Features of the waterpipe tobacco industry: A qualitative study of the third International Hookah Fair [version 1; referees: 1 approved, 1 approved with reservations]

Background: Little research has been done to uncover the features of the waterpipe tobacco industry, which makes designing effective interventions and policies to counter this growing trend challenging. The objective of this study is to describe the features of the waterpipe industry. Methods: In 2015, we randomly sampled and conducted semi-structured interviews with representatives of waterpipe companies participating in a trade exhibition in Germany. We used an inductive approach to identify emerging themes. Results: We interviewed 20 representatives and four themes emerged: industry growth, cross-industry overlap, customer-product relationship, and attitude towards policy. The industry was described as transnational, generally decentralized, non-cartelized, with ad hoc relationships between suppliers, distributors and retailers. Ties with the cigarette industry were apparent. The waterpipe industry appeared to be in an early growth phase, encroaching on new markets, and comprising of mainly small family-run businesses. Customer loyalty appears stronger towards the waterpipe apparatus than tobacco. There was a notable absence of trade unionism and evidence of deliberate breaches of tobacco control laws. Conclusion: The waterpipe industry appears fragmented but is slowly growing into a mature, globalized, and customer-focused industry with ties to the cigarette industry. Now is an ideal window of opportunity to strengthen public health policy towards the waterpipe industry, which should include a specific legislative waterpipe framework

Challenges of evidence synthesis during the 2020 COVID pandemic: a scoping review

Aim:: The objectives of this scoping review are to identify the challenges to conducting evidence synthesis during the COVID-19 pandemic and to propose some recommendations addressing the identified gaps. Methods:: A scoping review methodology was followed to map the literature published on the challenges and solutions of conducting evidence synthesis using the Joanna Briggs Methodology of performing scoping review. We searched several databases from the start of the Pandemic in December 2019 until 10th June 2021. Results:: A total of 28 publications was included in the review. The challenges cited in the included studies have been categorised into four distinct but interconnected themes including: upstream, Evidence synthesis, downstream and contextual challenges. These challenges have been further refined into issues with primary studies, databases, team capacity, process, resources, and context. Several proposals to improve the above challenges included: transparency in primary studies registration and reporting, establishment of online platforms that enables collaboration, data sharing and searching, the use of computable evidence and coordination of efforts at an international level. Conclusion:: This review has highlighted the importance of including artificial intelligence, a framework for international collaboration and a sustained funding model to address many of the shortcomings and ensure we are ready for similar challenges in the future. © 2021 Elsevier Inc

Using GRADE in situations of emergencies and urgencies: certainty in evidence and recommendations matters during the COVID-19 pandemic, now more than ever and no matter what

publishedVersio

Consumer willingness to pay for fair and sustainable foods: who profits in the agri-food chain?

Going through an era where sustainability and definitions of fairness have been extended and integrated into the agri-food chain, there is a need to understand, on a multi-dimensional and multinational level, the structure of agri-food value chain revenues and consumers’ intentions regarding necessity foods. The study analyzed 1,020 questionnaires from Algeria, Germany, Greece, Italy, and Tunisia revealing that taste prioritizes brand and packaging. Social networks, including family and friends, significantly influence the purchase of fair products. Furthermore, a choice experiment revealed the consumer preferences around attributes of the olive oil case as local, traditional, or organic, from a family or farmer association, in a glass bottle, purchased in small local shops/markets, typical and/or extensive nutritional labeling and health claims, non-relevant branding, and finally a fair price reflecting the reasonable quality of the olive oil product. Regarding the agri-food value chain, the results highlight the revenue distribution among stakeholders as unequal and unfair from consumer perceptions, with an imperative need for transparency. The study investigates in-depth the multifaceted dimensions of the fairness concept in the food market from a consumer’s perception, showing their willingness to pay for necessities based on fair pricing and sustainable practices

Prioritization approaches in the development of health practice guidelines: A systematic review

Background: Given the considerable efforts and resources required to develop practice guidelines, developers need to prioritize what topics and questions to address. This study aims to identify and describe prioritization approaches in the development of clinical, public health, or health systems guidelines. Methods: We searched Medline and CINAHL electronic databases in addition to Google Scholar. We included papers describing prioritization approaches in sufficient detail allowing for reproducibility. We synthesized findings in a semi-quantitative way. We followed an iterative process to develop a common framework of prioritization criteria that captures all of the criteria reported by each included study. Results: Our search captured 33,339 unique citations out of which we identified 10 papers reporting prioritization approaches for guideline development. All of the identified approaches focused on prioritizing guideline topics but none on prioritizing recommendation questions or outcomes. The two most frequently reported steps of the development process for these approaches were reviewing the grey literature (9 out of 10, 90%) and engaging various stakeholders (9 out of 10, 90%). We derived a common framework of 20 prioritization criteria that can be used when prioritizing guideline topics. The most frequently reported criteria were the health burden of disease which was included in all of the approaches, practice variation (8 out of 10, 80%), and impact on health outcomes (7 out of 10, 70%). Two of the identified approaches stood out as being comprehensive and detailed. Conclusions: We described 10 prioritization approaches in the development of health practice guidelines. There is a need to assess the effectiveness, efficiency and transparency of the identified approaches and to develop standardized and validated priority setting tools. © 2019 The Author(s)

A common framework of steps and criteria for prioritizing topics for evidence syntheses: a systematic review

Objective: The objective of the study was to systematically review the literature for proposed approaches and exercises conducted to prioritize topics or questions for systematic reviews and other types of evidence syntheses in any health-related area. Study Design and Setting: A systematic review. We searched Medline and CINAHL databases in addition to Cochrane website and Google Scholar. Teams of two reviewers independently screened the studies and extracted data. Results: We included 31 articles reporting on 29 studies: seven proposed approaches for prioritization and 25 conducted prioritization exercises (three studies did both). The included studies addressed the following fields: clinical (n = 19; 66%), public health (n = 10; 34%), and health policy and systems (n = 8; 28%), with six studies (21%) addressing more than one field. We categorized prioritization into 11 steps clustered in 3 phases (preprioritization, prioritization, and postprioritization). Twenty-eight studies (97%) involved or proposed involving stakeholders in the priority-setting process. These 28 studies referred to twelve stakeholder categories, most frequently to health care providers (n = 24; 86%) and researchers (n = 21; 75%). A common framework of 25 prioritization criteria was derived, clustered in 10 domains. Conclusion: We identified literature that addresses different aspects of prioritizing topics or questions for evidence syntheses, including prioritization steps and criteria. The identified steps and criteria can serve as a menu of options to select from, as judged appropriate to the context. © 2019 Elsevier Inc

Evidence Synthesis International (ESI): Position Statement

This paper is the initial Position Statement of Evidence Synthesis International, a new partnership of organizations that produce, support and use evidence synthesis around the world. The paper (i) argues for the importance of synthesis as a research exercise to clarify what is known from research evidence to inform policy, practice and personal decision making; (ii) discusses core issues for research synthesis such as the role of research evidence in decision making, the role of perspectives, participation and democracy in research and synthesis as a core component of evidence ecosystems; (iii) argues for 9 core principles for ESI on the nature and role of research synthesis; and (iv) lists the 5 main goals of ESI as a coordinating partnership for promoting and enabling the production and use of research synthesis

Equity in evidence synthesis : you can’t play on broken strings

Peer reviewe

Antibiotic prescribing guideline recommendations in COVID-19: a systematic survey

Background: COVID-19 and antimicrobial resistance (AMR) are two intersecting public health crises. Antimicrobial overuse in patients with COVID-19 threatens to worsen AMR. Guidelines are fundamental in encouraging antimicrobial stewardship. We sought to assess the quality of antibiotic prescribing guidelines and recommendations in the context of COVID-19, and whether they incorporate principles of antimicrobial stewardship. Methods: We performed a systematic survey which included a search using the concepts “antibiotic/antimicrobial” up to November 15, 2022 of the eCOVID-19 living map of recommendations (RecMap) which aggregates guidelines across a range of international sources and all languages. Guidelines providing explicit recommendations regarding antibacterial use in COVID-19 were eligible for inclusion. Guideline and recommendation quality were assessed using the AGREE II and AGREE-REX instruments, respectively. We extracted guideline characteristics including panel representation and the presence or absence of explicit statements related to antimicrobial stewardship (i.e., judicious antibiotic use, antimicrobial resistance or adverse effects as a consequence of antibiotic use). We used logistic regression to evaluate the relationship between guideline characteristics including quality and incorporation of antimicrobial stewardship principles. Protocol registration (OSF): https://osf.io/4pgtc. Findings: Twenty-eight guidelines with 63 antibiotic prescribing recommendations were included. Recommendations focused on antibiotic initiation (n = 52, 83%) and less commonly antibiotic selection (n = 13, 21%), and duration of therapy (n = 15, 24%). Guideline and recommendation quality varied widely. Twenty (71%) guidelines incorporated at least one concept relating to antimicrobial stewardship. Including infectious diseases expertise on the guideline panel (OR 9.44, 97.5% CI: 1.09–81.59) and AGREE-REX score (OR 3.26, 97.5% CI: 1.14–9.31 per 10% increase in overall score) were associated with a higher odds of guidelines addressing antimicrobial stewardship. Interpretation: There is an opportunity to improve antibiotic prescribing guidelines in terms of both quality and incorporation of antimicrobial stewardship principles. These findings can help guideline developers better address antibiotic stewardship in future recommendations beyond COVID-19. Funding: This project was funded by Michael G. DeGroote Cochrane Canada and McMaster GRADE centres. © 202

Molecular characterization of prostate cancer in Middle Eastern population highlights differences with Western populations with prognostic implication

Background: To investigate the incidence and prognostication of ERG, PTEN and SPINK1 protein expressions in prostate cancer cohort of Middle Eastern descent in comparison to published data from Western population. Methods: Immunohistochemistry for ERG, PTEN and SPINK1 was performed in a cohort of localized PCA (n = 340). The data were correlated to pathological and clinical outcomes and compared to Western populations. Results: ERG expression and PTEN loss were noted in 123/288 (42.7%) and 91/297 (30.6%) of patients, respectively. SPINK1 expression was assessed in a subset of cases, noted in 6/150 (4%) of patients. Only ERG expression was associated with grade groups, being more common in the lower grade groups (1–3 vs 4–5; p = 0.04). In contrast to the Western population, PTEN loss foci were more likely to be ERG negative, observed in 81% of tumor foci and patients with PTEN neg/ERG pos were more likely to exhibit biochemical recurrence (OR 2.831; 95% CI 1.10–726, p = 0.03). This association remained significant in multivariate analysis (OR 2.68; 95% CI 0.98–7.33, p = 0.05), after adjusting for GG, path stage and surgical margin. Conclusion: This study documents significant differences in key molecular events in PCA in Middle Eastern population compared to Western populations that could explain differences in PCA incidence, progression and prognostication. ERG, PTEN and SPINK1 genomic alteration occur less frequently and the enrichment of ERG for PTEN loss is not observed. Additionally, patients with combined PTEN loss/ERG positive are at highest risk for BCR vs North American Caucasian population where PTEN loss alone seems to be associated with the worst clinical outcome. The data presented here further support differences in clonal evolution between Middle Eastern and Western population in relation to PCA and add further insight to understanding PCA molecular pathways. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature