A Rapid Review of Sustainable Health Interventions: Results Synthesised from the PUBMED Database in 2014

Accommodation for both humans and animals could have impacted on both occupants and environments at the same time. Consequently, sustainable housing with a systematic life-cycle assessment has been one of the research focuses in the recent decades with an aim to lessen negative impacts on natural environments and to optimise occupant health and wellbeing. Following this context, it was aimed to carry out a systematic review to synthesise existing literature published until September 2014 on sustainable housing examples from two largest research databases covering health and development research. There were 10 research articles found in the PUBMED database and other 8 research articles additionally found in the ScienceDirect database. Sustainable housing examples mainly came from Americas and Europe while a few were from Africa and Australia. No sound studies were found from Asia. The research quality of these studies was from low to medium only. Research into sustainable housing examples for either humans or animals is still limited and research methodology was not robust enough to give clear indications on the promotion of sustainability in different housing environments. Collaborations between epidemiologists and engineers to employ real-life housing examples and to conduct rigorous research and follow-ups are therefore suggested.


Introduction
Health promotion and interventions have been one of the main focuses in clinical medicine and public health over decades.The aim of medical treatments and health promotion is to produce intervention effects that may be sustained over time and to help human individuals enact the "normal" life, which the majority has lived and been widely accepted in the society. 1 Until today, there does not seem to be a perfect prevention and/or intervention plan/program that could help sustain human health status for a very long time.The following negative effect is the excess medical and social resources and mental pressure for patients, family members and the whole society to burden.To policy makers, it is unfortunate that there were relatively few rigorous empirical studies and often with confusing definitions and statistical models.Innovative but low-cost interventions have been encouraged but the sustainability of each intervention program could have been ignored.Therefore, it was aimed to carry out a rapid review to synthesise very recent existing literature on sustainable health interventions.

Results and Discussion
There were 1,241 identified published articles from the PUBMED database using keywords including "sustainable" and "intervention".About 41 out of 198 (20.7%) research articles published in 2014 met the inclusion criterion (research articles describing health interventions in relation to followup time periods) and included for presentation.Table 1 presents publication year, journal, author(s), research question(s), study design and results from each of the included research articles.Critique on study limitations were discussed as well.Overall, the study samples used were small and not generalisable.The follow-up time periods varied and some of the studies also showed no significant effects over time which would leave room for improvement in future research.

Experimental Section
The present study employed a systematic review approach with a rather small time period (articles published in 2014 only), which is used to provide research evidence for future research and policy use.According to Khan, et al, 43 a review earns the adjective systematic if it is based on a clearly formulated question, identifies relevant studies, appraises their quality and summarises the evidence by use of explicit methodology.Following this framework, the proposed 5 steps, namely "Framing questions for a review", "Identifying relevant work", "Assessing the quality of studies", "Summarising the evidence" and "Interpreting the findings", of conducting a systematic review were therefore adopted in the current study.A rapid review using the systematic review approach summarises very recent research evidence, which was originally proposed to review literature from 6 weeks to 6 months. 44The strength is to keep up to date with research progress immediately and to adopt changes when necessary while the limitation is the missing of relevant information leading to conclusion bias.Therefore, rapid reviews are more suitable for indicating research gaps and future directions than determining specific research answers.In the present study, the inclusion criterion of literature was research articles describing health interventions in relation to follow-up time periods.Therefore, keywords used were "sustainable" and "intervention".Articles on interventions not for the purpose of tackling health problems were excluded.Since this study is only a literature search and synthesis by extracting published research articles from the PUBEMD database in 2014, no further ethics approval was required.

Conclusions
There have been an increase of research articles on health interventions with a focus on sustainable effects in recent years.However, methodologically, most of the studies were suffering from small sample size and/or sampling bias.In addition, most of the articles did not mention if and how their interventions could be improved and whether a plan to repeat would be expected thereafter.There could have been innovative and low-cost interventions presented, but interventions with long-term effects should be more explored and documented than those with short-term effects.It is not a game for researchers to compete on novel ways of studies to get published, but a contribution to be made to help and optimise human health in real life.In sum, academic rigour should be applied to sustainable health intervention research.A standard of documenting intervention effects according to follow-up time periods systematically would be strongly suggested.

Table 1 .
List of the included articles from the PUBMED database.