The objectives of this scoping review are to (1) describe the available literature regarding the utility of the debate-style journal club for health professional learners on literature evaluation skills and (2) report the themes found within debate-style journal club research and assessments in the context of professional education.
A total of 27 articles written in the English language were included in this scoping review. Published evaluations of debate-style journal clubs have been predominantly based in the pharmacy profession (48%, n = 13), but are reported in other health professions, such as medicine (22%, n = 6), dentistry (15%, n = 4), nursing (7%, n = 2), occupational therapy (4%, n = 1), and physical therapy (4%, n = 1), as well. The skills assessed in these studies often included critical literature evaluation, application of literature to patient care, critical thinking, knowledge retention, use of supporting literature, and debate-specific skills. Learners typically reported better understanding and application of the literature, and enjoying the experience more than traditional journal clubs, but note the increased assessor and learner time requirement for debating. Pharmacy learner-specific articles more often utilized a traditional, team-based debate format, incorporated grading rubrics for skill assessment and debate performance, and included a grading component for the debate in the course.
Debate-style journal clubs are well-received by learners but require an additional time commitment. Debate platforms, format, rubric use and validation, and outcome assessment vary across published reports.

BACKGROUND: Nurse educators are required to prepare graduates for the increasing complexities of the practice environment. Debate is an active teaching strategy long recognised in many disciplines to promote student-centred learning by enhancing the development of communication skills, collaboration, and critical thinking, all of which are essential skill for future nurses.
OBJECTIVE: The aim of this study was to compare in-class university structured debate implementation methods among undergraduate nursing students, and to identify the effect of such debate methods in the students\' learning.
METHODS: A systematic review of the literature.
METHODS: Publications in English identified in multiple databases (PubMed, CINAHL, Web of Science, Medline and ERIC) from the launch of the database until 26th November 2019.
METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review. Studies that investigated the use of in-class debate among undergraduate nursing students as a pedagogical tool were eligible. Information related to the study design, debate process characteristics, evaluation method of the teaching strategy and results were collected.
RESULTS: We identified 14 relevant studies describing structured implementation of debate, 11 of which were instructional design and 3 quasi-experimental studies. Heterogeneity was found across the papers regarding topics, timing schedules, group formation and positioning. Most of the studies evaluated implementation using satisfaction questionnaires or subjective observations. Three quasi-experimental studies reported that implementation of debating improved declarative capacity, argumentative capacity, idealistic moral judgment, and realistic moral judgment.
CONCLUSIONS: Current studies do not provide enough evidence to understand the scope of structured debating as an instrument to develop personal competences needed in nursing. However, based on the evidence reviewed, we have identified elements to establish a debate-based learning format that might enhance student\'s learning and future studies.

The degree to which sex differences exist in the brain is a current topic of debate. In the present discussion paper, we reviewed eight functional magnetic resonance imaging (fMRI) papers to determine whether there are sex differences in brain activity during long-term memory retrieval. The objectives were: 1) to compare the experimental parameters in studies reporting significant versus null long-term memory sex differences, and 2) to identify whether specific brain regions were associated with sex differences during long-term memory. The following experimental parameters were extracted from each paper: the number of participants, the average age of participants, stimulus type(s), whether or not performance was matched, whether or not sex differences were reported, the type of between-subject statistical test used, and the contrast(s) employed. The particular experimental parameters employed in each study did not appear to determine whether sex differences were observed, as there were sex differences in all eight studies. An activation likelihood estimation (ALE) meta-analysis was conducted to identify brain regions activated to a greater degree by females than males or males than females. This ALE meta-analysis revealed sex differences (male > female) in the lateral prefrontal cortex, visual processing regions, parahippocampal cortex, and the cerebellum. This constitutes compelling evidence that there are substantial sex differences in brain activity during long-term memory retrieval. More broadly, the present findings question the widespread practice of collapsing across sex in the field of cognitive neuroscience.

Critical lesion of the unprotected left main coronary disease carries a tremendous mortality burden, often associated with a diabetes status or multivessel disease, with coronary artery bypass grafting being the standard treatment for over 40 years. Percutaneous coronary intervention with drug eluting stents should be taken into consideration and could be a better option for patients with low SYNTAX score as validated by the recently published studies. This review summarizes the major randomized clinical trials and meta-analyses concerning the debate regarding percutaneous coronary intervention with drug eluting stents versus coronary artery bypass grafting for unprotected left main coronary disease, along with the latest European and American revascularization guidelines and tries to shed light on this matter. The most results advocate that there is no convincing difference in survival rate for both therapies, especially in patients with isolated left main disease but with fewer major ischemic events for coronary artery bypass grafting when compared with percutaneous coronary intervention in multivessel coronary artery disease, at the rate of a higher stroke incidence. The gaps in evidence are also highlighted, especially the lack of randomized clinical trials with new generation drug eluting stents versus coronary artery bypass grafting or those regarding the best revascularization strategy for an acute coronary syndrome when unprotected left main coronary disease is involved.

Background: It is unavoidable for learners undergoing health professions training to encounter different complex clinical scenarios related to diagnoses, treatment and ethical dilemmas. The lack of standard answers to such clinical challenges can cause uncertainty in the process of teaching, learning and assessment as learners grapple with the need to critically appraise the specific context, past practices and extant literature to arrive at a thoughtful decision. In this aspect, debate can be a useful pedagogical tool to consider multiple, different perspectives regarding these issues. As the use of debate within the health professions education has not been reviewed, we conducted a systematic review of the current literature on the adoption of debate as a pedagogical tool to clarify the specific context of use as well as its effectiveness in the learning of skills and content within the health professions education. Methods: A systematic review was conducted on relevant published literature in English within journal databases until September 2018 that employed debate as a pedagogical tool within health professions education. Results: Out of 626 screened articles, 12 studies were finally included based on inclusion/exclusion criteria. The 12 studies (9 undergraduate, 3 postgraduate) covered a diverse range of disciplines and debate in health professions education was adopted for acquisition of skills (such as critical thinking, communication skills, teamwork), or learning of specific topics (such as patient safety, ethical issues, teaching of new topics) as well as to examine evidence based practice. In the majority of studies (10 of 12 studies, 83.3%), debate has been deemed by the learners to be effective in facilitating the learning of new content and skills such as communication and critical thinking, which are related to processes aligned with adult learning, motivational, reflective and social learning theories. Conclusion: Overall, sparse studies to date with relatively low risk of bias found debate to be effective in enabling the learning of skills and content within health professions education. Future studies may want to incorporate more objective measures of the learning outcomes of learners following the adoption of debate as a teaching tool as well as to examine the combinatorial use of debate with other pedagogical tools and their longitudinal impact on learners and learning.
Hintergrund: Für Lernende während der ärztlichen Ausbildung ist es unvermeidbar, verschiedenen komplexen klinischen Szenarien hinsichtlich Diagnose, Behandlung und ethischer Dilemmata zu begegnen. Der Mangel an Standardantworten auf solche klinischen Herausforderungen kann zu Unsicherheit im Prozess des Lehrens, Lernens und der Einschätzung führen, da die Lernenden sich mit dem Bedürfnis nach kritischer Bewertung eines spezifischen Kontextes, vergangenen Praktiken und vorhandener Literatur auseinandersetzen müssen, um zu einer durchdachten Entscheidung zu gelangen. In dieser Hinsicht kann die Debatte ein nützliches pädagogisches Werkzeug sein, um verschiedenartige, multiple Perspektiven bezüglich dieser Probleme zu berücksichtigen. Da der Nutzen von Debatten innerhalb der ärztlichen Ausbildung noch nicht überprüft worden ist, haben wir einen systematischen Überblick über die aktuelle Literatur zur Einbeziehung von Debatten als pädagogisches Werkzeug vorgenommen, um deren spezifischen Nutzungskontext sowie Effektivität beim Erlernen von Fähigkeiten und Inhalten innerhalb der ärztlichen Ausbildung zu klären. Methoden: Es wurde eine systematische Überprüfung der relevanten, bis September 2018 veröffentlichten englischsprachigen Literatur in Zeitschriftendatenbanken durchgeführt, die sich mit Debatten als pädagogischem Werkzeug innerhalb der Ausbildung von Gesundheitsberufen befassten. Ergebnisse: Von 626 angezeigten Artikeln wurden schließlich 12 Studien basierend auf Inklusions-/Exklusionskriterien einbezogen. Diese 12 Studien (9 universitäre, 3 postgraduierte) deckten ganz verschiedene Bereiche und Disziplinen ab, und die Debatte in der Ausbildung von Gesundheitsberufen wurde zum Erwerb von Fähigkeiten (wie z. B. kritisches Denken, kommunikative Fähigkeiten, Teamwork) oder zum Erlernen spezifischer Themen (wie z. B. Patientensicherheit, ethische Probleme, Unterrichten neuer Themenbereiche) sowie zur Überprüfung Evidenz-basierter Praxis genutzt. Bei der Mehrheit der Studien (10 von 12 Studien, 83,3%) wurden Debatten seitens der Lernenden als effektiv bei der Erleichterung des Erlernens neuer Inhalte und Fähigkeiten, wie z. B. bei der Kommunikation und dem kritischen Denken, eingeschätzt, die verbunden sind mit Prozessen, die am Lernen im Erwachsenenalter, an Motivations-, Reflexions- und sozialen Lerntheorien ausgerichtet sind.Schlussfolgerung: Insgesamt schätzten die bislang nur spärlich vorhandenen Studien mit einem relativ niedrigen Risiko der systematischen Verzerrung Debatten als effektiv bei der Ermöglichung des Erlernens von Fähigkeiten und Inhalten innerhalb der Ausbildung von Gesundheitsberufen ein. Zukünftige Studien sollten eventuell objektivere Maßstäbe bzgl. der Lernergebnisse nach Einbeziehung von Debatten als Lehrwerkzeug anlegen, sowie die kombinierte Nutzung von Debatten zusammen mit anderen pädagogischen Werkzeugen und deren langfristigen Einfluss auf Lernende und Lernen untersuchen.

Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS. The aim of this narrative review is to shed light on the debate prevailing regarding characteristics, as well as metabolic, hematological, and potential management modalities. Literature review was performed from January 1, 2000 to March 31, 2017 with specific word search such as lean PCOS, hormonal abnormalities in lean PCOS, and the management of lean PCOS. All retrieved articles were carefully assessed, and data were obtained. We could conclude that the debate is still prevailing regarding this specific lean population with PCOS, especially with regard to their characteristics and management modalities. Further studies are still required to resolve this debate on the presence of PCOS in lean women.

In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care.
To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year\'s value for palliative care.
The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped.
A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years.
Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied.
The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to-in addition to the EQ-5D- make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year.