The Use of Palliative Sedation to Treat Existential Suffering: A Scoping Review on Practices, Ethical Considerations, and Guidelines

2019 ◽  
Vol 35 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Allysa L. Ciancio ◽  
Raza M. Mirza ◽  
Amy A. Ciancio ◽  
Christopher A. Klinger
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Research Policy ◽  
Grey Literature ◽  
Palliative Sedation ◽  
Ethical Considerations ◽  
Policy And Practice ◽  
Refractory Symptoms ◽  
Existential Suffering ◽  
The Impact

Context: Though palliative sedation has been recognized as an acceptable practice in Canada for many years now, there is a lack of clinical research and guidelines pertaining to its use as a treatment of existential refractory symptoms in the terminally ill. Objectives: This scoping review aimed to survey the literature surrounding palliative sedation and existential suffering and to inform research, policy, and practice. Methods: To address the main research question: Is palliative sedation an acceptable intervention to treat existential refractory symptoms in adults aged 65 and older? a scoping review following Arksey and O’Malley’s framework was performed, spanning electronic databases of the peer reviewed and grey literature. Articles were screened for inclusion, and a thematic content analysis allowed for a summary of key findings. Results: Out of 427 search results, 71 full text articles were obtained, 20 of which were included. Out of these articles, four themes were identified as key findings. These included: (1) Ethical considerations; (2) The role of the health care provider; looking specifically at the impact on nurses; (3) The need for multidisciplinary care teams; and (4) Existential suffering’s connection to religiosity and spirituality. Conclusion: Palliative sedation to treat existential refractory symptoms was labelled a controversial practice. A shortage of evidence-based resources limits the current literature’s ability to inform policy and clinical practice. There is a need for both qualitative and quantitative multi-center research so health care professionals and regional-level institutions have firm roots to establish proper policy and practice.

scholarly journals THE ADOPTION OF E-GOVERNMENT IN THE TAX ADMINISTRATION: A SCOPING REVIEW

Scientax ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 109-130
Author(s):  
Nugroho Dian Respati
Keyword(s):  
Scoping Review ◽  
Research Policy ◽  
Tax Administration ◽  
Policy And Practice ◽  
Technology System ◽  
Search Terms ◽  
Digital Services ◽  
The Government ◽  
Key Aspects ◽  
The Impact

With the spread of information, technology and the Internet, we have found that the tax administration is moving towards online or digital services. The study aims to identify what has worked in the adoption of e-government in tax services. The key aspects include the design of e-government in tax procedures, acceptance and usability factors, impacts, and challenges in the implementation. A scoping review was designed to map the existing evidence on the application of information and technology system in delivering tax services, or known as e-government. Key search terms were developed and mapped. Selected databases and key journals were used in this scoping review. Using the criteria that were determined, we identified 79 articles that most closely demonstrated the purpose of this study. However, we only reported the detailed of the findings from ten included articles. The identified studies reflected the majority of articles investigated the reasons behind the success or failure of e-government projects in the tax administration. This review concludes that in an environment in which the government faced many challenges with the limited resources, e-government adoption in tax administration offers the potential benefit to strengthen the government finances. A greater understanding of the purpose, adoption & acceptance factors, the impact and challenges in the application of e-government projects in tax services is a priority for research, policy and practice.

The Relationship Between Highly Visual Social Media and Young People’s Mental Health: A Scoping Review (Preprint)

2020 ◽  
Author(s):  
Alanna McCrory
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Young People ◽  
Scoping Review ◽  
Quantitative Methods ◽  
Grey Literature ◽  
Significant Proportion ◽  
Mental Wellbeing ◽  
Published Evidence ◽  
The Impact

UNSTRUCTURED Users of highly visual social media (HVSM), such as Snapchat and Instagram, share their messages through images, rather than relying on words. A significant proportion of people that use these platforms are adolescents. Previous research reveals mixed evidence regarding the impact of online social technologies on this age group’s mental wellbeing, but it is uncertain whether the psychological effects of visual content alone differ from text-driven social media. This scoping review maps existing literature that has published evidence about highly visual social media, specifically its psychological impact on young people. Nine electronic databases and grey literature from 2010 until March 2019 were reviewed for articles describing any aspect of visual social media, young people and their mental health. The screening process retrieved 239 articles. With the application of eligibility criteria, this figure was reduced to 25 articles for analysis. Results indicate a paucity of data that exclusively examines HVSM. The predominance of literature relies on quantitative methods to achieve its objectives. Many findings are inconsistent and lack the richness that qualitative data may provide to explore the reasons for theses mixed findings.

scholarly journals Exploring equity, gender and social determinants aspects of antimicrobial resistance: Scoping review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Saint ◽  
A Mohsenpour ◽  
C Mühling ◽  
K Bozorgmehr
Keyword(s):  
Antimicrobial Resistance ◽  
Social Determinants ◽  
Scoping Review ◽  
Research Policy ◽  
Modern Medicine ◽  
Vulnerable Groups ◽  
Structural Level ◽  
Policy And Practice ◽  
Social Construct ◽  
Structural Inequities

Abstract Background Antimicrobial resistance (AMR) is a considerable threat to modern medicine and global health. Inequity, gender and social determinants of health (SDH) have a significant impact on health and health services, including in relation to AMR. Despite this, there is a lack of systematic focus on these dimensions in AMR research, policy and practice. We aimed to scope and review the existing evidence related to the equity, gender and SDH considerations for AMR globally through a systematic, iterative approach. Methods We conducted a scoping review by searching PubMed, Web of Science and CINAHL for empirical research on AMR in humans, with consideration of equity, gender or SDH, published in English between January 2000 and September 2019. In a two-stage process, we analysed full texts to extract information about explicit and then implicit references to equity, gender or SDH. Results The search yielded 4628 articles after removing 578 duplicates. 737 articles were analysed with explicit reference to equity, gender or SDH in title or abstract. Preliminary results show that 93.2% of these studies mentioned gender but mostly meaning biological sex (90.8%) rather than its social construct. Articles on equity (6.0%) and SDH (1.1%) reported on associations between AMR rates and income and non-income dimensions of inequality, health system issues and disadvantaged subpopulations within countries. Other articles in this category explored public and policy discourse or approaches for AMR (0.8%) and equity issues for AMR-related R&D (0.7%). These results combined with the PROGRESS-Plus acronym informed the subsequent analysis of the 4628 articles for implicit considerations of equity, gender and SDH. Conclusions Despite casting a wide net, we found relatively little research explicitly considering equity, gender and SDH aspects of AMR especially at a systematic or structural level. This reflects an important gap in the current understanding of and efforts to tackle AMR. Key messages We conducted a scoping review on equity, gender and social determinants considerations of AMR that indicates limited research on these important aspects of the social and structural drivers of AMR. Further research on these aspects is essential to inform the design of effective policy and practice interventions that target vulnerable groups and address structural inequities.

scholarly journals P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Services ◽  
Grey Literature ◽  
Study Data ◽  
Care Utilization ◽  
Alternative Source ◽  
Increased Risk ◽  
The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

scholarly journals Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046547
Author(s):  
Luke Johnson ◽  
Kerry Gutridge ◽  
Julie Parkes ◽  
Anjana Roy ◽  
Emma Plugge
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Grey Literature ◽  
Well Being ◽  
Health Impact ◽  
Poor Quality ◽  
Eligibility Criteria ◽  
Prison Staff ◽  
The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

THE IMPACT OF RESEARCH AND DEVELOPMENT INVESTMENT ON AGRICULTURAL SECTOR PERFOMANCE IN KENYA

2017 ◽  
Vol 2 (1) ◽  
pp. 34-57
Author(s):  
John Githii Kimani ◽  
Dr. George Ruigu Ruigu
Keyword(s):  
Research And Development ◽  
Agricultural Sector ◽  
Research Policy ◽  
Trade Openness ◽  
Policy And Practice ◽  
Long Run ◽  
Short Run ◽  
The Government ◽  
Parsimonious Model ◽  
The Impact

Purpose: The purpose of the study was to assess the impact of research and development investment/expenditure on the agricultural sector performance in Kenya.Methodology: The study took the peoples impact assessment direction. The data for this study was collected from various government agencies such as KARI, ASTI, Kenya Agricultural Sector Data compendium website, FAOSTAT, World Bank among others. Co-integration and error correction modeling methods were used in analyzing the data for this study.Results: Co-integration results for both the parsimonious and non-parsimonious model indicated that that there is a long-run relationship among the variables in the agriculture performance in Kenya. Further, findings in this study indicated that the variables under study were insignificant determinants of the long run Total Factor Productivity of the agricultural sector.  Meanwhile, Trade openness was the only significant determinant of the short run agricultural Total Factor Productivity.Unique Contribution to Policy and Practice: This study recommends the institutionalization of policies aimed at ensuring interaction between the various stakeholders in the agricultural sectors. This interaction will ensure that resources are better allocated to reduce duplication of research and dissemination activities. In addition, greater collaboration among the stakeholders will promote and strengthen the connection between research, policy and the application of research findings. The study further advocates that the government should follow a trade liberazation oriented approach to the agricultural sector as opposed to a trade tightening approach.

scholarly journals Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Protocol for a Scoping Review

10.2196/19072 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e19072
Author(s):  
Susanne Grødem Johnson ◽  
Thomas Potrebny ◽  
Lillebeth Larun ◽  
Donna Ciliska ◽  
Nina Rydland Olsen
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Mobile Apps ◽  
Research Question ◽  
Grey Literature ◽  
Research Area ◽  
Research Field ◽  
Learning Technologies ◽  
Health Care Education ◽  
Care Education

Background E-learning technologies, including mobile apps, are used to a large extent in health care education. Mobile apps can provide extendable learning environments and motivate students for adaptive and collaborative learning outside the classroom context. Developers should design practical, effective, and easy-to-use mobile apps. Usability testing is an important part of app development in order to understand if apps meet the needs of users. Objective The aim of this study is to perform a scoping review of usability methods and attributes reported in usability studies of mobile apps for health care education. Methods The scoping review is guided by the methodological framework developed by Arksey & O’Malley and further developed by Levac et al and Kahlil et al. The stages we will follow are as follows: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; and (5) summarizing and reporting the results. We have developed two research questions to meet the aim of the study, which are as follows: (1) What usability methods are used to evaluate the usability of mobile apps for health care education? and (2) What usability attributes are reported in the usability studies of mobile apps for health care education? We will apply a comprehensive search of the literature, including 10 databases, a reference search, and a search for grey literature. Two review authors will independently screen articles for eligibility. Results The initial electronic database searches were completed in March 2019. The literature search identified 14,297 unique references. Following title and abstract screening, the full texts of 369 records were obtained. The scoping review is expected to be completed in spring 2021. Conclusions We expect the overview of usability methods and attributes reported in usability studies of mobile apps for health care education to contribute to the knowledge base for researchers and developers. It will give an overview of the research field and provide researchers and developers with relevant and important information on the usability research area, including highlighting possible research gaps. International Registered Report Identifier (IRRID) DERR1-10.2196/19072

scholarly journals Managing Borders During Public Health Emergencies of International Concern: A Proposed Typology of Cross-border Health Measures

2021 ◽  
Author(s):  
Kelley Lee ◽  
Karen A Grépin ◽  
Catherine Worsnop ◽  
Summer Marion ◽  
Julianne Piper ◽  
...  
Keyword(s):  
Public Health ◽  
Research Policy ◽  
Grey Literature ◽  
World Health ◽  
Border Health ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Cross Border ◽  
Health Measures ◽  
Starting Point

Abstract BackgroundThe near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition. ResultsBased on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently – type of movement (travel and trade), policy goal, level of jurisdiction, use by public versus private sector, stage of journey, and degree of restrictiveness. These categories are then be brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. The typology facilitates evidence-informed decision-making which takes account of policy complexity including trade-offs and externalities. Finally, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005). ConclusionsThe widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.

scholarly journals Educational Resources and Curriculum on Lactation for Health Undergraduate Students: A Scoping Review

2020 ◽  
pp. 089033442098069
Author(s):  
Suzanne Hetzel Campbell ◽  
Nicole de Oliveira Bernardes ◽  
Thayanthini Tharmaratnam ◽  
Flaviana Vely Mendonça Vieira
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Scoping Review ◽  
Professional Education ◽  
Health Care Professionals ◽  
Grey Literature ◽  
Educational Resources ◽  
Inclusion Criteria ◽  
Breastfeeding Support ◽  
Support Skills

Background Breastfeeding is a fundamental component of health care, and health professionals need to be adequately prepared. As part of the system, health care professionals have the ability to influence the establishment and maintenance of breastfeeding. The global literature regarding the curricular approach or established best practices for health professional education in lactation is inconclusive and lacking in rigor. Research aim To explore the literature for the educational resources, methods, and curriculum used in the education of undergraduate health students related to lactation. Methods A scoping review examining the curricular programs of health professional students in lactation was undertaken exploring and summarizing evidence from peer reviewed and grey literature. A scoping review with a five-stage review process was followed. The database search between 1982–2018 generated 625 results, 79 full-text articles were reviewed, and 29 articles published in English met the inclusion criteria. Results In general, educational resources, methods, curricular approaches, and foundational topics were based on best practice standards. Some authors incorporated a variety of learning methods and provided experiential learning, with evidence of translation of knowledge into clinical practice. In the studies examined, researchers reported that students had improved their: knowledge and attitudes (59%); breastfeeding support skills (45%); and confidence (10%). However, even in programs that focused on developing students’ breastfeeding support skills, authors reported a lack of change in students’ confidence. Conclusions Although only English articles met the inclusion criteria, this review was unique in its search of multidisciplinary, multilingual, and international studies. Consistency in teaching across disciplines is key and not evident in the studies reviewed.

Sign in / Sign up

Export Citation Format

Share Document