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A halting debate performance by President Biden left Democratic strategists reeling, raising questions about his fitness to stay in the race.
By Alan Rappeport
Reporting from Washington
In the first presidential debate of the year between the leading Democratic and Republican candidates, President Biden and former President Donald J. Trump clashed on inflation, taxes, Ukraine and the future of democracy.
A halting performance from Mr. Biden and a relatively steady and measured delivery by Mr. Trump left Democrats deeply concerned about Mr. Biden’s prospects. Personal attacks overshadowed discussions of policy during the debate, with the candidates sparring over who had a better golf game, their respective cognitive abilities and their legal problems.
On cable news and social media, strategists from both parties wondered if Mr. Biden could continue in the race against Mr. Trump. Few Democrats could muster an upbeat assessment of the president’s performance.
Here is a sampling of the reaction.
“It was a really disappointing debate performance from Joe Biden. I don’t think there’s any other way to slice it. His biggest issue was to prove to the American people that he had the energy, the stamina — and he didn’t do that,” Kate Bedingfield, Mr. Biden’s former White House communications director, said on CNN.
“Biden is even whiffing on his easy pitches — abortion and Jan. 6. I mean, my God,” said Matt Gorman, a Republican strategist and former senior adviser to the presidential campaign for Senator Tim Scott of South Carolina.
“Look, I debated Joe 7 times in 2020. He’s a different guy in 2024,” Andrew Yang, a Democratic presidential candidate in 2020, said on the social media platform X, adding the hashtag #swapJoeout.
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Oat ( Avena sativa L. ) is a cereal grain that produces edible seeds known as oats.
Eating oats can boost the nutrient density of your diet and protect your health in several ways. Studies show that eating oats may reduce heart disease risk by lowering LDL cholesterol, supporting the health of the digestive system, and boosting feelings of fullness after eating.
However, with so many types of oats to choose from, shopping for them can be a confusing process. While most oat products are nutritious, some are better for your health than others.
R.Tsubin / Getty Images
Oat groats, also known as whole oats, are oat kernels that have had their tough outer shells known as hulls removed. Oat groats are the least processed of all oat products and all oats, including steel-cut and rolled oats, begin as oat groats.
Oat groats are slightly higher in fiber and protein than steel-cut and rolled oats, though they contain similar amounts of vitamins and minerals.
Here's the nutrition breakdown of a 1/4 cup serving of dry oat groats:
Oat groats may be a better choice for blood sugar control than more processed oat products as they have a lower glycemic index (GI), which is a measure of a food's impact on blood sugar. The GI ranks foods on a scale of 0-100. Low-GI foods score less than 55, moderate GI foods score between 56-69, and high-GI foods score 70 or greater.
Studies show that intact oat products, such as oat groats, have a GI value of around 43.4, which is considered low.
Because oat groats have an intact grain structure, it's harder for your body to digest and absorb them, which lowers their impact on your blood sugar. They're also a good source of iron , a mineral needed for oxygen transportation, growth and development, cellular function, and the production of certain hormones.
Oat groats have a chewy texture and take about 30 minutes to prepare by boiling on the stovetop. Try swapping out your regular bowl of cereal for oat groats topped with nuts and berries for a nutritious and delicious way to start your day.
annabogush / Getty Images
Oat bran is made by grinding whole oat grains and separating the outer bran layer from the rest of the grain . Oat bran is high in fiber, containing at least 16% fiber by weight, and is also rich in β-glucan, a type of soluble fiber that lowers cholesterol by increasing cholesterol excretion through the stool and preventing its absorption in the digestive tract.
Findings from a 2022 review of 13 studies suggested that supplementation with oat β-glucan is effective for significantly lowering total and LDL cholesterol levels in people with high cholesterol .
A 1/4 cup serving of oat bran provides:
Oat bran is lower in calories and carbs than other oat products, making it a good choice for those looking to reduce their carbohydrate intake. Since it's low in calories and a good source of fiber, it's popular amongst those looking to boost weight loss.
In addition to fiber, oat bran is a good source of zinc , which plays an important role in immune function and skin health.
Oat bran can be enjoyed as a hot cereal and can also be used to boost the fiber intake of home-baked products like bread , muffins, and crackers.
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After oat groats, steel-cut oats are the least processed type of oat product you can buy. Steel-cut oats are made by chopping oat groats into smaller pieces, which results in an oat product with a chewier texture and higher fiber content than rolled oats.
Here's the nutrition breakdown for a 1/4 cup serving of dry steel-cut oats:
Like oat groats, steel-cut oats are a good source of iron . They also provide a good source of fiber and protein, though slightly lower in these nutrients than oat groats. Steel-cut oats have a GI of around 53, making them a good choice for maintaining healthy blood sugar regulation.
Steel-cut oats take longer to prepare than rolled oats, with an average cooking time of 20-30 minutes on the stovetop. Soaking steel-cut oats overnight can help cut back on cooking time and also help reduce antinutrients found in oats, like phytates, tannins, and oxalates, which interfere with the absorption of nutrients like zinc and iron.
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Rolled oats, commonly known as "old fashioned" oats, are one of the most popular types of oat products. They're made by steaming and flattening oat groats, which improves the texture of the oats and decreases cooking time. Rolled oats have a soft texture and are much quicker to prepare than steel-cut oats or oat groats, with a cook time averaging around five minutes.
Though they're slightly lower in fiber and protein than oat groats and steel-cut oats, they're still a healthy choice.
A 1/4 cup serving of raw rolled oats contains:
Because rolled oats are more processed than steel-cut oats or oat groats, they're easier to digest and have a higher glycemic index. Rolled oats have a GI of around 56, which is considered a moderate GI. To reduce the impact of rolled oats on your blood sugar, try eating oats alongside foods high in fiber and protein. Fiber and protein help slow digestion, which reduces the rate at which sugar is absorbed into the bloodstream.
For example, try making a savory breakfast bowl by topping rolled oats with protein-rich eggs and fiber-rich sautéed vegetables for a blood sugar-friendly breakfast idea.
Instant oats are popular amongst those looking for a quick breakfast option that saves them time in the kitchen. Quick oats are rolled very thin and are sometimes pre-cooked, which cuts down on cooking time. Most instant oats take just a minute or two to prepare.
Instant oats can be found individually packaged in single servings and come in a variety of flavors such as cinnamon sugar, maple, and strawberries and cream.
Though instant oats provide important nutrients, flavored instant oats can be very high in added sugar, which can be problematic when consumed in large quantities.
Here's the nutrition breakdown for a single-serving package of Quaker Maple and Brown Sugar instant oatmeal:
Because they're lower in fiber and protein, instant oats have a more significant effect on blood sugar than steel-cut oats or oat groats. Many instant oat products are also high in added sugar, which can increase their effect on blood sugar levels.
Some instant oatmeal products can contain several teaspoons of added sugar per serving and can harm health if consumed regularly. Studies show that diets high in added sugar contribute to several health issues, from promoting weight gain to increasing the risk of heart disease .
If you want the convenience of instant oats without added sugar , try plain quick-cooking rolled oats. Quick-cooking rolled oats are rolled oats that have been rolled out to a thinner consistency than traditional rolled oats, which cuts back on cooking time. Quick cooking rolled oats usually take under five minutes to prepare, making them a convenient choice.
YelenaYemchuk / Getty Images
If you're looking for a way to add oats into your diet but aren't a fan of oatmeal or oat bran, consider trying oat flour.
Oat flour provides the same nutrients and beneficial compounds as oats, including β-glucan, which can help support healthy blood sugar regulation, reduce cholesterol levels, and promote digestive health by encouraging the growth of beneficial probiotic bacteria in the gastrointestinal tract.
A 1/4 cup serving of oat flour provides:
Oat flour is higher in protein and fiber than all-purpose flour and provides a decent amount of minerals such as zinc and iron. It also makes an excellent all-purpose flour substitute for people with celiac disease and non-celiac gluten intolerance, as it's naturally gluten-free .
Oat flour has a mild, slightly nutty flavor and is delicious in baked goods like cookies, breads, and muffins. Because it's lighter than all-purpose flour, you'll need to use slightly more when using it in place of all-purpose flour in recipes. It's often recommended to use 1¼ cups of unpacked oat flour for every one cup of unpacked all-purpose flour.
Oats are nutritious and versatile and can be used to create quick, filling dishes, including sweet and savory recipes.
Here are a few ways to enjoy oats:
There are many other ways to incorporate oat products, like oat groats, rolled oats, oat bran, and oat flour into your diet. Try keeping a variety of oat products in your pantry so you always have a healthy option on hand.
Oats are a good source of several nutrients, including fiber, iron, and protein, and can be incorporated into both sweet and savory recipes. There are several types of oat products, some of which are more nutritious than others.
While oat groats, steel-cut oats, rolled oats, and oat bran make healthy choices, it's important to watch out for high levels of added sugar in flavored instant oat products.
Paudel D, Dhungana B, Caffe M, Krishnan P. A review of health-beneficial properties of oats . Foods . 2021;10(11):2591. doi:10.3390/foods10112591
Joyce SA, Kamil A, Fleige L, Gahan CGM. The cholesterol-lowering effect of oats and oat beta glucan: modes of action and potential role of bile acids and the microbiome . Front Nutr . 2019;6:171. doi:10.3389/fnut.2019.00171
U.S. Department of Agriculture. FoodData Central. BOB'S RED MILL, WHOLE GRAIN OAT GROATS .
Ahmed J, Riaz M, Imtiaz R. Glycemic index and glycemic load values . Pak J Med Sci . 2021;37(4):1246-1247. doi:10.12669/pjms.37.4.4555
Zhang K, Dong R, Hu X, Ren C, Li Y. Oat-based foods: chemical constituents, glycemic index, and the effect of processing . Foods . 2021;10(6):1304. doi:10.3390/foods10061304
National Institutes of Health: Office of Dietary Supplements. Iron .
Yu J, Xia J, Yang C, et al. Effects of oat beta-glucan intake on lipid profiles in hypercholesterolemic adults: a systematic review and meta-analysis of randomized controlled trials . Nutrients . 2022;14(10):2043. doi:10.3390/nu14102043
U.S. Department of Agriculture: FoodData Central. Oat bran, raw .
National Institutes of Health: Office of Dietary Supplements. Zinc .
U.S. Department of Agriculture. FoodData Central. STEEL-CUT ORGANIC QUICK COOK OATS, STEEL-CUT .
Alemayehu GF, Forsido SF, Tola YB, Teshager MA, Assegie AA, Amare E. Proximate, mineral and anti-nutrient compositions of oat grains (Avena sativa) cultivated in Ethiopia: implications for nutrition and mineral bioavailability . Heliyon . 2021;7(8):e07722. doi:10.1016/j.heliyon.2021.e07722
U.S. Department of Agriculture: FoodData Central. Old fashioned oats .
Murillo S, Mallol A, Adot A, et al. Culinary strategies to manage glycemic response in people with type 2 diabetes: A narrative review . Front Nutr . 2022;9:1025993. doi: 10.3389/fnut.2022.1025993
Quaker. Maple brown sugar instant oats .
Yi SY, Steffen LM, Terry JG, et al. Added sugar intake is associated with pericardial adipose tissue volume . Eur J Prev Cardiol . 2020;27(18):2016-2023. doi:10.1177/2047487320931303
DiNicolantonio JJ, O’Keefe JH. Added sugars drive insulin resistance, hyperinsulinemia, hypertension, type 2 diabetes and coronary heart disease . Mo Med . 2022;119(6):519-523. PMID: 36588634
Joyce SA, Kamil A, Fleige L, Gahan CGM. The cholesterol-lowering effect of oats and oat beta glucan: modes of action and potential role of bile acids and the microbiome . Front Nutr . 2019;6:171. doi:10.3389/fnut.2019.00171
U.S. Department of Agriculture: FoodData Central. Oat flour .
By Paige Stables
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For a recent Hamptons getaway, I packed not one… not two… but three hot tools in my carry-on bag: a Dyson Supersonic blow-dryer , a GHD Platinum flatiron , and a Dyson Airwrap . All three were necessary to bring along. (Hold any eye-rolling, please.) All three were, in fact, used to style my hair throughout the long weekend. And though I’m not a light packer—evidently, I like to be fully accessorized—I would happily only pack a single tool if it could create the different styles (straight and polished, a voluminous blowout , soft waves) I regularly wear and keep my bangs sleek. T3’s brand-new Aire 360 might just be the solution.
At first glance, T3’s pretty-in-pastel-pink gadget looks familiar. To the Dyson Airwrap (I hold both side-by-side) and the numerous other air stylers on the market, certainly, but also to the brand’s existing Airebrush Duo that launched in 2021. That’s because it’s a similar concept: there’s a base complete with three heat settings, a cool shot function, and three speed settings, plus four attachments (a concentrated dryer nozzle, an oval brush—it’s the same design as the 2021 version —and two curling barrels for creating waves in opposite directions). What makes it unique: “Our barrels are ceramic, not plastic, so the heat management is different,” T3 cofounder Julie Chung tells me at the launch event. She emphasizes, “It's not tech for the sake of tech.”
What that means: the Aire 360 gets HOT. (Warning: Do not touch the attachments after styling—except on the heat-proof ends—or they will burn you.) But not too hot for your hair: T3 did independent testing on the tool to determine exactly how high they could turn up the heat to lock in a style—without causing hair damage. According to the brand’s research, tools over 320 degrees Fahrenheit will cause damage, specifically to wet hair. The highest setting on the Aire 360 is well under that at about 237 degrees Fahrenheit (Remember to keep your fingers—and ears—at a distance from the barrels!), whereas most curling irons reach nearly 400 degrees Fahrenheit. Even so, prepping with a heat protectant is still imperative to shield your hair from potential damage.
Allure senior beauty editor Paige Stables styles her hair with T3's new Aire 360.
And like most other “blowout brushes,” heated air is flowing through the attachments, but “air is not just air,” says Chung. Like the brand’s other Best of Beauty-winning dryers, the SoftAire Drying Concentrator attachment emits ion-enriched air to speed up drying time.
When I went to put the Aire 360 to the test on my fine, wavy hair, I was impressed before I even pulled the tool out of its millennial pink vegan leather storage bag. Each attachment has a dedicated pocket in the pouch. Chung tells me it’s called the “Ashley bag” internally, named after her friend who expressed the need for a proper, non-bulky, and elevated place to keep all the gadgets (because, with most hot tools, you get a bulky box… or nothing) between uses and easily on the go.
Inside the bag, I reached for the dryer attachment first (this eliminates the need to have a separate blow-dryer on hand—hallelujah!) and started by rough-drying my hair. “A good way to avoid over-blow-drying is to rough-dry your hair first to get a good amount of the moisture out and then smooth it with a boar-bristle brush,” Rachel Bodt , a colorist in New York City, previously told Allure . The delicate gust (on the medium setting) was enough to sweep my bangs into formation.
Allure senior beauty editor Paige Stables' hair after styling it with the T3 Aire 360.
Once my hair was about 80% dry, I grabbed the Custom Oval Brush attachment to get volume at the roots, smooth the ends, and polish my bangs. Unlike a traditional round brush, you don’t have to be a professional to operate it (I type this from experience), and the flexible bristles easily glide through my hair for a sleek finish after just a few passes. I was pleased with the flowy, polished finish but could have added more of a bend with the round brush, too.
Another day, I took things a step further, testing out the curling barrels. Each barrel rotates in opposite directions (to curl your hair away from your face and not have to do gymnastics with your arms). One minor caveat: I have been spoiled by Dyson’s curling barrels clicking back and forth into different airflow directions, whereas with T3's design, you have to swap out the entire attachment—but it requires very minimal effort to interchange the two. Once locked in, T3’s barrels do all the work for you, creating pristine curls (in about five to seven seconds). Hairstylist Xavier Velasquez advises grabbing one-inch sections and hitting the cool shot “for five to ten seconds” before releasing the curl for the best results. Velasquez explains, “You don’t have to twist or twirl the [curling barrels].” Instead he “pushes and pulls the tool in and out.”
Allure’s associate manager of special projects Talia Gutierrez was initially drawn to the Aire 360 for its oval blow-dry brush attachment. “The bristles allow for a tight grip around my thick hair, shortening the number of passes needed to smooth my otherwise wavy, coarse hair,” says Gutierrez. That said, she was even more impressed by the curling barrels: “My hair can typically hold a curl for days, but it usually requires the heat of a curling iron, and with T3's new tool on the highest heat and airflow settings, I was able to get shiny, large, bouncy ringlets that lasted.”
By Sophie Saint Thomas
By Aliza Kelly
That was the brand’s big goal: “The curls will last. No hacks. Full stop,” says Chung. And we can confirm they do—on both the finest and thickest hair. After wearing soft waves to a night at the ballet, I woke up to “bedhead” that looked more like a fresh, wavy blowout. And that is no small feat.
You can shop the T3 Aire 360 for $300 on t3micro.com and sephora.com .
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By Annie Blay
25 companies hiring now for fully remote jobs in 2024.
When searching for remote work, ensure that the company provides holistic wellbeing and career ... [+] support as well
Within the United States, the professional, scientific, and computer-related occupations have the highest shares of job postings for hybrid roles, and most importantly, fully remote work, according to recent findings from a National Bureau of Economic Research study .
Across these sectors can be found companies who have taken innovative approaches to hiring and proactive employee retention, ensuring employee wellbeing is consistently upheld, including fully remote, hybrid options, unlimited PTO, and even offering access to meditation, yoga, and wellness classes.
Some of these employers have been highlighted by FlexJobs as being most active in posting the highest number of remote jobs, hiring fully remote and flexible roles since the start of the year.
The industries represented by these employers span the most popular industries for remote work, mirroring the sectors listed in the NBER study, such as healthcare, consulting, technology, finance, and social media.
They also are highly diverse and span a wide range of career paths and interests, so you are sure to find something suitable for your career goals:
Here are 25 from their full list, and some noteworthy highlights for a few of these employers:
Best 5% interest savings accounts of 2024, 1. robert half international.
Robert Half, a recruitment agency and HR consulting firm, is listed as being the one of the "Best Workplaces for Parents" in 2023, was included in Fortune's "Most Admired Companies" in 2024, and provides strong career development support and an almost four-star rating on Glassdoor.
Veeva is an international cloud-computing company specifically focused on the life sciences industry. They also have a work-from-anywhere policy , while investing in their global offices for occasional meetings.
AECOM is an infrastructure consulting firm, covering several projects on a multinational level, including large-scale construction management, urban planning, and engineering. The employer was also listed as one of the Most Admired Companies.
A household name for many, CVS Health is the second-largest healthcare company, being beaten only by UnitedHealth Group. It provides health solutions including CVS Pharmacy, Aetna Health, and CVS Speciality, with associated apps. CVS Health expresses commitment to diversity including employees with disabilities, and is transparent about its hiring process on its website.
HubSpot, a leading provider in digital marketing, sales and customer service tools, training, and support, is based internationally and takes a very flexible, innovative approach to employee location, providing three options for candidates when they join the company. This makes it very attractive for those who desire fully remote work, as well as those who wish to come into the office from time to time.
All roles are eligible to be fully remote, however you have the option of also selecting their flex plan (coming into the local office more than twice a quarter), or their office-based plan if you would prefer in-person work and the office is local to you.
Some of the other employers listed who are hiring and support fully remote and flexible working for their roles, include:
Many of these employers not only offer remote jobs, but they are proactive about providing you with the opportunity to thrive while working from home, so you do not feel isolated, and to ensure that your role is fully supported so you can deliver your best work. For example, some employers such as HubSpot provide a stipend for working from home, in addition to a Slack hub and extra training resources to enable you to thrive in your job.
Some employers offer a WFH stipend and flexible location options as part of their fully remote ... [+] policy
When searching for employers who are hiring for fully remote jobs, remember to consider the bigger picture. Is remote an afterthought, something that they've shoved into their policy as a way to attract talent, but hasn't been fully thought through? Or is remote working part of a more extensive employee support and development package, in which your wellbeing and professional growth is holistically championed?
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Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
Chapter 9 methods for literature reviews.
Guy Paré and Spyros Kitsiou .
Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).
Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).
The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).
When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.
The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.
As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:
Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).
Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).
EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.
The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).
Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).
Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.
Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.
The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).
In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.
An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).
Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.
Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).
One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).
Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.
Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:
Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.
The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed independently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.
Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.
A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guidelines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.
In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).
Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).
To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).
The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.
Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).
Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.
Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.
Typology of Literature Reviews (adapted from Paré et al., 2015).
As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.
In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.
We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.
To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.
This publication is licensed under a Creative Commons License, Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0): see https://creativecommons.org/licenses/by-nc/4.0/
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From ice-cream sandwiches to uniquely flavored cartons, Trader Joe's sells an array of frozen desserts.
Step into Trader Joe's , and you'll find an impressive selection of ice cream year-round.
So, I tried as many of the chain's frozen treats as I could get my hands on to figure out which ones are worth buying.
Here's how each treat stacked up.
Editor's Note: This story was originally published in August 2022, and most recently updated on June 28, 2024. Product availability may vary from year to year.
Like true horchata, this ice cream derives its flavor from a sweet-rice and cinnamon base.
Though the beverage traditionally doesn't contain any dairy, this dessert had a creamier flavor.
The horchata ice cream reminded me of leftover cereal milk with cinnamon, and I was absolutely here for it. It was sweet and tasty, yet incredibly light on the tongue.
There were also tiny pieces of horchata-flavored cookies mixed in throughout that added a pop of cinnamon.
VERDICT: This was a perfect 10. I hope Trader Joe's keeps it around so I can buy it again and again.
It may seem silly to review vanilla ice cream, especially when Trader Joe's has so many inspired flavors, but this one deserves a shout-out.
I was impressed by the quality right off the bat.
The authentic vanilla flavor struck the right balance of sweet and creamy without being overwhelming.
This would be great with baked goods or other sweet toppings, like chocolate or caramel sauce.
VERDICT: I don't usually reach for vanilla ice cream, but this will be my go-to for birthday parties and other gatherings.
This ice cream felt high quality — it didn't rely on sugar or extracts for flavor. The overall texture was as smooth as gelato.
There was even finely ground espresso mixed in for an artisan flair.
This ice cream tasted more like coffee than the average, java-flavored carton — which was a good thing.
It was incredible on its own, but if you wanted to elevate the dessert, pile it on one of Trader Joe's chocolate lava cakes .
VERDICT: This delicious ice cream sported just the right balance of roasted-coffee flavor and sweetness.
These sandwiches have a lot going for them. They're portable, sport a tasty center of coffee ice cream, and use brownies in place of wafers.
Plus the chocolate chips on top made every bite satisfyingly chewy.
Even though the texture was on point, the chocolaty flavor of the brownies was underwhelming.
The brownie crisps might've been better mixed into ice cream, but they didn't impress as the star of the show.
That said, I probably wouldn't have noticed or cared so much if the coffee ice cream wasn't so good. The difference was stark.
VERDICT: These were still pretty tasty, if not for the coffee ice cream alone, but I wouldn't choose them over the chocolate-chip-cookie sandwiches.
Every once in a while, I try to limit my dairy intake for personal reasons.
And these chocolate-fudge oat bars satisfied my craving for a sweet, chocolaty treat that didn't leave me feeling heavy.
The oat base offered a smooth mouthfeel and subtle sweetness without an obvious aftertaste.
The chocolaty flavor wasn't as bold as a traditional Fudgsicle and tasted slightly less sweet, but for a dairy-free option, it still satisfied.
To take these to the next level, I'd dip them in a vegan chocolate shell made of melted chocolate chips and coconut oil .
VERDICT: I'd definitely buy these again and recommend them to anyone looking for a chocolaty, vegan treat.
Ube is a purple yam native to the Philippines. The flavor was extracted into a puree for this ice cream and gives the treat its gorgeous lilac color.
There's been so much buzz around this flavor ever since it dropped in 2019. For over a week, I checked my Trader Joe's to find a carton, and when I finally did, this was the last one.
This ice cream offered such a unique flavor experience. It tasted like a cross between pistachio and toasted coconut, with notes of white chocolate. It was absolutely delicious.
I particularly liked that the sweetness was quite mellow, which allowed the flavor to seem more nutty than sugary.
VERDICT: Two thumbs up from me.
This wouldn't be a Trader Joe's roundup without something featuring cookie butter.
This ice cream was packed with semi-solidified chunks of actual cookie butter, so every bite was caramelly and buttery, with the inviting hint of cinnamon and ginger spice.
As expected, this flavor was unmistakably sweet and tasty.
However, some of the cookie-butter pieces had a slightly waxy texture that left an odd taste on the sides of my mouth.
This wasn't off-putting enough to ruin the whole thing, but it definitely kept me from wanting more than a scoop or two at a time.
VERDICT: If you're like me and obsess over the Speculoos cookie butter, this would be right up your alley.
I'm always intrigued by unique, vegan treats.
Made with a base of coconut milk, this frozen dessert was flavored like cold brew and sported the small tapioca pearls you can find at some beverage shops.
This had more of a sweet, milky taste, like a latte , rather than an intense coffee flavor of a cold brew, but it was still quite yummy.
I wasn't sold on the texture, which was more icy than creamy. Granted, this isn't technically ice cream, just a frozen dessert.
There were plenty of chewy tapioca pearls, which would be great for boba fans, but folks who've never had bubble tea may find them a bit overwhelming.
VERDICT: I wouldn't reach for this again, but it was a decent vegan option.
Between the fresh berry purée, sweet-cream ice cream, and cheesecake pieces, every spoonful of this carton screamed perfection.
It appeared delightfully decadent, yet bright and inviting.
The blueberries and raspberries added a brightness that really popped against the rich ice cream.
And even though the cheesecake pieces were quite small, they made each bite all the more exciting.
VERDICT: This ice cream doesn't need toppings to be worth your while. I wish it came by the gallon, but for my sake, it's best that it doesn't.
I haven't eaten a creamsicle in about 20 years, so seeing these ice pops brought me back.
Instead of a traditional orange-sherbet coating, this used a tangerine shell, so the color was more of a natural yellow, like fresh-squeezed juice.
This pop was more tart than I anticipated, but this made the sweet vanilla ice cream at the center all the more satisfying.
VERDICT: I'd gladly buy these every summer, just for the nostalgic taste.
This dessert had an oat-milk base and almond-brittle chunks.
I'm not vegan, but I still thank my lucky stars there are plant-based frozen desserts that don't have an off-putting aftertaste.
The texture was light and fluffy, almost mousse-like. The strawberry flavor reminded me of yogurt , with a candied sweetness that was mellow enough to not be cloying.
However, the advertised almond brittle was more like candied nuts. I appreciated the attempt to cut through the fruity sweetness and add some dimension, but its overall presence seemed unnecessary.
Not all ice creams need texture, and the brittle makes this product unfriendly to many people with nut allergies.
VERDICT: I'm not rushing to buy this again, but I wouldn't turn it away if I were offered some.
With punny-named, multidimensional flavors, Trader Joe's may be in its Ben and Jerry's era, and I'm not mad about it.
If you love the chain's dark-chocolate peanut-butter cups, this ice cream was made for you.
It had a superrich, chocolate ice-cream base with ribbons of actual peanut butter and soft pieces of peanut-butter Joe-Joe's.
The iconic flavor combo hit again.
However, the mix-ins seemed inconsistent. Some bites tasted like pure peanut butter , which caught me off guard.
It also could've used more Joe-Joe's chunks.
VERDICT: On the whole, this was passable — just not something I'm in a hurry to buy again.
In college, I'd buy cookie ice-cream sandwiches, so this box of four caught my eye.
Even better, they tasted just as yummy as the "fresh" ones.
The chocolate-chip cookies were soft and chewy, like they were freshly baked, but stayed intact through every bite without crumbling or getting soggy.
The chocolate chips lining the outside of each sandwich added some texture that made this fun to eat. And, of course, the vanilla ice cream was the perfect complement to the notes of brown sugar.
VERDICT: I enjoyed these even more than the brownie-crisp sandwiches.
Like a regular bonbon, these featured a great-tasting chocolate shell that gave way to a vanilla center.
I was worried the coconut "ice cream" would make these taste like a frozen Mounds bar, but Trader Joe's expertly masked that flavor.
Despite this treat's impressive taste, the mixed-in cookie bits didn't offer much besides a vaguely chocolaty nuance, so it didn't quite achieve the cookies-and-creme flavor advertised on the box.
That wasn't a dealbreaker, though. For a vegan ice-cream snack , these hit the spot.
Plus, each bonbon was a multi-bite treat, so one was more than enough to satisfy me.
VERDICT: I'd definitely buy these again for weeks when I want to limit my dairy intake.
This gelato looked so pretty in the carton that I didn't want to scoop it up.
When I opened the container, I saw four pinwheel-like swirls of chocolate and vanilla gelato covered with ribbons of fudge resembling snowy mountain tops. It reminded me of the displays in Italian gelato shops.
I'm no gelato expert, but I'd say this was worth buying. Texture-wise, it was thicker than ice cream but softer on the palate (gelato is made with less milk fat than ice cream, which might explain this).
It wasn't as icy as traditional ice cream, but was closer to smooth frozen yogurt or soft serve.
I usually go for exciting gelato flavors, like pistachio or salted caramel, so the chocolate and vanilla were a bit underwhelming to me. But that doesn't make this bad. It's just something I'm unlikely to reach for again in the future.
VERDICT: I thought the flavors were sort of boring, so I'll likely skip this in the future. However, it's worth trying if you're new to gelato.
As someone who grew up in the '90s, I can say with authority that back then, nothing was better than enjoying a bright blue, red, green, or purple ice pop on a hot day. So, I was really excited when I saw these colorful ice pops in Trader Joe's freezer section.
The ice pops, which come in cherry-limeade, berry, and orange flavors, had a modern feel. Like the freezer pops I enjoyed as a kid, these had a bright, fruity taste.
The packaging advises shaking the bag of ice pops before freezing them to avoid awkward juice pooling. I skipped this step, but the flavor of the freezer pops seemed fine to me.
The packaging notes that this take on handheld ice pops is made with 100% juice. However, I don't know if that makes much of a difference as far as flavor goes, since most ice pops taste just like juice to me.
By far, my favorite flavor was cherry limeade. The combination of citrusy and tart flavors tasted so grown-up. On that note, I'd gladly stick one of these pops into a cranberry cocktail for an added punch of flavor.
VERDICT : It's worth having a bag of these ice pops in the freezer for hot summer days.
Trader Joe's fudgy cookie-dough ice cream was creamy and chock full of slightly crumbly chocolate-chip cookie-dough nuggets.
I intended to sample just a spoonful but ended up returning for a full bowl.
The swirls of fudge made this ice cream an absolute standout that's worth buying. The faintest hint of sea salt from the fudge swirl enhanced the vanilla ice cream and made the chocolate chips pop.
It's the kind of detail you don't think would make a big difference in overall flavor, but it made this ice cream much more memorable. If Trader Joe's threw brownies into the mix, this could give Ben & Jerry's popular Half Baked ice cream (another chocolate-heavy cookie-dough flavor) a run for its money.
VERDICT: This flavor only comes around during the summer, so I plan to stock up every June.
Snacks like this are the reason I love Trader Joe's. I was excited to see a baked good complete with a pre-torched marshmallow. I thought these s'mores bars, made with a fudgy brownie sandwiched between a graham-cracker crust and toasted-marshmallow topping, would have the vibes of a great camping trip and a bougie café treat.
Per the package instructions, you can either thaw these bars at room temperature for two hours or heat them in a conventional oven or air fryer. I chose the first option because I didn't want to turn on either appliance and heat my apartment on a hot summer day. Looking back, though, I'd go with the oven option to get the full s'mores experience.
After two hours, the bars were still sort of cold, but I indulged anyway. Lucky for me, they were still quite tasty.
I devoured two bars in the amount of time it takes to toast a marshmallow on a campfire, which should tell you everything you need to know. These were delicious.
The brownie layer was satisfyingly chewy and fudgy, with an intense, chocolaty flavor. The marshmallow component was fluffy, like the jarred stuff you get in the store, and tasted exactly as I'd expected. However — this may sound nitpicky — there's something about a warm, gooey marshmallow that a room-temperature one can't compare to.
The graham-cracker layer held together decently under the marshmallow, but I wished it were a bit thicker or had a standout cinnamony flavor — as it was, it got a bit buried under the other two layers. To me, it tasted more like a simple pie crust. Still, it worked as an anchor to tone down all the sweetness.
VERDICT: I'm a picky s'mores traditionalist, so it's hard to say this truly delivers the vibe of the campfire classic. I think of this as a marshmallow brownie more than a play on s'mores. I also wish these came individually wrapped so I didn't feel pressured to finish them all during the workweek.
Otherwise, they're worth every penny. I'd buy this again to avoid baking anything.
Click to keep reading other Trader Joe's taste tests in this series .
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3. Types of Review Articles. The first step in writing a good literature review is to decide on the particular type of review to be written; hence, it is important to distinguish and understand the various types of review articles.
Systematic review: Seeks to systematically search for, appraise and synthesis research evidence, often adhering to guidelines on the conduct of a review. Systematic search and review: Combines strengths of critical review with a comprehensive search process. Typically addresses broad questions to produce 'best evidence synthesis'. Systematized ...
There are many types of reviews --- narrative reviews, scoping reviews, systematic reviews, integrative reviews, umbrella reviews, rapid reviews and others --- and it's not always straightforward to choose which type of review to conduct.These Review Navigator tools (see below) ask a series of questions to guide you through the various kinds of reviews and to help you determine the best choice ...
Types of reviews and examples. Definition: "A term used to describe a conventional overview of the literature, particularly when contrasted with a systematic review (Booth et al., 2012, p. 265). Characteristics: Example: Mitchell, L. E., & Zajchowski, C. A. (2022). The history of air quality in Utah: A narrative review.
This site explores different review methodologies such as, systematic, scoping, realist, narrative, state of the art, meta-ethnography, critical, and integrative reviews. The LITR-EX site has a health professions education focus, but the advice and information is widely applicable. Types of Reviews. Review the table to peruse review types and ...
Outlines other types of reviews like rapid reviews, mixed methods reviews, overview of reviews, etc. For each review, includes: definition, process, timeframe, limitations, + links to useful resources for conducting the review.
A well-written review article must summarize key research findings, reference must-read articles, describe current areas of agreement as well as controversies and debates, point out gaps in current knowledge, depict unanswered questions, and suggest directions for future research ( 1 ). During the last decades, there has been a great expansion ...
Three common types of review articles submitted to CMEJ. Often associated with Cochrane Reviews, this type of review aims to answer a narrowly focused question and uses a predetermined structured method to search, screen, select, appraise and summarize findings. Tang KS, Cheng DL, Mi E, Greenberg PB.
The review purpose, methods used and the results produced vary among different kinds of literature reviews; some of the common types of literature review are detailed below. Common Types of Literature Reviews 1 Narrative (Literature) Review. A broad term referring to reviews with a wide scope and non-standardized methodology
Rapid Review. Knowledge synthesis that accelerates the process of conducting a traditional systematic review; Streamlines or omits specific steps to produce evidence for stakeholders in a resource-efficient manner; Umbrella Review. Review of reviews; Synthesizes evidence from other published systematic reviews and/or meta-analyses on a broad topic
Types of Literature Reviews: Critically Appraised Topic (CATs) : A critically appraised topic (or CAT) is a short summary of evidence on a topic of interest, usually focused around a clinical question. A CAT is like a shorter and less rigorous version of a systematic review, summarizing the best available research evidence on a topic.
Classic literature reviews help advance a subject area. In this article, we discuss the types of review articles and what kinds of review articles are likely to be impactful. In the case of theme- based reviews, we suggest that framework-based reviews that use a framework such as TCCM (Theory, Context, Characteristics, Methods) are generally ...
Reporting. Three key aspects of this final step are common across systematic reviews. First, the results from the fifth step need to be presented, clearly and compellingly, using narratives, tables, and figures. Second, core results that emerge from the review must be interpreted and discussed by the author.
Types of review articles. Review articles are typically of three types: literature reviews, systematic reviews, and meta-analyses. A literature review is a general survey of the research topic and aims to provide a reliable and unbiased account of the current understanding of the topic.
Systematic Reviews. With a clearly defined question, systematically and transparently searches for a broad range of information to synthesize, in order to find the effect of an intervention. uses a protocol. has a clear data extraction and management plan. Time-intensive and often take months to a year or more to complete, even with a multi ...
An umbrella review is a review of multiple systematic reviews. The process uses explicit and systematic methods to search for, and identify, systematic reviews on related research questions in the same topic area. The purpose of an umbrella review is to synthesize the results of the systematic reviews across important outcomes.
Different Types of Article Review. In academic writing, the landscape of article reviews is diverse and nuanced, encompassing a variety of formats that cater to different research purposes and methodologies. Among these, three main types of article reviews stand out due to their distinct approaches and applications: Narrative.
What are the different types of reviews? Although systematic reviews are one of the most well-known review types, there are a variety of different types of reviews that vary in terms of scope, comprehensiveness, time constraints, and types of studies included. Type of Review. Description. Time to Complete. Search Strategy.
Peer review. Peer review is the process by which experts in the subject area review and article and provide their feedback. Journals typically have between 1-3 reviewers per article depending on the journal's review criteria and the availability of reviewers. Journals should establish how they will recruit peer reviewers.
Review articles can be of three types, broadly speaking: literature reviews, systematic reviews, and meta-analyses. Review articles can be of varying lengths depending upon the journal and subject area. For narrative reviews or literature reviews, the length could range anywhere between 8000 to 40,0006 words while systematic reviews are usually ...
In this article, we are going to provide you with the 10 major types of reviews. They include umbrella, scoping, critical, literature, realistic, integrative, mapping, rapid, and quantitative systematic review. We have discussed them below. 1. Umbrella Review. An umbrella review is the master review.
Peer review brings academic research to publication in the following ways: Evaluation - Peer reviewing research helps publications select the highest quality articles.; Integrity - Peer review ensures the integrity of the publishing process and the scholarly record.; Quality - The filtering process and revision advice offered by verified experts within the academic field improves the ...
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9.3. Types of Review Articles and Brief Illustrations. EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic.
I tried every Trader Joe's ice-cream flavor and frozen dessert I could find and reviewed them. The chain's horchata-inspired and ube-flavored ice creams were both unique, delicious options. Trader ...