_Background:_ Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems (...) in children and adolescents. _Method:_ A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. _Results:_ Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. _Conclusions:_ The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements. (shrink)

The present narrative review seeks to unravel where we are now, and where we need to go to delineate the active ingredients in psychotherapy delivered by conversational agents (e.g., chatbots). While psychotherapy delivered by conversational agents has shown promising effectiveness for depression, anxiety, and psychological distress across several randomized controlled trials, little emphasis has been placed on the therapeutic processes in these interventions. The theoretical framework of this narrative review is grounded in prominent perspectives on the (...) active ingredients in psychotherapy. Based on search terms derived from various theoretical perspectives, we conducted a systematic literature search of four scientific databases and identified 17 studies. Across the selected studies, three themes emerged: relationship variables, emotional venting, and cognitive factors. While methodological issues compromise the epistemic value of this evidence base, core questions also remain to be answered. Such questions include, but are not limited to, whether humans can form affectionate bonds to inanimate beings and whether these kind of mental health treatments should be understood as psychotherapy or something else. Researchers should therefore be cautious when applying theories of psychotherapy in the realm of conversational agents. We conclude the paper by introducing recommendations for future research, which we hope will help instigate methodologically sound studies in this field. (shrink)

Background: Medical Assistance in Dying, also known as euthanasia or assisted suicide, is expanding internationally. Canada is the first country to permit Nurse Practitioners to provide euthanasia. These developments highlight the need for nurses to reflect upon the moral and ethical issues that euthanasia presents for nursing practice. Purpose: The purpose of this article is to provide a narrative review of the ethical arguments surrounding euthanasia in relationship to nursing practice. Methods: Systematic search and narrative (...) class='Hi'>review. Nine electronic databases were searched using vocabulary developed from a stage 1 search of Medline and CINAHL. Articles that analysed a focused ethical question related to euthanasia in the context of nursing practice were included. Articles were synthesized to provide an overview of the literature of nursing ethics and euthanasia. Ethical Considerations: This review was conducted as per established scientific guidelines. We have tried to be fair and respectful to the authors discussed. Findings: Forty-three articles were identified and arranged inductively into four themes: arguments from the nature of nursing; arguments from ethical principles, concepts and theories; arguments for moral consistency; and arguments from the nature of the social good. Key considerations included nursing’s moral ontology, the nurse–patient relationship, potential impact on the profession, ethical principles and theories, moral culpability for acts versus omissions, the role of intention and the nature of the society in which euthanasia would be enacted. In many cases, the same assumptions, values, principles and theories were used to argue both for and against euthanasia. Discussion: The review identified a relative paucity of literature in light of the expansion of euthanasia internationally. However, the literature provided a fulsome range of positions for nurses to consider as they reflect on their own participation in euthanasia. Many of the arguments reviewed were not nursing-specific, but rather are relevant across healthcare disciplines. Arguments explicitly grounded within the nature of nursing and nurse–patient relationships warrant further exploration. (shrink)

IntroductionInternational sharing of health data opens the door to the study of the so-called ‘Big Data’, which holds great promise for improving patient-centred care. Failure of recent data sharing initiatives indicates an urgent need to invest in societal trust in researchers and institutions. Key to an informed understanding of such a ‘social license’ is identifying the views patients and the public may hold with regard to data sharing for health research.MethodsWe performed a narrative review of the empirical evidence (...) addressing patients’ and public views and attitudes towards the use of health data for research purposes. The literature databases PubMed, Embase, Scopus and Google Scholar were searched in April 2019 to identify relevant publications. Patients’ and public attitudes were extracted from selected references and thematically categorised.ResultsTwenty-seven papers were included for review, including both qualitative and quantitative studies and systematic reviews. Results suggest widespread—though conditional—support among patients and the public for data sharing for health research. Despite the fact that participants recognise actual or potential benefits of data research, they expressed concerns about breaches of confidentiality and potential abuses of the data. Studies showed agreement on the following conditions: value, privacy, risk minimisation, data security, transparency, control, information, trust, responsibility and accountability.ConclusionsOur results indicate that a social license for data-intensive health research cannot simply be presumed. To strengthen the social license, identified conditions ought to be operationalised in a governance framework that incorporates the diverse patient and public values, needs and interests. (shrink)

Invalidation from healthcare practitioners is an experience shared by many patients, especially those marginalized or living with contested conditions (e.g., chronic pain, fibromyalgia, etc.). Invalidation can include not taking someone’s testimony seriously, imposing one’s thoughts, discrediting someone’s emotions, or not perceiving someone’s testimony as equal and competent. Epistemic injustices, that is, the disqualification of a person as a knower, are a form of invalidation. Epistemic injustices have been used as a theoretical framework to understand invalidation that occurs in the patient-healthcare (...) provider relationship. However, to date, the different recommendations to achieve epistemic justice have not been listed, analyzed, nor compared yet. This paper aims at better understanding the state of the literature and to critically review possible avenues to achieve epistemic justice in healthcare. A systematic and critical review of the existing literature on epistemic justice was conducted. The search in four databases identified 629 articles, from which 35 were included in the review. Strategies to promote epistemic justice that can be applied to healthcare are mapped in the literature and sorted in six different approaches to epistemic justice, including virtuous, structural, narrative, cognitive, and partnership approaches, as well as resistance strategies. These strategies are critically appraised. A patient partnership approach based on the Montreal Model, implemented at all levels of healthcare systems, seems promising to promote epistemic justice in healthcare. (shrink)

There is a considerable scholarly discussion regarding how Islamic values influence CSR, but prior studies remain fragmented and scattered across several fields. This paper, therefore, aims to offer a more comprehensive understanding of the impacts of Islamic values on CSR by conducting a systematic literature review of 84 relevant publications from 1995 through 2020. The results of a thematic analysis show that there are four underlying themes to consider when explaining the influence of Islamic values on CSR: (1) (...) Islamic narratives promoting CSR, (2) Islam-based CSR, (3) Islamic financial institutions as enablers of CSR, and (4) stakeholders’ perspectives on how Islamic values influence CSR. This study contributes to the CSR literature by providing a systematic understanding of how Islamic values influence CSR and by identifying current challenges and promising directions for future exploration along this line of inquiry. (shrink)

BackgroundNarrative reviews are the commonest type of articles in the medical literature. However, unlike systematic reviews and randomized controlled trials (RCT) articles, for which formal instruments exist to evaluate quality, there is currently no instrument available to assess the quality of narrative reviews. In response to this gap, we developed SANRA, the Scale for the Assessment of Narrative Review Articles.MethodsA team of three experienced journal editors modified or deleted items in an earlier SANRA version based on (...) face validity, item-total correlations, and reliability scores from previous tests. We deleted an item which addressed a manuscript’s writing and accessibility due to poor inter-rater reliability. The six items which form the revised scale are rated from 0 (low standard) to 2 (high standard) and cover the following topics: explanation of (1) the importance and (2) the aims of the review, (3) literature search and (4) referencing and presentation of (5) evidence level and (6) relevant endpoint data. For all items, we developed anchor definitions and examples to guide users in filling out the form. The revised scale was tested by the same editors (blinded to each other’s ratings) in a group of 30 consecutive non-systematic review manuscripts submitted to a general medical journal.ResultsRaters confirmed that completing the scale is feasible in everyday editorial work. The mean sum score across all 30 manuscripts was 6.0 out of 12 possible points (SD 2.6, range 1–12). Corrected item-total correlations ranged from 0.33 (item 3) to 0.58 (item 6), and Cronbach’s alpha was 0.68 (internal consistency). The intra-class correlation coefficient (average measure) was 0.77 [95% CI 0.57, 0.88] (inter-rater reliability). Raters often disagreed on items 1 and 4.ConclusionsSANRA’s feasibility, inter-rater reliability, homogeneity of items, and internal consistency are sufficient for a scale of six items. Further field testing, particularly of validity, is desirable. We recommend rater training based on the “explanations and instructions” document provided with SANRA. In editorial decision-making, SANRA may complement journal-specific evaluation of manuscripts—pertaining to, e.g., audience, originality or difficulty—and may contribute to improving the standard of non-systematic reviews. (shrink)

Recent years have been characterized by an ever-growing interest in consumers' behavior while purchasing green food products. Although existing research has produced a great number of papers on this topic, the knowledge generated in the field appears fragmented and, in certain cases, ambiguous. The main reasons can be traced back to the lack of reference frameworks that clarify the most used concepts, thus providing a shared language in this research domain. Despite other literature reviews that have been carried out on (...) the domain of green food purchasing behavior, these works mainly rely on narrative summaries and qualitative analyses, which can overlook the complexity and interdependencies inherent in this research domain. The complexity of interconnected factors within this research domain poses challenges in effectively understanding and representing the underlying dynamics. To overcome these limitations, this paper proposes the use of a System Thinking based approach as a valuable method to provide a complete view of dynamics occurring in the green consumption behavior domain. In particular, we propose the integration of causal loop diagrams as a powerful visual tool to augment the conventional Systematic Literature Review process to provide a view at a glance of dynamics and capture the complex interdependencies occurring in a specific research domain. We carried out a systematic literature review by analyzing a set of 67 papers. We find nine relevant themes in the investigated research domain. Besides a descriptive picture of the scientific activity, a map of the main dynamics occurring in green food purchasing behavior has been provided. (shrink)

Background: Even in countries with an opt-out or presumed consent system, relatives have a considerable influence on the post-mortem organ harvesting decision. However, their reflection capacity may be compromised by grief, and they are, therefore, often prone to choose refusal as default option. Quite often, it results in late remorse and dissatisfaction. So, a high-quality reflection support seems critical to enable them to gain a stable position and a long-term peace of mind, and also avoid undue loss of potential grafts. (...) In practice, recent studies have shown that the ethical aspects of reflection are rarely and often poorly discussed with relatives and that no or incomplete guidance is offered. No review of the literature is available to date, although it could be of value to improve the quality of the daily practice. Objectives: The objective was to review and synthesize the main concepts and approaches, theories and practices of ethical reflection support of the relatives or surrogates of potential post-mortem organ donors. Research design: A narrative review was performed in the medical, psychological and ethical fields using PubMed, PsycArticles and Web of Science databases (1980–2020). Results: Out of 150 papers, 25 were finally retained. Four themes were drawn: the moral status of the potential post-mortem organ donor, the principlistic approach with its limits and critics, the narrative approach and the transcendental approach. Discussion: This review suggests an extension of psychological support towards ethical reflection support. The process of helping relatives in their ethical exploration of post-mortem organ donation is psychologically and morally characterized. The need for specialized professionals educated and experienced both in clinical psychology and in health ethics to carry out this task is discussed. Practical impact: This review could contribute to optimize the quality of the ethical reflection support by initiating an evolution from an empirical, partial and individual-dependent support to a more systematized, professionalized and exhaustive support. (shrink)

Due to digital transformation, technology advancements, telework, we can no longer pretend that traditional work offers high incentives and efficiency, but on the contrary, traditional work falls behind each year, deeming organizations and individuals to adopt the agile work. Rapid technological developments have altered the way businesses operate, with the goal of producing viable solutions in an environment fraught with unpredictability. This paper is a theoretical narrative review on the general topic of agile work. The present paper addresses (...) the issue of determining the best international practices for implementing agile methodology at work, carrying out a theoretical narrative review. Basing on literature on present-day theory the authors make an attempt to explain the implications of implementing agile methodologies into organizational culture, summarize existing approaches to classifying the main effects on implementing agile methodologies at work, consolidate and document best international practices for agile methodologies development among employers. After defining the concepts of agile method tailoring and agile maturity, the data obtained in the theoretical narrative analysis reveal that the implementing agile methodologies have a direct impact on management style, on teams, on learning environments, and on employee’s mental health. An overall conclusions and discussions section is presented along with the personal opinion of authors. This work is intended to open a post-pandemic agile work research methodology, since there are no systematic approaches to this topic. (shrink)

When it is ethically justifiable to stop medical treatment? For many Muslim patients, families, and clinicians this ethical question remains a challenging one as Islamic ethico-legal guidance on such matters remains scattered and difficult to interpret. In light of this gap, we conducted a systematic literature review to aggregate rulings from Islamic jurists and juridical councils on whether, and when, it is permitted to withdraw and/or withhold life-sustaining care. A total of 16 fatwās were found, 8 of which (...) were single-author rulings, and 8 represented the collective view of a juridical council. The fatwās are similar in that nearly all judge that Islamic law, provided certain conditions are met, permits abstaining from life-sustaining treatment. Notably, the justifying conditions appear to rely on physician assessment of the clinical prognosis. The fatwās differ when it comes to what conditions justify withdrawing or withholding life- sustaining care. Our analyses suggest that while notions of futility greatly impact the bioethical discourse regarding with holding and/or withdrawal of treatment, the conceptualization of futility lacks nuance. Therefore, clinicians, Islamic jurists, and bioethicists need to come together in order to unify a conception of medical futility and relate it to the ethics of withholding and/or withdrawal of treatment. (shrink)

BackgroundDescriptive studies examining publication rates and citation counts demonstrate a geographic skew toward high-income countries (HIC), and research from low- or middle-income countries (LMICs) is generally underrepresented. This has been suggested to be due in part to reviewers’ and editors’ preference toward HIC sources; however, in the absence of controlled studies, it is impossible to assert whether there is bias or whether variations in the quality or relevance of the articles being reviewed explains the geographic divide. This study synthesizes the (...) evidence from randomized and controlled studies that explore geographic bias in the peer review process.MethodsA systematic review was conducted to identify research studies that explicitly explore the role of geographic bias in the assessment of the quality of research articles. Only randomized and controlled studies were included in the review. Five databases were searched to locate relevant articles. A narrative synthesis of included articles was performed to identify common findings.ResultsThe systematic literature search yielded 3501 titles from which 12 full texts were reviewed, and a further eight were identified through searching reference lists of the full texts. Of these articles, only three were randomized and controlled studies that examined variants of geographic bias. One study found that abstracts attributed to HIC sources elicited a higher review score regarding relevance of the research and likelihood to recommend the research to a colleague, than did abstracts attributed to LIC sources. Another study found that the predicted odds of acceptance for a submission to a computer science conference were statistically significantly higher for submissions from a “Top University.” Two of the studies showed the presence of geographic bias between articles from “high” or “low” prestige institutions.ConclusionsTwo of the three included studies identified that geographic bias in some form was impacting on peer review; however, further robust, experimental evidence is needed to adequately inform practice surrounding this topic. Reviewers and researchers should nonetheless be aware of whether author and institutional characteristics are interfering in their judgement of research. (shrink)

We apply Ken Wilber's Integral Theory to AI governance, demonstrating its ability to systematize diverse approaches in the current multifaceted AI governance landscape. By analyzing ethical considerations, technological standards, cultural narratives, and regulatory frameworks through Integral Theory's four quadrants, we offer a comprehensive perspective on governance needs. This approach aligns AI governance with human values, psychological well-being, cultural norms, and robust regulatory standards. Integral Theory’s emphasis on interconnected individual and collective experiences addresses the deeper aspects of AI-related issues. Additionally, we (...) propose using Integral Theory as a methodology for literature reviews to overcome the fragmented understanding often seen in traditional reviews of AI governance. (shrink)

Background Flourishing and belonging are key concepts for the wellbeing of staff and the success of a profession. Alienation and anomie are distinct types of psycho-social ills which inhibit flourishing and belonging. A better understanding of these may offer hope in preventing many negative work endpoints, including burnout and intention to leave. Objectives To systematically review and narratively synthesise alienation and/or anomie in pharmacists across the globe, reviewing all types of methodological designs, published in peer-reviewed journals. Methods We identified (...) published peer-reviewed research through searching eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science – Core Collection, Scopus, and Google Scholar) and extensive hand/citation searching. Two independent reviewers identified and critiqued eligible studies, extracted data, and synthesised the findings. The synthesis evaluated the focuses, causes, associated factors, and/or consequences of alienation and/or anomie and aligned these to six deductive themes from alienation theory: care; values; meaning; recognition; autonomy; and shared responsibility. Results Searches identified 886 papers, with 47 included in the final results. From the synthesis, ten key causes of alienation and/or anomie were identified; 1) Changing Professional Identity, 2) Reimbursement Models & Corporatisation, 3) Focus on Medicines Rather than People, 4) Misunderstanding & Deprofessionalisation, 5) Environments & Culture, 6) Suboptimal Societal Mandate, 7) Roles Misaligned with Aspirations, 8) Systematic Underutilisation, 9) Lack of Professional Agency, and 10) Value Conflict. From the evidence, there was high confidence that inhibitions of care, values, recognition, and/or autonomy (four of the six deductive themes) were associated with alienation and/or anomie. Conclusion Alienation and/or anomie are present across many countries and regions. This paper helps us understand the aetiology of this complex psycho-social syndrome, a necessary first step in creating an inclusive profession where all pharmacists can flourish. Future research needs to trial new interventions targeted at correcting this professional malady. (shrink)

Experimental studies have developed, conducted, and evaluated classroom interventions for foreign language anxiety reduction. However, various characteristics of those classroom interventions make it difficult to synthesize the findings and apply them to practice. We conducted what is, to the best of our knowledge, the first systematic review on educational interventions for FLA. Six criteria were established for inclusion of studies. Using English keywords, we identified 854 potentially eligible studies through ProQuest and Scopus, 40 of which were finally included. (...) All included studies were published from 2007 to 2020. The studies differed in type of intervention, duration of intervention, and scale to measure FLA. Our systematic review resulted in seven features of classroom interventions, categorized as student–student interactions, student-teacher interactions, self-management, and mood boosters; we also categorized interventions as either individual or interactional. (shrink)

Introduction: Evidence supporting the use of music interventions to maximize arousal and awareness in adults presenting with a disorder of consciousness continues to grow. However, the brain of a child is not simply a small adult brain, and therefore adult theories are not directly translatable to the pediatric population. The present study aims to synthesize brain imaging data about the neural processing of music in children aged 0-18 years, to form a theoretical basis for music interventions with children presenting with (...) a disorder of consciousness following acquired brain injury.Methods: We conducted a systematic review with narrative synthesis utilizing an adaptation of the methodology developed by Popay and colleagues. Following the development of the narrative that answered the central question “what does brain imaging data reveal about the receptive processing of music in children?”, discussion was centered around the clinical implications of music therapy with children following acquired brain injury.Results: The narrative synthesis included 46 studies that utilized EEG, MEG, fMRI, and fNIRS scanning techniques in children aged 0-18 years. From birth, musical stimuli elicit distinct but immature electrical responses, with components of the auditory evoked response having longer latencies and variable amplitudes compared to their adult counterparts. Hemodynamic responses are observed throughout cortical and subcortical structures however cortical immaturity impacts musical processing and the localization of function in infants and young children. The processing of complex musical stimuli continues to mature into late adolescence.Conclusion: While the ability to process fundamental musical elements is present from birth, infants and children process music more slowly and utilize different cortical areas compared to adults. Brain injury in childhood occurs in a period of rapid development and the ability to process music following brain injury will likely depend on pre-morbid musical processing. Further, a significant brain injury may disrupt the developmental trajectory of complex music processing. However, complex music processing may emerge earlier than comparative language processing, and occur throughout a more global circuitry. (shrink)

Flying phobia is a highly prevalent anxiety disorder, which causes sufferers significant distress and life interference. The processes which maintain flying phobia remain poorly understood. A systematic search of the literature was performed to identify what research has been conducted into the processes which may be involved in the fear of flying and whether processes which are believed to maintain other anxiety disorder diagnoses have been investigated in flying phobia. The results of the literature review are presented and (...) related to existing cognitive behavioral theory and research. The results indicate that little research has been conducted into a number of areas considered important in the wider cognitive behavioral literature on anxiety disorders: namely attention, mental imagery, memory, worry, and safety-seeking behaviors. The review proposes a hypothetical model, derived from cognitive behavioral theory, for the processes which may be involved in maintaining flying phobia, and considers a number of areas for future research. (shrink)

U.S. law imposes strict recording and reporting requirements on all entities that manufacture and distribute controlled substances. As a result, the prescription opioid crisis has unfolded in a data-saturated environment. This article asks why the systematic documentation of opioid transactions failed to prevent or mitigate the crisis. Drawing on a recently disclosed trove of 1.4 million internal records from Mallinckrodt Pharmaceuticals, a leading manufacturer of prescription opioids, we highlight a phenomenon we propose to call data diversion, whereby data ostensibly (...) generated or collected for the purpose of regulating the distribution of controlled substances were repurposed by the industry for the opposite aim of increasing sales at all costs. Systematic data diversion, we argue, contributed substantially to the scale of drug diversion seen with opioids and should become a focus of policy intervention. (shrink)

Aims: The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress. Background: Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon. Design: (...) class='Hi'>Systematic literature review and narrative synthesis (November 2015–March 2016). Data sources: Ovid MEDLINE® In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO® 1967–Present, CINAHL® Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts. Review methods: Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis. Results: In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity. Conclusion: We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

As the size of the published scientific literature has increased exponentially over the past 30 years, review articles play an increasingly important role in helping researchers to make sense of original research results. Literature reviews can be broadly classified as either “systematic” or “narrative”. Narrative reviews may be broader in scope than systematic reviews, but have been criticised for lacking synthesis and rigour. The submission of more scientific manuscripts requires more researchers acting as peer reviewers, (...) which requires adding greater numbers of new reviewers to the reviewing population over time. However, whereas there are many easily accessible guides for reviewers of primary research manuscripts, there are few similar resources to assist reviewers of narrative reviews. Here, I summarise why literature reviews are valued by their diverse readership and how peer reviewers with different levels of content expertise can improve the reliability and accessibility of narrative review articles. I then provide a number of recommendations for peer reviewers of narrative literature reviews, to improve the integrity of the scientific literature, while also ensuring that narrative review articles meet the needs of both expert and non-expert readers. (shrink)

In this systematic review, we collected and analyzed literature works comparing self-reported fatigue and objectively-measured fatigue in individuals with cerebral palsy and in age-matched typically developing/typically developed controls. The search was conducted on four electronic databases/platforms using the key words “cerebral palsy” combined with “fatig*,” where the asterisk was used as a wildcard. As a critical appraisal tool, the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies was used. A total of 22 studies passed the critical appraisal (...) rating and were included in both narrative and quantitative analyses. The overall evidence quality of the findings was considered very good. Data of objectively-measured fatigue in performing maximal fatiguing tasks indicated lower fatigue levels in participants with CP, possibly due to their pathological inability to recruit highly fatigable muscle fibers. Highly trained individuals with CP and TD controls performing maximal fatiguing tasks seem to be an exception to this, as they exhibited similar levels of fatigue. In submaximal fatiguing tasks, including daily physical activities, either objectively-measured or self-reported fatigue was higher in participants with CP than in TD controls, indicating a lower ability for development of neurophysiological compensation for fatigue among participants with CP. Further studies on fatigue are needed to gain an insight into the multifold mechanisms of fatigue in individuals with CP. Understanding fatigue mechanisms could help in setting up strategies for effective intervention programs, with benefits in healthcare and improved quality of life of individuals with CP.Systematic Review Registration: [PROSPERO 2019], identifier [CRD42019143524]. (shrink)

From the literature study, it was observed that there are significantly fewer studies that review ontology- based narrative models. This motivates the current work. A parametric approach was adopted to report the existing ontology-driven models for narrative information. The work considers the narrative and ontology components as parameters. This study hopes to encompass the relevant literature and ontology models together. The work adopts a systematic literature review methodology for an extensive literature selection. The models (...) were selected from the literature using a stratified random sampling technique. The findings illustrate an overview of the narrative models across domains. The study identifies the differences and similarities of knowledge representation in ontology-based narrative information models. This paper will explore the basic concepts and top-level concepts in the models. Besides, this study provides a study of the narrative theories in the context of ongoing research. It also identifies the state-of-the-art literature for ontology-based narrative information. Keywords: ontologies, narrative information, modelling. (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic (...) review was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

The increasing societal emphasis on physical appearance, particularly influenced by social media, has led to a significant rise in demand for aesthetic dentistry procedures. This study aims to explore the ethical dimensions of marketing practices and the phenomenon of overtreatment in cosmetic dental procedures, highlighting the implications for patient care and professional integrity. A systematic literature review was conducted across four databases, yielding an initial 76 articles. After applying inclusion and exclusion criteria, 12 articles were selected for analysis. (...) The review focused on ethical considerations, marketing practices, and overtreatment in aesthetic dentistry, employing narrative synthesis to extract relevant data. The findings indicate that social media is a primary driver of patient expectations, often prioritizing aesthetic outcomes over health considerations. This trend raises ethical concerns about informed consent and autonomy. The commodification of dental care, fueled by aggressive marketing strategies, has resulted in a notable increase in overtreatment, where unnecessary procedures are performed to satisfy commercial pressures and idealized beauty standards. The review highlights a lack of robust ethical guidelines governing marketing practices in aesthetic dentistry, exacerbating these issues. The study underscores the urgent need for clear ethical frameworks to guide dental practitioners in balancing patient welfare with business interests. Recommendations include the implementation of ethics education in dental curricula, the development of comprehensive ethical guidelines, and fostering open communication between practitioners and patients. These measures are essential for enhancing informed decision-making and ensure that patient care remains the priority in aesthetic dentistry. (shrink)

Background: Mild traumatic brain injury results from an external force to the head or body causing neurophysiological changes within the brain. The number and severity of symptoms can vary, with some individuals experiencing rapid recovery, and others having persistent symptoms for months to years, impacting their quality of life. Current rehabilitation is limited in its ability to treat persistent symptoms and novel approaches are being sought to improve outcomes following mTBI. Neuromodulation is one technique used to encourage adaptive neuroplasticity within (...) the brain.Objective: To systematically review the literature on the efficacy of neuromodulation in the mTBI population.Method: A systematic review was conducted using Medline, Embase, PsycINFO, PsycARTICLES and EBM Review. Preferred Reporting Items for Systematic Reviews and the Synthesis Without Meta-analysis reporting guidelines were used and a narrative review of the selected studies was completed. Fourteen articles fulfilled the inclusion criteria which were published in English, investigating an adult sample and using a pre- and post-intervention design. Studies were excluded if they included non-mild TBI severities, pediatric or older adult populations.Results: Thirteen of fourteen studies reported positive reductions in mTBI symptomatology following neuromodulation. Specifically, improvements were reported in post-concussion symptom ratings, headaches, dizziness, depression, anxiety, sleep disturbance, general disability, cognition, return to work and quality of life. Normalization of working memory activation patterns, vestibular field potentials, hemodynamics of the dorsolateral prefrontal cortex and excessive delta wave activity were also seen. The studies reviewed had several methodological limitations including small, heterogenous samples and varied intervention protocols, limiting generalisability. Further research is required to understand the context in which neuromodulation may be beneficial.Conclusions: While these positive effects are observed, limitations included unequal representation of neuromodulation modalities in the literature, and lack of literature describing the efficacy of neuromodulation on the development or duration of persistent mTBI symptoms. Better clarity regarding neuromodulation efficacy could have a significant impact on mTBI patients, researchers, clinicians, and policy makers, facilitating a more productive post-mTBI population. Despite the limitations, the literature indicates that neuromodulation warrants further investigation. PROSPERO registration number: CRD42020161279. (shrink)

In an unprecedented fashion, COVID-19 has impacted the work-family interface since March 2020. As one of the COVID-19 pandemic consequences, remote work became widely adopted. Furthermore, it is expected that other pandemics will occur in the future. Hence, this context represents a chance to gain deeper insight into telecommuters’ work and family spheres. Following PRISMA guidelines, the present narrative review aims to synthesise the COVID-19 impact on the work-family interface. Out of 121 screened references, 32 articles that measure (...) at least one of the following variables–work-family conflict, work-family enrichment, work-family balance, and boundary management were included. A thematic analysis using NVIVO12 was conducted, from which eight topics emerged: “paid workload, unpaid workload, and gender”; “well-being and gender”; “job resources, job demands, and gender”; “couples and gender”; “parenting and gender”; “occurrence of work-family enrichment with work-family conflict and gender”; “enforced blurred boundaries, its management, and gender”; “boundary management impact on work-family conflict, work-family enrichment, and work-family balance.” Overall, studies point out that COVID-19 had a complex effect on both work-family conflict and work-family balance, making it difficult to state whether these variables were mitigated or augmented. Findings demonstrated that COVID-19 produced little changes in work-family enrichment. As for the COVID-19 impact on work-family boundary management, individuals had to create new tactics to manage them due to the absence of boundaries between both systems. Besides, due to traditional gendered roles, the COVID-19 health crisis seems to have brought additional hurdles to couples and women.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278254], identifier [CRD42021278254]. (shrink)

Este artículo tiene como objetivo sistematizar los avances del enfoque narrativo en bioética con el fin de proponer una fundamentación de las prácticas de salud intercultural que facilite su complementariedad con el conjunto del sistema sanitario. Para ello revisará críticamente los fundamentos de la bioética narrativa y su vinculación con las corrientes hermenéuticas en las éticas aplicadas y con el movimiento de la medicina narrativa. A la vez relacionará el enfoque narrativo con el paradigma intercultural en salud, en orden a (...) evaluar sus capacidades de complementación y articulación con la sabiduría ancestral mapuche, desde su raigambre y especificidad. Finalmente informará sobre las posibilidades de desarrollo de una bioética narrativa en clave intercultural, adecuada a las prácticas en el ámbito sanitario que se basan en el acervo de la sabiduría ancestral mapuche. This article aims to systematize the progress of the narrative approach in bioethics in order to propose a groundwork for intercultural health practices. Seeks propose a basis for intercultural health practices that facilitate the complementarity of the health system through the recovery of ancestral Mapuche Worldview, their roots and specificity. It will critically review the basics of narrative bioethics and its relationship with the hermeneutical currents in applied ethics and the movement of Narrative Medicine. At the same time relates the narrative approach to the intercultural paradigm in health, in order to assess its capabilities complementation and articulation. And finally it will report on the possibilities of developing an intercultural key Narrative Bioethics appropriate to the intercultural practices in health care based on the acquis of the Mapuche Ancestral Wisdom. (shrink)

Introduction: the neuroscientific turn in political science The observation that brains and political orders are interdependent is almost trivial. Obviously, political orders require brain processes in order to emerge and to remain in place, as these processes enable action and cognition. Conversely, every since Aristotle coined man as “by nature a political animal” (Aristotle, Pol.: 1252a 3; cf. Eth. Nic.: 1097b 11), this also suggests that the political engagements of this animal has likely consequences for its natural development, including the (...) development of its psychological functions. Given these mutual interdependencies, it is remarkable that only since the 1960s, the more general domain of ‘biopolitics’ has attracted attention though first particularly in the form of behavioral politics (Alford and Hibbing). Since then biopolitics has gained in interest, so much so that different subdomains can be identified. Indeed, a 2008 review of the field of biopolitics identified five ‘headings’ of it: “(1) the case for a ‘more biologically oriented political science’, (2) ‘biologically related’ public policy issues, (3) physiological measures of political attitudes and behaviour, (4) the influence of physiological factors on actual political behaviour, and (5) the manner in which our species’ evolutionary history has left homo sapiens genetically endowed with certain social and political behavioural tendencies” (Somit and Peterson 43). Striking is how the relation between biology and politics is taken here in a rather unidirectional way, emphasizing particularly the decisive power of biology upon politics. The reverse relation is not mentioned specifically, reflecting the field of biopolitics, perhaps until quite recently. This absence of studies of political influences on our biology may have to do with the difficulty in investigating such influences. Empirical studies in biopolitics have two foci, broadly speaking: genetics and the brain, both of which have turned out to be complex and dynamic phenomena (Alford and Hibbing). Yet the studies of genetics and brain processes have made much progress in the last few decades, thanks to the development of research instruments - like fMRI brain scanners and TMS brain stimulation instruments - and of computational tools for data analysis and the simulation of explanatory models. For the field of biopolitics it is particularly relevant that within cognitive neuroscience the study of social and political issues has witnessed an increasing interest of researchers even more recently. Indeed, aware of the enabling and mediating role of the brain regarding those issues, a truly ‘neuroscientific turn’ can be observed in the social sciences, testified for example by the emergence of the field of ‘neuropolitics’ (Connolly; Vandervalk). Developing a systematic neuropolitics or biopolitics in general is a difficult challenge because of the wealth of causal influences on and interdependencies between biological, brain, cognitive and socio-political factors. Taking a somewhat more abstract perspective, this paper focuses on the process of emerging complexity in adaptive systems, enabling those to conduct ever more complex processes. Yet, parallel to that development can be observed that such systems, or organisms, are also capable in reducing the complexity of the information they are to process. Once they’re capable of developing and adjusting such compressed and complex representations of information, those systems or organisms can handle more information faster and more efficient and adaptive, yielding important benefits to the organism in navigating its environment (Halford, Wilson and Phillips). Before focusing on the role of narrative as a cognitive strategy for such a reduction of informational complexity, I will discuss the development of stable structures and increasing complexity in dynamic systems. Such a more general perspective prepares our discussion of the structures of both narratives and politics and in doing so contributes to the explanation of their interaction. (shrink)

This paper is a review of the experiences gained whilst working with the ‘expertise in practice project’. The project was concerned with understanding the complex phenomenon of practitioners investigating and evaluating their own practice. The research intention was focused on making a difference to how those nurses practised, through introducing systematic practice‐based inquiry processes that could enable nurses to think more critically about their work and how their practice affects others. Particular attention is paid to the process of (...) engaging people who use healthcare services, as research participants in the evaluation of nursing practice expertise. We outline how the project incorporated practitioners’ concerns about asking people who use health care services opinions on nursing practice expertise and how a process of discovery emerged that enabled transformation of practice and consideration of the patient‐participants’ role as a sophisticated evaluator of health‐care. As a result, we present a case for transformational qualitative research. Such research is values‐driven and uses inclusive, collaborative and facilitative processes. It contributes to human flourishing, not only through its ‘ends’ (i.e. research products) but also, intentionally, through its ‘means’ (e.g. research processes and stakeholder involvement). Thus, transformational research is complex and requires that researchers engage in reflexivity (deep self‐reflection) to examine and critique their personal values. (shrink)

Background: Depression is the largest cause of mental ill health worldwide. Although interventions such as Dance Movement Therapy (DMT) may offer interesting and acceptable treatment options, current clinical guidelines do not include these interventions in their recommendations mainly because of what is perceived as insufficient research evidence. The 2015 Cochrane review on DMT for depression includes only three RCTs leading to inconclusive results. It is therefore, necessary to also look beyond such designs in order to identify and assess the (...) range of current evidence. Methods: We therefore, conducted a systematic review of studies that aimed to explore the effectiveness in the use of DMT with people with depression. This led to a qualitative narrative synthesis followed by a subgroup analysis and a sensitivity analysis. In all meta-analyses a random effects model was used with Standardised Mean Differences (SMD) to accommodate for the heterogeneity of studies and outcome measures. Results: From the 817 studies reviewed, eight studies met our inclusion criteria. 351 people with depression (mild to severe) participated, 192 of whom attended DMT groups while receiving treatment as usual (TAU) and 159 received TAU only. Qualitative findings suggest there was a decrease in depression scores in favour of DMT groups in all studies. Subgroup analysis performed on depression scores before and three months after the completion of DMT groups suggested changes in favour of the DMT groups. When sensitivity analysis was performed, RCTs at high risk of bias were excluded, leaving only studies with adult clients up to the age of 65. In these studies, the highest effect size was found favouring DMT plus TAU for adults with depression, when compared to TAU only. Conclusions: Based on studies with moderate to high quality, we concluded that DMT is an effective intervention in the treatment of depression with adults. Furthermore, by drawing on a wide range of designs with diverse quality, we were able to compile a comprehensive picture of relevant trends. Despite the fact that there remains a paucity of high-quality studies, the results have relevance to both policy-making and clinical practice, and become a platform for further research. (shrink)

Although the influence of social support in health is a widely acknowledged factor, there is a significant gap in the understanding of its role on cognition. The purpose of this systematic review was, therefore, to determine the state-of-the-art on the literature testing the association between social support and cognition. Using six databases, we identified 22 articles published between 1999 and 2019 involving an empirical quantitative focus which meet the inclusion criteria. Data extraction was performed following PRISMA recommendations. To (...) summarize the extracted data, we used a narrative synthesis approach. Despite limitations, there is overall preliminary evidence of a relevant positive association between social support and cognition. Our results demonstrate there is enough information for an outbreak of experimental research in the area and an expansion of this body of knowledge. We argue that the present evidence lays the foundations for a more comprehensive theoretical model, one that corresponds with the complexity of the topic and possibly considers models derived from social interaction and active inference theories. (shrink)

A challenge of performing research in the paediatric emergency and acute care setting is obtaining valid prospective informed consent from parents. The ethical issues are complex, and it is important to consider the perspective of participants, health care workers and researchers on research without prospective informed consent while planning this type of research. We performed a systematic review according to PRISMA guidelines, of empirical evidence relating to the process, experiences and acceptability of alternatives to prospective informed consent, in (...) the paediatric emergency or acute care setting. Major medical databases and grey sources were searched and results were screened and assessed against eligibility criteria by 2 authors, and full text articles of relevant studies obtained. Data were extracted onto data collection forms and imported into data management software for analysis. Thirteen studies were included in the review consisting of nine full text articles and four abstracts. Given the heterogeneity of the methods, results could not be quantitatively combined for meta-analysis, and qualitative results are presented in narrative form, according to themes identified from the data. Major themes include capacity of parents to provide informed consent, feasibility of informed consent, support for alternatives to informed consent, process issues, modified consent process, child death, and community consultation. Our review demonstrated that children, their families, and health care staff recognise the requirement for research without prior consent, and are generally supportive of enrolling children in such research with the provisions of limiting risk, and informing parents as soon as possible. Australian data and perspectives of children are lacking and represent important knowledge gaps. (shrink)

Background The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated. Methods We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving (...) for older persons. Results 156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns. Conclusion The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons. Registration We registered our systematic review in the PROSPERO network under CRD42021248543. (shrink)

An analysis of the value systems of critical social issues is difficult to carry out in any qualified sense from an unstructured basis and that attempts to do so easily result in relatively superficial discussions of particular issues. Instead, we suggest how this might be viewed from a more holistic ethical and systems theological perspective. In doing so, we review a new framework that aims to distil relevant issues regarding necessary trade-offs and how this can be done. Broadly speaking, (...) this consists of a kind of Socratic dialogue that systematically examines the value basis of the decisions that need to be made, as well as whether the effects of the decisions become unacceptable and thus need to be modified vis-à-vis the normative system embraced by the decision-maker. We discuss the role of theologians in this and emphasise that they should take a larger place in discussions on how to deal with complex societal crises. (shrink)

Starting from a genesis of the concept of narrative identity, this article attemps to interpret the constitution process of our narrative identities through a systematic and synthetic review of the main contributions of the Ricœurian theory of imagination, from Freedom and Nature to Oneself as Another. In its complex imaginative constitution, narrative identity can then be characterized as a poetico-practical mix that mediates and puts in a dialectical relation two distinct functions of the imagination: a (...) poetic and a practical one, which are themselves enlivened by a dialectic and an internal duplication. (shrink)

In this systematic review, we summarized and evaluated the evidence for effects of, and associations between, immersive nature-experience on mental, physical and social health promotion outcomes. Immersive nature-experience was operationalized as non-competitive activities, both sedentary and active, occurring in natural environments removed from everyday environments. We defined health according to the World Health Organization’s holistic and positive definition of health and included steady-state, intermediate, and health promotion outcomes. An electronic search was performed for Danish, English, German, Norwegian, and (...) Swedish articles published between January 2004 and May 2017. Manual approaches, e.g., bibliographies from experts, supplemented the literature search. Data were extracted from 461 publications that met the inclusion criteria. To assess the status and quality of the evidence for health promotion effects of immersive nature-experience, we focused on the subset of studies based on controlled designs (n = 133). Outcome level quality of the evidence was assessed narratively. Interventions most often involved adventure-based activities, short-termed walking, and seated relaxation in natural environments. We found positive effects on a range of health promotion outcomes grouped under psychological wellbeing (n = 97; ≈55% positive; ≈13% mixed; ≈29% non-significant; 2% negative); psychosocial function (n = 67; ≈61% positive; ≈9% mixed; ≈30% non-significant); psychophysiological stress response (n = 50; ≈58% positive; ≈18% mixed; ≈24% non-significant), and cognitive performance (n = 36; ≈58% positive; ≈6% mixed; ≈33% non-significant; 3% negative); and social skills and relationships (n = 34; ≈70% positive; ≈7% mixed; ≈22% non-significant). Findings related to outcomes categorized under physical health, e.g., risk of cardiovascular disease, were less consistent (n = 51; ≈37% positive; ≈28% mixed; ≈35% non-significant). Across the types of interventions and outcomes, the quality of the evidence was deemed low and occasionally moderate. In the review, we identify, discuss, and present possible solutions to four core methodological challenges associated with investigating immersive nature-experience and health outcomes: 1) intervention and program complexity; 2) feasibility and desirability of randomization; 3) blinding of participants and researchers; and 4) transferability and generalizability. The results of the review have been published as a popular-scientific report and a scientific research overview, both in Danish language. (shrink)

This contribution offers a survey of the modern African theological discourse on the Trinity as a distinctive Christian doctrine of God. It is a systematic narrative review of primary literature on the doctrine of the Trinity in modern African theology with a view to identify main trends, key concepts and major proponents. It is argued that the contemporary African Trinitarian Hermeneutics cannot be understood in isolation from African debates on translatability of concepts of God framed first in (...) terms of the reinterpretation of the theological significance of pre-Christian African concepts of God and subsequently as an outcome of African Christological reflection. The article affirms an apophatic resistance to any tendency to take God for granted as recently advanced by Ernst Conradie and Teddy Sakupapa. (shrink)

Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, (...) outcomes, and results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB. (shrink)

BackgroundSocially assistive devices (care robots, companions, smart screen assistants) have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. One of the most prevalent arguments in the debate is the double-benefit argument claiming that socially assistive devices may not only provide benefits for autonomy and well-being of their users but might also be more efficient than other caring practices and might help to mitigate scarce resources in healthcare. Against this background, we (...) used a subset of comparative empirical studies from a comprehensive systematic review on effects and perceptions of human-machine interaction with socially assistive devices to gather and appraise all available evidence supporting this argument from the empirical side.MethodsElectronic databases and additional sources were queried using a comprehensive search strategy which generated 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 39 reports using a comparative study design, a narrative synthesis was performed.ResultsThe data shows positive evidential support to claim that some socially assistive devices (Paro) might be able to contribute to the well-being and autonomy of their users. However, results also indicate that these positive findings may be heavily dependent on the context of use and the population. In addition, we found evidence that socially assistive devices can have negative effects on certain populations. Evidence regarding the claim of efficiency is scarce. Existing results indicate that socially assistive devices can be more effective than standard of care but are far less effective than plush toys or placebo devices.DiscussionWe suggest using the double-benefit argument with great caution as it is not supported by the currently available evidence. The occurrence of potentially negative effects of socially assistive devices requires more research and indicates a more complex ethical calculus than suggested by the double-benefit argument. (shrink)

Caregiving dyads work as an interdependent emotional system, whereby it is assumed that what happens to one member of the dyad essentially happens to the other. For example, both members of the dyad are involved in care giving and care receiving experiences and therefore major life events, such as a serious illness affect the dyad and not only the individual. Consequently, informal caregiving may be considered an example of dyadic interdependence, which is “the process by which interacting people influence one (...) another’s experience.” This systematic review aimed to synthesize studies of dyadic interdependence, specifically in non-spousal caregiving dyads. Electronic databases were systematically searched for dyadic studies reporting on interdependence in the emotional and relational wellbeing of non-spousal caregiving dyads. A total of 239 full-text studies were reviewed, of which 14 quantitative and qualitative studies met the inclusion criteria with a majority of dyads consisting of adult daughters caring for their older mothers. A narrative synthesis suggested mutual influences between non-spousal caregiving dyad members based on: associations between intrapersonal and interpersonal variables and emotional and relational wellbeing of the dyad; associations between care context variables and emotional and relational wellbeing of the dyad; and patterns of covariation between caregivers’ and care recipients’ wellbeing. Evidence supporting dyadic interdependence among non-spousal caregiving dyads shed light on the ways dyad members influence each other’s wellbeing while providing and receiving care. Future studies investigating mutual influences in dyads, should differentiate subsamples of caregivers based on relationship type, and adopt dyadic and longitudinal designs.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42021213147]. (shrink)

Drug misuse is a complex social and health problem. People who use drugs have very specific profiles according to their life cycle and sociocultural circumstances. For this reason, contextualized approaches are needed in addiction interventions that take on board the particularities of consumption patterns and their circumstances. The storytelling technique as a narrative communication strategy can serve as the main methodological intervention component that enhances this contextualized approach.

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. (...) Studies involving informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

The end of the 1990s witnessed the development of evidence-based medicine, which proposed to screen, organize, and classify knowledge production in the health sciences. In this period, an increasing number of scientific publications started to incorporate the digital format and became easily accessible through the Internet. Since then, we have become used to the idea that there is a hierarchy in medical evidence. Its upper stratum, the gold standard of evidence, contains systematic reviews and meta-analyses of randomized clinical trials. (...) The base of such hierarchy contains case studies, clinical cases, and personal opinions.This knowledge hierarchy is not harmless. It has practical influences on... (shrink)

Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and (...) a narrative synthesis of these new studies with those identified in the earlier reviews. The updated search identified 37 papers. When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers. The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations, and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people. (shrink)

Socially assistive devices such as care robots or companions have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. An important part of the ethical evaluation is to understand how users interact with these devices and how interaction influences users’ perceptions and their ability to express themselves. In this review, we report and critically appraise findings of non-comparative empirical studies with regard to these effects from an ethical perspective.Electronic databases and (...) other sources were queried using a comprehensive search strategy generating 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 22 reports on 21 datasets using a non-comparative design a narrative synthesis was performed.Data shows positive findings in regard to attitudes and emotional reactions of users. Varying perception of a social relation and social presence are the most commonly observed traits of interaction. Users struggle with understanding technical complexities while functionality of the devices is limited. This leads to a behavioral alignment of users towards the requirements of the devices to be able to make use of them.This evidence adds to three important ethical debates on the use of socially assistive devices in healthcare in regard to (1) reliability of existing empirical evidence to inform normative judgements, (2) ethical significance of the social presence of devices and (3) user autonomy in regard to behavioral alignment. (shrink)

Electroencephalography (EEG) is a non-invasive method to identify markers of treatment response in major depressive disorder (MDD). In this review, existing literature was assessed to determine how EEG markers change with different modalities of MDD treatments, and to synthesize the breadth of EEG markers used in conjunction with MDD treatments. PubMed and EMBASE were searched from 2000 to 2021 for studies reporting resting EEG (rEEG) and transcranial magnetic stimulation combined with EEG (TMS-EEG) measures in patients undergoing MDD treatments. The (...) search yielded 966 articles, 204 underwent full-text screening, and 51 studies were included for a narrative synthesis of findings along with confidence in the evidence. In rEEG studies, non-linear quantitative algorithms such as theta cordance and theta current density show higher predictive value than traditional linear metrics. Although less abundant, TMS-EEG measures show promise for predictive markers of brain stimulation treatment response. Future focus on TMS-EEG measures may prove fruitful, given its ability to target cortical regions of interest related to MDD. (shrink)

The purpose of this study was to investigate emotion recognition and processing in patients with mild cognitive impairment in order to update the state of current literature on this important but undervalued topic. We identified 15 papers published between 2012 and 2022 that meet the inclusion criteria. Paper search, selection, and extraction followed the PRISMA guidelines. We used a narrative synthesis approach in order to report a summary of the main findings taken from all papers. The results collected are (...) still ambiguous: some studies did not find any differences between MCI and healthy controls groups in emotion recognition and processing, and other results reported emotion-specific deficits in emotion recognition regarding MCI patients. It is essential to underline that these findings could not be generalized to the whole MCI population due to the heterogeneous use of measures and composition of the sample. This does not allow us to make a comprehensive comparison between the results. Our suggestion for future research is to align the results using the same type of tests and emotion recognition assessment. (shrink)