Measuring and valuing the health co-benefits of climate change mitigation: a scoping review.

Despite growing interest in the health co-benefits of climate change mitigation actions, there is little recent evidence on the appropriateness of the measurement techniques being used to estimate them. We did a scoping review to identify the different approaches that have been used to measure and value health co-benefits in the climate change mitigation literature. We searched three databases (EBSCOhost, Web of Science, and MEDLINE Ovid) to identify relevant papers published between 2010 and 2023, and identified 267 studies that met our inclusion criteria to be included in the review. We found that health co-benefit studies are more typically published in the environmental science literature than in health journals. Despite calls going back many years for greater standardisation in methods, we found a highly diverse set of health measures and valuation approaches still in use. The majority of studies (232 [87%]) measured only near-term health co-benefits from reduced air pollution, and only 13 (5%) studies incorporated the longer term health benefits from mitigating the future health harms of climate change. Just over half the studies included monetary valuation of health co-benefits, using a variety of valuation approaches. Public and planetary health researchers, epidemiologists, and health economists should seek to engage more actively with those undertaking research in health co-benefits. This would allow consideration of how best to reconcile differing perspectives and techniques, how to achieve better standardisation of measurement and valuation, and how to extend the generally narrow focus of current health co-benefit studies to become more holistic and comprehensive.

Resident learning trajectories in the workplace: A self-regulated learning analysis.

CONTEXT: Research in workplace learning has emphasised trainees' active role in their education. By focusing on how trainees fine-tune their strategic learning, theories of self-regulated learning (SRL) offer a unique lens to study workplace learning. To date, studies of SRL in the workplace tend to focus on listing the factors affecting learning, rather than on the specific mechanisms trainees use to regulate their goal-directed activities. To inform the design of workplace learning interventions that better support SRL, we asked: How do residents navigate their exposure to and experience performing invasive procedures in intensive care units? METHODS: In two academic hospitals, we conducted post-call debriefs with residents coming off shift and later sought their elaborated perspectives via semi-structured interviews. We used a constant comparative methodology to analyse the data, to iteratively refine data collection, and to inform abductive coding of the data, using SRL principles as sensitising concepts. RESULTS: We completed 29 debriefs and nine interviews with 24 trainees. Participants described specific mechanisms: identifying, creating, avoiding, missing and competing for opportunities to perform invasive procedures. While using these mechanisms to engage with procedures (or not), participants reported: distinguishing trajectories (i.e. becoming attuned to task-relevant factors), navigating trajectories (i.e. creating and interacting with opportunities to perform procedures), and co-constructing trajectories with their peers, supervisors and interprofessional team members. CONCLUSIONS: We identified specific SRL mechanisms trainees used to distinguish and navigate possible learning trajectories. We also confirmed previous findings, including that trainees become attuned to interactions between personal, behavioural and environmental factors (SRL theory), and that their resulting learning behaviours are constrained and guided by interactions with peers, supervisors and colleagues (workplace learning theory). Making learning trajectories explicit for clinician teachers may help them support trainees in prioritising certain trajectories, in progressing along each trajectory, and in co-constructing their plans for navigating them.

Knowledge synthesis methods for integrating qualitative and quantitative data: a scoping review reveals poor operationalization of the methodological steps.

OBJECTIVES: To describe and compare, through a scoping review, emerging knowledge synthesis methods for integrating qualitative and quantitative evidence in health care, in terms of expertise required, similarities, differences, strengths, limitations, and steps involved in using the methods. STUDY DESIGN AND SETTING: Electronic databases (e.g., MEDLINE) were searched, and two reviewers independently selected studies and abstracted data for qualitative analysis. RESULTS: In total, 121 articles reporting seven knowledge synthesis methods (critical interpretive synthesis, integrative review, meta-narrative review, meta-summary, mixed studies review, narrative synthesis, and realist review) were included after screening of 17,962 citations and 1,010 full-text articles. Common similarities among methods related to the entire synthesis process, while common differences related to the research question and eligibility criteria. The most common strength was a comprehensive synthesis providing rich contextual data, whereas the most common weakness was a highly subjective method that was not reproducible. For critical interpretive synthesis, meta-narrative review, meta-summary, and narrative synthesis, guidance was not provided for some steps of the review process. CONCLUSION: Some of the knowledge synthesis methods provided guidance on all steps, whereas other methods were missing guidance on the synthesis process. Further work is needed to clarify these emerging knowledge synthesis methods.

A scoping review identifies multiple emerging knowledge synthesis methods, but few studies operationalize the method.

OBJECTIVES: To systematically identify, define, and classify emerging knowledge synthesis methods through a scoping review. STUDY DESIGN AND SETTING: MEDLINE, CINAHL, EMBASE, PsycINFO, the Cochrane Methodology Register, the Cochrane Database of Systematic Reviews, Social Sciences Abstracts, Library and Information Science Abstracts, Philosopher's Index, and Education Resources Information Center were searched to identify articles reporting emerging knowledge synthesis methods across the disciplines of health, education, sociology, and philosophy. Two reviewers independently selected studies and abstracted data for each article. RESULTS: In total, 409 articles reporting on 25 knowledge synthesis methods were included after screening of 17,962 titles and abstracts and 1,010 potentially relevant full-text articles. Most of the included articles were an application of the method (83.9%); only 3.7% were seminal articles that fully described the method (i.e., operationalized the steps). Most of the included articles were published after 2005. The methods were most commonly used across the fields of nursing, health care science and services, and health policy. CONCLUSION: We found a lack of guidance on how to select a knowledge synthesis method. We propose convening an international group of leaders in the knowledge synthesis field to help clarify emerging approaches to knowledge synthesis.

The Ontario Drug Policy Research Network: bridging the gap between Research and Drug Policy.

Policymakers have cited several barriers to using evidence in policy decisions, including lack of research relevance and timeliness. In recent years, several reports have focused on the successes and challenges of researcher-policymaker collaborations, a form of policy engagement intended to help overcome barriers to the use of research evidence in policymaking. Although these reports often demonstrate an increase in research relevance, rarely do they provide concrete methods of enhancing research timeliness, which is surprising given policymakers' expressed need to receive "rapid-response" research. Additionally, the impact of researcher-policymaker collaborations is not well-discussed. In this paper, we aim to describe the collaboration between the Ontario Drug Policy Research Network (ODPRN) and its policymaker partner, the Ontario Public Drug Program (OPDP), with a particular focus on the ODPRN's research methodology and unique rapid-response approach for policy engagement. This approach is illustrated through a specific case example regarding drug funding policies for pulmonary arterial hypertension. Moreover, we discuss the impact of the ODPRN's research on pharmaceutical policy and lessons learned throughout the ODPRN and OPDP's five-year partnership. The described experiences will be valuable to those seeking to enhance evidence uptake in policymaking for immediate policy needs.

Pertussis: a persistent cause of morbidity and mortality in young infants.

In 2012, a pertussis outbreak in Dallas County resulted in the deaths of 4 children (3, unvaccinated; 2, <60 days of age). Despite recommendations that include immunization of women preferably during the third trimester of pregnancy or postpartum, household contacts ("cocooning"), and infants as early as 42 days of age, challenges in pertussis prevention remain.

Desvenlafaxine and venlafaxine exert minimal in vitro inhibition of human cytochrome P450 and P-glycoprotein activities.

OBJECTIVE: Identification of potential pharmacokinetic drug-drug interactions is an important step in clinical drug development.We assessed and compared the drug-drug interaction potential of desvenlafaxine and venlafaxine, based on their inhibitory potency on human cytochrome P450 (CYP) and P-glycoprotein (P-gp) activities in vitro. METHODS: Reversible inhibition of CYP1A2, CYP2A6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A4, and mechanism-based inhibition of CYP2C9, CYP2C19, CYP2D6, and CYP3A activity by desvenlafaxine and venlafaxine were determined in human liver microsomes.Whether these drugs were substrates for efflux or inhibitors of P-gp were determined in Caco-2 monolayers. RESULTS: Desvenlafaxine and venlafaxine showed little or no reversible inhibition of various CYP enzymes (concentration that inhibits 50% [IC50] or inhibition constant [Ki] ~ or >100 muM). In addition, neither drug acted as a mechanism-based inhibitor of CYP2C9, CYP2C19, CYP2D6, or CYP3A as they did not reduce the IC50 value for any of these enzymes in the presence of preincubations with or without a nicotinamide adenine dinucleotide phosphate-regenerating system. Desvenlafaxine and venlafaxine showed little inhibition of P-gp activity (IC50 values >250 muM) and did not act as substrates (efflux ratios <2) for efflux in Caco-2 monolayers. CONCLUSIONS: Considering in vitro and available clinical data, desvenlafaxine and venlafaxine appear to have low potential for pharmacokinetic drug-drug interactions via inhibiting the metabolic clearance of concomitant drugs that are substrates of various CYP enzymes, in particular CYP2D6. In addition, these data suggest that desvenlafaxine and venlafaxine exhibit little potential for pharmacokinetic interactions with concomitant drugs that are substrates or inhibitors of P-gp.