What Works
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2021 ◽  
Vol 72 ◽  
pp. 102669
Wendy Masterton ◽  
Kirsty Park ◽  
Hannah Carver ◽  
Tessa Parkes

2021 ◽  
Lawrence Ganong ◽  
Caroline Sanner ◽  
Steven Berkley ◽  
Marilyn Coleman

2021 ◽  
Dean M. Thompson ◽  
Lesley Booth ◽  
Jonathan Mathers

Abstract Background: People with chronic conditions experience functional impairment, lower quality of life, and greater economic hardship and poverty. Social isolation and loneliness are common for people with chronic conditions, with multiple co-occurring chronic conditions predicting an increased risk of loneliness. Peer support is a socially driven intervention involving people with lived experience of a condition helping others to manage the same condition, potentially offering a sense of connectedness and purpose, and experiential knowledge to manage disease. However, it is unclear what outcomes are important to patients across the spectrum of chronic conditions, what works and for whom. The aims of this review were to (1) collate peer support intervention components, (2) collate the outcome domains used to evaluate peer support, (3) synthesise evidence of effectiveness, and (4) identify the mechanisms of effect, for people with chronic conditions.Methods: A systematic review of reviews was conducted. Reviews were included if they reported on formal peer support between adults or children with one or more chronic condition. Data were analysed using narrative synthesis.Results: The search identified 6222 unique publications. Thirty-one publications were eligible for inclusion. Components of peer support were organised into nine categories: social support, psychological support, practical support, empowerment, condition monitoring and treatment adherence, informational support, behavioural change, encouragement and motivation, and physical training. Fifty-five outcome domains were identified. Quality of life, and self-efficacy were the most measured outcome domains identified. Most reviews reported positive but non-significant effects.Conclusions: The effectiveness of peer support is unclear and there are inconsistencies in how peers are defined, a lack of clarity in research design and intervention reporting, and widely variable outcome measurement. This review presents a range of components of peer support interventions that may be of interest to clinicians developing new support programmes. However, it is unclear precisely what components to use and with whom. Therefore, implementation of support in different clinical settings may benefit from participatory action research so that services may reflect local need.

2021 ◽  
Steven De Peuter

The research culture of research institutions is increasingly recognized as an central driver of research integrity and institutions are urged to develop research integrity promotion plans to foster a culture of research integrity. A host of guidelines and associated initiatives have been issued, but what is generally lacking is specific, actionable recommendations for institutions. Based on a broad literature review, in the current paper some practical advice for institutions is suggested, grouped into 1) policies, procedures and processes, 2) dealing with breaches of research integrity, and 3) education and training. From the review, it is clear that more research is necessary to gather additional knowledge on what works and what doesn’t work, knowledge that is ideally shared openly. This will allow institutions to learn from one another, facilitate harmonization of policies, and may possibly create a virtuous cycle that empowers the shift towards a culture of collective openness in science.

Ingrid Oakley-Girvan ◽  
Reem Yunis ◽  
Michelle Longmire ◽  
Jessey Schwartz Ouillon

2021 ◽  
Biljana Macura ◽  
Nella Canales ◽  
Inès Bakhtaoui ◽  
Richard Taylor ◽  

International climate finance plays a key role in enabling the implementation of adaptation measures. However, while there is a common metric for gauging the effectiveness of finance for mitigation – greenhouse gas emission reduction per unit of funding – no corresponding metric exists for adaptation. Instead, assessments of what works best in adaptation finance focus either on procedural aspects of funding modalities, such as equity in the allocation of funding, or on the extent to which specific adaptation activities produce the desired results. This mixed methods systematic review aims to assess the effectiveness of adaptation finance and bridge the gap between those two approaches. It involves a transparent and comprehensive synthesis of the academic and grey literature on how different characteristics of adaptation projects in sub-Saharan Africa – and finance for those projects – affect adaptation outcomes, particularly in terms of risk and vulnerability to climate change impacts. Finalised adaptation projects funded by a set of the multilateral climate funds and two bilateral donors (United Kingdom and Sweden) are the focus of this review. The findings can help inform the future design and implementation of adaptation activities as well as funding decisions.

Henrik Vogt ◽  
Bjørn Hofmann

Rationale and aims: Precision medicine (PM) raises a key question: How can we know what works when the number of people with a health problem becomes small or one (n=1)? We here present a formative case from Norway. The Norwegian Board of Health Supervision was faced with a cancer patient, who had improved after treatment with a drug in the private health sector but was refused continued treatment in the public health service due to lack of clinical trial evidence. The Board overturned this decision, arguing that the drug had been unambiguously documented to work in the individual case. We aim to provide an in-depth analysis of this case and The Board´s decision and thereby to illustrate and elucidate key epistemological and ethical issues and developments in PM. Method: We provide our analysis and discussion using tools of critical thinking and concepts from philosophy of science and medicine such as uncertainty, evidence, forms of inference and causation. We also examine the case in the light of the history of evidence-based medicine (EBM). Results and discussion: The case reflects an epistemological shift in medicine where PM puts greater emphasis on evidence that arises in individual patients after the treatment is provided over preexisting population-based evidence. PM may rely more heavily on abduction to decide what works and qualitative, rather than quantitative judgments. The case also illustrates a possible shift in the concept of causation from regularity accounts to mechanistic and process accounts. We discuss ethical implications of a shift from more “traditional” to “personalized EBM”. Conclusion: A framework that is more based on abductions and evidence arising in the individual case has problems in creating quantifiable, reliable, and generalizable evidence, and in promoting transparency and accountability. PM currently lacks clear criteria for deciding what works in an individual, posing ethical challenges.

2021 ◽  
Vol 19 (S3) ◽  
Maryse Kok ◽  
Lauren Crigler ◽  
David Musoke ◽  
Madeleine Ballard ◽  
Steve Hodgins ◽  

Abstract Background While the evidence supporting the effectiveness of community health worker (CHW) programmes is substantial, there is also considerable evidence that many of these programmes have notable weaknesses that need to be addressed in order for them to reach their full potential. Thus, considerations about CHW programme performance and its assessment must be taken into account as the importance of these programmes is becoming more widely appreciated. In this paper, the tenth in our 11-paper series, “Community health workers at the dawn of a new era”, we address CHW programme performance and how it is assessed from a systems perspective. Methods The paper builds on the 2014 CHW Reference Guide, a compendium of case studies of 29 national CHW programmes, the 2018 WHO guideline on health policy and system support to optimize CHW programmes, and scientific studies on CHW programme performance published in the past 5 years. Results The paper provides an overview of existing frameworks that are useful for assessing the performance of CHW programmes, with a specific focus on how individual CHW performance and community-level outcomes can be measured. The paper also reviews approaches that have been taken to assess CHW programme performance, from programme monitoring using the routine health information system to national assessments using quantitative and/or qualitative study designs and assessment checklists. The paper also discusses contextual factors that influence CHW programme performance, and reflects upon gaps and needs for the future with regard to assessment of CHW programme performance. Conclusion Assessments of CHW programme performance can have various approaches and foci according to the programme and its context. Given the fact that CHW programmes are complex entities and part of health systems, their assessment ideally needs to be based on data derived from a mix of reliable sources. Assessments should be focused not only on effectiveness (what works) but also on contextual factors and enablers (how, for whom, under what circumstances). Investment in performance assessment is instrumental for continually innovating, upgrading, and improving CHW programmes at scale. Now is the time for new efforts in implementation research for strengthening CHW programming.

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e048922
Linda Richter Sundberg ◽  
Monica Christianson ◽  
Maria Wiklund ◽  
Anna-Karin Hurtig ◽  
Isabel Goicolea

IntroductionStrengthening first-line mental healthcare services for youth remains a priority for the Swedish government. The government is currently investigating how different sectors involved can be strengthened, but evidence is scarce. Youth clinics play a key role in these discussions, being one of the most trusted services for youth. However, analysis of organisational functions and coordination with other services is important to strengthen youth clinics’ role in first-line mental healthcare. This study investigates these challenges and aims to analyse the integration of mental healthcare within youth clinics to identify strategies to strengthen first-line mental healthcare for youth in Sweden.Methods and analysisThis study adopts a health policy and systems approach. In the first phase, a formative realist evaluation is conducted to ascertain what works in terms of integrating mental healthcare services within youth clinics, for what type of youth subpopulations and under what circumstances. National-level stakeholders will be interviewed to elicit the programme theory that explains how the intervention is supposed to work. The programme theory will then be tested in three–five cases. The cases will be comprised of youth clinics and their stakeholders. Quantitative and qualitative information will be gathered, including via visual methodologies and questionnaires. The second phase includes a concept mapping study, engaging stakeholders and young people to build consensus on strategies to strengthen the integration of mental healthcare into youth clinics.Ethics and disseminationThe Swedish Ethical Review Authority has approved the study (2019-02910 and 2020-04720). The results will be published in open-access peer-reviewed journals and presented at scientific conferences.

2021 ◽  
Chris Bryan ◽  
Ehsaan Nasir

Abstract Evaluating Electrical Submersible Pumps (ESPs) [SS1] [NA2] run-lives and performance in unconventional well environments is challenging due to many different factors -including the reservoir, well design, and production fluids. Moreover, reviewing the run-lives of ESPs in a field can be rather complex since the run-life data is incomplete. Often ESPs are pulled while they are still operational, or the ESP has not been allowed to run until failure. These are some of the complications that arise when gauging ESP performance. A large dataset of ESP installs was assessed using Kaplan-Meier survival analysis for the North American unconventional application to better understand those factors that may affect ESP run lives. The factors were studied including but are not limited to the following: Basin and producing formation Comparing different ESP component types such pumps and motors, and new or used ESP components Completion intensity of the frac job (lb/ft of proppant) Kaplan-Meier survival analysis is one of the commonly used methods to measure the fraction or probability of group survival after certain time periods because it accounts for incomplete observations. Using Kaplan-Meier analysis generates a survival curve to show a declining fraction of surviving ESPs over time. Survival curves can be compared by segmenting the runlife data into buckets (based on different factors), therefore to analyze the statistical significance of each and how they affect ESP survivability. Kaplan-Meier analysis was performed on the aforementioned dataset to answer these questions in order to better understand the factors that affect ESP runlives in North American unconventional plays. This work uses a unique dataset that encompasses several different ESP designs, with the ESPs installed in different North American plays. The observations and conclusions drawn from it, by applying survival analysis, can help in benchmarking ESP runtimes and identifying what works in terms of prolonging ESP runlife. The workflow is also applicable to any asset in order to better understand the drivers behind ESP runlife performance.

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