Synthesis Of Research Evidence Research Articles

Individual Predictors of Language Treatment Response in Children With Developmental Language Disorder: A Systematic Review.

Treatment response is the degree to which an individual benefits from a treatment. This systematic review sought to identify and synthesize research evidence regarding individual characteristics that predict language treatment response among children with developmental language disorder (DLD). To be eligible for inclusion, articles needed to report results of an oral language treatment program in a group of children aged 4-10 years with identified DLD and also include a quantitative analysis of the relation between one or more pretreatment child characteristics and the outcome of language treatment. Seven databases (Cumulated Index to Nursing and Allied Health Literature, Dissertations and Theses Global, Education Resources Information Center, Linguistics and Language Behavior Abstracts, PsycINFO, Medline, and Web of Science) were searched for articles in June and July 2021, with search updates conducted in May 2023. Studies were categorized by the type of treatment provided, and results were synthesized qualitatively. The review included 31 studies, 1,551 participants with DLD, and over 300 statistical tests of a predictor's effect on language treatment response. Most studies (n = 21) included only monolingual speakers of English, with five studies including bilinguals and five including monolingual speakers of non-English languages. Language treatments targeted word learning in controlled or clinical conditions, grammatical learning in controlled or clinical conditions, or multiple language targets in clinical conditions. Predictors of treatment response are summarized across four categories: cognitive, demographic, pretreatment language levels, and other. There were relatively few significant tests of the predictors of language treatment response. A central limitation of the evidence is that most included studies were designed to consider language treatment efficacy, not predictors of treatment response. Increasing research attention to the question of predictors of language treatment response in children with DLD is needed to enhance treatment and optimize outcomes for individual children. https://doi.org/10.23641/asha.26170006.

Determining the future role of clinical practice guidelines: The experience of Australia and New Zealand.

There has been recent discussion in Australia and New Zealand concerning the utility of Clinical Practice Guidelines (CPGs) and the role of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in their development. The College Board therefore established a Steering Group (SG) to oversee an exploration of options and produce recommendations about contemporary approaches to the development of high-quality evidence-based clinical practice guidance for psychiatry. This paper outlines the SG's conclusions and recommendations, as well as the underlying methods and reasoning. In particular, we discuss best practice and recent developments in the synthesis of research evidence. Account has been taken of the opportunities offered by digital technologies, the proliferation of clinical evidence and awareness of the gains to be made by increased inclusion of lived-experience perspectives. It is recommended that the broader concept of best practice resources (BPRs) as now emphasised in so many fields of service is the most appropriate starting point for the College's role in this area especially as the expertise of the College and its fellows lends itself to the development of a range of BPRs. In conclusion, contemporary guidance needs to be tailored to the requirements of the practitioners seeking it, to articulate the real-world needs and experiences of patients, and to be delivered in a contemporary format that is responsive to rapidly emerging evidence. The experience in Australia and New Zealand may have implications elsewhere for the development of CPGs and BPRs more broadly.

A global survey exploring tackle training knowledge, attitudes and practices of women's rugby union coaches

The coaching and performance context in women's rugby is not well understood, despite growing popularity worldwide. The aim of this study was to describe the knowledge, attitudes and tackle training practices of women's rugby coaches in relation to tackle safety and performance. A globally distributed online survey exploring coaches’ knowledge, attitudes and practices towards tackling women's rugby was completed by 357 coaches (mean age 41 ± 0.6 years) from 58 countries. The cross-sectional survey was distributed from March 2023 to June 2023. Survey development was guided by the Health Action Process Approach and informed by coaching experts, research evidence synthesis, and guidelines for international tackle safety programmes. Coaches believed that the risk of tackle injury in women's rugby is high and that proper tackle technique for safety is very important. More than 75% of coaches had never completed a tackle-specific training course, with only 39% aware of the availability of such courses. Time spent on controlled-contact and full-contact activities varied from 0 to 40+ min per week, averaging 10–20 min for both types of training. Barriers to the effectiveness of tackle training related to sociocultural factors, coach knowledge gaps, training environments, and player training considerations. Coach education, improved infrastructures, and physical development were ranked the highest priorities for improving tackle safety and performance. These findings inform future implementation strategies for tackle safety and performance in the context of women's rugby, highlighting the need to involve coaches in providing practical solutions, and the role of education and institutional/organisational support in facilitating such improvements.

Parenting and family interventions in lower and middle-income countries for child and adolescent mental health: A systematic review

BackgroundGiven the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential. MethodThis systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0–24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes. Main findingsWe found a total of 80 studies (n = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs. Preliminary conclusionsDespite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.

Standardized Sampling for Systematic Literature Reviews (STAMP Method): Ensuring Reproducibility and Replicability

Systematic literature reviews (SLRs) are an effective way of mapping a research field and synthesizing research evidence. However, especially in communication research, SLRs often include diverse theories and methods, which come with a considerable downside in terms of reproducibility and replicability. As a response to this problem, the present article introduces the method of standardized sampling for systematic literature reviews (STAMP). The method is a structured, four-stage approach that is centered around score-based screening decisions. Originating from principles of standardized content analysis, a method common in communication research, and supplementing established guidelines like Cochrane or PRISMA, the STAMP method contributes to more transparent, reproducible, and replicable SLR sampling processes. As we illustrate throughout the article, the method is adaptable to various SLR types. The article also discusses the method’s limitations, such as potential coder effects and comparatively high resource intensity. To facilitate the application of STAMP, we provide a comprehensive guideline via the Open Science Framework that offers a succinct overview for quick reference and includes practical examples for different types of SLRs.

An examination of studies related to the sport of curling: a scoping review.

There has been growth in research in the sport of curling over the past few decades. The need for a scoping review is warranted. This study's purpose was to identify and synthesize research evidence regarding quantitative variables for a series of components within the sport of curling. A scoping review of studies published and established within four databases was performed. One independent reviewer selected studies based on a systematic procedure. Inclusion criteria for studies were: (1) interventions that focused on the sport of curling; (2) quantitative in nature; (3) written in English; and (4) published within a peer-reviewed journal, a conference presentation, or a published thesis. Searching identified 8,467 articles and 94 met the inclusion criteria. Data were organized and synthesized based on the devised research variables from the sport of curling: The curl mechanism of the curling stone; the impact of sweeping on stone trajectory; curling delivery mechanics; wheelchair curling; technology analysis; strategy and tactics; psychological factors; injury occurrences; facility and arena infrastructure; and assessment of curling training and ability. The findings confirm the strong knowledge base that exists across game variables and unveil controversy between the underlying physics that produces curl, as well as the mechanisms of sweeping responsible for manipulating the stone trajectory. Knowledge derived from this review can assist researchers, coaches, and curlers in addressing the specific variables of the sport that influence stone trajectory and game results. Such awareness will expose gaps in the current understanding and foster new research endeavors to further the knowledge of the sport.

Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention

BackgroundAbdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA size. Individuals in AAA surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance pathways.MethodsIntervention mapping methods were used to co-develop the intervention with individuals with AAA, families/carers, and healthcare staff. We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention.ResultsThe developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient’s AAA screening appointment for the duration that they are in surveillance.DiscussionThe developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population.Trial registrationInternational Clinical Trial Registration: ISRCTN93993995.

Lymphoma-associated hemophagocytic lymphohistiocytosis (LA-HLH): a scoping review unveils clinical and diagnostic patterns of a lymphoma subgroup with poor prognosis.

Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome driven by pathologic activation of cytotoxic T-lymphocytes and macrophages. Despite advances in diagnostics and management, adult patients with lymphoma-associated HLH (LA-HLH) harbor particularly poor prognosis and optimal treatment remains challenging. As systematic data on LA-HLH are scarce, we aimed to synthesize research evidence by thorough analysis of the published literature in PubMed (MEDLINE-database) within the context of a scoping review. Of 595 search results, 132 articles providing information on 542 patients were reviewed and analyzed. Median patient age was 60 years (range, 18-98) with male predominance (62.7%). B- and T-NHL were equally represented (45.6% and 45.2%), Hodgkin's lymphoma was reported in 8.9% of the cases. The majority of patients (91.6%) presented in Ann-Arbor-Stages III and IV, and bone marrow infiltration was observed in a significant proportion of patients (61.5%). Soluble CD25 levels were markedly elevated (median 10,000 U/ml), with levels beyond 10,000 U/ml indicating unfavorable prognosis for 30-day and overall survival. 66.8% of the patients died after median 5.1 months. LA-HLH remains a clinical challenge requiring specialized management. Timely diagnosis and appropriate lymphoma-specific treatment are of utmost importance to enhance patient outcomes.

Can new approaches to synthesising evidence help achieve a consensus in psychotherapy research?

The recent debate around the College's Clinical Practice Guidelines on mood disorders have highlighted differences in opinion on interpreting evidence from randomised control trials (RCTs) for psychodynamic psychotherapy. This paper discusses new techniques of synthesising research evidence (e.g., umbrella reviews) that may help minimise disagreements in the interpretation of RCTs and foster greater consensus on treatment guidelines. Findings from the latest umbrella review suggest that psychodynamic therapy is an evidence-based approach, among several, for common mental disorders.

Exploring the impact of housing insecurity on the health and well-being of children and young people: a systematic review

Background Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are (1) not through choice and (2) related to poverty. For example, due to short-term private rental tenancies, temporary or emergency housing, and homelessness. Housing insecurity has grown due to recent trends in the cost and availability of housing. The quality, affordability and stability of housing have all been shown to impact children’s health and well-being. However, the pathways linking housing and child health and well-being are complex and poorly understood. Objectives To identify, appraise and synthesise research evidence that explores the relationship between housing insecurity and the health and well-being of children and young people. Data sources MEDLINE via Ovid (searched 8 April 2022), EMBASE via Ovid (searched 8 April 2022), PsycINFO via Ovid (searched 8 April 2022). Review methods We undertook a systematic review synthesising qualitative data. We searched databases, reference lists and United Kingdom grey literature. We extracted and tabulated key data from the included papers, and appraised study quality. We synthesised the data qualitatively into an a priori conceptual framework using best-fit framework synthesis combined with thematic synthesis, and generated logic models to highlight links between specific exposures, impacts and outcomes. Results We included 59 studies and identified four populations: those experiencing housing insecurity in general (40 papers); associated with domestic violence (nine papers); associated with migration status (13 papers) and those forced to relocate due to demolition (two papers). Most published studies had an overall assessment of moderate-high quality, and most grey literature originated from known and valued sources. Housing insecurity took many forms and resulted from several, often inter-related, situations, including being evicted or having a forced move, living in temporary accommodation, exposure to problematic behaviour, overcrowded/poor-condition/unsuitable property, and making multiple moves. The resultant housing insecurity had multiple impacts, including school-related, psychological, financial and family well-being impacts, long-distance travel to attend school and see friends, living in a poor-condition or unsuitable property, all of which could further exacerbate housing insecurity. These experiences impacted health and well-being, in terms of mental health problems (often manifesting physically/behaviourally) and physical health problems related to poor housing conditions. Some factors lessened the impact of housing insecurity, including friendship and support, staying at the same school, having hope for the future and protective parenting. The negative impacts of housing insecurity on health and well-being may be compounded by specific situations and life circumstances, such as escaping domestic violence, migration status, or a forced relocation due to housing demolition. Limitations Many accounts were from parents or other informants, and more data directly from children and young people may give a more nuanced picture. Likewise, there was little information relating to outcomes, and it is difficult to know whether the current evidence has captured all relevant outcomes, and the links from impacts to health and well-being outcomes are less well understood. The complexity and diversity of the data added additional challenges to the synthesis process. Conclusions Our findings suggest that policies should focus on reducing housing insecurity among families, particularly in relation to reducing eviction, improving and reducing the need for temporary accommodation, minimum requirements for property condition, and support to reduce multiple moves and moves far from families’ desired location. Those working with children and families experiencing housing insecurity should give them optimal choice and control over situations that affect them. Future work Future qualitative research should focus explicitly on the health and well-being of children and young people experiencing housing insecurity, and how it links with the impacts identified in the current review, foregrounding the accounts of children and young people themselves, including specific groups of young people who are likely to be marginalised. Qualitative research focusing on the impact of interventions to address housing insecurity among families in the United Kingdom is also needed. Study registration This study is registered as PROSPERO CRD42022327506. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (Award ref: NIHR135455) and is published in full in Public Health Research; Vol. 11, No. 13. See the NIHR Funding and Awards website for further award information. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

The “What” and “Why” of (Un)Ethical Evaluation Practice: A Meta-Narrative Review and Ethical Awareness Framework

There is growing recognition of the complex moral and ethical tensions associated with evaluation practice. However, there are scant evidence-informed frameworks for cultivating ethical awareness or informing ethical deliberation across the evaluation landscape. Thus, we aimed to synthesize research evidence on evaluation ethics, and draw on these findings to develop an evidence-informed evaluation ethics framework. Our methodological approach involved, first, conducting a meta-narrative review of empirical studies on evaluation ethics. Specifically, we conducted a systematic peer-reviewed and grey literature search, then identified, extracted, and thematically organize data from 20 studies that meet inclusion criteria. Second, in consultation with an ethicist, we curated findings on ethical concerns within an integrated evaluation ethics framework. Our results illustrate six thematic patterns of research inquiry on evaluation ethics and highlight trends, and gaps. The ethics framework (ACAP) we develop includes four multi-faceted categories. It outlines six Accountabilities (where ethical consideration is owed), illustrates how ethical Concerns can manifest in practice, and outlines diverse stakeholder groups’ Agency over the management of ethical concerns. Critically, it outlines five meta-categories of ethical principles (P) including systematic and transparent inquiry, accordant self-determination, fairness, beneficence and non-maleficence, and reflexive stewardship. Implications for priming ethical awareness, navigating ethical conflicts, and advancing evaluation ethics education and research are discussed.

Involving carer advisors in evidence synthesis to improve carers' mental health during end-of-life home care: co-production during COVID-19 remote working.

Family carers play a central role in supporting people at the end of life, but often suffer detrimental impacts on their own mental health as a result. This project conducted evidence synthesis of research into factors that may affect carers' mental health to help identify ways of maintaining their mental health. It worked closely with a carer Review Advisory Panel to help ensure the findings made sense and were communicated meaningfully from the carers' perspective. To present: (1) principles and components that facilitated successful patient and public involvement in an evidence synthesis project to help inform patient and public involvement in similar projects; (2) recommendations for carer support that were instigated and produced by the Review Advisory Panel. Nine Review Advisory Panel meetings including four to five carers, a lay Chair and three researchers were held. Solid 'groundwork' was invested in recruitment and relationship-building prior to meetings, and it was ensured that there was agreement of how to work together and clarification of expectations at the first meeting. Key meeting principles were: having a majority of carers, and a Chair with both carer and patient and public involvement experience, to ensure carer voices remained at the fore substantial researcher representation, including the project lead, to highlight the value placed on Review Advisory Panel meetings flexibility to follow carers' agendas, enabling 'space to talk' and 'space to change' appropriate and prompt carer payment, again emphasising patient and public involvement value to the project. Added general principles were: ongoing training, ample funded time for Review Advisory Panel preparation and ongoing communication outside meetings. COVID moved all meetings online after the first meeting, but the principles were maintained. The project saw an evolution from patient and public involvement consultation to co-production. The main patient and public involvement output was recommendations for supporting carers based on project findings, instigated and produced by the Review Advisory Panel. Five carers (including the Chair) and six researchers responded to questions by e-mail. Analysis by one researcher, aided by two other researchers, was then reviewed by all participants and revised. Both carers and researchers felt the components that made the patient and public involvement work were: (1) a shared sense of purpose of and gains from the Review Advisory Panel; (2) personal gains; (3) mutual commitment and respect; and (4) bridging between academic and lay perspectives, through investment in training, ensuring carers were able to meaningfully comment, and continuous negotiation and compromise. Challenges were that the COVID-induced move from face-to-face to online meetings reduced informality, flexibility, personal connection and non-verbal communication. However, earlier groundwork facilitated group resilience to these challenges. Patient and public involvement representation on the wider Research Management Group proved less successful, flagging the importance of negotiating and defining patient and public involvement roles at all project levels. The patient and public involvement principles employed, including meeting composition and chairing, and flexibility to follow carers' agendas, appeared to facilitate the evolution from consultation to co-production of carer recommendations, but require further testing. Preconditions for successful remote working should be further investigated, as the different advantages of face-to-face and virtual meetings may be combined through hybrid working. The iterative and responsive working required for genuine co-production may require more flexible patient and public involvement funding models. This study is registered as PROSPERO registration 2019 CRD42019130279 at https://www.crd.york.ac.uk/prospero/. This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (grant 18/01/01) and will be published in full in Health and Social Care Delivery Research. See the NIHR Journals Library website for further project information.

The development of a core outcome set for studies of pregnant women with multimorbidity

BackgroundHeterogeneity in reported outcomes can limit the synthesis of research evidence. A core outcome set informs what outcomes are important and should be measured as a minimum in all future studies. We report the development of a core outcome set applicable to observational and interventional studies of pregnant women with multimorbidity.MethodsWe developed the core outcome set in four stages: (i) a systematic literature search, (ii) three focus groups with UK stakeholders, (iii) two rounds of Delphi surveys with international stakeholders and (iv) two international virtual consensus meetings. Stakeholders included women with multimorbidity and experience of pregnancy in the last 5 years, or are planning a pregnancy, their partners, health or social care professionals and researchers. Study adverts were shared through stakeholder charities and organisations.ResultsTwenty-six studies were included in the systematic literature search (2017 to 2021) reporting 185 outcomes. Thematic analysis of the focus groups added a further 28 outcomes. Two hundred and nine stakeholders completed the first Delphi survey. One hundred and sixteen stakeholders completed the second Delphi survey where 45 outcomes reached Consensus In (≥70% of all participants rating an outcome as Critically Important). Thirteen stakeholders reviewed 15 Borderline outcomes in the first consensus meeting and included seven additional outcomes. Seventeen stakeholders reviewed these 52 outcomes in a second consensus meeting, the threshold was ≥80% of all participants voting for inclusion. The final core outcome set included 11 outcomes. The five maternal outcomes were as follows: maternal death, severe maternal morbidity, change in existing long-term conditions (physical and mental), quality and experience of care and development of new mental health conditions. The six child outcomes were as follows: survival of baby, gestational age at birth, neurodevelopmental conditions/impairment, quality of life, birth weight and separation of baby from mother for health care needs.ConclusionsMultimorbidity in pregnancy is a new and complex clinical research area. Following a rigorous process, this complexity was meaningfully reduced to a core outcome set that balances the views of a diverse stakeholder group.

Exploring nurse practitioner practice in Australian rural primary health care settings: A scoping review.

Australians in rural areas experience limited access to services and poorer health outcomes than residents of metropolitan areas. Nurse practitioners (NPs) were introduced in 2000 to reduce pressure on the health system, address workforce shortages and improve rural populations' access to health care services. This scoping review sought to identify, examine and synthesise research evidence of NP practice in Australian rural primary health care services to better understand how NPs are addressing service gaps in rural areas and to identify existing gaps in our knowledge. Peer-reviewed and grey literature from July 2012 to June 2022 was accessed from seven electronic databases, grey literature and hand searching of reference lists and citations. From 154 articles, 19 articles of relevance were identified. Several projects describe the processes required for success, whilst others reported the challenges and barriers encountered. Limited research evidence of rural NP practice exists with a significant gap about how roles operate and their value in primary health care. Uptake and envisaged benefits of rural primary health care NP roles have yet to be realised, with barriers to implementing and sustaining NP roles persisting. Low-level awareness with ambiguity at health service and community level adversely impact on systematic implementation of NP roles. Robust evaluations demonstrating the value of NP skills and practice are needed in combination with bipartisan support from all levels of health care and government providing adequate funding to enable effective implementation of NP roles in poorly resourced rural areas.

What are the main factors that are thought to impact upon the implementation of a whole school approach to student mental health and wellbeing in schools? A systematic review

Increased availability of evidence-informed, school-based, prevention and intervention programmes in the area of mental health and wellbeing promotion has contributed to a shift in research priorities from efficacy to implementation and dissemination. A central issue for school psychology research in moving research to practice is to ensure high quality implementation of both the intervention programmes and the support system that sustains it. The purpose of this review is to identify, appraise and synthesise research evidence using an implementation science framework in order to identify key contextual and ecological factors (facilitators and barriers) that impact upon the implementation process of whole school approaches to mental health and wellbeing promotion. Nine studies that met inclusion criteria were synthesised and critically appraised. A total of eighty-seven facilitators and sixty-seven barriers were extracted across the nine studies. Limitations of findings and methodologies relative to the review questions are outlined and discussed.

TFOS Lifestyle - Evidence quality report: Advancing the evaluation and synthesis of research evidence

Evidence-based practice is a dominant paradigm in healthcare that emphasizes the importance of ensuring the translation of the best available, relevant research evidence into practice. An Evidence Quality Subcommittee was established to provide specialized methodological support and expertise to promote rigorous and evidence-based approaches for the Tear Film and Ocular Surface Society (TFOS) Lifestyle Epidemic reports. The present report describes the purpose, scope, and activity of the Evidence Quality Subcommittee in the undertaking of high-quality narrative-style literature reviews, and leading prospectively registered, reliable systematic reviews of high priority research questions, using standardized methods for each topic area report. Identification of predominantly low or very low certainty evidence across the eight systematic reviews highlights a need for further research to define the efficacy and/or safety of specific lifestyle interventions on the ocular surface, and to clarify relationships between certain lifestyle factors and ocular surface disease. To support the citation of reliable systematic review evidence in the narrative review sections of each report, the Evidence Quality Subcommittee curated topic-specific systematic review databases and relevant systematic reviews underwent standardized reliability assessment. Inconsistent methodological rigor was noted in the published systematic review literature, emphasizing the importance of internal validity assessment. Based on the experience of implementing the Evidence Quality Subcommittee, this report makes suggestions for incorporation of such initiatives in future international taskforces and working groups. Content areas broadly relevant to the activity of the Evidence Quality Subcommittee, including the critical appraisal of research, clinical evidence hierarchies (levels of evidence), and risk of bias assessment, are also outlined.

Experiences of older people, healthcare providers and caregivers on implementing person-centered care for community-dwelling older people: a systematic review and qualitative meta-synthesis

BackgroundPerson-centered care (PCC) is a critical approach to improving the quality of care for community-dwelling older people. Old-age care services could be provided according to older peoples’ choices, needs, and preferences. The purpose of this study was to synthesize research evidence on the experiences of older people, healthcare providers, and caregivers with PCC and to identify the enablers and barriers to implementing PCC for community-dwelling older people.MethodsA meta-synthesis of qualitative research design was adopted. Data searches were performed using CINAHL (EBSCOhost), PubMed (OvidSP), Embase (Ovid), Cochrane Database, and PsycINFO (Ovid) in published articles and were reviewed from the earliest date to February 2023. The Qualitative Method Appraisal Tool was used to conduct a quality appraisal on selected articles. Data were extracted based on the capacity, opportunity, and motivation-behavior model (COM-B model), and the findings were synthesized using the meta-aggregative approach.ResultsTwelve included articles were analyzed to identify 122 findings that were organized into 11 categories and combined into three synthesized findings—capacities of older people, healthcare providers, and caregivers; opportunities in the implementation of PCC; motivation in implementing PCC. Capacities consisted of a lack of person-centered knowledge and skills, negative attitudes toward shared decision-making, and a lack of formal training to enhance capabilities among HCPs. Opportunities included a lack of coordination in resource allocation, strengthening multidisciplinary teamwork, establishing a desirable environment, and time constraints. Motivation in implementing PCC included encouraging self-reflection and regulation, respecting the autonomy of older people, lack of clear reward and empowerment mechanisms, and being resilient and optimistic.ConclusionsThe findings of this research provide a reference for implementing successful PCC in the community. The researchers identified barriers and facilitators of implementing PCC, facilitating through stakeholder’s person-centered knowledge and skills being valued and respecting the autonomy of older people. Establishing a positive environment and strengthening multidisciplinary team members also promotes the implementation of PCC. However, additional studies are required to explore the influencing factors and address the barriers.

Identification and treatment of individuals with attention-deficit/hyperactivity disorder and substance use disorder: An expert consensus statement.

Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with substance use (SU) and/or substance use disorder (SUD). Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment. This can be further complicated by the context in which services are delivered. Also, when working with young people and adults with co-existing ADHD and SU/SUD, there is uncertainty among healthcare practitioners on how best to meet their needs. In February 2022, the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues. Following presentations providing attendees with an overview of the literature, group discussions were held synthesizing research evidence and clinical experience. Topics included: (1) A review of substances and reasons for use/misuse; (2) identification, assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services; and (3) identification, assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services. Dis-cussions highlighted inter-service barriers and fragmentation of care. It was concluded that a multimodal and multi-agency approach is needed. The consensus group generated a table of practice recommendations providing guidance on: identification and assessment; pharmacological and psychological treatment; and multi-agency interventions.

Dancing for Parkinson’s Disease Online: Clinical Trial Process Evaluation

Background: Dancing is an engaging physical activity for people living with Parkinson's disease (PD). We conducted a process evaluation for a PD trial on online dancing. Methods: "ParkinDANCE Online" was co-produced by people with PD, healthcare professionals, dance instructors, and a PD organisation. The evaluation mapped the following inputs: (i) stakeholder steering group to oversee program design, processes, and outcomes; (ii) co-design of online classes, based on a research evidence synthesis, expert advice, and stakeholder recommendations; (iii) trial fidelity. The key activities were (i) the co-design of classes and instruction manuals, (ii) the education of dance teachers, (iii) fidelity checking, (iv) online surveys, (v) and post-trial focus groups and interviews with participants. The outputs pertained to: (i) recruitment, (ii) retention, (iii) adverse events, (iv) fidelity, (v) protocol variations, and (vi) participant feedback. Results: Twelve people with PD, four dance instructors and two physiotherapists, participated in a 6-week online dance program. There was no attrition, nor were there any adverse events. Program fidelity was strong with few protocol variations. Classes were delivered as planned, with 100% attendance. Dancers valued skills mastery. Dance teachers found digital delivery to be engaging and practical. The safety of online testing was facilitated by careful screening and a home safety checklist. Conclusions: It is feasible to deliver online dancing to people with early PD.

A primer on synthesizing individual participant data obtained from complex sampling surveys: A two-stage IPD meta-analysis approach.

The increasing availability of individual participant data (IPD) in the social sciences offers new possibilities to synthesize research evidence across primary studies. Two-stage IPD meta-analysis represents a framework that can utilize these possibilities. While most of the methodological research on two-stage IPD meta-analysis focused on its performance compared with other approaches, dealing with the complexities of the primary and meta-analytic data has received little attention, particularly when IPD are drawn from complex sampling surveys. Complex sampling surveys often feature clustering, stratification, and multistage sampling to obtain nationally or internationally representative data from a target population. Furthermore, IPD from these studies is likely to provide more than one effect size. To address these complexities, we propose a two-stage meta-analytic approach that generates model-based effect sizes in Stage 1 and synthesizes them in Stage 2. We present a sequence of steps, illustrate their implementation, and discuss the methodological decisions and options within. Given its flexibility to deal with the complex nature of the primary and meta-analytic data and its ability to combine multiple IPD sets or IPD with aggregated data, the proposed two-stage approach opens up new analytic possibilities for synthesizing knowledge from complex sampling surveys. (PsycInfo Database Record (c) 2023 APA, all rights reserved).