, -12.81; p<0.001; I2 = 71.6%) for the first 24 hours after the surgery. TLIP block significantly reduced postoperative pain intensity at rest or movement at various time points compared with non-block care, and reduced rescue analgesia requirement ((RR 0.47; 95%CI 0.30, 0.74; p = 0.001; I2 = 0.0%) and postoperative nausea and vomiting (RR 0.58; 95%CI 0.39, 0.86; p = 0.006; I2 = 25.1%). Besides, TLIP block is superior to wound infiltration in terms of opioid consumption (WMD -17.23, 95%CI -21.62, -12.86; p<0.001; I2 = 63.8%), and the postoperative pain intensity at rest was comparable between TLIP block and wound infiltration.ConclusionTLIP block improved analgesic efficacy in spine surgery compared with non-block care. Furthermore, current literature supported the TLIP block was superior to wound infiltration in terms of opioid consumption.

Factors affecting the preparedness of overnight hikers in national parks: Insights from Tasmania, Australia

Visiting and experiencing national parks, especially hiking in backcountry areas, has become a global phenomenon. Park managers are often challenged by how to ensure that hikers are not harmed due to lack of preparedness. Rescuing injured visitors and recovering deceased can be expensive, dangerous and emotionally difficult. Prevention of harm rests primarily on visitors’ preparation (e.g., packing essential gear, conducting pre-planning, trail familiarisation). This paper reports findings from research using a combination of a systematic quantitative literature review and a cross-sectional survey to examine preparedness of overnight hikers to national parks in Tasmania, Australia – an internationally popular wilderness travel destination. Data was collected on the gear carried, socio-demographics, experience, information sources, and self-reported ratings of fitness, risk, and preparedness. Results show 13% of hikers had never previously completed an overnight hike. Safety items were less frequently carried; female hikers often missed items. We found a weak positive correlation in males between self-reported preparedness and fitness, and risk and preparedness. Better prepared hikers were more open to improved safety solutions compared with under-prepared hikers. Findings suggest interventions need to be tailored to visitor type, and may include education, advertisements, EPIRB check in/check out and fines for noncompliance. Management implications suggest using diverse intervention methods and targeting hiking behaviour to reduce future problems. Further research is necessary to validate findings in other countries.

A systematic review of quantitative and qualitative literature on health professionals' experiences communicating with Chinese immigrants.

The aim of this study is to determine health professionals' experiences communicating with Chinese immigrants and identify potential education barriers. Health professionals caring for Chinese immigrants often encounter communication barriers, leading to uncertainty of quality of care. This study is a quantitative and qualitative systematic review. MEDLINE, Scopus, CINAHL, PubMed and Google Scholar were searched, limited to 1980 to October 2020. Articles were included if they reported results about health professional communication with Chinese patients. Quality was appraised using Consolidated Criteria for Reporting Qualitative Research guidelines and thematic synthesis conducted. Of 1363 articles, seven studies were included. These described provider-patient communication in primary care, oncology and palliative settings only. Three core themes were identified: (1) family-centred health communication where family controls provider-patient information exchange; (2) mismatch of provider-patient health beliefs and knowledge on diet, nutrition, traditional medicine, place for death and disease prevention and (3) mismatch of language and resources as skilled providers proficient in specific dialects are limited; communication resources are perceived as infrequently available and content is insufficient. Studies describing health professionals' experiences communicating with Chinese immigrants are limited. Key barriers identified included cultural and language disparities and communication resources are inadequate to support health professionals' needs.

Sharing economy research in hospitality and tourism: a critical review using bibliometric analysis, content analysis and a quantitative systematic literature review

PurposeThis study aims to conduct a critical review of the research on the sharing economy to identify its key intellectual foundations and their evolution and offers thematic and methodological recommendations for future research to advance the domain.Design/methodology/approachA tri-method approach using bibliometric (co-citation) analysis, thematic content analysis and a quantitative systematic literature review was conducted on sharing economy research in hospitality and tourism journals, up to and including May 2020.FindingsThe findings from the three methods were coherent and provide a clear picture of the fact that while research on the sharing economy in hospitality and tourism has achieved significant depth, the breadth of the understanding of this area remains somewhat limited. Each of the three periods of research on the sharing economy identified in the study were marked by a focus on specific thematic areas, with largely Western-situated researchers demonstrating limited theoretical engagement and using a limited range of methods and perspectives (disciplinary, stakeholders and sectors) to examine these themes.Research limitations/implicationsRecommendations for future thematic research opportunities are provided using a multi-level perspective. The present review does not include research that incorporates the impacts of COVID-19, which has significantly disrupted the hospitality and tourism industry and is the focus of current research in the field. However, the review represents the largest and most comprehensive assessment of the state of research on the sharing economy prior to COVID-19, and, as such, can serve as a valuable baseline for future reviews of sharing economy research during and after the pandemic.Originality/valueIn contrast with previous literature reviews, the present review is comprehensive in its scope, methodology and temporal coverage of sharing economy research. It also examines the evolution of research on the topic, enabling a more nuanced identification of gaps and future thematic and methodological research opportunities.

Prevalence of dental caries among Indigenous populations compared to non-Indigenous populations: a quantitative systematic review protocol.

The objective of this review is to evaluate if the prevalence of dental caries is higher among Indigenous populations compared to non-Indigenous populations. Globally, Indigenous populations have experienced substantial inequalities in health, including oral health care, when compared to their non-Indigenous counterparts. Indigenous populations experience a higher prevalence of dental caries, but most of this data has been collected from convenience samples not involving non-Indigenous groups. This review will highlight differences in the prevalence of dental caries globally among Indigenous groups compared to non-Indigenous groups. The systematic review will include all studies that have compared the prevalence of dental caries (% of decayed teeth>0) and dental caries experience (mean score of decayed, missing, filled teeth) among Indigenous and non-Indigenous populations across all ages. Initially, articles will be searched in MEDLINE, followed by a more comprehensive search on Scopus, EBSCO (Dentistry and Oral Sciences Sources), Cochrane Database, and OpenGrey. The search will be conducted independently by two reviewers from database inception to September 2020. A reference list will be made identifying all eligible studies. Titles and abstracts will be reviewed, as well as the full text of articles that meet the inclusion criteria. To assess methodological quality, a standardized critical appraisal checklist for studies reporting prevalence will be selected, followed by standardized data extraction using the JBI tool. The results from included studies will be analyzed using JBI SUMARI. PROSPERO CRD42020204311.

Ecotoxicity of Microplastic Pollutants to Marine Organisms: a Systematic Review

Plastic is a ubiquitous material used across the globe. It is easily transported to various habitats and can then be ingested by animals, with the potential to bioaccumulate up the food chain further. Although classified as solid waste, some plastics can be considered hazardous waste due to the chemicals used in the production process and those that can be adsorbed, such as hydrophobic pollutants in seawater. Plastics can break down into secondary particulate plastics, or be microscopically primary plastics, smaller than 5 mm. Marine organisms of all sizes can mistake plastic for food or consume prey with microplastics. This can cause detrimental toxic effects at a cellular, biochemical, and muscular level. This research uses a systematic quantitative literature review (SQLR) method to determine the most common polymers, hazardous chemicals, and marine organisms to ingest microplastic and incur ecotoxicological consequences. The results indicated polyethylene (PE), polypropylene (PP), and polystyrene (PS) to be the topmost common polymers, with sizes between 1 and 100 μm. Plastic was observed to be a sink for non-additive pollutants more than a vector. Persistent organic pollutants (POPs) were the most common pollutants found. Biological impacts and side effects included mortality, reproductive effects, genotoxicity, accumulation, and behavioral effects. Further research is needed regarding the interrelationship of plastic polymers, additives, and non-additives combined for inducing toxic effects.

Rainforest tourism: a systematic review of established knowledge and gaps in research

ABSTRACT Rainforests provide exceptional spaces for nature-based tourism activities attracting large numbers of visitors. Simultaneously, tourism activities may create environmental, social and economic impacts that require management in order to conserve sensitive rainforest environments. Rainforest tourism constitutes a travel sector that receives growing interest worldwide. This study presents a timely review of current knowledge and research gaps in a new conceptual model to give recommendations for a future research agenda. Through a systematic quantitative review, the study identified 48 peer-reviewed journal articles addressing conservation and management topics (33), followed by visitor-related research (23), impacts (10), and finally community and stakeholder research (3) of rainforest tourism, published between 1975 and 2019. The majority of research focused on management issues relating to policy development, planning, education and conservation measures. A strong geographic bias was noted with very limited research available for rainforest regions in Africa and Asia. Future research should be concerned with expanding and linking rainforest research across countries, and filling knowledge gaps around visitor monitoring, specific impacts and causes, and the complexity of community and stakeholder involvement in managing impacts. Protocols may need to be established to facilitate the design and delivery of standardised research approaches across the globe.

Effectiveness of telemonitoring on self-care behaviors among community-dwelling adults with heart failure: a quantitative systematic review.

ABSTRACTObjective:This review examined the effectiveness of telemonitoring versus usual care on self-care behaviors among community-dwelling adults with heart failure.Introduction:Heart failure is a global health crisis. There is a body of high-level evidence demonstrating that telemonitoring is an appropriate and effective therapy for many chronic conditions, including heart failure. The focus has been on traditional measures such as rehospitalizations, length of stay, cost analyses, patient satisfaction, quality of life, and death rates. What has not been systematically evaluated is the effectiveness of telemonitoring on self-care behaviors. Involving patients in self-care is an important heart failure management strategy.Inclusion criteria:This review included studies on adult participants (18 years and older), diagnosed with heart failure (New York Heart Association Class I – IV), who used telemonitoring in the ambulatory setting. Studies among pediatric patients with heart failure, adult patients with heart failure in acute care settings, or those residing in a care facility were excluded.Methods:Eight databases, including CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Epistemonikos, ProQuest Dissertations and Theses, PsycINFO, and Web of Science were systematically searched for English-language studies between 1997 and 2019. Studies selected for retrieval were assessed by two independent reviewers for methodological quality using critical appraisal checklists appropriate to the study design. Those meeting a priori quality standards of medium or high quality were included in the review.Results:Twelve publications were included in this review (N = 1923). Nine of the 12 studies were randomized controlled trials and three were quasi-experimental studies. Based on appropriate JBI critical appraisal tools, the quality of included studies was deemed moderate to high. In a majority of the studies, a potential source of bias was related to lack of blinding of treatment assignment. Telemonitoring programs ranged from telephone-based support, interactive websites, and mobile apps to remote monitoring systems and devices. Self-care outcomes were measured with the European Heart Failure Self-care Behaviour Scale in nine studies and with the Self-care of Heart Failure Index in three studies. Telemonitoring improved self-care behaviors across 10 of these studies, achieving statistical significance. Clinical significance was also observed in nine of the 12 studies. All studies utilized one of two validated instruments that specifically measure self-care behaviors among patients with heart failure. However, in some studies, variation in interpretation and reporting was observed in the use of one instrument.Conclusions:Overall, telemonitoring had a positive effect on self-care behavior among adult, community-dwelling patients with heart failure; however, there is insufficient and conflicting evidence to determine how long the effectiveness lasts. Longitudinal studies are needed to determine the sustained effect of telemonitoring on self-care behaviors. In addition, the limitations of the current studies (eg, inadequate sample size, study design, incomplete statistical reporting, self-report bias) should be taken into account when designing future studies. This review provides evidence for the use of telemonitoring, which is poised for dramatic expansion given the current clinical environment encouraging reduced face-to-face visits.Systematic review registration number:PROSPERO CRD42019131852

Systematic literature review on computable general equilibrium applications in tourism

Assessment of the economy-wide impacts of tourism has increased importance due to the unprecedented impacts of COVID-19. Computable general equilibrium (CGE) approach is a versatile tool for estimating the economy-wide impacts of tourism, as opposed to alternative general equilibrium approaches and partial equilibrium approaches. However, there has not been any systematic review done on CGE applications in tourism literature. The article reviews CGE applications in tourism over the past 25 years using a systematic quantitative literature review approach. This review presents potentially important applications of CGE models in guiding post-COVID tourism. Further, the article highlights the new developments in CGE modelling, which are yet to be adopted in tourism economics. Existing studies show a strong geographical bias. Notable research gaps exist in the areas of poverty, inequality, gender, environmental and the climate change impacts of tourism. Future research in these areas will be vital to effectively guide post-COVID tourism recovery.

The effect of systemic lidocaine on post-operative opioid consumption in ambulatory surgical patients: a meta-analysis of randomized controlled trials

BackgroundAmbulatory surgical procedures continue to grow in relevance to perioperative medicine. Clinical studies have examined the use of systemic lidocaine as a component of multimodal analgesia in various surgeries with mixed results. A quantitative review of the opioid-sparing effects of systemic lidocaine in ambulatory surgery has not been investigated. The primary objective of this study was to systematically review the effectiveness of systemic lidocaine on postoperative analgesic outcomes in patients undergoing ambulatory surgery.MethodsWe performed a quantitative systematic review of randomized controlled trials in electronic databases (Cochrane Library, Embase, PubMed, and Google Scholar) from their inception through February 2019. Included trials investigated the effects of intraoperative systemic lidocaine on postoperative analgesic outcomes, time to hospital discharge, and adverse events. Methodological quality was evaluated using Cochrane Collaboration’s tool and the level of evidence was assessed using GRADE criteria. Data was combined in a meta-analysis using random-effects models.ResultsFive trials evaluating 297 patients were included in the analysis. The pooled effect of systemic lidocaine on postoperative opioid consumption at post-anesthesia care unit revealed a significant effect, weighted mean difference (95% CI) of − 4.23 (− 7.3 to 1.2, P = 0.007), and, at 24 h, weighted mean difference (95% CI) of − 1.91 (− 3.80 to − 0.03, P = 0.04) mg intravenous morphine equivalents. Postoperative pain control during both time intervals, postoperative nausea and vomiting reported at post anesthesia care unit, and time to hospital discharge were not different between groups. The incidence rate of self-limiting adverse events of the included studies is 0.007 (2/297).ConclusionOur results suggest that intraoperative systemic lidocaine as treatment for postoperative pain has a moderate opioid-sparing effect in post anesthesia care unit with limited effect at 24 h after ambulatory surgery. Moreover, the opioid-sparing effect did not impact the analgesia or the presence of nausea and vomiting immediately or 24 h after surgery. Clinical trials with larger sample sizes are necessary to further confirm the short-term analgesic benefit of systemic lidocaine following ambulatory surgery.Trial registrationPROSPERO (CRD42019142229)

A Note on the General Solution to Completing Partially Specified Correlation Matrices

ABSTRACT Partially specified correlation matrices (not to be confused with matrices with missing data or EM-correlation matrices) can appear in research settings such as integrative data analyses, quantitative systematic reviews or whenever the study design only allows for the collection of certain variables. Although approaches to fill in these missing entries have been considered for special cases of low-dimensional matrices, a general approach that can handle correlation matrices of arbitrary size and number of missing entries is needed. The present article relies on the theory of convex optimization and semidefinite programming to derive a semidefinite program that can offer researchers a mathematically principled approach to fill in the missing entries. An easy-to-use function in the R programming language is also presented that implements the theory derived herein.

Evidence for factors associated with diet and physical activity in African and Caribbean countries.

ObjectiveTo identify and describe summarized evidence on factors associated with diet and physical activity in low- and middle-income countries in Africa and the Caribbean by performing a scoping review of reviews.MethodsWe searched the Medline®, LILACS, Scopus, Global Health and Web of Science databases for reviews of factors associated with diet or physical activity published between 1998 and 2019. At least 25% of studies in reviews had to come from African or Caribbean countries. Factors were categorized using Dahlgren and Whitehead’s social model of health. There was no quality appraisal.FindingsWe identified 25 reviews: 13 on diet, four on physical activity and eight on both. Eighteen articles were quantitative systematic reviews. In 12 reviews, 25–50% of studies were from Africa or the Caribbean. Only three included evidence from the Caribbean. Together, the 25 reviews included primary evidence published between 1926 and 2018. Little of the summarized evidence concerned associations between international health or political factors and diet or associations between any factor and physical activity across all categories of the social model of health.ConclusionThe scoping review found a wide range of factors reported to be associated with diet and physical activity in Africa and the Caribbean, but summarized evidence that could help inform policies encouraging behaviours linked to healthy diets and physical activity in these regions were lacking. Further reviews are needed to inform policy where the evidence exists, and to establish whether additional primary research is needed.

The Effectiveness of De-Escalation Techniques as Compared to Physical Restraint/Seclusion on Inpatient Psychiatric Units: A Quantitative Systematic Review

Restraint and seclusion were considered a form of treatment but consistently has led to physical and mental injuries to staff and patients. De-escalation has been viewed as a safer option. Understanding which intervention yields decreased injuries, aggression and violence will guide policy and inform practice. To identify which intervention leads to decreased physical and psychological injury to patients and staff. The frequency of physical injuries to patients and staff from aggressive patients; frequency of psychological injuries to patients and staff from violent, aggressive incidents; frequency of violence, agitation and aggression; competence of staff at managing aggression and violence were evaluated. Fourteen studies were included in this review. There are many forms of de-escalation. Studies where techniques were taught to staff, the intervention was effective in decreasing injury in approximately half the studies. De-escalation techniques taught to patients decreased injury in 100% of the studies included in this review. Consensus on which intervention works best could not be reached, nor is there overwhelming evidence for a particular type of de-escalation better suited for decreasing aggression and violence. Caution should be exercised when choosing a de-escalation technique for implementation in institutions due to lack of regulating agencies that inform practice and standards. In addition, the literature lacks best practices for de-escalation techniques backed by evidence. Restraint and seclusion should be used as a last resort due to inherent risk associated with the intervention.