Tamara Lotfi | American University of Beirut (original) (raw)

Papers by Tamara Lotfi

Research paper thumbnail of Open synthesis and the coronavirus pandemic in 2020

Journal of Clinical Epidemiology, 2020

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Research paper thumbnail of Evidence Synthesis International (ESI): Position Statement

Systematic Reviews, 2020

This paper is the initial Position Statement of Evidence Synthesis International, a new partnersh... more 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.

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Research paper thumbnail of Engagement of medical specialty trainees in research: experience at a Lebanese medical school

Eastern Mediterranean Health Journal, 2020

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Research paper thumbnail of Physical distancing, face masks, and eye protection for prevention of COVID-19

The Lancet, 2020

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Research paper thumbnail of Prioritization approaches in the development of health practice guidelines: a systematic review

Background Given the considerable efforts and resources required to develop practice guidelines, ... more Background Given the considerable efforts and resources required to develop practice guidelines, guideline developers need to prioritize the 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, 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 23,722 unique citations out of which we identified 10 papers reporting prioritization approaches for guideline development. All of the identified prioritization approaches focused on prioritizing guideline topics but none on prioritizing recommend...

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Research paper thumbnail of Screening Mammography Outcomes in One Community-Based Initiative in Lebanon

Journal of Community Medicine & Health Education, 2016

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Research paper thumbnail of Molecular Characterization of Prostate Cancer Following Androgen Deprivation: The Devil in the Details

European Urology, 2014

Androgen-deprivation therapy (ADT) remains the mainstay of therapy for advanced prostate cancer (... more Androgen-deprivation therapy (ADT) remains the mainstay of therapy for advanced prostate cancer (PCa). However, patients inevitably progress and become resistant to treatment targeting the androgen signaling axis. Castrationresistant PCa (CRPC) represents the final stage of the disease, with median survival of <2 yr. Despite the recent addition of new agents to the armamentarium against CRPC, it remains incurable and universally lethal. Many fundamental questions about ADT and CRPC remain largely unanswered: How does PCa adapt to ADT? What are the most common mechanisms of resistance? Can recurrence be predicted and averted? The molecular profiling of PCa following ADT holds the potential to unlock the biology of CRPC, possibly revealing biomarkers necessary to predict response to therapy and to identify early recurrence as well as potentially identifying novel therapeutic targets. In this issue of European Urology, Rajan et al. report on a pilot study of gene expression profiling of seven patients with advanced PCa, with paired samples before and after ADT [1]. Using RNA sequencing and bioinformatics approaches, the authors identify alterations in the Wnt/b-catenin signaling pathway following ADT. Furthermore, they show dysregulation of b-catenin in a subset of CRPCs in an independent cohort and a small amount of functional data in cell lines suggesting that inhibition of Wnt/b-catenin signaling may preferentially inhibit CRPC cell growth. The authors should be commended for an approach that attempts to directly interrogate the impact of ADT on PCa signaling pathways in patients and to elucidate the molecular events underlying the emergence of CRPC.

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Research paper thumbnail of COVID-19 transmission during swimming-related activities: a rapid systematic review

BMC Infectious Diseases, 2021

Background There are uncertainties about mitigating strategies for swimming-related activities in... more Background There are uncertainties about mitigating strategies for swimming-related activities in the context of the COVID-19 pandemic. There is an opportunity to learn from the experience of previous re-openings to better plan the future one. Our objectives are to systematically review the evidence on (1) the association between engaging in swimming-related activities and COVID-19 transmission; and (2) the effects of strategies for preventing COVID-19 transmission during swimming-related activities. Methods We conducted a rapid systematic review. We searched in the L·OVE (Living OVerview of Evidence) platform for COVID-19. The searches covered the period from the inception date of each database until April 19, 2021. We included non-randomized studies for the review on association of COVID-19 transmission and swimming-related activities. We included guidance documents reporting on the strategies for prevention of COVID-19 transmission during swimming-related activities. We also incl...

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Research paper thumbnail of Risk-assessment models for VTE and bleeding in hospitalized medical patients: an overview of systematic reviews

Blood Advances, 2020

Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical p... more Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical patients have been developed. To inform the 2018 American Society of Hematology (ASH) guidelines on VTE, we conducted an overview of systematic reviews to identify and summarize evidence related to RAMs for VTE and bleeding in medical inpatients. We searched Epistemonikos, the Cochrane Database, Medline, and Embase from 2005 through June 2017 and then updated the search in January 2020 to identify systematic reviews that included RAMs for VTE and bleeding in medical inpatients. We conducted study selection, data abstraction and quality assessment (using the Risk of Bias in Systematic Reviews [ROBIS] tool) independently and in duplicate. We described the characteristics of the reviews and their included studies, and compared the identified RAMs using narrative synthesis. Of 15 348 citations, we included 2 systematic reviews, of which 1 had low risk of bias. The reviews included 19 unique s...

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Research paper thumbnail of Evidence synthesis 2.0: when systematic, scoping, rapid, living, and overviews of reviews come together

Journal of Clinical Epidemiology, 2020

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Research paper thumbnail of Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models

PLoS currents, Jan 3, 2016

Our objective was to identify published models of coordination between entities funding or delive... more Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the "Cluster Approach" (with 16 case studies), the 4Ws "Who is Where, When, doing What" mapping tool (with four case studies), the "Sphere Project" (with two case stud...

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Research paper thumbnail of Knowledge, beliefs and attitudes of physicians in low and middle-income countries regarding interacting with pharmaceutical companies: a systematic review

BMC Health Services Research, 2016

Understanding the perceptions and attitudes of physicians is important. This knowledge assists in... more Understanding the perceptions and attitudes of physicians is important. This knowledge assists in the efforts to reduce the impact of their interactions with the pharmaceutical industry on clinical practice. It appears that most studies on such perceptions and attitudes have been conducted in high-income countries. The objective was to systematically review the knowledge, beliefs and attitudes of physicians in low and middle-income countries regarding interactions with pharmaceutical companies. Eligible studies addressed any type of interaction between physicians and pharmaceutical companies. The outcomes of interest included knowledge, beliefs and attitudes of practicing physicians. The search strategy covered MEDLINE and EMBASE databases. Two reviewers completed in duplicate and independently study selection, data abstraction, and assessment of methodological features. The data synthesis consisted of a narrative summary of the findings stratified by knowledge, beliefs and attitudes. We included ten reports from nine eligible studies, each of which had a number of methodological limitations. Four studies found that the top perceived benefits of this interaction were receiving information and rewards. In five out of eight studies assessing the perception regarding the impact of the interaction on the behavior of physician prescription, the majority of participants believed it to be minor. In one of these studies, participants perceived that impact to be lesser when asked about their own behavior. The attitudes of physicians towards information and rewards provided by pharmaceutical company representatives (PCRs) (assessed in 5 and 2 studies respectively) varied across studies. In the only study assessing their attitudes towards pharmaceutical-sponsored Continuing Medical Education, physicians considered local conferences to have higher impact. Their attitudes towards developing policies restricting physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interactions with PCRs were positive in two studies. In one study, the majority of participants did not mind the public knowing that physicians were receiving gifts and awards from drug companies. This review identified few studies conducted in low and middle-income countries. While physicians generally perceived the impact of interactions on their behavior to be minor, their attitudes toward receiving information and rewards varied across studies.

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Research paper thumbnail of Validity of tools used for surveying physicians about their interactions with pharmaceutical company: a systematic review

BMC research notes, Jan 25, 2015

There is evidence that physicians' prescription behavior is negatively affected by the extent... more There is evidence that physicians' prescription behavior is negatively affected by the extent of their interactions with pharmaceutical companies. In order to develop and implement policies and interventions for better management of interactions, we need to understand physicians' perspectives on this issue. Surveys addressing physicians' interactions with pharmaceutical companies need to use validated tools to ensure the validity of their findings. To assess the validity of tools used in surveys of physicians about the extent and nature of their interactions with pharmaceutical companies, and about their knowledge, beliefs and attitudes towards such interactions; and to identify those tools that have been formally validated. We developed a search strategy with the assistance of a medical librarian. We electronically searched MEDLINE and EMBASE databases in September 2015. Teams of two reviewers conducted data selection and data abstraction. They identified eligible studi...

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Research paper thumbnail of Free versus Fixed Combination Antihypertensive Therapy for Essential Arterial Hypertension: A Systematic Review and Meta-Analysis

Background

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Research paper thumbnail of The allure of the waterpipe: a narrative review of factors affecting the epidemic rise in waterpipe smoking among young persons globally

Objective The objective of this narrative review is to highlight the determinants of the epidemic... more Objective The objective of this narrative review is to highlight the determinants of the epidemic rise in waterpipe tobacco smoking (WTS) among youth globally. The Ecological Model of Health Promotion (EMHP) was the guiding framework for the review. Data extraction Articles which analysed determinants of WTS at any of the levels of the EMHP were retained regardless of methodological rigour: 131 articles are included. Articles were coded in a standard template that abstracted methods as well as results. Data synthesis The review found that methodologies used to assess determinants of WTS among youth were often conventional and lacked rigor: 3/4 of the studies were cross-sectional surveys and most enrolled non-representative samples. Within the framework, the review identified determinants of WTS at the intrapersonal, interpersonal, organisational, community and policy levels. Conclusions The review suggests potential interventions to control WTS among youth, with emphasis on creative utilisation of social media, and tobacco control policies that include the specificities of WTS. The review further suggests the need for rigorous qualitative work to better contextualise determinants, and prospective observational and experimental studies that track and manipulate them to assess their viability as intervention targets. BACKGROUND

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Research paper thumbnail of Association between low vitamin D levels and the diagnosis of asthma in children: a systematic review of cohort studies

Background: There is conflicting evidence about the association between low vitamin D levels in c... more Background: There is conflicting evidence about the association between low vitamin D levels in children and development of asthma in later life. The objective of this study was to systematically review the evidence for an epidemiological association between low serum levels of vitamin D and the diagnosis of asthma in children. Methods: We used the Cochrane methodology for conducting systematic reviews. The search strategy included an electronic search of MEDLINE and EMBASE in February 2013. Two reviewers completed, in duplicate and independently, study selection, data abstraction, and assessment of risk of bias.

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Research paper thumbnail of Open synthesis and the coronavirus pandemic in 2020

Journal of Clinical Epidemiology, 2020

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Research paper thumbnail of Evidence Synthesis International (ESI): Position Statement

Systematic Reviews, 2020

This paper is the initial Position Statement of Evidence Synthesis International, a new partnersh... more 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.

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Research paper thumbnail of Engagement of medical specialty trainees in research: experience at a Lebanese medical school

Eastern Mediterranean Health Journal, 2020

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Physical distancing, face masks, and eye protection for prevention of COVID-19

The Lancet, 2020

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Research paper thumbnail of Prioritization approaches in the development of health practice guidelines: a systematic review

Background Given the considerable efforts and resources required to develop practice guidelines, ... more Background Given the considerable efforts and resources required to develop practice guidelines, guideline developers need to prioritize the 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, 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 23,722 unique citations out of which we identified 10 papers reporting prioritization approaches for guideline development. All of the identified prioritization approaches focused on prioritizing guideline topics but none on prioritizing recommend...

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Research paper thumbnail of Screening Mammography Outcomes in One Community-Based Initiative in Lebanon

Journal of Community Medicine & Health Education, 2016

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Research paper thumbnail of Molecular Characterization of Prostate Cancer Following Androgen Deprivation: The Devil in the Details

European Urology, 2014

Androgen-deprivation therapy (ADT) remains the mainstay of therapy for advanced prostate cancer (... more Androgen-deprivation therapy (ADT) remains the mainstay of therapy for advanced prostate cancer (PCa). However, patients inevitably progress and become resistant to treatment targeting the androgen signaling axis. Castrationresistant PCa (CRPC) represents the final stage of the disease, with median survival of <2 yr. Despite the recent addition of new agents to the armamentarium against CRPC, it remains incurable and universally lethal. Many fundamental questions about ADT and CRPC remain largely unanswered: How does PCa adapt to ADT? What are the most common mechanisms of resistance? Can recurrence be predicted and averted? The molecular profiling of PCa following ADT holds the potential to unlock the biology of CRPC, possibly revealing biomarkers necessary to predict response to therapy and to identify early recurrence as well as potentially identifying novel therapeutic targets. In this issue of European Urology, Rajan et al. report on a pilot study of gene expression profiling of seven patients with advanced PCa, with paired samples before and after ADT [1]. Using RNA sequencing and bioinformatics approaches, the authors identify alterations in the Wnt/b-catenin signaling pathway following ADT. Furthermore, they show dysregulation of b-catenin in a subset of CRPCs in an independent cohort and a small amount of functional data in cell lines suggesting that inhibition of Wnt/b-catenin signaling may preferentially inhibit CRPC cell growth. The authors should be commended for an approach that attempts to directly interrogate the impact of ADT on PCa signaling pathways in patients and to elucidate the molecular events underlying the emergence of CRPC.

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Research paper thumbnail of COVID-19 transmission during swimming-related activities: a rapid systematic review

BMC Infectious Diseases, 2021

Background There are uncertainties about mitigating strategies for swimming-related activities in... more Background There are uncertainties about mitigating strategies for swimming-related activities in the context of the COVID-19 pandemic. There is an opportunity to learn from the experience of previous re-openings to better plan the future one. Our objectives are to systematically review the evidence on (1) the association between engaging in swimming-related activities and COVID-19 transmission; and (2) the effects of strategies for preventing COVID-19 transmission during swimming-related activities. Methods We conducted a rapid systematic review. We searched in the L·OVE (Living OVerview of Evidence) platform for COVID-19. The searches covered the period from the inception date of each database until April 19, 2021. We included non-randomized studies for the review on association of COVID-19 transmission and swimming-related activities. We included guidance documents reporting on the strategies for prevention of COVID-19 transmission during swimming-related activities. We also incl...

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Research paper thumbnail of Risk-assessment models for VTE and bleeding in hospitalized medical patients: an overview of systematic reviews

Blood Advances, 2020

Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical p... more Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical patients have been developed. To inform the 2018 American Society of Hematology (ASH) guidelines on VTE, we conducted an overview of systematic reviews to identify and summarize evidence related to RAMs for VTE and bleeding in medical inpatients. We searched Epistemonikos, the Cochrane Database, Medline, and Embase from 2005 through June 2017 and then updated the search in January 2020 to identify systematic reviews that included RAMs for VTE and bleeding in medical inpatients. We conducted study selection, data abstraction and quality assessment (using the Risk of Bias in Systematic Reviews [ROBIS] tool) independently and in duplicate. We described the characteristics of the reviews and their included studies, and compared the identified RAMs using narrative synthesis. Of 15 348 citations, we included 2 systematic reviews, of which 1 had low risk of bias. The reviews included 19 unique s...

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Research paper thumbnail of Evidence synthesis 2.0: when systematic, scoping, rapid, living, and overviews of reviews come together

Journal of Clinical Epidemiology, 2020

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Research paper thumbnail of Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models

PLoS currents, Jan 3, 2016

Our objective was to identify published models of coordination between entities funding or delive... more Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the "Cluster Approach" (with 16 case studies), the 4Ws "Who is Where, When, doing What" mapping tool (with four case studies), the "Sphere Project" (with two case stud...

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Research paper thumbnail of Knowledge, beliefs and attitudes of physicians in low and middle-income countries regarding interacting with pharmaceutical companies: a systematic review

BMC Health Services Research, 2016

Understanding the perceptions and attitudes of physicians is important. This knowledge assists in... more Understanding the perceptions and attitudes of physicians is important. This knowledge assists in the efforts to reduce the impact of their interactions with the pharmaceutical industry on clinical practice. It appears that most studies on such perceptions and attitudes have been conducted in high-income countries. The objective was to systematically review the knowledge, beliefs and attitudes of physicians in low and middle-income countries regarding interactions with pharmaceutical companies. Eligible studies addressed any type of interaction between physicians and pharmaceutical companies. The outcomes of interest included knowledge, beliefs and attitudes of practicing physicians. The search strategy covered MEDLINE and EMBASE databases. Two reviewers completed in duplicate and independently study selection, data abstraction, and assessment of methodological features. The data synthesis consisted of a narrative summary of the findings stratified by knowledge, beliefs and attitudes. We included ten reports from nine eligible studies, each of which had a number of methodological limitations. Four studies found that the top perceived benefits of this interaction were receiving information and rewards. In five out of eight studies assessing the perception regarding the impact of the interaction on the behavior of physician prescription, the majority of participants believed it to be minor. In one of these studies, participants perceived that impact to be lesser when asked about their own behavior. The attitudes of physicians towards information and rewards provided by pharmaceutical company representatives (PCRs) (assessed in 5 and 2 studies respectively) varied across studies. In the only study assessing their attitudes towards pharmaceutical-sponsored Continuing Medical Education, physicians considered local conferences to have higher impact. Their attitudes towards developing policies restricting physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interactions with PCRs were positive in two studies. In one study, the majority of participants did not mind the public knowing that physicians were receiving gifts and awards from drug companies. This review identified few studies conducted in low and middle-income countries. While physicians generally perceived the impact of interactions on their behavior to be minor, their attitudes toward receiving information and rewards varied across studies.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Validity of tools used for surveying physicians about their interactions with pharmaceutical company: a systematic review

BMC research notes, Jan 25, 2015

There is evidence that physicians' prescription behavior is negatively affected by the extent... more There is evidence that physicians' prescription behavior is negatively affected by the extent of their interactions with pharmaceutical companies. In order to develop and implement policies and interventions for better management of interactions, we need to understand physicians' perspectives on this issue. Surveys addressing physicians' interactions with pharmaceutical companies need to use validated tools to ensure the validity of their findings. To assess the validity of tools used in surveys of physicians about the extent and nature of their interactions with pharmaceutical companies, and about their knowledge, beliefs and attitudes towards such interactions; and to identify those tools that have been formally validated. We developed a search strategy with the assistance of a medical librarian. We electronically searched MEDLINE and EMBASE databases in September 2015. Teams of two reviewers conducted data selection and data abstraction. They identified eligible studi...

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Research paper thumbnail of Free versus Fixed Combination Antihypertensive Therapy for Essential Arterial Hypertension: A Systematic Review and Meta-Analysis

Background

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Research paper thumbnail of The allure of the waterpipe: a narrative review of factors affecting the epidemic rise in waterpipe smoking among young persons globally

Objective The objective of this narrative review is to highlight the determinants of the epidemic... more Objective The objective of this narrative review is to highlight the determinants of the epidemic rise in waterpipe tobacco smoking (WTS) among youth globally. The Ecological Model of Health Promotion (EMHP) was the guiding framework for the review. Data extraction Articles which analysed determinants of WTS at any of the levels of the EMHP were retained regardless of methodological rigour: 131 articles are included. Articles were coded in a standard template that abstracted methods as well as results. Data synthesis The review found that methodologies used to assess determinants of WTS among youth were often conventional and lacked rigor: 3/4 of the studies were cross-sectional surveys and most enrolled non-representative samples. Within the framework, the review identified determinants of WTS at the intrapersonal, interpersonal, organisational, community and policy levels. Conclusions The review suggests potential interventions to control WTS among youth, with emphasis on creative utilisation of social media, and tobacco control policies that include the specificities of WTS. The review further suggests the need for rigorous qualitative work to better contextualise determinants, and prospective observational and experimental studies that track and manipulate them to assess their viability as intervention targets. BACKGROUND

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Research paper thumbnail of Association between low vitamin D levels and the diagnosis of asthma in children: a systematic review of cohort studies

Background: There is conflicting evidence about the association between low vitamin D levels in c... more Background: There is conflicting evidence about the association between low vitamin D levels in children and development of asthma in later life. The objective of this study was to systematically review the evidence for an epidemiological association between low serum levels of vitamin D and the diagnosis of asthma in children. Methods: We used the Cochrane methodology for conducting systematic reviews. The search strategy included an electronic search of MEDLINE and EMBASE in February 2013. Two reviewers completed, in duplicate and independently, study selection, data abstraction, and assessment of risk of bias.

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