To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Refugees and asylum seekers often experience trauma, leading to high rates of post-traumatic stress disorder (PTSD). However, the extent to which trauma and PTSD impacts social functioning, such as social relationships or engaging with community activities in new environments, remains unclear.
Aims
This systematic review aims to identify key areas of social functioning influenced by trauma and PTSD, with additional analyses stratified by trauma type.
Method
A comprehensive search of five databases, grey literature sources, and reference lists was conducted in February 2025. Included papers explored the impact of trauma or PTSD on social functioning in adult displaced populations post-migration, within the last 30 years. Studies’ risk of bias was assessed using the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist. Data were extracted on associations between trauma, PTSD and social functioning outcomes.
Results
Of the studies, encompassing 15 394 participants, 38 met the inclusion criteria. Our analysis indicated that trauma and PTSD have an impact on multiple domains of social functioning, including post-migration living difficulties, everyday functioning, acculturation and integration, social relationships, and employment and education. War-related trauma predominantly affected psychosocial functioning and integration, whereas interpersonal trauma had a greater impact on social relationships. While most findings indicated a negative influence of trauma and PTSD on these areas, some evidence suggested the potential for post-traumatic growth.
Conclusions
The findings underscore the challenges displaced groups face, alongside the possibility of post-traumatic growth. Future research should focus on identifying factors that facilitate positive adaptation, informing interventions to support social integration in these vulnerable groups.
Individuals with cerebral palsy (CP) experience significant impairments in lower limb mobility, which severely limit their daily activities and overall quality of life. Robotic exoskeletons have emerged as a cutting-edge solution to assist in the rehabilitation of individuals with CP by improving their motor functions. This systematic review, conducted following PRISMA guidelines, critically evaluates lower limb robotic exoskeletons specifically designed for individuals with CP, focusing on their design, rehabilitation interfaces, and clinical effectiveness. The review includes research papers published between 2010 and 2024, analyzing 30 lower limb exoskeletons reported in 57 papers. We analyze each exoskeleton, focusing on its technological features, user experience, and clinical outcomes. Notably, we identify a trend in which researchers are increasingly adapting exoskeleton functions to the specific needs of individual users, facilitating personalized rehabilitation approaches. Additionally, we highlight critical gaps in current research, such as the lack of sufficient long-term evaluations and studies assessing sustained therapeutic impacts. While ease of use remains crucial for these devices, there is a pressing need for user-friendly designs that promote prolonged engagement and adherence to therapy. This comprehensive review of existing gait rehabilitation exoskeleton technologies aimed to inform future design and application, ultimately contributing to the development of devices that better address the needs of individuals with CP and enhance their motor functions and quality of life.
Abstract screening, a labor-intensive aspect of systematic review, is increasingly challenging due to the rising volume of scientific publications. Recent advances suggest that generative large language models like generative pre-trained transformer (GPT) could aid this process by classifying references into study types such as randomized-controlled trials (RCTs) or animal studies prior to abstract screening. However, it is unknown how these GPT models perform in classifying such scientific study types in the biomedical field. Additionally, their performance has not been directly compared with earlier transformer-based models like bidirectional encoder representations from transformers (BERT). To address this, we developed a human-annotated corpus of 2,645 PubMed titles and abstracts, annotated for 14 study types, including different types of RCTs and animal studies, systematic reviews, study protocols, case reports, as well as in vitro studies. Using this corpus, we compared the performance of GPT-3.5 and GPT-4 in automatically classifying these study types against established BERT models. Our results show that fine-tuned pretrained BERT models consistently outperformed GPT models, achieving F1-scores above 0.8, compared to approximately 0.6 for GPT models. Advanced prompting strategies did not substantially boost GPT performance. In conclusion, these findings highlight that, even though GPT models benefit from advanced capabilities and extensive training data, their performance in niche tasks like scientific multi-class study classification is inferior to smaller fine-tuned models. Nevertheless, the use of automated methods remains promising for reducing the volume of records, making the screening of large reference libraries more feasible. Our corpus is openly available and can be used to harness other natural language processing (NLP) approaches.
Depression is one of the most common mental diseases, leading to a decline in both psychiatric and physical functions. One non-pharmacological therapeutic strategy for the management of psychiatric disorders is music therapy.
Aims
To assess the clinical effectiveness of music therapy and its various subscales for managing depressive symptoms (primary outcome) and related problems (secondary outcome) in comparison with other conventional treatments.
Method
A comprehensive search of MEDLINE, Embase, Cochrane Review, CINAHL, PsyInfo and KMbase was conducted to identify randomised controlled trials published up to 31 August 2023. Studies assessing the clinical effectiveness of music therapy for individuals with depression were included, and data on participants, music therapy and clinical measurement scores were extracted. This study was registered with PROSPERO (no. CRD42023466833).
Results
Music therapy was significantly more effective than controls in reducing depressive symptoms (standardised mean difference (SMD) −0.97 [95% CI: −1.23 to −0.71], P < 0.01). This benefit was consistent regardless of music therapy types, delivery methods or provider professionalism. In addition, music therapy was significantly better than controls in improving quality of life (SMD 0.51 [95% CI: 0.19−0.83], P < 0.01) and sleep quality (SMD −0.61 [95% CI: −1.03 to −0.19], P < 0.01), although it showed only a non-significant trend towards reducing anxiety (SMD −0.98 [95% CI: −2.01 to 0.06], P = 0.06). The evidence level was very low due to high risk of bias, inconsistency due to high heterogeneity and imprecision.
Conclusions
Despite the very low evidence level, music therapy may be recommended with weak strength for patients with depression, considering the results of the meta-analysis and the high accessibility and broad applicability of music.
The National Institute for Health and Care Excellence (NICE) in England introduced early value assessments (EVAs) as an evidence-based method of accelerating access to promising health technologies that could address unmet needs and contribute to the National Health Service’s Long Term Plan. However, there are currently no published works considering differences and commonalities in methods used between Assessment Reports for EVAs.
Methods
This rapid scoping review included all completed EVAs published on the NICE website up to 23 July 2024. One reviewer screened potentially relevant records for eligibility, checked by a second reviewer. Pairs of independent reviewers extracted information on the methods used in included EVAs using a prepiloted form; these were checked for accuracy. Data were described in graphical or tabular format with an accompanying narrative summary.
Results
In total, seventeen EVA Reports of sixteen EVAs were included in this scoping review. Five Reports did not specify how many reviewers undertook screening, whereas five did not report data extraction methods. Five EVAs planned to conduct meta-analyses, nine planned narrative syntheses, and seven planned narrative summaries. Eleven conceptual decision models were presented, with available evidence used to construct cost-utility analyses (N = 5); cost-effectiveness analyses (CEAs; N = 4); a mix of CEAs and cost-consequence analyses (CCA; N = 2); one CCA; and one cost-comparison.
Conclusion
Future EVA Reports should enhance the transparency of the methods used. Furthermore, EVAs could provide opportunities for the adoption of innovative methodological approaches and more flexible communication between EVA authors and key stakeholders, including patients and clinicians, companies, and NICE.
Inclusive education, a foundation of modern educational discourse, requires progressive approaches that extend beyond cultural boundaries and promote effective, collaborative learning environments. In this systematic review, we thoroughly examine preservice teachers’ readiness for inclusive education by analysing how their attitudes, experiences, and training shape their perceptions and self-efficacy. Drawing on studies from the past two decades, we report generally positive attitudes toward inclusive practices alongside challenges such as limited practical experience, time constraints, and insufficient institutional support. In this review, we critique current tools for measuring teacher self-efficacy and call for more comprehensive, culturally responsive approaches. Findings indicate that although formal training fosters positive attitudes, its impact is maximised when combined with authentic teaching experiences. Overall, this systematic review underscores the need for an integrated teacher education strategy that bridges theory and practice, thereby equipping teachers with the skills and confidence to meet students with diverse needs.
Major depressive disorder (MDD) is a significant public health concern, and current treatments often have limitations in effectiveness and adherence. Psilocybin, a psychedelic compound found in certain mushrooms, is being explored as a potential treatment for depression. It primarily acts through the serotonin 5-HT2A receptor but interacts with 5-HT1A and 5-HT2C receptors. Its precise mechanisms remain under investigation.
Objectives:
(1) To consolidate evidence on psilocybin’s efficacy and safety for depression, (2) to identify limitations in the literature, and (3) to highlight areas needing further research.
Methods:
This systematic review follows PRISMA guidelines and analyzes 20 studies, including randomized controlled trials (RCTs) and open-label studies. The studies cover various populations, including individuals with treatment-resistant depression, different dosing regimens, and adjunctive therapies.
Results:
Psilocybin therapy shows substantial and rapid antidepressant effects, often after one or two sessions with psychological support. Improvements are sustained for weeks or months in many cases. Psilocybin is generally well-tolerated, with mild adverse effects such as anxiety during administration and transient headaches, which are manageable in controlled settings .
Conclusions:
Psilocybin demonstrates promise as a novel treatment for depression, especially for individuals unresponsive to conventional antidepressants. Further research is needed to refine dosing, explore long-term effects, and understand its mechanisms of action.
The symptoms of anxiety in the outbreak of COVID-19 were so severe that they entered the research literature as the term COVID-19 anxiety. This systematic review and meta-analysis study aimed to identify the variables related to COVID-19 anxiety and the effectiveness of psychological interventions on it.
Methods
In the present systematic review and meta-analysis, the literature was systematically searched in PubMed, Scopus, Web of Science, Science Direct, ISI, and Persian databases such as Noormags and SID on COVID-19 anxiety from January 2020 to April 2022. In the initial search, 105 articles were found. In the data correlation section, 13 studies for the fixed effects model were meta-analyzed. In the interventional section, 14 articles were selected. The systematic review data were extracted, and all statistical data were analyzed by CMA-2.
Results
The results of the meta-analyses for psychopathological correlations with COVID-19 anxiety in 13 articles indicated the correlation between COVID-19 anxiety and other mental states and disorders (P = .0001/I2 = 97.27%). Other findings demonstrated the effect of psychological interventions on COVID-19 anxiety in 14 articles with high effectiveness of these treatments (P = .00/I2 = 85.67%).
Conclusions
It seems COVID-19 anxiety is affected by psychological variables. Hence, psychological interventions represent effective treatments for anxiety due to COVID-19.
The optimal duration for maintaining antidepressant treatment in individuals with obsessive-compulsive disorder (OCD) who achieve symptom stabilization remains unclear.
Methods
This systematic review and pairwise meta-analysis of double-blind randomized placebo-controlled trials (DBRPCTs) compared antidepressant maintenance and antidepressant discontinuation groups in terms of relapse rate at each DBRPCT study endpoint (primary outcome), OCD symptom improvement, all-cause discontinuation, and adverse event-related discontinuation. Furthermore, relapse rates at 4, 8, 12, 16, 20, and 24 weeks were compared between the groups. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. The absolute risk reduction (ARR) and number needed to treat to benefit (NNTB) for relapse rates were also estimated.
Results
Nine trials (n = 1084; mean age: 32.8 years; proportion of males: 53.3%) were included. The antidepressant maintenance group had lower relapse rates at each DBRPCT study endpoint (RR [95% CI] = 0.53 [0.42–0.68]; ARR = 21.0%; NNTB = 5) and lower all-cause and adverse event-related discontinuation rates than the antidepressant discontinuation group. The maintenance group also exhibited lower relapse rates at 4 weeks (RR [95% CI] = 0.47 [0.31–0.70]; ARR: not significant; NNTB: not significant), 8 weeks (0.42 [0.31–0.57]; 12.0%; 8), 12 weeks (0.43 [0.32–0.56]; 18.0%; 6), 16 weeks (0.41 [0.32–0.52]; 25.0%; 4), 20 weeks (0.43 [0.34–0.53]; 26.0%; 4), and 24 weeks (0.42 [0.33–0.52]; 27.0%; 4) than the discontinuation group. Moreover, the maintenance group outperformed the discontinuation group regarding OCD symptom improvement.
Conclusions
Individuals with OCD may benefit from continued antidepressant treatment, provided that it is well tolerated.
Indonesia is home to a high number of Critically Endangered land vertebrates. Examining the research on these species is important to improve biodiversity-related policy and management and to provide insight into knowledge gaps. We conducted a comprehensive review of 2,188 publications published during 2000–2021 that studied the Critically Endangered vertebrate species of Indonesia, to understand variations in the level of research on each species and the proportion of research carried out within Indonesia and by Indonesian researchers. Over this 22-year period, research on Critically Endangered species in Indonesia increased, but > 50% of this research was carried out by researchers based outside Indonesia. Moreover, the quantity of research was uneven across taxonomic classes, indicating an imbalance in research attention. Most publications during the period were on mammals (1,573 publications), followed by reptiles (310), birds (300) and amphibians (5). We identified 17 species for which there were no significant publications, suggesting little attention has been given to these species. We highlight three key issues: limited Indonesian authorship, taxonomic bias towards mammals and birds, and a need to address these challenges in authorship and bias. The low number of publications on many Critically Endangered land vertebrates reflects a lack of research effort, mostly because of limited funds and unequal conservation attention.
Effort is a ubiquitous feature in the decision-making literature. Increasing numbers of studies examine the effect of effort requirements on behavior using a discounting framework, assessing the process by which the subjective value of an outcome decreases as the effort required to obtain it increases. Therefore, a review of methodological approaches, findings, and issues is timely. Accordingly, in this systematic review, we identified research studies examining effort discounting to explore how choice architecture factors used in delay discounting and other experimental manipulations affected effort discounting, and the mathematical descriptors used to summarize the relationship between subjective value and effort requirements. Our analysis suggests an area ripe for future research and identifies important knowledge gaps. These gaps are attributable to the use of divergent definitions of effort, as well as highly heterogeneous methodologies, which limit our ability to generate strong conclusions about the intersection between effort and delay discounting processes.
Inlight of varying outcomes from prior research concerning the relationship between different food groups and the risk of chronic kidney disease (CKD), this study was conducted to examine the relationship between the consumption of various food groups and CKD risk via a dose–dependent meta-analysis of prospective cohort studies. Searches were conducted in the Web of Science, PubMed and Google Scholar databases through January 2025. Out of 6460 publications, twenty-one studies were selected for final analysis. The results revealed that red meat consumption is associated with an increased risk of CKD (RR: 1·39; 95 % CI: 1·13, 1·71). Conversely, consumption of fish (RR: 0·88; 95 % CI: 0·80, 0·97), grains (RR: 0·87; 95 % CI: 0·77, 0·99) and legumes (RR: 0·83; 95 % CI: 0·72, 0·92) showed a protective effect against CKD. The linear dose–response analysis indicated that for every 100 g/d increment in red meat and total meat consumption, the risk of CKD escalated by 34 and 2 %, respectively. Furthermore, an increase of 15 g/d in dietary fish, 28 g/d in nuts and 50 g/d in legumes was associated with a 6, 21 and 13 % decreased risk of CKD, respectively. Overall, higher red meat intake correlates with a heightened CKD risk, whereas the consumption of fish, grains and legumes is associated with a lowered risk. Further longitudinal cohort studies with extended follow-up are recommended to validate our findings.
Core premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder, can cause significant impairment. Despite evidence linking stress and premenstrual symptoms, a systematic synthesis is lacking.
Aims
To systematically review the literature and meta-analyse evidence on the relationship between premenstrual symptoms and stress.
Method
Four databases (Web of Science, PubMed, PsycINFO, Scopus) and Google Scholar were searched for studies indexed before 27 August 2024 (no language/year restrictions) assessing the relationship between self-reported stress and premenstrual symptoms in regularly menstruating individuals (PROSPERO: CRD42021244503). Three multilevel meta-analyses estimated (a) the correlation between stress and premenstrual symptom severity, (b) stress differences between individuals with and without core PMD across the menstrual cycle and (c) the impact of traumatic experiences on the occurrence of premenstrual symptoms. Study quality and publication bias were assessed.
Results
We synthesised 188 effect sizes from 66 studies (N = 38 344), indicating (a) a positive correlation (r = 0.29, 95% CI 0.23–0.36); (b) higher stress levels in participants with core PMD (d = 0.79, 95% CI 0.32–1.26), particularly during the luteal phase (dlut = 1.01, 95% CI 0.46–1.57); and (c) over twofold higher odds (odds ratio 2.45, 95% CI 1.87–3.23) of PMS in individuals with a history of trauma. Heterogeneity was high (I2 = 84.64–91.38%); one meta-analysis (c) showed evidence of publication bias.
Conclusions
The results indicate an association between stress and premenstrual symptoms, an effect of cycle phase and trauma as a risk factor for PMS. Future research should explore underlying biopsychosocial mechanisms.
Vagal nerve stimulation (VNS) has recently emerged as a prospective therapeutic approach for addressing trauma- and stressor-related disorders (TSRDs).
Aims
We assessed findings from randomised controlled trials for the safety and efficacy of VNS as a viable treatment for TSRDs.
Method
We systematically searched Medline, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Central databases, trial registries, preprint servers and Google Scholar from inception to December 2023. Rayyan software was used for screening procedures. Two reviewers independently completed data extraction based on the inclusion criteria.
Results
We synthesised data by using a narrative approach. A total of 322 abstracts were identified and assessed, and seven studies were included in the review. Based on evidence synthesis, the present state of VNS as a treatment intervention for TSRDs, namely post-traumatic stress disorder (PTSD), is limited and does not meet clinical expectations. The overall certainty of evidence was very low. However, evidence shows that VNS may alter and reduce specific aspects associated with PTSD phenomenology, including the reduction of anger responses and the attenuation of hyperarousal during psychological interventions.
Conclusions
Although preliminary analyses provide evidence that transcutaneous VNS temporarily increases parasympathetic activity under specific conditions, these effects appear to be short-lasting, and the impact of repeated administration on long-term autonomic function remains unknown. Future randomised control trials should evaluate the therapeutic efficacy of VNS for treating TSRDs.
This systematic review aimed to analyze studies assessing the extent to which General Practitioners (GPs) engage patients in the decision-making process during consultations.
Background:
Shared Decision Making (SDM) stands at the core of patient-centred care, particularly in primary healthcare, where a diverse array of medical decisions transpires. In a 2015 systematic review summarizing studies on the Observing Patient Involvement in Decision Making (OPTION) instrument to assess SDM objectively across healthcare settings, a notable dearth of patient involvement was observed.
Methods:
A comprehensive literature search encompassing three digital databases was conducted up to November 2023. Inclusion criteria focused on studies employing a comparative study design, centric to primary healthcare, and utilizing the OPTION-5 or -12 instrument to gauge SDM levels. Two investigators independently performed study selection, risk of bias assessment, and data extraction using a list of predefined variables, with discrepancies resolved by a third reviewer. PROSPERO registration-ID: CRD42023475419.
Findings:
Initially, harvesting 447 articles, our review retained 29 studies published between 2003 and 2022. Mean age of GPs was 45.5 (range 33–53) years. Reported baseline OPTION scores varied between 1.5 and 57.2 on a 0–100-point scale, with a median score of 16. Following SDM interventions, OPTION-scores increased significantly to a median of 28.5, range 16–83.
Conclusion:
The overall level of SDM among GPs remains relatively low and has shown minimal improvement over the past decade. However, interventions promoting SDM appear to enhance patient involvement levels. This underscores the necessity for increased education and tools, directed at GPs and patients, to foster and elevate the practice of SDM.
The global prevalence of mental health disorders among youths aged 15 to 24 is a significant public health concern. This systematic review aimed to explore global strategies for promoting mental well-being and addressing mental health challenges within this demographic, as defined by the World Health Organization. A comprehensive search of electronic scientific databases was conducted on November 1, 2023, yielding 43 studies with a total of 29,581 participants published between 2008 and 2023 that examined mental health interventions targeting youth. This review identified heterogeneity across multiple dimensions including modes and modalities of intervention delivery, conceptualisations of mental health, measurement tools and implementation settings. Digital/ technology-based interventions were prevalent in high-income countries, whereas physical interventions were more commonly employed across all income groups, especially where technological infrastructure was limited. Cognitive-behavioural therapy, psychoeducation and mindfulness-based interventions dominated the intervention modalities, likely due to their structured formats, scalability and broad applicability across a range of settings and mental health conditions. However, limited evidence of cultural adaptation in the reviewed interventions highlights the need for more inclusive and context-sensitive approaches. Schools were the most frequent delivery setting; however, reliance on educational platforms risks excluding out-of-school and marginalised youth. Conceptually, the reviewed interventions reflected both disorder-specific (diagnostic) and transdiagnostic understandings of mental health, affirming a spectrum-based view that integrates symptom reduction with well-being enhancement. This dual lens supports emerging frameworks such as the Hierarchical Taxonomy of Psychopathology (HiTOP). Measurement heterogeneity mirrored conceptual diversity, with both standardised and context-specific tools used to assess outcomes. This diversity highlighted the urgent need for culturally relevant, flexible and multi-modal interventions that span diverse settings and conceptualisations to equitably support youth mental health worldwide.
Major depressive disorder (MDD) is a disabling psychiatric condition in which physical activity provides clinical benefits. While exercise effectively alleviates depressive symptoms, its biological mechanisms remain unclear.
Methods
This systematic review investigated the neurobiological effects of physical exercise on biomarkers in adults with MDD through randomized controlled trials, including studies assessing exercise interventions and reporting data on their biological effects.
Results
A total of 30 studies, including 2194 participants, were included, examining the effects of physical exercise on various biological systems in patients with MDD. Exercise interventions had mixed effects on inflammatory markers, including interleukins, C-reactive protein, and tumor necrosis factor-α, suggesting a potential but inconsistent anti-inflammatory role. Neurotrophic factors, such as brain-derived neurotrophic factor showed promise as biomarkers of treatment response, but their role in clinical improvements remained inconclusive. Findings for the stress-response system, including cortisol and monoaminergic systems, primarily involving serotonin and dopamine, were limited and variable. Exercise demonstrated potential benefits in reducing oxidative stress and enhancing β-endorphin levels, although these effects were not consistently observed.
Conclusion
This systematic review adopted a broader perspective than prior studies, exploring less-studied biological systems and identifying several limitations in the included studies, including small sample sizes, varying methodologies, and a predominant focus on biochemical markers. Future research should prioritize larger, standardized trials and particularly employ omics approaches to better understand the biological mechanisms underlying the effects of exercise in MDD. The findings highlight the complexity of exercise’s biological effects and emphasize the need for further research to clarify its mechanisms.
This systematic review aims to identify the theoretical-based frameworks and content of disaster training programs for nurses worldwide.
Methods
This systematic review was conducted following the PRISMA guidelines across 5 databases: Web of Science, PubMed, CINAHL, Cochrane, and Google Scholar. Studies were selected on disaster training programs for nurses and published within the past decade.
Results
This systematic review analyzed 14 studies that utilized a variety of theoretical-based disaster nursing training programs. Among the theoretical frameworks identified, the International Council of Nurses (ICN) framework emerged as the most frequently applied, likely due to its global applicability and comprehensive approach in disaster training programs. In contrast, other frameworks—such as the Bioterrorism Guidelines and Infectious Disease Response Guidelines from the Korea Disease Control and Prevention Agency, the Malkina-Pykh Mixed Model, the World Health Organization (WHO) framework, and the National League for Nurses/Laerdal Simulation Model, and others—were each used only once.
Conclusions
These findings suggest the ICN framework’s potential to serve as a leading model for the development of future disaster training programs. Achieving an optimal balance of theory, practice, and evidence-based content is crucial for preparing nurses to respond effectively to disasters.
Design computing refers to the usage of computer frameworks, models or systems in design-related activities. Design computing research, in turn, refers to the development of these frameworks/models/systems, and so forth. As design practice increasingly relies on computer tools, the demand for research in design computing grows. While this opens innumerable venues for research, the profusion of information in the field poses significant challenges for researchers. Therefore, meta-level surveys of the field are called for. To provide researchers with a useful overview of design computing research, we set out to identify some of the main clusters of activity in the field. By “clusters of activity”, we refer to groups of researchers pursuing similar or identical research questions. Our PRISMA-style review focuses on the identification of such clusters, based on the complete proceedings (N = 404) of a long-standing conference (Design Computing and Cognition, DCC, 2004–2024), which captures the richness and diversity of the field. The primary contribution of this work is a map that organizes the main questions explored and the approaches taken in exploring them, which are informative for researchers and educators alike. This map may also help to execute large-scale surveys via automation, toward obtaining a comprehensive view of the field.