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ABSTRACTIntroduction Influenza causes significant morbidity and mortality, but influenza vaccine uptake remains below most countries’ targets. Vaccine policy recommendations vary, as do procedures for reviewing and appraising the evidence.Areas Covered During a series of roundtable discussions, we reviewed procedures and methodologies used by health ministries in four European countries to inform vaccine recommendations. We review the type of evidence currently recommended by each health ministry and the range of approaches toward considering randomized controlled trials (RCTs) and real-world evidence (RWE) studies when setting influenza vaccine recommendations.Expert Opinion Influenza vaccine recommendations should be based on data from both RCTs and RWE studies of efficacy, effectiveness, and safety. Such data should be considered alongside health-economic, cost-effectiveness, and budgetary factors. Although RCT data are more robust and less prone to bias, well-designed RWE studies permit timely evaluation of vaccine benefits, effectiveness comparisons over multiple seasons in large populations, and detection of rare adverse events, under real-world conditions. Given the variability of vaccine effectiveness due to influenza virus mutations and increasing diversification of influenza vaccines, we argue that consideration of both RWE and RCT evidence is the best approach to more nuanced and timely updates of influenza vaccine recommendations.

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of food, nutrition, biology, physiology, behaviour, management, communication and society to achieve and maintain human health. Thus, there is huge complexity in delivering evidence-based nutrition interventions to individuals. This paper examines available frameworks for appraising the quality and certainty of nutrition research evidence, the development nutrition practice guidelines to support evidence implementation in practice and the influence of other sources of nutrition information and misinformation. The paper also considers major challenges in applying research evidence to an individual and suggests consensus recommendations to begin to address these challenges in the future. Our recommendations target three groups; those who deliver nutrition interventions to individuals, those funding, commissioning or undertaking research aimed at delivering evidence-based nutrition practice, and those disseminating nutritional information to individuals. [ABSTRACT FROM AUTHOR]

Background: Long term intervention services have proven to be effective in improving mental health (MH) outcomes and the quality of life for children and young people (CYP). Aim: To synthesize evidence on the effectiveness of long-term interventions in improving MH outcomes for CYP, 0-17 years, presenting with MH conditions. Methods: A systematic search was carried out and the methodological quality of included long term MH intervention studies were assessed. Six databases were searched for peer-reviewed articles between January 2000 and September 2022. Results: We found 30 studies that reported on the effectiveness of a range of long-term MH interventions in the form of (i) group therapy, (ii) multisystemic behavior therapy, (iii) general services, (iv) integrated services, (v) psychotherapy, (vi) intensive intervention services, (vii) comprehensive collaborative care, (viii) parent training, and (ix) home outreach service. Among the included studies, seven were rated as high level of evidence based on the National Health and Medical Research Council (NHMRC) levels of evidence hierarchy scale and seven were of moderate quality evidence. Others were rated as lower-quality evidence. Among the studies providing high quality evidence, most were reported for group therapy, general services, and psychotherapy studies demonstrating beneficial effects. Conclusion: This systematic review provides evidence to demonstrate the benefits of a range of long-term interventions, in a range of settings, can be effective in improving MH outcomes for CYP and their families. [ABSTRACT FROM AUTHOR]

This paper briefly discusses the necessity to stop working in silos for the research community and clinical practitioners. The need of the hour is to create a research clinical practice ecosystem that is a dynamic, interconnected, complex, and integrated system where all the stakeholders (researchers, policymakers, industry, academia, independent clinical associations, clinicians with academic attachment, clinicians, and patients) are well linked. Steps must be taken for knowledge translation with an effective communicative strategy targeted toward the clinicians to undertake evidence-based practice and for the consumer (patient and caregiver) to acquire knowledge about their health condition and become responsible for their health. [ABSTRACT FROM AUTHOR]

In the US, there is a need for integrated behavioural health crisis programs that can offer alternatives to inpatient placements and improve client outcomes. In response, GRAND Mental Health in Oklahoma developed the Grand Response Access Network on Demand Model (GRAND Model) in 2016. The purpose of this research was to evaluate the GRAND Model's outcomes and establish the evidence that it reduces inpatient placements. A longitudinal research design using secondary data was used to assess outcomes before and after the GRAND Model implementation in 2016. Quantitative data-informed changes in the central outcome of interest: reductions in inpatient hospitalisations. From 2015 to 2021, the number of inpatient hospitalisations among GRAND adult clients at any Oklahoma psychiatric hospital (excluding Wagoner) fell from 959 (2015) to 66 (2021), a reduction of 93.1%. Inpatient hospitalisations among GRAND adult clients at Wagoner Hospital fell from 841 (2015) to 0 (2021), a reduction of 100%. The findings presented here suggest that the GRAND Model could be effective in reducing inpatient hospitalisations among adults. Replication of the model is encouraged by other communities, particularly those in rural areas. [ABSTRACT FROM AUTHOR]

The article examines the statistics of the Prosecutor General's Office, the Ukrainian Helsinki Union for Human Rights, and the Kharkiv Human Rights Group regarding the investigation of international war crimes. A sociological survey of NPU employees, the prosecutor's office, lawyers, and victims of war crimes was analyzed, and problematic issues that hinder the effective investigation of international crimes were outlined based on the results. It was found that the jurisdiction of the International Criminal Court in relation to the investigation of the most serious international crimes is divided into: subject, territorial, universal, temporal and substantive. The subject jurisdiction of the ICC extends to crimes of genocide, crimes against humanity, war crimes, and crimes of aggression. The national system of investigating crimes has been studied since 2014. It is theoretically justified that the key task at the moment is to document the consequences of an armed invasion - in an intensified mode, with the aim of providing both national and international judicial institutions with sufficient evidence, the Office of the General Prosecutor, the SBU, the NPU, the National Guard of Ukraine, other law enforcement structures. The problem of ensuring security during the collection of information by law enforcement officers, as well as other persons involved in the process of transferring information, evidence, testimony, etc., is outlined, because all these processes, as a rule, take place in the combat zone or in the adjacent territories. It was concluded that in order to improve the effectiveness of the investigation of international crimes in Ukraine, it is necessary to implement as soon as possible: a clear policy regarding the national system of prosecution for international crimes; effective coordination of both national and international bodies of pretrial investigation; quick exchange of information; a generalized electronic database of documentation with access to both prosecutors and investigators. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine the barriers and facilitators of conducting and implementing research in frontline child and youth mental health settings in the UK. Design/methodology/approach: Researchers, clinicians and commissioners who attended a workshop at the Big Emerging Minds Summit in October 2022 provided their expert views on the structural barriers and possible solutions to integrating research in clinical practice based on their experiences of child and young people mental health research. Findings: The identified barriers encompass resource constraints, administrative burdens and misalignment of research priorities, necessitating concerted efforts to foster a research-supportive culture. This paper proposes the potential actionable solutions aimed at overcoming challenges, which are likely applicable across various other health-care systems and frontline NHS services. Solutions include ways to bridge the gap between research and practice, changing perceptions of research, inclusive engagement and collaboration, streamlining ethics processes, empowering observational research and tailored communication strategies. Case examples are outlined to substantiate the themes presented and highlight successful research initiatives within NHS Trusts. Originality/value: This paper provides an insight into the views of stakeholders in child and youth mental health. The themes will hopefully support and influence clinicians and academics to come together to improve the integration of research into clinical practice with the hope of improving service provision and outcomes for our children and young people. [ABSTRACT FROM AUTHOR]

BackgroundLong term intervention services have proven to be effective in improving mental health (MH) outcomes and the quality of life for children and young people (CYP).AimTo synthesize evidence on the effectiveness of long-term interventions in improving MH outcomes for CYP, 0-17 years, presenting with MH conditions.MethodsA systematic search was carried out and the methodological quality of included long term MH intervention studies were assessed. Six databases were searched for peer-reviewed articles between January 2000 and September 2022.ResultsWe found 30 studies that reported on the effectiveness of a range of long-term MH interventions in the form of (i) group therapy, (ii) multisystemic behavior therapy, (iii) general services, (iv) integrated services, (v) psychotherapy, (vi) intensive intervention services, (vii) comprehensive collaborative care, (viii) parent training, and (ix) home outreach service. Among the included studies, seven were rated as high level of evidence based on the National Health and Medical Research Council (NHMRC) levels of evidence hierarchy scale and seven were of moderate quality evidence. Others were rated as lower-quality evidence. Among the studies providing high quality evidence, most were reported for group therapy, general services, and psychotherapy studies demonstrating beneficial effects.ConclusionThis systematic review provides evidence to demonstrate the benefits of a range of long-term interventions, in a range of settings, can be effective in improving MH outcomes for CYP and their families.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022323324.

AbstractComprehensive sexuality education (CSE) prepares young people to make informed decisions about their sexuality. A review by the Institute of Research and Evaluation that analysed 43 CSE studies in non-US settings found the majority to be ineffective and concluded that there was little evidence of the effectiveness of CSE. We reanalysed the review to investigate its validity. We found several weaknesses with the review’s methodology and analysis: (1) there was an absence of a clearly articulated search strategy and specific eligibility criteria; (2) the authors put forth criteria for programme effectiveness but included studies that did not collect the data needed to show programme effectiveness and thus several studies were determined to be ineffective by default; (3) the analytical framework minimised positive intervention effects and privileged negative intervention effects; and (4) there were errors in the data extracted, with 74% of studies containing one or more discrepancies. Overall, our reanalysis reveals that the IRE review suffers from significant methodological flaws and contains many errors which compromise its conclusions about CSE. Our reanalysis is a tool for the international community to refute CSE opposition campaigns based on poor science.

Background The evidence base for racemic ketamine treatment for treatment-resistant major depressive disorder (TRD) continues to expand, but there are major challenges translating this evidence base into routine clinical care. Aim To prepare guidelines for ketamine treatment of TRD that are suitable for routine use by publicly funded specialist mental health services. Method We consulted with senior leadership, clinical pharmacy, psychiatrists, nursing, service users and Māori mental health workers on issues relating to ketamine treatment. We prepared treatment guidelines taking the evidence base for ketamine treatment and the consultation into account. Results Ketamine treatment guidance is reported. This offers two treatment pathways, including a test of ketamine responsiveness with intramuscular ketamine and the dominant use of oral ketamine for a 3-month course to maximise the opportunity for the short-term benefits of ketamine to accumulate. Conclusions We have responded to the challenges of translating the evidence base for ketamine treatment into a form suitable for routine care.

SUMMARY: On average, 49–63% of people with intellectual disabilities and/or autism spectrum disorder (ASD) are prescribed psychotropic medications to treat psychopathology, including psychiatric illness, behaviours that challenge and the core symptoms and associated behaviours of these developmental disorders. In many cases, psychotropics, particularly antipsychotics, are used off-label without a proper indication, particularly to manage behaviours that challenge. The RCTs show moderate evidence supporting the efficacy of low-dose risperidone and some preliminary evidence for aripiprazole in treating behaviours that challenge among children with ASD and/or intellectual disabilities. The RCT-based evidence for the other psychotropics is equivocal, so no definitive conclusions can be made on their efficacy. Polypharmacy and the use of high doses of antipsychotics are prevalent in this population, leading to the risk of adverse events and drug–drug interactions. Despite various national and international guidelines, and government initiatives encouraging reduced psychotropic use, there is little evidence of this happening; on the contrary, the use of antidepressants, mood stabilisers and benzodiazepines may be increasing. A concerted multi-agency effort is urgently needed to address this significant public health concern of the overmedication of people with intellectual disabilities and/or ASD. [ABSTRACT FROM AUTHOR]

This research aims to compare the policy response to residential methamphetamine contamination by public housing authorities in the United States and New Zealand. We utilize a comparative case study approach to analyze the process of policy development, implementation, and outcomes by the Salish and Kootenai Housing Authority (SKHA, US) and Housing New Zealand (HNZ now Kāinga Ora, NZ). Both housing authorities initially developed their policies based on a 'zero tolerance' precautionary principle to protect their tenants' health and discourage drug related activities. This approach caused unintended consequences for housing agencies and tenants, including significant financial expenditure on methamphetamine testing and remediation, a decline in housing portfolios due to contamination, and termination of tenancies, with imposition of financial penalties, contributing to homelessness. Liability for contamination was determined either by baseline testing (SKHA) or the Tenancy Tribunal (HNZ). In both cases, a review of policies prompted a shift to a harm reduction approach focused on compensating and supporting tenants, avoiding evictions. The initial zero tolerance approach caused considerable harms to vulnerable tenants that likely outweighed the health risks from methamphetamine exposure. This research underlines the importance of developing appropriate policies that balance health risks with possible social impacts of the policy response. [ABSTRACT FROM AUTHOR]

The regulation of health claims for foods by the Nutrition and Health Claims Regulation is intended, primarily, to protect consumers from unscrupulous claims by ensuring claims are accurate and substantiated with high quality scientific evidence. In this position paper, the Academy of Nutrition Sciences uniquely recognises the strengths of the transparent, rigorous scientific assessment by independent scientists of the evidence underpinning claims in Europe, an approach now independently adopted in UK. Further strengths are the separation of risk assessment from risk management, and the extensive guidance for those submitting claims. Nevertheless, four main challenges in assessing the scientific evidence and context remain: (i) defining a healthy population, (ii) undertaking efficacy trials for foods, (iii) developing clearly defined biomarkers for some trial outcomes and (iv) ensuring the composition of a food bearing a health claim is consistent with generally accepted nutrition principles. Although the Regulation aims to protect the consumer from harm, we identify some challenges from consumer research: (i) making the wording of some health claims more easily understood and (ii) understanding the implications of the misperceptions around products bearing nutrition or health claims. Recommendations are made to overcome these challenges. Further, the Academy recommends that a dialogue is developed with the relevant national bodies about Article 12(c) in the Regulation. This should further clarify the GB Guidance to avoid the current non-level playing field between health professionals and untrained 'influencers' who are not covered by this Article about the communication of authorised claims within commercial communications. [ABSTRACT FROM AUTHOR]

Recognition of the importance of end-of-life care will enable improvements in the quality of care delivered to patients and their families. Australia is experiencing an increasing number of deaths, (many expected), with an aging population who are living longer, often with multimorbidity. This makes end of life care a priority. The last year of someone's life takes place in a complex healthcare system, with increasing pressures on care delivery, placing the spotlight on health service providers to ensure that teams and individuals are supported and enabled to provide such care. Two rapid literature reviews identified best practice principles and processes for delivering safe and high-quality end-of-life care in acute care, aged care and community settings. The reviews identified that end-of-life care is experienced within the whole health and social care system, including hospital admissions interspersed with care in the community, outpatient and emergency department visits and potentially admission to a hospice. Much of this last year of life is spent at home, which may be a personal residence, an aged care facility, prison, supported accommodation or even on the streets. Transitions across settings requires seamless care, as well as organisational readiness to deliver safe and culturally appropriate care. This is more important now with end-of-life care subject to quality assurance mechanisms within the National Safety and Quality Health Service Standards (2nd edn): Comprehensive care. This requires all sectors to work collaboratively when caring for someone at the end of their life in order to see positive changes in care outcomes. [ABSTRACT FROM AUTHOR]

The article presents the discussion on claims about the nutritional and health benefits of foods and drinks Position Paper emphasises the learnings gaining through the implementation of the European Food Safety Authority evidence‐based process for assessment of proposed claims; and main audience for the Academy's work is the nutrition science community/profession and its stakeholders.

SUMMARY: Yoga was developed primarily as a tool for self-mastery and spiritual progress. However, over the past few decades, the therapeutic applications of yoga in mental healthcare have been explored with promising results. This article aims to inform psychiatrists about the clinical usefulness of yoga for mental disorders. We discuss the rationale and latest evidence base for the use of yoga in psychiatric practice, including the neurobiological mechanisms and indications and contraindications for yoga therapy. We suggest practical yoga techniques that can be used as an add-on for managing common psychiatric conditions. Finally, we discuss the setting up and running of yoga clinical services in a tertiary psychiatric hospital in India and explore what can be learnt to facilitate yoga as a therapeutic approach in the Western world. [ABSTRACT FROM AUTHOR]

The strategy of the United Nations Decade on Ecosystem Restoration identifies three pathways for action for overcoming six global barriers thought to hamper upscaling. We evaluated 6,023 peer‐reviewed and gray literature papers published over the last two decades to map the information landscape underlying the barriers and associated pathways for action across world regions, terrestrial ecosystem types, restorative interventions and their outcomes. Overall, the literature addressed more the financial and legislative barriers than the technical and research‐related ones, supporting the view that social, economic and political factors hamper scaling up ecosystem restoration. Latin America, Africa, and North America were the most prominent regions in the literature, yet differed in the number of publications addressing each barrier. An overwhelming number of publications focused on forests (78%), while grasslands (6%), drylands (3%), and mangroves (2%) received less attention. Across the three pathways for action, the action lines on (1) promoting long‐term ecosystem restoration actions and monitoring and (2) education on restoration were the most underrepresented in the literature. In general, restorative interventions assessed rendered positive outcomes except those of a political, legislative or financial nature which reported negative or inconclusive outcomes. Our indicative assessment reveals critical information gaps on barriers, pathways, and types of restorative interventions across world regions, particularly related to specific social issues such as education for ecosystem restoration. Finally, we call for refining "strength of evidence" assessment frameworks that can systematically appraise, synthesize and integrate information on traditional and practitioner knowledge as two essential components for improving decision‐making in ecosystem restoration. [ABSTRACT FROM AUTHOR]

[Purpose] This article is aimed at revealing the theoretical features of an electronic transaction as evidence in the procedural and legal field of a judicial instance. [Methodology/Approach/Design] The leading method of studying this issue is a combination of materials and methods of scientific knowledge. The main one is the dialectical method, which was used during the entire study and is considered the basic one in all components of the work, which made it possible to analyse comprehensively the theoretical developments of domestic and foreign scientists, as well as to study the judicial practice of applying the regulatory framework in the evidentiary process and the practical activities of leading lawyers in the judicial process of using electronic evidence. [Findings] The relevance of this article is due to the increasing trend in the use of electronic transactions, as well as the use of the latter in court as evidence. So, the legal nature of electronic transactions is analysed here in detail, namely: the history of occurrence, approval by national legislation, methods and conditions of conclusion, as well as legal force in legal relations between individuals and legal entities, the methodological basis for the study of the concept of electronic transactions has been determined, and their sources of legal regulation of their existence have been identified. The article provides a list of characteristic features of electronic transactions, reveals the main methods of their conclusion, justifies the effectiveness of using electronic transactions in courts as an evidence base, identifies the main legal omissions and shortcomings of the regulatory framework. [Practical Implications] The materials of this article provide applied value in the course of the reform and improvement of procedural legislation, as well as the development of methodological manuals for training and skill development of practising jurists and lawyers.

Abstract Non‐native tree species (NNT) are used in European forestry for many purposes including their growth performance, valuable timber, and resistance to drought and pest or pathogen damage. Yet, cultivating NNT may pose risks to biodiversity, ecosystem functioning, and the provisioning of ecosystem services, and several NNT have been classified as invasive in Europe. Typically, such classifications are based on risk assessments, which do not adequately consider site‐specific variations in impacts of the NNT or the extent of affected areas. Here, we present a new methodological framework that facilitates both mitigating risks associated with NNT and taking advantage of their ecosystem services. The framework is based on a stratified assessment of risks posed by NNT which distinguishes between different sites and considers effectiveness of available management strategies to control negative effects. The method can be applied to NNT that already occur in a given area or those NNT that may establish in future. The framework consists of eight steps and is partly based on existing knowledge. If adequate site‐specific knowledge on NNT does not yet exist, new evidence on the risks should be obtained, for example, by collecting and analyzing monitoring data or modeling the potential distribution of NNT. However, limitations remain in the application of this method, and we propose several policy and management recommendations which are required to improve the responsible use of NNT.

This special issue of the Journal of Youth Development on international positive youth development brings together diverse perspectives of research, practice, and policy regarding the challenges and opportunities facing international efforts to promote the positive development of youth. To represent a plurality of perspectives on international PYD, the authors sought to represent a variety of continents, countries, genders, races, ethnicities, sectors, and levels of experience with publishing. There is also variety in the types of articles such as case studies, presentations of frameworks and curricula, letter-style commentary by youth, and cutting-edge research methodologies and studies. A few key themes frame the volume, including (a) diversity in definitions of youth and operationalizations of PYD; (b) the multifaceted and multidimensional ways in which PYD is integrated into different sectors, domains, and types of programmatic and organizational contexts; and (c) the importance of and need for an accessible evidence base of PYD informed by rigorous science. Thought leader commentaries are interspersed in the beginning, middle, and end of the issue. The articles represent the current state of the field of PYD internationally with an outlook toward the future and how the integration of PYD research and practice can enhance contributions of youth to equity, social justice, and democracy.

Agroforestry is often seen as a panacea that offers multiple environmental, economic, and social benefits. However, the validity of generalized statements on agroforestry outcomes is doubtful because the evidence base is unclear. Systematic reviews and meta-analyses exist on the topic in addition to many case studies that address specific outcomes of individual agroforestry practices at different sites. However, the overall picture of available scientific evidence on agroforestry outcomes remains opaque due to the wide diversity of existing agroforestry practices, outcome indicators, and spatial locations. To clarify whether and in which areas the research landscape allows conclusions to be drawn about the potential benefits or drawbacks of agroforestry compared to other land uses, an evidence review map was created for the purpose of this study. Based on a systematic literature search and screening, 64 systematic review articles were finally identified that summarize ecological, economic, or social outcomes of at least one agroforestry practice compared to another land use as control. The thematic and spatial coverage of the systematic reviews on agroforestry outcomes is mapped to identify density and research gaps in the evidence base. Moreover, the comprehensibility of the study selection for each identified systematic review is critically assessed. The resulting evidence review map discloses a solid evidence base for environmental outcomes and productivity aspects of individual agrisilvicultural practices, as well as for agroforestry systems when considering an aggregate level. However, the outcomes of individual silvopastoral and agrosilvopastoral practices have been less studied in the literature. A global coverage at the level of individual agroforestry practices is only available for impacts on climate change mitigation. Major research gaps were identified for systematic analysis of social outcomes of all agroforestry types. The results of the evidence mapping highlight further research needs, but also urge for caution in making generalized statements about the benefits of agroforestry.

Medical practice is dogged by dogma. A conclusive evidence base is lacking for many aspects of patient management. Clinicians, therefore, rely upon engrained treatment strategies as the dogma seems to work, or at least is assumed to do so. Evidence is often distorted, overlooked or misapplied in the re-telling. However, it is incorporated as fact in textbooks, policies, guidelines and protocols with resource and medicolegal implications. We provide here four examples of medical dogma that underline the above points: loop diuretic treatment for acute heart failure; the effectiveness of heparin thromboprophylaxis; the rate of sodium correction for hyponatraemia; and the mantra of "each hour counts" for treating meningitis. It is notable that the underpinning evidence is largely unsupportive of these doctrines. We do not necessarily advocate change, but rather encourage critical reflection on current practices and the need for prospective studies. [ABSTRACT FROM AUTHOR]

[Purpose] This article is aimed at revealing the theoretical features of an electronic transaction as evidence in the procedural and legal field of a judicial instance. [Methodology/Approach/Design] The leading method of studying this issue is a combination of materials and methods of scientific knowledge. The main one is the dialectical method, which was used during the entire study and is considered the basic one in all components of the work, which made it possible to analyse comprehensively the theoretical developments of domestic and foreign scientists, as well as to study the judicial practice of applying the regulatory framework in the evidentiary process and the practical activities of leading lawyers in the judicial process of using electronic evidence. [Findings] The relevance of this article is due to the increasing trend in the use of electronic transactions, as well as the use of the latter in court as evidence. So, the legal nature of electronic transactions is analysed here in detail, namely: the history of occurrence, approval by national legislation, methods and conditions of conclusion, as well as legal force in legal relations between individuals and legal entities, the methodological basis for the study of the concept of electronic transactions has been determined, and their sources of legal regulation of their existence have been identified. The article provides a list of characteristic features of electronic transactions, reveals the main methods of their conclusion, justifies the effectiveness of using electronic transactions in courts as an evidence base, identifies the main legal omissions and shortcomings of the regulatory framework. [Practical Implications] The materials of this article provide applied value in the course of the reform and improvement of procedural legislation, as well as the development of methodological manuals for training and skill development of practising jurists and lawyers. [ABSTRACT FROM AUTHOR]

The database at Nutrigenetics.net has been under development since 2007 to facilitate the identification and classification of PubMed articles relevant to human genetics. A controlled vocabulary (i.e., standardized terminology) is used to index these records, with links back to PubMed for every article title. This enables the display of indexes (alphabetical subtopic listings) for any given topic, or for any given combination of topics, including for genes and specific genetic variants. Stepwise use of such indexes (first for one topic, then for combinations of topics) can reveal relationships that are otherwise easily overlooked. These relationships include environmental and lifestyle variables with potential relevance to risk modification (both beneficial and detrimental), and to prevention, or at least to the potential delay of symptom onset for health conditions like Alzheimer disease among many others. Thirty-four specific genetic variants have each been mentioned in at least ≥1,000 PubMed titles/abstracts, and these numbers are steadily increasing. The benefits of indexing with standardized terminology are illustrated for genetic variants like MTHFR 677C-T and its various synonyms (e.g., rs1801133 or Ala222Val). Such use of a controlled vocabulary is also helpful for numerous health conditions, and for potential risk modifiers (i.e., potential risk/effect modifiers).

Reviews provide a condensed representation of existing literature on a particular topic. Both systematic reviews and narrative reviews have their individual merits and limitations in terms of goals, applicability, process and scope. This work aims to provide an overview of the relevance of narrative reviews in today's era of sophisticated research methodologies and to describe in detail the process involved in writing a narrative review. Narrative reviews provide a concise review of literature with the liberty to raise questions and stimulate further research. The process of writing a good narrative review involves framing a research question, deciding the most suitable methodology, going through literature, representation of evidence and preparing a draft. Some key considerations and potential pitfalls while writing narrative reviews have also been discussed.

An issue of habitual miscarriage poses a high social importance especially during COVID-19 pandemic. Meanwhile, healthcare workers faced a mass media campaign against using micronized progesterone upon habitual miscarriage, which, as viewed by publication authors, displays signs of prejudiced data manipulation and may disorient practitioners. Authors of published letter provide objective information on accumulated data regarding gestagens efficacy and safety. They invoke healthcare professionals to make decisions deserving independent primary source trust presented by original scientific papers published in peer-reviewed journals, clinical recommendations proposed by professional medical communities as well as treatment standards and protocols.

The published literature on the application of systems thinking to influence policies and programs has grown in recent years. The original article by Haynes et al and the subsequent commentaries have focused on the upstream connection between capacity building for systems thinking and systems informed decision-making. This commentary explores the downstream connection between systems-informed decision-making and broader impacts on the health system, the health of the population and other economic and social benefits. Storytelling, systems-based syntheses and systems intervention principles are explored as approaches to strengthen the evidence base. For systems thinking to gain broader acceptance and application to complex health-related challenges, we need more of an evidence base demonstrating impact.

Non‐native tree species (NNT) are used in European forestry for many purposes including their growth performance, valuable timber, and resistance to drought and pest or pathogen damage. Yet, cultivating NNT may pose risks to biodiversity, ecosystem functioning, and the provisioning of ecosystem services, and several NNT have been classified as invasive in Europe. Typically, such classifications are based on risk assessments, which do not adequately consider site‐specific variations in impacts of the NNT or the extent of affected areas. Here, we present a new methodological framework that facilitates both mitigating risks associated with NNT and taking advantage of their ecosystem services. The framework is based on a stratified assessment of risks posed by NNT which distinguishes between different sites and considers effectiveness of available management strategies to control negative effects. The method can be applied to NNT that already occur in a given area or those NNT that may establish in future. The framework consists of eight steps and is partly based on existing knowledge. If adequate site‐specific knowledge on NNT does not yet exist, new evidence on the risks should be obtained, for example, by collecting and analyzing monitoring data or modeling the potential distribution of NNT. However, limitations remain in the application of this method, and we propose several policy and management recommendations which are required to improve the responsible use of NNT. [ABSTRACT FROM AUTHOR]

Reviews provide a condensed representation of existing literature on a particular topic. Both systematic reviews and narrative reviews have their individual merits and limitations in terms of goals, applicability, process and scope. This work aims to provide an overview of the relevance of narrative reviews in today’s era of sophisticated research methodologies and to describe in detail the process involved in writing a narrative review. Narrative reviews provide a concise review of literature with the liberty to raise questions and stimulate further research. The process of writing a good narrative review involves framing a research question, deciding the most suitable methodology, going through literature, representation of evidence and preparing a draft. Some key considerations and potential pitfalls while writing narrative reviews have also been discussed. [ABSTRACT FROM AUTHOR]

Open fracture management in the United Kingdom and several other countries is guided by the British Orthopaedic Association's Standards for Trauma Number 4 (BOAST-4). This is updated periodically and is based on the best available evidence at the time. The aim of this study is to evaluate the evidence base forming this guidance and to highlight new developments since the last version in 2017. Searches have been performed using the PubMed, Embase and Medline databases for time periods a) before December 31, 2017 and from 01/01/2018–01/02/2021. Results have been summarized and discussed. Several contentious issues remain within the 2017 guideline. Antibiotic guidance, the use of antibiotic impregnated PMMA beads and intramedullary devices, irrigation in the emergency department, time to theatre and the use of negative pressure dressings and guidance regarding the management of paediatric injuries have all demonstrated no clear consensus. The advent of the BOAST-4 guideline has been of huge benefit, however the refinement and improvement of this work remains ongoing. There remains a need for further study into these contentious issues previously listed. [ABSTRACT FROM AUTHOR]

The growing evidence base on the extent of and opportunities to reduce inequities in children's health and development still lacks the specificity to inform clear policy decisions. A new phase of research is needed that builds on contemporary directions in precision medicine to develop precision policy making; with the aim to redress child inequities. This would include identifying effective interventions and their ideal time point(s), duration, and intensity to maximize impact. Drawing on existing data sources and innovations in epidemiology and biostatistics would be key. The economic and social gains that could be achieved from reducing child inequities are immense.

Cellular blood components and plasma-derived medicinal products (PDMPs) are obtained from blood donated by volunteers. In a growing number of countries, in line with World Health Organization advice issued since the mid-1970s, donors are not remunerated. In recent decades, considerable efforts have been made to restrict the indications for labile blood components to those based on evidence, to ensure efficacy and safety. By contrast, the producers of PDMPs have developed pathogen reduction techniques for inactivating the microorganisms in (pooled) plasma, but little attention has been paid to the pertinence of the clinical indications for these products. The use of blood, and of erythrocytes in particular, has declined by almost 40%, but the use of immunoglobulins (IG) tripled between 2004 and 2018, making it necessary to pay donors to obtain sufficient blood to meet the market demand for these products. We analyzed the reasons for this increase to unsustainable levels of use, by investigating (practice) guidelines, recommendations, Cochrane data analyses and systematic reviews for clinical indications for IG over time. We found no new evidence explaining the huge increase up to 2018 or the predicted 5-7% yearly annual increase until 2024. For some former evidence-based indications, biologics have largely replaced IG, but the administration of IG for doubtful indications (up to 40%) has not decreased in recent decades. The main development since 2004 is that IG use in Europe has become market-driven rather than evidence-guided. As transfusion specialists and blood therapists, we must raise the alarm that this situation is likely to continue in the absence of good clinical studies determining the place of IG alongside other treatments, and for as long as market profitability remains the dominant driving force. We discuss here approaches for reversing this trend and moving towards European self-sufficiency through non-remunerated voluntary blood donation. [ABSTRACT FROM AUTHOR]

Objectives: To assess the quality of research evidence for the different activity components for the psycho-social Namaste Care intervention for care home residents with advanced dementia. Design: Namaste Care is a multi-component intervention delivered on a daily basis to people living with advanced dementia or people at end of life with dementia. A significant part of its operationalisation within care homes is the delivery of a number of activities delivered by trained in-house Namaste Care workers to a group of residents with similar high dependency needs. The Namaste Care workers focus on touch, music, nature, sensory experience, aromas and interactions with objects delivered in a way to enhance feelings of enjoyment and wellbeing. This review evaluated the evidence for using these activities with people living with advanced dementia. A systematic search of peer-reviewed research articles was conducted between November 2016 and September 2018 using search terms of activities used in Namaste Care. The quality of each accepted article was rated using the Rapid Evidence Assessment scale. Results: The initial literature search returned 1341 results: 127 articles including 42 reviews were included. The majority of activity interventions yielded between 10 and 20 peer-reviewed papers. The use of smells and aromas, interacting with animals and dolls, the use of various forms of music (e.g. background music, singing, personalised music), nature, lighting, various forms of touch/massage and sensory interventions (including Snoezelen) all appear to have proven efficacy with people living with advanced dementia. Conclusions: There is generally a limited number of research papers and reviews in this area, but overall there is a good evidence base for including these activities within Namaste Care for people living with advanced dementia. [ABSTRACT FROM AUTHOR]

Context: Autologous chondrocyte implantation (ACI) is a tissue-engineered surgical technique initially developed for articular cartilage repair of isolated chondral lesions of the knee. Third-generation techniques (ACI3) are now available that deliver autologous cultured chondrocytes into the defect using cell scaffolds. The successful outcomes of these techniques have some dependency on presurgical and postsurgical patient rehabilitation. Objectives: To determine if the standard of reporting for rehabilitation has improved in ACI3 studies; previous reviews in this field recommended describing the detail of this rehabilitation and patient compliance as integral elements. Evidence Acquisition: A computerized search was performed in March 2013. Criteria for inclusion were any studies that evaluated or described the process of ACI3 in the knee and subsequent rehabilitation. The modified Coleman Methodology Score (CMS) was used to rate the standard of reporting of rehabilitation and surgical procedures; review articles were also evaluated for quality using the Strength of Recommendation Taxonomy (SORT). Mean scores, odds ratios, 95% confidence intervals, and Mann-Whitney U statistics were calculated. Evidence Synthesis: An improvement in mean CMS was seen compared with previous reviews, but rehabilitation reporting scores were lower than their surgical equivalent; significant association was seen between studies with rehabilitator involvement and high scores in the individual CMS rehabilitation element. Predominant SORT scores of 2A indicated medium strength of recommendation. Conclusions: The CMS provides a general overview of methodological quality, but a more specialized tool to report on the quantitative and qualitative aspects of the rehabilitation process would help raise the standards. It is recommended that rehabilitation therapists be included as key members of research teams and be involved in the design, implementation, and reporting of future studies. [ABSTRACT FROM AUTHOR]

Understanding forest area development as a function of socio-economic dynamics is of crucial importance for halting deforestation and shaping future options for action. Here, multivariable statistical models can be promising facilitators of knowledge generation. With the aim of enabling the further development of statistical analysis, this study describes the state of research for two prominent concepts used to analyze forest development in terms of socio-economic development: The forest transition hypothesis (FTH) and the environmental Kuznets curve for deforestation (EKCd). In order to learn from the wide variety of studies that differ in their model specification, region, variable selection, and statistical methods used, this study presents a systematic overview of the existing literature. This study is designed as an evidence and gap map (EGM)—a method of systematic literature research according to the RepOrting standards for systematic evidence synthesis process. A search for relevant literature was carried out in two data repositories. A thorough screening of the literature results yielded 46 articles with a total of 141 different model studies for evaluation. Our results reveal that (a) the evidence base for the EKCd is more comprehensive than for FTH, (b) the majority of eligible studies focus on the analysis of data from developing countries, and (b) a statistical analysis of the EKCd and FTH concepts does not provide a unified picture, but rather a variety of interpretations and specifications. Based on the results of this EGM, we can conclude that further investigations in the form of additional clustering and a deeper analysis of the different approaches used to interpret the two concepts is needed. Future studies should extend the study design by determining the relevant variables for future forest agenda setting and the policies that could be effective in halting deforestation by targeting certain baseline variables.

Introduction: Influenza causes significant morbidity and mortality, but influenza vaccine uptake remains below most countries' targets. Vaccine policy recommendations vary, as do procedures for reviewing and appraising the evidence., Areas Covered: During a series of roundtable discussions, we reviewed procedures and methodologies used by health ministries in four European countries to inform vaccine recommendations. We review the type of evidence currently recommended by each health ministry and the range of approaches toward considering randomized controlled trials (RCTs) and real-world evidence (RWE) studies when setting influenza vaccine recommendations., Expert Opinion: Influenza vaccine recommendations should be based on data from both RCTs and RWE studies of efficacy, effectiveness, and safety. Such data should be considered alongside health-economic, cost-effectiveness, and budgetary factors. Although RCT data are more robust and less prone to bias, well-designed RWE studies permit timely evaluation of vaccine benefits, effectiveness comparisons over multiple seasons in large populations, and detection of rare adverse events, under real-world conditions. Given the variability of vaccine effectiveness due to influenza virus mutations and increasing diversification of influenza vaccines, we argue that consideration of both RWE and RCT evidence is the best approach to more nuanced and timely updates of influenza vaccine recommendations.