The Recovery of Human Remains in Weapon-Contaminated Settings: Towards Guidance for the Mine Action Community

Mine action and forensic services are critical elements in the response to humanitarian needs during and after armed conflict. Mine action operators will work to identify, mark, and eventually clear areas contaminated with landmines and explosive remnants of war (ERW). Forensic specialists and other related experts will be operational in the search for missing persons and the management of the dead by locating, recovering, and helping to identify human remains, while ensuring maximum protection, dignity of the deceased, and attention to their families.[1] These professions can often intersect in situations where human remains and explosive hazards are both present

Accepted Manuscript Cognitive and affective reassurance and patient outcomes in primary care: a systematic review Cognitive and affective reassurance and patient outcomes in primary care: a systematic review

Abstract In the context of uncertainty about aetiology and prognosis, good clinical practice commonly recommends both affective (creating rapport, showing empathy) and cognitive reassurance (providing explanations and education) to increase self-management in groups with non-specific pain conditions. The specific impact of each of these components in reference to patients' outcomes has not been studied. This review aimed to systematically evaluate the evidence from prospective cohorts in primary care that measured patient-practitioner interactions with reference to patient outcomes. We carried out a systematic literature search and appraisal of study methodology. We extracted measures of affective and cognitive reassurance in consultations and their associations with consultation-exit and follow up measures of patients' outcomes. We identified 16 studies from 16,059 abstracts. Eight studies were judged to be high in methodological quality. Pooling could not be achieved due to heterogeneity of samples and measures. Affective reassurance showed inconsistent findings with consultation exit outcomes. In three high-methodology studies, an association was found between affective reassurance and higher symptom burden and less improvement at follow up. Cognitive reassurance was associated with higher satisfaction and enablement and reduced concerns directly after the consultations in eight studies; with improvement in symptoms at follow up in seven studies; and with reduced health care utilization in three studies. Despite limitations, there is support for the notion that cognitive reassurance is more beneficial than affective reassurance. We present a tentative model based on these findings and propose priorities for future research