A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions

Psychosocial factors associated with j-pouch surgery for patients with IBD: a scoping review

BACKGROUND

Ulcerative colitis and Crohn's disease are subtypes of inflammatory bowel disease: a chronic condition of unclear etiology characterized by inflammation of the small and large intestine. Inflammatory bowel disease is managed with diet, medications, and surgeries, with the most common surgery, recommended to ulcerative colitis patients being j-pouch surgery.

PURPOSE

To assess the current literature concerning psychosocial factors associated with j-pouch surgery for patients with inflammatory bowel disease.

METHODS

A systematic scoping review of the empirical and grey literature was conducted for original research on j-pouch surgery and psychosocial variables. Eight databases were searched: Medline, PsychInfo, CINAHL, EBM Reviews, ProQuest Dissertations and Theses Global, ResearchGate, Prospero, and PrePubMed.

RESULTS

Thirty-nine articles were identified. Many studies (n = 18) adopted a case-series design, and none examined psychosocial interventions. The most popular psychosocial variables assessed were quality of life (n = 34) and those associated with sexual health and functioning (n = 9).

CONCLUSIONS

Despite being an established surgical procedure, little research has examined the psychosocial implications of j-pouch surgery. As such, clinicians lack a robust understanding of how this procedure affects patients' psychiatric and social status and adaptive abilities. There is a need for high-quality research utilizing validated measures and rigorous design methodologies with control populations.

The 5-HT7 receptor system as a treatment target for mood and anxiety disorders: A systematic review

BACKGROUND

Preclinical animal and preliminary human studies indicate that 5-HT7 antagonists have the potential as a new treatment approach for mood and anxiety disorders. In this systematic review, we aimed to review the relationship between the 5-HT7 receptor system and mood and anxiety disorders, and to explore the pharmacology and therapeutic potential of medications that target the 5-HT7 receptor for their treatment.

METHODS

Medline, Cochrane Library, EMBASE, PsycINFO databases, the National Institute of Health website Clinicaltrials.gov, controlled-trials.com, and relevant grey literature were used to search for original research articles, and reference lists of included articles were then hand searched.

RESULTS

Sixty-four studies were included in the review: 52 animal studies and 12 human studies. Studies used a variety of preclinical paradigms and questionnaires to assess change in mood, and few studies examined sleep or cognition. Forty-four out of 47 (44/47) preclinical 5-HT7 modulation studies identified potential antidepressant effects and 20/23 studies identified potential anxiolytic effects. In clinical studies, 5/7 identified potential antidepressant effects in major depressive disorder, 1/2 identified potential anxiolytic effects in generalized anxiety disorder, and 3/3 identified potential antidepressant effects in bipolar disorders.

CONCLUSION

While there is some evidence that the 5-HT7 receptor system may be a potential target for treating mood and anxiety disorders, many agents included in the review also bind to other receptors. Further research is needed using drugs that bind specifically to 5-HT7 receptors to examine treatment proof of concept further.

How effective are psychosocial interventions at improving body image and reducing disordered eating in adult men? A systematic review

Disordered eating and body image concerns significantly impact a growing number of men. This systematic review assessed the evidence of the effectiveness of psychosocial interventions to improve body image and eating pathology in men. Searches were conducted in December 2022 in 13 databases (PsycINFO, MEDLINE, CINAHL Plus, AMED, PubMed, Scopus, Cochrane, EMBASE, ASSIA, British Nursing Index, Wiley and OpenGrey). Studies that quantitatively evaluated psychosocial interventions and reported pre-post body image or disordered eating outcomes in men aged 18 years and over were eligible. Articles including boys, uncontrolled designs, or not in English were excluded. Findings were narratively synthesised and presented according to intervention approach. Quality was assessed using EPHPP. Eight studies including six RCTs were reviewed. Five were assessed as being moderate quality and three as weak. Evidence from moderate quality studies suggested that dissonance-based interventions showed promising improvements in body image and disordered eating for up to six months post-intervention in men with and without body dissatisfaction. Evidence for media literacy and psychoeducational interventions was limited. Findings were limited by heterogeneity in outcome measures and homogeneity of participants preventing generalisability. Robust research with longer follow-ups is needed to confirm effectiveness.

Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

Cardiometabolic risk factors in South American children: A systematic review and meta-analysis

BACKGROUND

Cardiometabolic risk factors (impaired fasting glucose, abdominal obesity, high blood pressure, dyslipidemia) cluster in children, may predict adult disease burden, and are inadequately characterized in South American children.

OBJECTIVES

To quantify the burden of cardiometabolic risk factors in South American children (0-21 years) and identify knowledge gaps.

METHODS

We systematically searched PubMed, Google Scholar, and the Latin American and Caribbean Health Sciences Literature via Virtual Health Library from 2000-2021 in any language. Two independent reviewers screened and extracted all data.

RESULTS

179 studies of 2,181 screened were included representing 10 countries (n = 2,975,261). 12.2% of South American children experienced obesity, 21.9% elevated waist circumference, 3.0% elevated fasting glucose, 18.1% high triglycerides, 29.6% low HDL cholesterol, and 8.6% high blood pressure. Cardiometabolic risk factor definitions varied widely. Chile exhibited the highest prevalence of obesity/overweight, low HDL, and impaired fasting glucose. Ecuador exhibited the highest prevalence of elevated blood pressure. Rural setting (vs. urban or mixed) and indigenous origin protected against most cardiometabolic risk factors.

CONCLUSIONS

South American children experience high rates of obesity, overweight, and dyslipidemia. International consensus on cardiometabolic risk factor definitions for children will lead to improved diagnosis of cardiometabolic risk factors in this population, and future research should ensure inclusion of unreported countries and increased representation of indigenous populations.

Effectiveness of flipped classroom in pharmacy education - a meta-analysis

BACKGROUND

Flipped classroom, blended with online and offline learning, was regarded as an effective learning approach in pharmacy education. This meta-analysis was to comprehensively compare the effectiveness of flipped classroom and traditional lecture-based approaches, attempting to generate a unified and firm conclusion of the effectiveness of flipped classroom in pharmacy education.

METHODS

Data were collected from 7 databases, involving Cochrane Library, PubMed, Embase, ScienceDirect, Web of Science, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Service System (SinoMed). The studies were included if they included objective evaluation of students' performance between groups of flipped classroom and traditional approaches. The standardized mean difference (SMD) with a corresponding 95% confidence interval (95% CI) was used as the outcomes for data pooling.

RESULTS

A total of 22 studies (28 comparing groups) with 4379 participants were included in the meta-analysis. The risk of bias was relatively high. Results of the analysis revealed that flipped classroom presented significant advantages over traditional approaches in student performance improvement, with no evidence of publication bias. Through subgroup analysis, it showed better outcomes for flipped classrooms over traditional lectures for the other subgroups, including different performance, degree programs.

CONCLUSIONS

Current evidence reveals that the flipped classroom approach in pharmacy education yields a statistical improvement in student learning compared with traditional methods. In the future, instructors should introduce more online technology into classroom and construct an interactive learning environment.

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis

The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Does the Installation or the Improvement of Existing Outdoor Parks Increase Physical Activity Levels? A Systematic Review

Investment in outdoor parks is proposed as a promising large-scale strategy to promote physical activity (PA). This study aimed to systematically review the impact of park renovations or installing new ones in increasing PA. Searches were conducted using predefined terms in three databases (PubMed, Scopus, and Web of Science) in March 2022. Studies examining the effectiveness of park renovations or developing new ones in increasing PA and having control or comparison were eligible for inclusion. Study quality was assessed using the Quality Assessment Tool for Quantitative Studies. Data were extracted from the included records using a predefined extraction table. The database search yielded 959 records, and 26 were included. For park renovations (n = 17), 11 (65%) studies presented findings supporting a positive effect on PA. The other six (35%) studies found no PA benefits when compared to control or pre-renovations/improvement levels. Regarding new installations (n = 9), five (56%) studies presented improvements in PA, and four (44%) did not. A promising positive impact of park renovations and new installations on park use and PA was observed. The review findings reflect the need to understand the context, daily routines, and interests of the surrounding population before renovating or installing new outdoor parks.

Agricultural exposures and risk of childhood neuroblastoma: a systematic review and meta-analysis

While neuroblastoma accounts for an estimated 8% of childhood cancers, it causes about 15% of childhood cancer deaths in the United States. The role of agricultural exposures in the development of neuroblastoma is unclear. We conducted a systematic review and meta-analysis of studies examining the relationship between agricultural exposures and neuroblastoma. MEDLINE, EMBASE, Scopus, and Google Scholar were searched in February 2022, identifying 742 publications. Seventeen articles met the inclusion criteria; all were published between 1985 and 2020 and included 14 case-control, one cross-sectional, and two cohort studies. Random and fixed effects models were used to calculate summary odds ratios (sORs) and 95% confidence intervals (CIs). An increased odds of developing neuroblastoma with parental exposure to any pesticides (sOR = 1.25, 95% CI: 1.03-1.48; 4 studies), insecticides (sOR = 1.55, 95% CI: 1.19-1.91; 3 studies), and residential exposure to crops/vegetables (sOR = 1.04, 95% CI: 1.01-1.06; 2 studies) was seen. Heterogeneity was low in all analyses, and no publication bias was evident. No significant associations were found with agricultural occupations, herbicides, and agricultural dusts. The studies were limited by exposure measurements and small sample sizes. Further studies are needed to explore mechanisms in the development of neuroblastoma in children with parental agricultural exposures, especially pesticides, and to improve methods of measuring agricultural-related exposures.

The characteristics and efficacy of educational nurse-led interventions in the management of children with atopic dermatitis - An integrative review

OBJECTIVE

This integrative review investigates the modalities, characteristics, and efficacy of educational nurse-led interventions for parents of children with atopic dermatitis (AD).

METHODS

We conducted an integrative review with the following inclusion criteria: Quantitative, qualitative and mixed-method studies written in English or German and published between 1 January 2000 and 31 December 2021. We searched for entirely nurse-led interventions.

RESULTS

Four RCTs, three pre-post studies without control groups, and one post-test study without control group met the inclusion criteria. Nurse-led interventions were found to have medium to large positive effect sizes on disease severity, and none to large positive effects on quality of life. There was significant heterogeneity across study designs with a wide variety in educational interventions and outcome measures used. The quality of most included studies was low.

CONCLUSION

Nurse-led educational interventions for parents of children with AD are beneficial in reducing disease severity. However, it remains unclear, which main components of the nurse-led intervention are most effective.

PRACTICE IMPLICATIONS

Based on the results of this review, we think that trained and qualified nurses who are part of the entire treatment of children with AD and do as well educational interventions have the greatest potential to improve outcomes.

Impact of Listening to Indian Classical Music, or Rāgas, on the Electroencephalogram: A Meta-Analysis

Ancient Indian classical music (ICM) has long been lauded and recognized for influencing emotional responses by influencing the human body's resonance. A meta-analysis of prospective case studies published in the last ten years on the effect of ancient Indian music rāgas on brain waves is investigated. This meta-analysis aimed to analyze published prospective studies investigating the effect of ancient Indian rāgas on EEG in healthy subjects. The present study included prospective studies published since 2012. Studies were obtained by searching four databases, such as PsychINFO, PubMed, Google Scholar, and JSTOR, and searching related journals. Eligibility criteria included studies assessing the impact of listening to Indian classical music on the EEG. Primary outcomes were changes in the brain waves, frequency, and power and their relationship to activity-related arousal, attention, and mental tasks. The studies were analyzed according to the PRISMA guidelines. There were a total of five included studies with 71 participants in the age range of 19-30, and the conditions for the test groups were generally similar except for varying types of rāgas used and time of day. Analysis of the data collected from 71 participants revealed that music interventions had statistically significant effects on increasing alpha activity and attention scores. Fractal analysis was sensitive enough to detect EEG brainwave changes while and after listening to the rāga musical intervention. Rāgas stimulate arousal in different areas of the brain, depending on the emotions they are designed to evoke. However, the synchronized studies together could not highlight a significant relationship between rāgas and EEG fractal dimension values. Although the meta-analysis failed to reproduce the same results from the individual studies, potentially due to the small sample size and study variation, the meta-analysis opens doors to the potential of rāgas to elicit distinct emotions and serve as robust predictors of emotional response. Future studies can explore the therapeutic potential of various rāgas in the clinical setting, such as in the management of cognitive disorders and stress or in modulating heart rate variability and cognitive performance.

Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review

BACKGROUND

Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old.

METHODS

Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old.

RESULTS

A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs.

CONCLUSIONS

Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.

Is dieting a risk for higher weight gain in normal-weight individual? A systematic review and meta-analysis

While there is an increasing prevalence of dieting in the overall population, weight loss (WL) practices could be a risk factor for weight gain (WG) in normal-weight (NW) individuals. The aim of the present work was to systematically review all the studies implicating diet restriction and body weight (BW) evolution in NW people. The literature search was registered in PROSPERO (CRD42021281442) and was performed in three databases from April 2021 to June 2022 for articles involving healthy NW adults. From a total of 1487 records initially identified, eighteen were selected in the systematic review. Of the eight dieting interventional studies, only one found a higher BW after weight recovery, but 75 % of them highlighted metabolic adaptations in response to WL favouring weight regain and persisting during/after BW recovery. Eight of the ten observational studies showed a relationship between dieting and major later WG, while the meta-analysis of observational studies results indicated that 'dieters' have a higher BW than 'non-dieters'. However, considering the high methodological heterogeneity and the publication bias of the studies, this result should be taken with caution. Moreover, the term 'diet' was poorly described, and we observed a large heterogeneity of the methods used to assess dieting status. Present results suggest that dieting could be a major risk factor for WG in the long term in NW individuals. There is, however, a real need for prospective randomised controlled studies, specifically assessing the relationship between WL induced by diet and subsequent weight in this population.

Factors influencing emotional support of older adults living in the community: a scoping review protocol

BACKGROUND

Emotional support is key to improve older adults' subjective health, and psychological, social and emotional well-being. However, many older adults living in the community lack emotional support, increasing the risk for loneliness, depression, anxiety, potentially avoidable healthcare use and costs, and premature death. Multiple intersecting factors may influence emotional support of older adults in the community, but these are poorly understood. Studies have focused on specific populations (e.g., older adults with depression, cancer). Although relevant, these studies may not capture modifiable factors for the wider and more diverse population of older adults living in the community. Our scoping review will address these important gaps. We will identify and synthesize the evidence on factors that influence emotional support of older adults in the community.

METHODS

We will use the Johanna Briggs Institute updated methodological guidance for the conduct of scoping reviews to guide our review process. We will search MEDLINE, EMBASE, APA Psycinfo, CINAHL, Dissertations and Theses Global, and Scopus from inception. We will include studies published in English, examining factors influencing emotional support of older adults residing in community, without restrictions on the study design or year of publication. We will also include gray literature (dissertations and reports). Two independent reviewers will conduct title, abstract, and full-text screening, as well as risk of bias assessment, using validated quality appraisal tools based on study designs. Discrepancies will be resolved by consensus. The primary reviewer will extract the data from all studies, and the second reviewer will check the extractions of all the studies. We will use descriptive statistics and narrative synthesis for analysis. Family/friend caregivers and older adults involved as an advisory group will help with explaining the findings in terms of whether associations observed reflect their experiences and reality. We will analyze the discussion and generate themes, and summarize in a narrative form.

DISCUSSION

This scoping review may identify factors that could be modified or mitigated to improve emotional support provision for older adults residing in community. The knowledge will inform the development of tailored interventions directed to older adults and their caregivers.

SYSTEMATIC REVIEW REGISTRATION

https://doi.org/10.17605/OSF.IO/4TAEB (associated project link: osf.io/6y48t).

Childhood verbal abuse as a child maltreatment subtype: A systematic review of the current evidence

BACKGROUND

In recent years, the prevalence of childhood emotional abuse has surpassed other forms of maltreatment. Childhood verbal abuse (CVA) is a key attribute of emotional abuse, yet CVA is not recognized as its own form of maltreatment and thus, has not received adequate attention. Clear terminology, definitions, and measures are needed to aid in assessing the occurrence and impact of CVA for its recognition and prevention.

OBJECTIVE

We aim to synthesize the evidence on the terms, definitions, and measurements of CVA and identify outcomes associated with CVA.

PARTICIPANTS AND SETTING

A systematic review focused on adult perpetration of CVA among children and adolescents using clinical, community-based, and population-based samples.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and four databases were utilized in May 2022: PsycINFO, MEDLINE, EMBASE, and ProQuest. A total of 149 quantitative and 17 qualitative studies were identified.

RESULTS

Across studies reviewed, the most common perpetrators of CVA were parents, mothers, and teachers. Definitional themes for CVA included negative speech volume, tone, and speech content, and their immediate impact. The most frequent measures cited were Adverse Childhood Experiences Study (ACE) Questionnaire and the Conflict Tactics Scale (CTS); 50 % used self-created measures. CVA was associated with a range of internalizing and externalizing outcomes across the lifespan.

CONCLUSIONS

Recognizing CVA as a form of maltreatment will be a starting point for its identification and prevention. Primary prevention of CVA using trauma-informed approaches must include adult training on the importance of safety, support, and nurturance during verbal communication with children.

Systematic Review on Environmental Design for Adaptive and Problem Behaviors of People With Intellectual and Developmental Disabilities

OBJECTIVES

The presented systematic review explores the empirical studies regarding environmental design strategies that support adaptive behaviors while improving problem behaviors of people with intellectual and developmental disabilities (IDD).

BACKGROUND

People with IDD perceive and interact with their environment differently from people without disabilities. Design research has not always considered these differences, and environmental design solutions are not commonly found.

METHODS

The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. The study reports the findings from the systematic review of 32 peer-reviewed studies published in EBSCO, ERIC, ProQuest, PsycINFO, MEDLINE CINAHL, Consumer Health Complete (EBSCOhost), and Psychology and Behavioral Sciences Collection between 1990 and 2020. In addition, quality assessment tools appraised the study's quality.

RESULTS

The review identified 26 design strategies. Five themes qualitatively organized these environmental attributes: coherence, affordance, control, stimulation, and restoration.

CONCLUSION

The evidence indicates that adequately designed physical environments can support the adaptive behaviors of people with IDD while alleviating behavioral problems. Design features not supported by strong empirical evidence should be further addressed in future studies.

Advanced practice physiotherapists can diagnose and triage patients with musculoskeletal disorders while providing effective care: a systematic review

QUESTIONS

What is the diagnostic and surgical triage concordance between advanced practice physiotherapists (APPTs) and physicians? What is the clinical efficacy of advanced practice physiotherapy care compared with usual medical care?

DESIGN

Systematic review with meta-analyses.

LITERATURE SEARCH

Medline, Embase, Cochrane CENTRAL and CINAHL were searched up to March 2022.

STUDY SELECTION CRITERIA

Concordance studies on diagnostic or surgical triage between APPTs and physicians and randomised controlled trials comparing the clinical efficacy of an advanced practice physiotherapy (APP) model of care compared with usual medical care for participants with musculoskeletal disorders.

DATA SYNTHESIS

Meta-analyses were performed for concordance and clinical outcomes. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to evaluate the certainty of evidence.

RESULTS

Nineteen concordance studies (n = 1,745) and six randomised trials (n = 1,960) were included. Based on moderate-certainty evidence, the pooled Kappa for diagnostic concordance between APPTs and physicians was 0.76 (95% CI 0.68 to 0.85, n = 1,108). Based on high-certainty evidence, the pooled Kappa for surgical triage concordance was 0.71 (95% CI 0.63 to 0.78, n = 1,128). Based on moderate-certainty evidence, APP care resulted in a comparable or greater reduction in pain (MD -0.92 out of 10, 95% CI -1.75 to -0.10, n = 494) when compared with usual medical care at medium-term follow-up. Based on low-certainty evidence, APP care resulted in a comparable or greater reduction in disability (SMD -0.31, 95% CI -0.67 to 0.04, n = 535) when compared with usual medical care at medium-term follow-up.

CONCLUSION

Concordance between APPTs and physicians is probably good to very good for diagnosis and good to very good for surgical triage of musculoskeletal disorders. Patients with musculoskeletal disorders managed in an APP model of care probably report comparable or greater pain and disability reductions when compared with usual medical care.

REGISTRATION

CRD42022320950.

Association between maternity leave policies and postpartum depression: a systematic review

PURPOSE

Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers' mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression.

METHODS

We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies.

RESULTS

Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design.

CONCLUSION

More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.

A systematic review of nonpharmacological interventions to reduce procedural anxiety among patients undergoing radiation therapy for cancer

Procedural anxiety is a concern for a number of patients undergoing radiation therapy. While procedural anxiety is often treated pharmacologically, there is a clinical need for effective alternative strategies for patients who are contraindicated from medication use, and those who prefer not to take unnecessary medications.

OBJECTIVES

The primary objective was to assess the efficacy of nonpharmacological interventions delivered to adults with cancer, in the radiation oncology department, just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety. The secondary objectives were to assess the efficacy of these interventions in reducing physiological symptoms of procedural anxiety and anxiety-related treatment disruptions.

DESIGN

Systematic review.

DATA SOURCES

Electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials) were searched from inception up until February 2022.

INCLUSION CRITERIA

Population: Adult patients with cancer undergoing external beam radiation therapy.

INTERVENTION

Nonpharmacological interventions delivered within the radiation therapy department. Comparison: standard care controls, or standard care plus an alternative intervention.

OUTCOMES

level of self-reported procedural anxiety (primary), physiological symptoms of anxiety (secondary) and measures of anxiety-related treatment disruptions (secondary).

DATA EXTRACTION AND ANALYSIS

Two reviewers independently extracted data. A meta-analysis was originally planned but deemed not feasible as the studies could not be confidently pooled for meta-analysis, due to the variability in the interventions, study designs and the generally low number of studies. Therefore, a narrative synthesis is presented.

RESULTS

Screening of 2363 records identified nine studies that met inclusion criteria: six studies of music interventions, two of video-based patient education and one of aromatherapy. Overall, three studies received a global rating of strong methodological quality and low risk of bias. Three studies reported a significant effect of the intervention on reducing the primary outcome of self-reported procedural anxiety: two music interventions (both strong methodological quality), and one video-based patient education (moderate methodological quality). One of the studies (a music intervention) also reported a significant reduction in the secondary outcome of physiological symptoms of procedural anxiety (systolic blood pressure).

CONCLUSIONS

The evidence for nonpharmacological interventions delivered to adults with cancer just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety is limited, with very few well-designed studies. There is a need for interventions for procedural anxiety during radiation therapy to be evaluated through rigorous randomised controlled trials.

Long-Term Neurophysiological Adaptations to Strength Training: A Systematic Review With Cross-Sectional Studies

ABSTRACT

Santos, PDG, Vaz, JR, Correia, J, Neto, T, and Pezarat-Correia, P. Long-term neurophysiological adaptations to strength training: a systematic review with cross-sectional studies. J Strength Cond Res 37(10): 2091-2105, 2023-Neuromuscular adaptations to strength training are an extensively studied topic in sports sciences. However, there is scarce information about how neural mechanisms during force production differ between trained and untrained individuals. The purpose of this systematic review is to better understand the differences between highly trained and untrained individuals to establish the long-term neural adaptations to strength training. Three databases were used for the article search (PubMed, Web of Science, and Scopus). Studies were included if they compared groups of resistance-trained with untrained people, aged 18-40 year, and acquired electromyography (EMG) signals during strength tasks. Twenty articles met the eligibility criteria. Generally, strength-trained individuals produced greater maximal voluntary activation, while reducing muscle activity in submaximal tasks, which may affect the acute response to strength training. These individuals also presented lower co-contraction of the antagonist muscles, although it depends on the specific training background. Global intermuscular coordination may be another important mechanism of adaptation in response to long-term strength training; however, further research is necessary to understand how it develops over time. Although these results should be carefully interpreted because of the great disparity of analyzed variables and methods of EMG processing, chronic neural adaptations seem to be decisive to greater force production. It is crucial to know the timings at which these adaptations stagnate and need to be stimulated with advanced training methods. Thus, training programs should be adapted to training status because the same stimulus in different training stages will lead to different responses.

What are the Effects of Exercise on Trabecular Microarchitecture in Older Adults? A Systematic Review and Meta-analysis of HR-pQCT Studies

The objective of this review was to determine the effects of exercise on high-resolution peripheral quantitative computed tomography (HR-pQCT) derived trabecular microarchitecture parameters in older adults. Five electronic databases were systematically searched by two independent reviewers. Inclusion criteria were adults age ≥ 50, any type of exercise as part of the intervention, and trabecular microarchitecture assessed via HR-pQCT. Data was extracted from included studies, and where suitable, included in a meta-analysis. Quality of included studies was appraised. Seven studies (397 participants) were included. All participants were postmenopausal women. Interventions included jumping, whole-body vibration, and power/plyometric training. All studies were rated as either weak or moderate quality. Meta-analysis (5 studies) showed no significant changes in any parameters when considering all exercise or sub-analysing based on type. Exercise was not found to have significant effects on trabecular microarchitecture in postmenopausal women over the age of 50. These findings should be interpreted with caution due to the small number of studies investigating few modes of exercise, their weak to moderate quality, and risk of bias. High-quality studies are needed to determine the effects of additional types of exercise in a more diverse population of older adults, including men.

Workload, Job Satisfaction and Quality of Nursing Care in Italy: A Systematic Review of Native Language Articles

Nursing research is rapidly increasing, yet contributions from numerous countries that may interest the international nursing community are impeded because many research articles are published in authors' native language and not in English. The objectives of this work were to systematically review papers published in Italian related to job satisfaction and the quality of nursing care, and to discuss their findings in light of the international literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used. The Directory of Open Access Journals (DOAJ) and Indice della Letteretura Italiana di Scienze Infermieristiche (ILISI) databases were consulted for eligible studies published from January 2015 to November 2022. Two hundred sixteen papers were identified, 11 of which were selected for review: 8 on job satisfaction, two on workload issues, and 1 on quality of nursing care. The quality of included studies was assessed through the Effective Public Health Practice Project quality assessment tool (EPHPP). The results of our review were in line with those of international literature, and they can help to fill the knowledge gap on the quality of nursing performance in Italian care settings. In addition, the proposed method can provide further elements of discussion among literature providers and reviewers.

The Effect of Female Genital Cosmetic and Reconstructive Procedures on Body and Genital Self-Image: A Systematic Review and Meta-Analysis

Performance of female genital cosmetic and reconstructive procedures (FGCRP) has been increasing over past decades. Appearance and functional concerns are the most common reasons for seeking FGCRP. Poor body and genital self-image may contribute to the increase in demand for surgery. The aim of this systematic review is to explore outcomes of FGCRP in the domains of body and genital self-image. A systematic literature review of PubMed, Web of Science, Scopus, PsycINFO, Embase, and the Cochrane Library was conducted to identify articles that measured body and genital self-image in females after FGCRP. The authors identified 5 articles for a systematic review of body image and 8 studies for a systematic review of genital self-image. The most common procedure performed was labia minora labiaplasty. Instruments for body image evaluation were the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder and the Body Image Quality of Life Inventory. Genital image was assessed with the Female Genital Self-Image Scale and Genital Appearance Satisfaction (GAS) scale. Most of the studies indicated that FGCRP can improve both body image and genital self-image; meta-analysis revealed that FGCRP improved GAS scores by 17.96 (range: 0-33; P < .001). It appears that FGCRP leads to improvements in females' body and genital self-image. Inconsistencies in study design and measures, however, limit this conclusion. Future research should involve more rigorous study designs (for example randomized clinical trials with large sample sizes) for a more accurate assessment of FGCRP's consequences.

LEVEL OF EVIDENCE: 4

The Risk of Methylphenidate Pharmacotherapy for Adults with ADHD

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. It was once thought to be a disorder affecting only children, but in those undiagnosed in childhood, symptoms do not disappear with age. There is now a growing recognition of the late diagnosis and treatment of adults with ADHD. The first-line drug in pharmacotherapy is methylphenidate, and information about its adverse effects, when used by adults, has not been as extensively described as in children. The aim of this article was to review the literature describing the risks of methylphenidate therapy for adults with ADHD. A total of 19 articles-15 clinical trials and 4 case reports presenting rare side effects resulting from methylphenidate therapy, such as reversible ischemic stroke, myocardial infarction, and psychotic episodes, were analyzed. The analysis from clinical trials included 3458 adult patients with ADHD and described the most common side effects, psychiatric adverse events, effects of methylphenidate treatment on sleep, laboratory results, body mass, and cardiovascular symptoms. Methylphenidate treatment is well tolerated, with side effects described, according to severity, as mild to moderate. We conclude that pharmacotherapy is not risk-free and methylphenidate, due to its side effects, may not be the first drug of choice for every patient.

The impact of health education interventions on oral health promotion among older people: a systematic review

BACKGROUND

One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people.

METHODS

Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP).

RESULTS

In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality.

CONCLUSION

This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field.

Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews

BACKGROUND

Maternal mortality in low- and middle-income countries (LMIC) has reduced considerably over the past three decades, but it remains high. Effective interventions are available, but their uptake and coverage remain low. We reviewed and synthesised evidence from systematic reviews on interventions to increase healthcare services utilisation to reduce maternal mortality in LMICs.

METHODS

We searched Medline PubMed and Cochrane Library databases for systematic reviews published between January 2014 and December 2021, investigating interventions to increase healthcare services uptake among pregnant women in LMICs. We used the AMSTAR tool (A Measurement Tool to Assess Systematic Reviews) to assess the methodological quality of the included reviews. We extracted data on the interventions and their effects and grouped them into broad groups based on the outcomes reported in each systematic review.

RESULTS

We retrieved 4,022 articles. After removing duplicates and screening, we included 14 systematic reviews. Male-partner interventions were effective in increasing skilled birth attendance (SBA) postnatal visits and maternal antiretroviral (ART) uptake for HIV-positive pregnant women. However, there was no evidence of their effectiveness on increased early ANC initiation or adequate ANC visits. Mobile health interventions were effective in increasing adequate ANC visits, SBA, facility-based service utilisation, early ANC initiation, and adherence to nutritional supplements. Incentive-based interventions, particularly financial incentives, were effective in increasing the number of ANC visits but not postnatal visits. Facility-based interventions were effective in increasing postnatal visits, maternal ART initiation and uptake, immunisation uptake and follow-up ANC visits. None of the reviews assessed their impact on SBA or adequate ANC visits. Community-based interventions were effective in increasing SBA, ANC service utilisation, ART initiation and uptake, and nutritional supplements and immunisation uptake.

CONCLUSION

Our findings show that the different interventions effectively improved different outcomes on the maternal healthcare continuum. Implementing these interventions in combination has the potential to enhance healthcare service uptake further.

10‐session Cognitive Behavioural Therapy (CBT-T) for Eating Disorders: A Systematic Review and Narrative Synthesis

To review the literature examining the effectiveness and efficacy of a cognitive behavioural therapy (CBT) for eating disorders delivered in ten sessions for those who are not underweight (CBT-T). A systematic search of the literature (MEDLINE, EMBASE, PsycINFO, Scopus and ProQuest) was conducted to identify relevant publications to date at the time of March 2022 (re-run in May 2023). Intervention studies of any study design that investigated CBT-T offering outcome data at least pre- to post- intervention for eating disorder and related outcomes were included. Results were reported for treatment attrition, abstinence, remission, eating disorder psychopathology, disordered eating behaviours, psychosocial impairment, depression and anxiety and synthesised using a narrative synthesis framework. The Effective Public Health Practice Project (EPHPP) quality assessment tool (Thomas et al., 2004) was used to assess the quality of included studies. Outcomes for 555 people who received CBT-T across eight studies (one randomised control trial and seven non-randomised studies) were synthesised. Support was found for the effectiveness and efficacy of CBT-T for a range of non-underweight eating disorders, with respect to eating disorder psychopathology, disordered eating behaviours, psychosocial impairment, abstinence and remission. CBT-T also led to improvements for depression and anxiety symptoms. CBT-T appears to improve eating disorder and co-morbid outcomes for people with non-underweight eating disorders within ten sessions, with comparable results to standard-length CBT for eating disorders (CBT-ED). Although results for CBT-T are promising, there were concerns with the quality of the studies. Future research is required to strengthen the evidence base with larger, higher-quality studies which compare CBT-T directly with recommended psychological treatments, such as standard-length CBT-ED.

Structured communication methods for mental health consultations in primary care: a scoping review

BACKGROUND

Majority of people with mental health problems attend primary care for support. Interventions that structure consultations have been found effective for physical health conditions and secondary mental health care. The aim of the review is to identify what tools or interventions exist to structure communication in primary care for appointments related to mental health problems and examine existing evidence for effectiveness for mental health and quality of life outcomes.

METHODS

Quantitative and qualitative studies were eligible for inclusion if staff was based in a primary care setting and the intervention involved bi-directional communication with adult patients. Six databases were searched (MEDLINE, Web of Knowledge, EMBASE, PsycINFO, The Cochrane Library, CINAHL) with no time restriction. Search terms combined four concepts with key words such as "structured" and "interaction" and "mental illness" and "primary care". Reference lists of eligible studies were searched.

RESULTS

After removing duplicates, 3578 records were found and underwent further screening. A total of 16 records were included, representing eight different interventions from five countries. The majority were delivered by primary care doctors and focused on patients experiencing psychological distress. Similarities across interventions' service delivery were that most were created for a broad patient population, used self-report assessments at the start and actions or plans as the end point, and employed group settings and didactic methods for training staff in the intervention. Booster and follow-up trainings were not offered in any of the interventions, and supervision was only part of the process for one. The evidence for effectiveness for mental health and quality of life outcomes was mixed with three out of five RCTs finding a positive effect.

CONCLUSIONS

Although the idea of structuring communication for mental health consultations has been around since the 1980s, relatively few interventions have attempted to structure the conversations within the consultation, rather than modifying pre-visit events. As the evidence-base showed feasibility and acceptability for a number of interventions, there is scope for those interventions to be developed further and tested more rigorously.

Outcomes of Patient Education in Nurse-led Clinics: A Systematic Review

Introduction

Patient education is an independent role of nurses performed in nurse-led clinics (NLCs). The measurement of patient education outcomes validates whether nursing educational interventions have a positive effect on patients, which helps determine whether changes in care are needed. Standardized nursing terminologies facilitate the evaluation of educational outcomes. We aimed to explore the outcomes of patient education in NLCs based on the Nursing Outcome Classification (NOC) system.

Methods

The review was conducted according to PRISMA guidelines. We searched "Medline", "Embase", "Web of Science", and "Scopus" databases for articles published between 2000 and 2022. Based on the search strategy, 1157 articles were retrieved from PubMed, Scopus, Web of Science, and Embase databases. After excluding the duplicates, 978 articles were appraised. 133 articles remained after reading the titles and abstracts of the articles. In the next step, the articles were evaluated regarding methodology, research population, and exclusion criteria, after which 112 articles were omitted, and finally, 21 articles were included in the full-text review. We assessed all included studies using the Quality Assessment of Controlled Intervention Studies checklist.

Results

A total of 21 randomized controlled trials met the inclusion criteria. "Physiologic health", "functional health", "psychosocial health", "health knowledge and behavior", and "perceived health" were the domains of nursing outcomes investigated as Patient Education Outcomes in NLCs.

Conclusion

Most of the outcomes were linked to lifestyle-related chronic diseases and, further studies are needed to determine the effects of patient education provided in NLCs in terms of family/society health outcomes.

Clomiphene citrate for male infertility: A systematic review and meta-analysis

BACKGROUND

Male infertility is a prevalent and worldwide problem with various difficulties in treatment. Clomiphene citrate is a selective estrogen receptor modulator and may improve semen quality by stimulating hormone synthesis and spermatogenesis. There is lack of evidence on the efficacy of clomiphene citrate as therapy for male infertility.

OBJECTIVES

Therefore, a systematic review and meta-analysis was performed to assess the efficacy of clomiphene citrate on sperm quality in infertile men.

METHODS

A search was conducted in the PubMed, EMBASE and Cochrane databases for effectiveness in infertile males treated with clomiphene citrate. Both intervention and observational studies were included. Primary outcome measures were semen parameters (concentration, motility and morphology). Secondary outcomes included hormonal evaluation, pregnancy rate and side effects. Studies were included for meta-analysis if they provided absolute numbers for outcomes before and during treatment with appropriate SD or SE.

RESULTS

Total 1799 studies were identified during the search, 18 studies remained for qualitative analysis (n = 731) and 15 studies for meta-analysis (n = 566). Study populations ranged between 11 and 140 participants. Sperm concentration was higher during treatment, with a mean difference 8.38 × 106 /ml (95% confidence interval: 5.17-11.59; p < 0.00001; I2  = 87%). Total sperm motility was higher during treatment, with a mean difference of 8.14% (95% confidence interval: 3.83-12.45; p < 0.00001; I2  = 76%). There was no difference in sperm morphology before and during treatment. Total testosterone, follicle-stimulating hormone, luteinizing hormone and estradiol were higher during clomiphene citrate treatment. During follow-up, no serious adverse effects occurred. In 10 studies, pregnancy rate was reported and yielded a mean of 17% during clomiphene citrate treatment (range: 0%-40%).

CONCLUSIONS

Clomiphene citrate increased sperm concentration and motility and could be considered as a safe therapy for improving sperm parameters in infertile males.

Quality appraisal of spatial epidemiology and health geography research: A scoping review of systematic reviews

A scoping review of peer-reviewed literature was conducted to understand how systematic reviews assess the methodological quality of spatial epidemiology and health geography research. Fifty-nine eligible reviews were identified and included. Variations in the use of quality appraisal tools were found. Reviews applied existing quality appraisal tools with no adaptations (n = 32; 54%), existing quality appraisal tools with adaptations (n = 9; 15%), adapted tools or methods from other reviews (n = 13; 22%), and developed new quality appraisal tools for the review (n = 5; 8%). Future research should focus on developing and validating a quality appraisal tool that evaluates the spatial methodology within studies.

Effects of public-private partnership on diet-related obesity risk factors among school-aged children: A systematic literature review

Background: Childhood obesity is a major public health challenge. Public-private partnerships (PPPs) have been proposed as a solution; however, valid concerns exist as to whether commercial interest can be balanced with public health goals. Aims: This study describes the effects of interventions carried out through PPPs on diet-related obesity risk factors, namely fruit and vegetable (F&V), sugar-sweetened beverage (SSB), and energy-dense food consumption, among school-aged children. Methods: A systematic literature review was conducted from January 1990 to December 2021 across three databases. Out of the 276 articles initially identified, 8 were included. Data were extracted from each article on study characteristics, partners involved, partnership descriptions, and partnership outcomes. A descriptive analysis included frequency counts for specific study attributes. Results: All studies took place in the United States and were published between 2010 and 2017. Most were cohort studies (75%) and involved structured, healthy lifestyle interventions (75%). Nearly all interventions included components targeting F&V consumption (88%), followed by energy-dense food consumption (50%), and SSB consumption (38%). Business sector partners were largely food producers, food retailers, and private healthcare providers; however, few studies provided details on their partnering arrangements. No studies reported harmful changes in diet-related obesity risk factors. Conclusion: Collaboration across sectors is needed to address drivers of obesity where children live, learn, and play. The small sample size and heterogeneity in this review prohibits definitive conclusions pertaining to the effect of PPPs on childhood obesity. Future research efforts are needed to develop a taxonomy for better classifying and examining PPPs.

The impact of mindfulness interventions for staff on the care, treatment, and experiences of people with intellectual disabilities: A systematic review

BACKGROUND

Mindfulness interventions have been shown to ameliorate stress in support staff working with people with intellectual disabilities. This review aimed to explore what impact mindfulness interventions for staff have on their care and support behaviours, and on the experiences of people with intellectual disabilities receiving support.

METHOD

A systematic search of PsycINFO, Web of Science, ASSIA, and PubMed identified nine studies meeting the inclusion criteria. Outcomes were collated and a quality assessment tool was used to inform the critical analysis of the studies.

RESULTS

Despite identified methodological issues, positive results were consistently reported. These included reduced use of restrictive practices by staff, increased positive interactions between staff and people with intellectual disabilities, and reduced aggression displayed by people with intellectual disabilities.

CONCLUSIONS

Further research in this area is required; however, this review supports the benefits of mindfulness on staff behaviour and the quality of life of people with intellectual disabilities.

Developing nurse-sensitive outcomes in acute inpatient mental health settings-A systematic review

BACKGROUND

While nurse-sensitive outcomes (NSOs) are well established in numerous health settings, to date there is no indicator suite of NSOs for inpatient mental health settings.

AIM

To assess the relationship between nursing variables and patient outcomes in acute inpatient mental health settings to determine which outcomes can be used as indicators of the quality of nursing care.

METHODS

Databases accessed were CINAHL, MEDLINE, PsycINFO and EMBASE, last searched in May 2022. The review followed the 2020 PRISMA checklist for systematic reviews. Papers published between 1995 and 2022, conducted in acute mental health care units were included. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool. A meta-analysis was not possible because of the large number of variables and measurement inconsistencies.

RESULTS

A total of 57 studies were reviewed. Studies were categorised according to whether they found a significant or non-significant relationship between nurse variables and patient outcomes. Seven outcomes-aggression, seclusion, restraint, absconding, pro-re-nata medications, special observations and self-harm-were identified. For each outcome, there were significant findings for several nurse variables indicating that all included outcomes could be used as NSOs. However, evidence for aggression, seclusion and restraint use as suitable NSOs was more robust than the evidence for self-harm, absconding, pro-re-nata medications and special observations.

CONCLUSION

All the seven outcomes can all be used to develop an NSO indicator suite in mental health inpatient settings. More work is needed to establish high-quality studies to clearly demonstrate the relationship between these outcome measures and changes in nurse variables such as nurse staffing, skill mix, work environment, nurse education and nurse experience.

PATIENT AND PUBLIC CONTRIBUTION

Patient or public contribution was not possible because of the type of the variables being explored.

Outpatient versus inpatient cervical ripening with a slow-release dinoprostone vaginal insert in term pregnancies on maternal, neonatal, and birth outcomes: A systematic review

BACKGROUNDS

Outpatient induction of labor (IOL) is an alternative choice offered to pregnant women requiring cervical ripening. Outpatient IOL can provide solutions in terms of women empowerment, but most importantly promotes as normal labor as possible, within the medical context of the IOL. The objectives of this systematic review were to assess safety and effectiveness of cervical ripening performed with a slow-release dinoprostone vaginal insert in term pregnancies in two settings: the outpatient (home) versus the inpatient (hospital).

METHODS

The electronic databases Cinahl, Embase, Medline and Maternity and Infant Care were searched to detect studies that met the inclusion criteria. Both reviewers collected the data and assessed the quality of the studies and assessed the pooled odds ratio using a 95% confidence interval and a random-effects model. Primary outcomes were linked to maternal and neonatal morbidity. Secondary outcomes were related to birth outcomes.

RESULTS

No statistical difference was seen between the outpatient and inpatient setting in terms of maternal complications, neonatal morbidity, cesarean section, and labor onset <24 h. Women in the outpatient setting were significantly less likely to experience uterine hyperstimulation, and they were also significantly more likely to require oxytocin to augment or induce their labor than the women in the inpatient setting. Women in the outpatient setting were more satisfied with the cervical ripening experience.

CONCLUSIONS

Cervical ripening with a slow-release dinoprostone vaginal insert in term pregnancies in the outpatient setting appears as safe as the inpatient setting in terms of maternal, neonatal, and birth outcomes.

Interventions to support patients with sharing genetic test results with at-risk relatives: a synthesis without meta-analysis (SWiM)

Whilst the finding of heritable susceptibility to disease was once relatively rare, mainstreaming of genetic testing has resulted in a steady increase. Patients are often encouraged to share their genetic test results with relevant relatives, but relatives may not receive this information, leaving them without knowledge of their own risk. Therefore, strategies to help communicate such information are important. This review aimed to explore the efficacy of existing interventions to improve the sharing of genetic test results. A synthesis without meta-analysis design was used. A systematic search of Medline, CINAHL, PsychINFO, and AMED was conducted, and five studies were identified worldwide. Data were extracted for each study regarding study aim, participant characteristics, condition, intervention details, comparison, study duration, outcome measures, theory and behaviour change techniques used. Limited efficacy and application of theory was found. Knowledge, motivation and self-efficacy were not increased in any intervention. No gender differences in communication behaviour were encountered in interventions that recruited men and women. Two studies reported an evaluation of acceptability, which showed that the interventions were well received by patients and health professionals. No study reported the involvement of the target population in any phase of intervention development. Given the lack of health psychology-informed interventions in this area of clinical genetics, we recommend genetic health professionals, health psychologists and patients collaborate on all stages of future interventions that involve the cascading of genetic health information within families. We also provide guidance regarding use of theory and intervention elements for future intervention development.

Effects of school indoor visual environment on children's health outcomes: A systematic review

Children's visual perceptions are critical for their comfort and health. This review explores the impacts of school indoor visual environment on children's health outcomes. A systematic search yielded 5704 articles, of which 32 studies were reviewed. Five environmental themes were identified: lighting, access to nature, window characteristics, art/environmental aesthetics, and ergonomics/spatial arrangement. Results affirm that visual environment affects children's health. There are disparities across environmental themes, with more extensive evidence for lighting and access to nature, but relatively limited in other areas. This study suggests a need for multi-disciplinary collaboration to develop a holistic perspective.

Cooking and Its Impact on Childhood Obesity: A Systematic Review

INTRODUCTION

This systematic review aimed to study the effect of a cooking intervention on obesity among children and adolescents aged < 18 years.

METHODS

Articles that studied the effect of cooking intervention with at least 4 sessions among children and adolescents on obesity (from January, 2000 to December, 2021) were included for analysis. Of the 500 articles identified through PubMed and ScienceDirect database, 9 studies qualified to be included in this review.

RESULTS

One-third of the studies found a positive effect of a cooking intervention on obesity among children and adolescents. School-based studies conducted among elementary school students were promising. Centers for Disease Control and Prevention body mass index percentile was the most common tool used to identify children and adolescents with overweight and obesity. The majority of the studies had a strong methodology.

DISCUSSION

All studies showed improvement in diet-related factors. Active participation of parents is crucial in making childhood interventions successful. It is difficult to delineate the effect of cooking alone on obesity as almost all studies had multicomponent interventions.

IMPLICATIONS FOR RESEARCH AND PRACTICE

These diverse results highlight the need for longitudinal studies in natural settings to comprehend the effect of long-term cooking on obesity in children and adolescents.

Evaluating the Effectiveness of Apps Designed to Reduce Mobile Phone Use and Prevent Maladaptive Mobile Phone Use: Multimethod Study

BACKGROUND

Mobile apps are a popular strategy for reducing mobile phone use and preventing maladaptive mobile phone use (MMPU). Previous research efforts have been made to understand the features of apps that have the potential to reduce mobile phone use and MMPU. However, there has been a lack of a comprehensive examination of the effectiveness of such apps and their features.

OBJECTIVE

This paper investigated existing apps designed to reduce mobile phone use and prevent MMPU and examined the evidence of their effectiveness. The research aimed to provide a comprehensive analysis of app features that can reduce mobile phone use and MMPU, while also assessing their effectiveness. In addition, we explored users' perceptions of these apps and the various features the apps offer to understand potential adoption issues and identify opportunities.

METHODS

This study used 3 methods: a review of scientific evidence, content analysis, and sentiment analysis.

RESULTS

Our study comprehensively examine the common features of 13 apps designed to reduce mobile phone use. We extracted and classified the features into 7 types: self-tracking, social tracking, goal setting, blocking, gamification, simplification, and assessment. The effectiveness of these apps in reducing mobile phone use and MMPU varied from weak to strong. On the basis of content analysis, self-tracking and goal setting were the most frequently used features, whereas gamification and assessment were used the least frequently. The intervention strategies that effectively reduce mobile phone use and MMPU included using grayscale mode, app limit features, and mixed interventions. Overall, users tended to accept these apps, as indicated by sentiment scores ranging from 61 to 86 out of 100.

CONCLUSIONS

This study demonstrates that app-based management has the potential to reduce mobile phone use and MMPU. However, further research is required to evaluate the effectiveness of app-based interventions. Collaborations among researchers, app developers, mobile phone manufacturers, and policy makers could enhance the process of delivering, evaluating, and optimizing apps aimed at reducing mobile phone use and MMPU.

The Impact of the COVID-19 Pandemic on Binge Eating Disorder: A Systematic Review

The aim of this systematic review was to synthesise the impact of the COVID-19 pandemic on binge eating disorder (BED) the new onset and course. Inclusion criteria: original articles and BED diagnosis; and the main outcomes: relationships between the COVID-19 pandemic and the new onset/clinical changes in BED, and specific results for BED. Exclusion criteria: mixed/inaccurate diagnoses and articles not written in English. We searched four databases and one registry until 5 May 2023. The quality appraisal was conducted using the Effective Public Health Practice Project (EPHPP) tool. Twelve studies with 4326 participants were included. All studies were observational with nine cross-sectional and three longitudinal. Four of the included studies investigated new-onset BED, while eight examined the BED clinical course of patients with a previous diagnosis. With the exception of one study, the available literature indicates both an increase in BED diagnoses and a clinical worsening during COVID-19. Major limitations include study quality (weak-to-moderate) and high heterogeneity in terms of pandemic phase, population, geographical areas, and psychometric tools. Our findings indicate that BED patients are particularly vulnerable to events characterised by social distancing and over-worry, and should be, therefore, carefully monitored. Further studies are needed to corroborate our findings, implement preventive strategies, and promote personalised treatments. PROSPERO registration number: CRD42023434106.

Nodal tumor volume as a prognostic factor for oral squamous cell carcinoma-a systematic review

Oral squamous cell carcinoma (OSCC) is a complex disease with a high potential for lymph node metastasis and poor survival rates. Accurate nodal staging is crucial for prognostic assessment and treatment planning in OSCC. Recent research has suggested that nodal tumor volume (NTV) may be a more accurate indicator of nodal disease burden than traditional staging methods. However, the prognostic significance of NTV in OSCC remains unclear. This systematic review aims to evaluate the existing evidence on the relationship between NTV and prognosis in OSCC. A comprehensive search of electronic databases was conducted, and studies meeting inclusion criteria were critically appraised and synthesized. Our review identified 23 studies that investigated the prognostic significance of NTV in OSCC. The majority of studies reported that larger NTV was associated with poorer survival outcomes, although the strength of the association varied. The review also identified several areas for future research, including the standardization of NTV measurement and the integration of NTV into the broader landscape of OSCC management. In conclusion, our review suggests that NTV holds promise as a novel prognostic factor in OSCC, but more research is needed to fully elucidate its potential and inform clinical decision-making.

The Impact of Social Media Use Interventions on Mental Well-Being: Systematic Review

BACKGROUND

There is some evidence that more social media use is related to poorer mental well-being and that social media use can become problematic when it starts to interfere with a person's daily life and mental well-being. To address this issue and improve users' mental well-being, social media use interventions (eg, abstinence from social media) have been developed and evaluated. However, there is limited understanding of the effectiveness of these interventions in improving mental well-being.

OBJECTIVE

This systematic review aimed to synthesize the literature on the effectiveness of social media use interventions in improving mental well-being in adults.

METHODS

A systematic search (January 1, 2004, to July 31, 2022) was completed across 3 databases in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Experimental studies evaluating the impact of social media use interventions on mental well-being in adults were included. Outcomes related to mental well-being, such as depression, anxiety, stress, and loneliness, were included. A narrative synthesis without meta-analysis was completed to summarize the study characteristics and effectiveness by outcome and intervention type. The Effective Public Health Practice Project Quality Assessment Tool was used to measure the quality of the studies.

RESULTS

Of the 2785 studies identified through the systematic search, 23 (0.83%) were included in the analysis. Many of the included studies (9/23, 39%) found improvements in mental well-being, some (7/23, 30%) found mixed effects, and others (7/23, 30%) found no effect on mental well-being. Therapy-based interventions that used techniques such as cognitive behavioral therapy were more effective than limiting use of social media or full abstinence from social media, with 83% (5/6) of these studies showing improvements in mental well-being compared with 20% (1/5) and 25% (3/12), respectively. Depression was the most frequently investigated and improved outcome with 70% (7/10) of the studies showing a significant improvement in depression after the intervention, whereas other outcomes showed more varied results. Quality was poor, with 96% (22/23) of the studies receiving a weak global score, mostly for issues related to selection bias because most of the studies (16/23, 70%) used a convenience sampling of university students.

CONCLUSIONS

This review provides some evidence that social media use interventions are effective in improving mental well-being, especially for depression and when using therapy-based interventions. Further experimental and longitudinal research is needed with representative samples to investigate who may benefit most from social media use interventions. This will help to develop guidance and recommendations for policy makers and clinicians on how best to manage problematic social media use.

Interventions targeting children and young people's physical activity behavior at home: A systematic review

BACKGROUND AND PURPOSE

Increased time at home during the COVID-19 pandemic significantly decreased children's physical activity. This systematic review aimed to evaluate the effectiveness of children's home-based physical activity interventions, and identify 'active ingredients' underpinning these.

METHODS

Databases searched-AMED, PsychINFO, CINAHL, Cochrane, EMBASE, PubMed/Medline, Scopus, SPORTDiscus and Web of Science, from inception until June 2022. Eligibility criteria-children aged 2-16 years, targeting home-based physical activity, a control group, and physical activity measured pre- and post- intervention. Studies were excluded if it was not possible to identify change in physical activity at home. The review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Study quality was evaluated using the quality assessment tool for quantitative studies. Study design, intervention characteristics, outcome data, behavior change theory, Behavior Change Techniques (BCTs) and process evaluation data were extracted and discussed using narrative syntheses.

RESULTS

13 studies (including 1,182 participants) from 25,967 were included. Interventions primarily involved active video games, with the addition of coaching or telehealth support (n = 5). Three of the 13 studies significantly increased children's physical activity (1 = Moderate to vigorous physical activity, 2 = total volume, P<0.05). The largest effect size (d = 3.45) was for moderate to vigorous physical activity. 29% of BCTs were identified across included interventions; the most common being adding objects to the environment. The most effective intervention scored strong for design quality, incorporated telehealth coaching, and included the most commonly coded BCTs. Variation among studies and insufficient reporting of data made a meta-analysis unfeasible.

CONCLUSION

COVID-19 emphasized the importance of the home for physical activity. Whilst effectiveness of interventions was limited, building social support and self-efficacy are mechanisms that should be explored further. The review provides recommendations to improve the design and evaluation of future interventions.

TRIAL REGISTRATION

Prospero registration number: CRD42020193110.

Advertising appeals effectiveness: a systematic literature review

Positive, negative and coactive appeals are used in advertising. The evidence base indicates mixed results making practitioner guidance on optimal advertising appeals difficult. This study aims to identify the most effective advertising appeals and it seeks to synthesize relevant literature up to August 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework a total of 31 studies were identified and analyzed. Emotional appeals, theory utilization, materials, results and quality were examined. Across multiple contexts, results from this review found that positive appeals were more often effective than coactive and negative appeals. Most studies examined fear and humour appeals, reflecting a literature skew towards the two emotional appeals. The Effective Public Health Practice Project framework was applied to assess the quality of the studies and identified that there remains opportunity for improvement in research design of advertising studies. Only one-third of studies utilized theory, signalling the need for more theory testing and application in future research. Scholars should look at increasing methodological strength by drawing more representative samples, establishing strong study designs and valid data collection methods. In the meantime, advertisers are encouraged to employ and test more positive and coactive advertising appeals.

GLIM criteria to identify malnutrition in patients in hospital settings: A systematic review

Malnutrition is recognized as one of the main public health problems in hospitals. The Global Leadership Initiative on Malnutrition (GLIM) has established a global consensus on the criteria for diagnosing malnutrition in adults in hospital settings. This study aimed to evaluate the ability of the GLIM criteria as a tool to identify malnutrition in hospital settings and to compare the prevalence of malnutrition identified by GLIM criteria with that identified by other screening and/or nutrition assessment methods. This was a systematic review. Searches were performed using MEDLINE/PubMed, Scopus, and Virtual Health Library, based on established descriptors. The included studies were observational and used screening and/or nutrition assessment tools to compare the prevalence of malnutrition and predictive capacity identified by GLIM criteria in patients aged >18 years in hospital settings. Twelve studies were included in this systematic review. A total of 4066 individuals with different pathologies and clinical conditions participated in the included studies. The prevalence of malnutrition, according to the GLIM criteria, ranged from 16% to 80%. In four studies, the prevalence of malnutrition based on GLIM was higher than that based on the other indicators. Six studies that evaluated the predictive ability of GLIM criteria identified satisfactory sensitivity and specificity. Four studies found low to high agreement between GLIM and the other methods. GLIM criteria can identify malnutrition and find a high prevalence and severity of malnutrition in the hospital setting, proving them to be a sensitive and specific instrument, with good agreement between screening and nutrition assessment methods.

Other treatments for CSP

Caesarean scar pregnancy (CSP) is an increasingly common clinical conundrum. The non-curettage surgical management of CSP can be categorised into hysteroscopic, vaginal, laparoscopic, and open removal modalities and the choice of treatment is surgeon-dependent. A systematic review of original studies reporting surgical treatment outcomes of CSP until March 2023 was conducted to evaluate the non-curettage surgical management of this highly morbid condition. A total of 60 studies of mostly weak methodological quality were identified involving 6720 CSP cases. Success rates were generally high across all treatment modalities although highest in vaginal and laparoscopic excisional approaches. Morbidity was most associated with haemorrhage although unplanned hysterectomy rates remained low across all treatment groups. Subsequent pregnancies are associated with morbidity despite being underreported and the impact of CSP treatment on future pregnancy is poorly understood. Substantive study heterogeneity precludes meta-analyses of pooled data and treatment superiority has not been demonstrated.

Effects of non-pharmacological interventions on loneliness among community-dwelling older adults: A systematic review, network meta-analysis, and meta-regression

BACKGROUND

The highly prevalent late-life loneliness, together with its deleterious health impacts, calls for increasing attention to the need for effective interventions targeting on this growing public health problem. With the increasing evidence on interventions for combating loneliness, it is timely to identify their comparative effectiveness.

OBJECTIVE

This systematic review, meta-analysis and network meta-analysis was to identify and compare the effects of various non-pharmacological interventions on loneliness in community-dwelling older adults.

METHODS

Systematic search was conducted in nine electronic databases from inception to 30th March 2023 for studies investigating the effects of non-pharmacological interventions on loneliness among community-dwelling older adults. The interventions were categorized according to the nature and purpose of use. Pairwise meta-analysis and network meta-analyses were sequentially performed to identify the effects of each category of interventions and their comparative intervention effectiveness, respectively. Meta-regression was performed to examine any influence of study design and participants' characteristics on the intervention effectiveness. The study protocol was registered at PROSPERO (CRD42022307621).

RESULTS

A total of 60 studies with 13,295 participants were included. The interventions were categorized as psychological interventions, social support interventions (by digital and non-digital means), behavioral activation, exercise intervention with and without social engagement, multi-component intervention and health promotion. Pairwise meta-analysis identified the positive effect of psychological interventions (Hedges' g = -2.33; 95%CI [-4.40, -0.25]; Z = -2.20, p = 0.003), non-digital social support interventions (Hedges' g = -0.63; 95%CI [-1.16, -0.10]; Z = 2.33, p = 0.02) and multi-component interventions (Hedges' g = -0.28 95%CI [-0.54, -0.03]; Z = -2.15, p = 0.03) on reducing loneliness. Subgroup analysis provided additional insights: i) social support and exercise interventions which integrated active strategies to optimize the social engagement demonstrated more promising intervention effects; ii) behavioral activation and multicomponent interventions worked better for older adults who were male or reported loneliness, respectively, and iii) counseling-based psychological interventions was more effective than mind-body practice. Network meta-analysis consistently pointed to the greatest therapeutic benefits of psychological interventions, and this was followed by exercise-based interventions, non-digital social support interventions and behavioral activation. Meta-regression further suggested that the therapeutic effects of the tested interventions were independent of the various factors relating to study design and participants' characteristics.

CONCLUSIONS

This review highlights the more superior effects of psychological interventions in improving loneliness among older adults. Interventions which have an attribute to optimize social dynamic and connectivity may also be effective.

TWEETABLE ABSTRACT

Psychological intervention is the best to beat late-life loneliness, but increasing social dynamic and connectivity may add an impact.

Music and musical elements in the treatment of childhood speech sound disorders: A systematic review of the literature

PURPOSE

Music-based interventions are used in the treatment of childhood speech sound disorders (SSDs). Hypotheses on working mechanisms are being developed, focussing on shared neural processes. However, evidence of the effect of treatment with musical elements in SSDs in children is lacking. This study reviews the literature regarding the use of music-based interventions in the treatment of childhood SSDs.

METHOD

A systematic search in six databases was conducted, yielding 199 articles, eight of which met the inclusion criteria. Included articles were reviewed on study characteristics, patient characteristics, interventions, outcomes and methodological quality.

RESULT

This review included four case studies, three single-subject design studies and one cohort study. Seven studies reported positive outcomes on speech production, but outcome measures in the four studies with experimental design were not all aimed at the level of speech (motor) processes. Methodological quality was sufficient in one study.

CONCLUSION

Seven out of eight studies in this review report positive outcomes of music-based interventions in the treatment of SSDs. However, these outcomes are not sufficiently supported by evidence due to insufficient methodological quality. Suggestions for improving methodological quality in future research are presented.

Sex differences in alpha-synucleinopathies: a systematic review

Background

Past research indicates a higher prevalence, incidence, and severe clinical manifestations of alpha-synucleinopathies in men, leading to a suggestion of neuroprotective properties of female sex hormones (especially estrogen). The potential pathomechanisms of any such effect on alpha-synucleinopathies, however, are far from understood. With that aim, we undertook to systematically review, and to critically assess, contemporary evidence on sex and gender differences in alpha-synucleinopathies using a bench-to-bedside approach.

Methods

In this systematic review, studies investigating sex and gender differences in alpha-synucleinopathies (Rapid Eye Movement (REM) Behavior Disorder (RBD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA)) from 2012 to 2022 were identified using electronic database searches of PubMed, Embase and Ovid.

Results

One hundred sixty-two studies were included; 5 RBD, 6 MSA, 20 DLB and 131 PD studies. Overall, there is conclusive evidence to suggest sex-and gender-specific manifestation in demographics, biomarkers, genetics, clinical features, interventions, and quality of life in alpha-synucleinopathies. Only limited data exists on the effects of distinct sex hormones, with majority of studies concentrating on estrogen and its speculated neuroprotective effects.

Conclusion

Future studies disentangling the underlying sex-specific mechanisms of alpha-synucleinopathies are urgently needed in order to enable novel sex-specific therapeutics.

Effectiveness of SBAR-based simulation programs for nursing students: a systematic review

BACKGROUND

Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students.

METHODS

A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project "Quality Assessment Tool for Quantitative Studies" was used to assess the quality of the included studies.

RESULTS

Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students' behaviors related to patient safety.

CONCLUSIONS

This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.