Reviewing studies with diverse designs: the development and evaluation of a new tool

What are the communication guidelines for people with dementia and their carers on the internet and are they evidence based? A systematic review

Introduction: Communication difficulties of people with dementia can negatively impact well-being of them and their carers. There are evidence-based and clinically recommended strategies that can be used to support people with dementia which they are more likely to access on websites than via academic literature. We aimed to search the internet for communication advice for people with dementia and their carers, describe the strategies and compare these to the evidence-base.Methods: After a systematic search of websites offering communication advice to people with dementia and their carers, we described the strategies there, used reflexive thematic analysis to identify the rationale for recommended strategies and compared the strategies to the evidence base. We included websites aimed at people with dementia and their carers published by dementia-related health and social care, or third sector organisations. We compared strategies to those in published systematic reviews and practice guidance from UK health and social care agencies.Results: Our review identified 39 eligible websites, containing 164 individual strategies. These were grouped into 26 strategy types, with nine latent themes developed. These were supporting communication strengths, valuing the interaction, prioritising needs, providing emotional safety, working together, adapting communication for the situation, developing carer communication skills, knowing the individual and focusing on broader meaning.Conclusion: Our review highlights the need for flexible approaches to supporting communication for people with dementia which consider the individual's needs and preferences, the context of the interaction, and the priority in that moment. We identify the inherent challenges for carers in trying to interpret advice for their own needs.

What is known about near miss events in the operating room? A systematic review of studies of mixed methods design

BACKGROUND

A near miss event (NME) in healthcare is an event that did not happen but would have caused serious harm if it did. The operating room (OR) is prone to risk and incidents, with estimates that 50% of all hospital adverse events occur in the OR, yet reporting of NME is uncommon in the OR.

OBJECTIVE

To carry out a systematic review of studies with mixed methods to establish what is known about NME reporting in the OR.

METHOD

Inclusion criteria will be those studies of mixed methods design, which have been conducted in the OR, with teams of surgeons, anaesthetists or nurses alone or in any combination. Using a publication timeframe of 2001-2023, the following databases were searched: Medline (OVID), CINAHL, Pubmed and Google Scholar. Selected papers for the review were assessed using the Quality Assessment Tool for Studies of Diverse Designs.

RESULTS

Fourteen papers were included in the review. NMEs are common occurrences that are underreported in the OR. When NMEs occur in multiples for the same patient, the risk of serious harm increases. Feedback and education about NME helps to improve reporting; ORs with high rates of NME reporting have less serious patient harm events.

DISCUSSION

The implications of the findings for improving healthcare safety are discussed and in particular the adoption of the science of Human Factors Ergonomics into healthcare.

The Effectiveness of Psychological Intervention for Women Who Committed Child Sexual Abuse: An Empty Systematic Review

The topic of sex offenses committed by women has received relatively little attention until recent decades. The scarcity of research in this domain underscores the urgent need for a more comprehensive understanding and effective interventions. Women who committed child sexual abuse (CSA) exhibit a distinct psychological profile compared to men, requiring specific intervention programs. The current systematic review has two aims: the primary aim is to analyze the effectiveness of psychological interventions with women who committed CSA, and the secondary aim is to identify the intervention models and strategies used with them. Six databases were searched for studies examining the effectiveness of psychological interventions. All retrieved papers were excluded after full-text assessments as none met the primary objective. However, eight publications fulfilled the secondary objective of identifying models and strategies that could inform intervention development. The intervention programs presented addressed specific targets focused on criminogenic needs highlighted in the literature as central to this population, as well as targets that complement the intervention according to individual characteristics. Moreover, the studies frequently emphasize an intervention approach centered on individuals' potential (and not just their deficits), employing a gender paradigm to underpin psychological interventions with this population. The results of this review highlight a major gap in the current literature concerning both the delivery and effectiveness assessment of psychological intervention for women who committed CSA. The studies incorporated for the second objective elucidated critical treatment targets and models to inform intervention strategies, which are subsequently discussed in terms of their practical implications.

Real-World Evidence of 3D Printing of Personalised Paediatric Medicines and Evaluating Its Potential in Children with Cancer: A Scoping Review

Personalised medicine, facilitated by advancements like 3D printing, may offer promise in oncology. This scoping review aims to explore the applicability of 3D printing for personalised pharmaceutical dosage forms in paediatric cancer care, focusing on treatment outcomes and patient experiences. Following the Joanna Briggs Institute (JBI) methodology, a comprehensive search strategy was implemented to identify the relevant literature across databases including PubMed, Embase, and Web of Science. Three independent reviewers conducted study selection and data extraction, focusing on studies involving paediatric patients under 18 years old and pharmaceutical dosage forms manufactured using 3D printing technology. From 2752 records screened, only six studies met the inclusion criteria, none of which specifically targeted paediatric cancer patients. These studies examined aspects of acceptability, including swallowability, taste, and feasibility of 3D-printed formulations for children. While the studies demonstrated the potential benefits of 3D printing in paediatric medication, particularly in personalised dosing, there is a notable lack of evidence addressing its acceptability in paediatric cancer patients. Further interdisciplinary collaborative research is needed in this area to fully assess preferences and acceptability among children with cancer and their parents or caregivers.

A systematic review of medical practitioners' retention and application of basic sciences to clinical practice

BACKGROUND

Medical education offers the foundational base for future healthcare professionals, with basic sciences playing a pivotal role in providing essential knowledge and skills for clinical practice. However, the long-term retention and application of this knowledge in clinical practice remain a significant challenge. This systematic review synthesised global evidence from diverse studies on the short / long-term retention and clinical application of basic sciences among medical doctors.

METHODS

A comprehensive search was conducted across six databases, including Web of Science, Scopus, Medline, CINAHL, Emcare, and Informit. The review included studies that encompassed a variety of study designs, participant groups, and educational interventions. The Quality Assessment with Diverse Studies (QuADS) tool was utilised to assess the quality of the reviewed studies.

RESULTS

A total of 10 studies were included in the review. The findings revealed that rehearsals significantly optimise the retention of basic science knowledge among medical practitioners. Retention varied by discipline, with medical practitioners retaining more knowledge in anatomy (mean scores ranging from 45.0 to 82.9%), while microbiology had the lowest retention score (39.1%). Factors influencing retention included age, gender, and curriculum type. Educational interventions such as targeted courses, integration of basic sciences with clinical skills, generative retrieval and continuous quality improvement in the curriculum were found to enhance both knowledge retention and clinical reasoning. The concept of 'encapsulated knowledge' demonstrates that integrated basic science knowledge helps in synthesising clinical presentations, reducing the need for detailed recall as clinical experience increases. The reviewed studies primarily involved interns and surgeons, leaving a significant gap in research for specialties like internal medicine and primary care/ general practice.

CONCLUSION

Detailed retention of basic science knowledge may diminish over time; however, the conceptual framework remains essential for ongoing learning and clinical reasoning. This review's findings highlight the need for specialised educational interventions to improve long-term retention. Continuous professional development and targeted educational techniques are vital for maintaining clinical competence and applying basic science knowledge effectively throughout a medical career. Further research is needed to address gaps in specialty-specific knowledge application and the impact of different instructional methods.

Experiences and Support Needs of Bereaved Students in Higher Education

Bereavement is commonly experienced by students in higher education and is associated with negative health and academic consequences. We conducted a systematic review of the literature to identify how grief affects students in higher education and the types of support they seek and/or find beneficial. A search of Health Collection, Medline, CINAHL Plus, Web of Science, Taylor and Francis online, ProQuest, and Open Grey resulted in 30 articles that met inclusion criteria. A narrative synthesis resulted in 11 themes focused on the university experience following bereavement (six themes) and supports following bereavement (five themes). Our review highlights how grief symptoms can have a negative impact on bereaved students' academic and social experiences. These difficulties are exacerbated by barriers to accessing grief supports, and unhelpful responses from staff and peers. Students' grief is often disenfranchised and so students learn to avoid grief related emotions, communications, and support-seeking.

Bowel burdens: a systematic review and meta-analysis examining the relationships between bowel dysfunction and quality of life after spinal cord injury

STUDY DESIGN

Systematic review and meta-analysis.

OBJECTIVES

Many individuals with spinal cord injury (SCI) experience autonomic dysfunction, including profound impairments to bowel and cardiovascular function. Neurogenic bowel dysfunction (NBD) is emerging as a potential determinant of quality of life (QoL) after SCI. For individuals with high-level lesions ( > T6), bowel care-related autonomic dysreflexia (B-AD; profound episodic hypertension) further complicates bowel care. We aimed to evaluate the extent of bowel dysfunction after SCI, and the impact of bowel dysfunction on QoL after SCI.

METHODS

We searched five databases to identify research assessing the influence of NBD or B-AD on QoL after SCI. Metrics of bowel dysfunction (fecal incontinence [FI], constipation, time to complete, and B-AD) and QoL data were extracted and synthesised. Where possible, meta-analyses were performed.

RESULTS

Our search identified 2042 titles, of which 39 met our inclusion criteria. Individuals with SCI identified problems with NBD (74.7%), FI (56.9%), and constipation (54.6%), and 49.3% of individuals with SCI > T6 experienced B-AD. Additionally, 40.3% of individuals experienced prolonged defecation ( > 30 min). Moderate/severe deterioration in QoL due to NBD was reported by 55.5% of individuals with SCI, with negative impacts on physical, emotional, and social health-related QoL associated with inflexibility of bowel routines, fear of accidents, and loss of independence.

CONCLUSION

Bowel dysfunction and bowel care challenges are prevalent and disabling for individuals with SCI, with a profoundly negative impact on QoL. Improving bowel management is a key target to improve QoL for those living with SCI.

Image Quality, Radiation Dose, and Patient Comfort Associated with Wireless Sensors in Digital Radiography: A Systematic Review

Radiography facilities face challenges with the positioning of digital radiography detectors. This study evaluates the image quality, radiation dose, and patient comfort associated with wireless sensors in digital radiography. A systematic exploration was performed across PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, and SCIELO. Nine papers met the eligibility criteria, including three observational studies with 111 patients, four in vitro experiments with 258 extracted human teeth, and two ex vivo investigations with 16 cadaver mandibles. All studies consistently reported high-quality images produced by wireless sensors. Two studies demonstrated the superiority of wireless sensors, one found comparable accuracy with conventional radiography, and another indicated similar image quality among the sensors. Both wireless and wired sensors significantly reduced radiation doses compared to conventional X-rays. The Visual Analog Scale (VAS) did not reveal a clear superiority of wireless over wired sensors, though both were generally less comfortable than traditional film. The wireless sensors consistently produce high-quality images, comparable to or superior to other digital devices. Both wireless and wired sensors significantly reduce radiation doses compared to conventional X-rays, emphasizing their safety and efficacy. Patient comfort levels vary, with neither sensor type showing clear superiority over the other, and both being less comfortable than traditional film.

Associations of Neighborhood Environments and Socioeconomic Status With Subclinical Atherosclerosis: An Integrative Review

BACKGROUND

A limited understanding exists on the associations of neighborhood environment with subclinical atherosclerosis and its progression.

PURPOSE

The purpose of this integrative review was to explore associations of neighborhood environments and socioeconomic status (SES) with subclinical atherosclerosis and its long-term progression.

RESULTS

Three themes were identified: environmental exposure affects the natural history of atherosclerosis, neighborhood characteristics are associated with subclinical atherosclerosis, and individual SES is associated with development and progression of subclinical atherosclerosis more so than neighborhood SES. Some variations in results were noted based on the vascular site examined.

CLINICAL IMPLICATIONS

Disadvantaged neighborhoods and low SES are associated with greater subclinical atherosclerosis. Inconsistencies in a few studies seemed to be related to lack of coronary artery progression among the relatively young adults. This suggests further examination is needed of the contextual associations of neighborhood and SES with markers of generalized atherosclerosis, such as carotid intima-media thickness.

Motivation toward physical activity in patients with chronic musculoskeletal disorders: a meta-analysis of the efficacy of behavioural interventions

Musculoskeletal disorders (MDs) represent a global health issue, which can lead to disability. Physical activity (PA) reduces pain and increases physical function among patients with MDs. To promote behavioural changes, it seems important to focus on modifiable factors, such as motivation. Thus, this review aims to assess effects of interventions targeting PA on motivation towards PA. Searches used terms referring to "physical activity", "motivation" and "chronic musculoskeletal disorders" on the databases PubMed, PsychINFO, MEDLINE, EMBASE, PEDro and Web of Science. All types of intervention-including but not limited to RCTs-were eligible for inclusion. Risk of bias was assessed with the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Among 6 489 abstracts identified, there were 387 eligible studies and 19 were included, reporting in total 34 effect sizes. The meta-analysis concerned 1 869 patients and indicated a small effect of interventions on change in motivation towards PA (d = 0.34; 95% CI [0.15; 0.54]; p < .01; k = 33). Behavioural interventions positively impact PA motivation in patients with MDs. In the literature, most studies focused on intervention's effect on fear of movement. Future research should assess other explicit motivational constructs, as well as implicit processes.

Pediatric language assessments via telehealth: A systematic review

INTRODUCTION

Assessment is crucial in the identification of children with potential delays/disorders and allows speech-language pathologists the opportunity to provide early intervention when indicated. For this reason, inaccessibility to formal assessments can be detrimental to the development and progression of overall communication skills for children with language disorders. The COVID-19 pandemic highlighted the need for increased telehealth services and how the provision of these remote services offers a much-needed alternative to face-to-face services for both clinicians and families.

METHOD

A systematic procedure involving online literature searches in four electronic databases was employed to identify studies for inclusion in this review. Inclusion criteria were as follows: (1) preschool or elementary pediatric participants, and (2) involve the delivery of language-based assessments via telehealth. Additionally, the search was limited to studies written in English, dated 2010 and newer, and published in peer-reviewed journals.

RESULTS

The results of the systematic review showed there was no significant difference between standard scores and behavioral ratings for both face-to-face and telehealth assessments. The studies reviewed determined that telehealth delivery was feasible and presented adequate reliability with high levels of agreement between assessment scores obtained via telehealth and face-to-face.

CONCLUSION

Current research suggests that there is no significant difference between remote and face-to-face assessment administration. Additional research is needed to examine the feasibility and reliability of conducting language-based assessments via telehealth in bilingual children, children younger than four years of age, and in different environments, such as schools or clinics.

Mechanical properties of 3D printed prosthetic materials compared with milled and conventional processing: A systematic review and meta-analysis of in vitro studies

STATEMENT OF PROBLEM

Three-dimensional (3D) additive manufacturing (AM) is an evolving technology in dentistry, proposed as an alternative to subtractive milling manufacture (MM) or conventional processing. However, a systematic review of the use of AM technology instead of milling or conventional processing is lacking.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the mechanical properties of 3D printed prosthetic materials compared with MM and conventional techniques.

MATERIAL AND METHODS

An electronic search of the literature was conducted on the MEDLINE (via PubMed), Scopus, and Web of Science databases. The inclusion criteria were in vitro studies published in the last 5 years, in English or Italian, and with 3D AM printed dental prosthetic materials. Data extraction was focused on dental prosthetic materials (ceramics, polymers, and metals) and their mechanical properties: flexural strength, fracture load, hardness, roughness, removable partial denture (RPD) fit accuracy, trueness, marginal discrepancy, and internal fit. Data considered homogenous were subjected to meta-analysis using the Stata17 statistical software program (95% confidence interval [CI]; α=.05). Since all variables were continuous, the Hedge g measure was calculated. A fixed-effects model was used for I2=0%, while the statistical analysis was conducted using a random-effects model with I2>0%.

RESULTS

From a total of 3624 articles, 2855 studies were selected, and 76 studies included after full-text reading. The roughness of AM-printed ceramics generally increased compared with that of conventional processing while the marginal discrepancy was comparable both for ceramics and polymers. The flexural strength, hardness, and fracture load of AM-printed polymers were statistically lower than those of the conventional group (P<.05). No significant difference was detected in terms of hardness, roughness, marginal discrepancy, fracture load, trueness, or internal fit between the AM and MM techniques (P>.05). Milling techniques showed significantly higher values of flexural strength (Hedge g=-3.88; 95% CI, -7.20 to -0.58; P=.02), also after aging (Hedge g=-3.29; 95% CI, -6.41 to -0.17; P=.04), compared with AM printing.

CONCLUSIONS

AM is comparable with MM in terms of mechanical properties, in particular with polymeric materials. The flexural strength of AM-printed prostheses is lower than with conventional and MM techniques, as are the parameters of hardness and fracture load, while the marginal discrepancy is similar to that of MM and conventional techniques. AM prostheses are commonly used for interim crowns and fixed partial dentures, as their rigidity and fracture resistance cannot support mastication forces for extended periods. More comparative studies are needed.

eHealth-Integrated Psychosocial and Physical Interventions for Chronic Pain in Older Adults: Scoping Review

BACKGROUND

Chronic noncancer pain (CNCP) is highly present among older adults, affecting their physical, psychological, and social functioning. A biopsychosocial multimodal approach to CNCP management is currently extensively suggested by international clinical practice guidelines. Recently, the growing development and application of eHealth within pain management has yielded encouraging results in terms of effectiveness and feasibility; however, its use among the older population remains underexamined.

OBJECTIVE

The overall aim of this scoping review was to systematically map existing literature about eHealth multimodal interventions (including both physical and psychosocial components) targeting older adults with CNCP.

METHODS

This review adhered to the JBI methodology, a protocol was a priori registered as a preprint on the medRxiv platform, and the results were reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and PsycINFO) were systematically searched for relevant articles. Studies were included if they reported on multimodal interventions (including both physical and psychosocial components) delivered through any eHealth modality to an older population with any type of CNCP. Two reviewers selected the studies: first by screening titles and abstracts and second by screening full-text articles. The quality of the included studies was evaluated using the Quality Assessment Tool for Studies with Diverse Designs. The results of the studies were summarized narratively.

RESULTS

A total of 9 studies (n=6, 67% published between 2021 and 2023) with quality rated as medium to high were included, of which 7 (78%) were randomized controlled trials (n=5, 71% were pilot and feasibility studies). All the included studies evaluated self-management interventions, most of them (n=7, 78%) specifically designed for older adults. The participants were aged between 65 and 75 years on average (mean 68.5, SD 3.5 y) and had been diagnosed with different types of CNCP (eg, osteoarthritis and chronic low back pain). Most of the included studies (5/9, 56%) involved the use of multiple eHealth modalities, with a higher use of web-based programs and video consulting. Only 1 (11%) of the 9 studies involved a virtual reality-based intervention. The evaluated interventions showed signs of effectiveness in the targeted biopsychosocial outcomes, and the participants' engagement and ratings of satisfaction were generally positive. However, several research gaps were identified and discussed.

CONCLUSIONS

Overall, of late, there has been a growing interest in the potential that eHealth multimodal interventions offer in terms of improving pain, physical, and psychosocial outcomes in older adults with CNCP. However, existing literature on this topic still seems scarce and highly heterogeneous, with few proper randomized controlled trials, precluding robust conclusions. Several gaps emerged in terms of the older population considered and the lack of evaluation of comorbidities.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1101/2023.07.27.23293235.

Characteristics and outcomes of community-based perinatal peer support: Protocol for a systematic review

BACKGROUND

Mental health issues and parenting difficulties in the perinatal period are common, and have significant negative impacts on individuals, families, and broader society. Community-based peer support programs might be an effective adjunct to standard mental health interventions in perinatal mental health issues, specifically where low-cost interventions are required, or access to professional care is limited.

METHODS

A systematic review will be undertaken. Searches will be conducted on four electronic databases (Pubmed, Embase, Cinahl, and PsycINFO), using terms related to perinatal mental health and peer support. Literature will be screened by title and abstract and then by full text. Selected studies will be evaluated using the Quality Assessment with Diverse Studies (QuADS) tool. Data relevant to community-based perinatal peer support intervention characteristics and outcomes will be extracted, and synthesised narratively.

DISCUSSION

This review will contribute to the existing evidence about perinatal mental health peer support, by synthesising information about community-based interventions specifically. The findings will be used to inform the design, implementation, and evaluation of a community-based perinatal mental health peer support program in urban and rural/remote hospital and health services in Australia.

TRIAL REGISTRATION

Systematic review registration: CRD42023451568.

Efficacy of wireless sensors in assessing occlusal and bite forces: A systematic review

BACKGROUND

The noteworthy correlation between bite force and masticatory performance emphasizes its significance as a meaningful and objective method for assessing oral function. Furthermore, in the study of bruxism, the measurement of intraoral bite force assumes critical importance. Given the importance of assessing occlusal forces and bite force, this systematic review aims to assess the efficacy of wireless sensors in measuring these forces.

METHODS

The search methodology employed in this systematic review adhered to the guidelines outlined by PRISMA. The strategy involved the exploration of various databases, including PubMed/MEDLINE, SCOPUS and SCIELO. An assessment tool was employed to evaluate the bias risk and study quality.

RESULTS

This systematic review encompassed six prospective clinical studies involving a total of 89 participants. Wireless sensors for measuring occlusal forces and bite forces were predominantly employed in healthy adults or individuals with bruxism, along with children undergoing orthodontic treatment. All wireless sensors employed in the studies underwent validation and reproducibility assessments, affirming their reliability. The findings indicated that all wireless sensors exhibited efficacy in detecting occlusal forces and bite forces.

CONCLUSION

Wireless sensors offer real-time monitoring of occlusal and bite forces, aiding in understanding force distribution and identifying bruxism patterns. Despite limited studies on their application, these sensors contribute to evolving insights. Integration into clinical practice requires careful consideration of factors like calibration and patient compliance. Ongoing research is crucial to address limitations and enhance the efficacy of wireless sensors in measuring occlusal and bite forces and managing bruxism.

Climate change and heat stress resilient outdoor workers: findings from systematic literature review

PURPOSE

Global warming has led to an increase in the number and intensity of extreme heat events, posing a significant threat to the health and safety of workers, especially those working outdoors, as they often have limited access to cooling strategies. The present systematic literature review (a) summarizes the current knowledge on the impacts of climate change on outdoor workers, (b) provides historical background on this issue, (c) explores factors that reduce and increase thermal stress resilience, (d) discusses the heat mitigation strategies, and (e) provides an overview of existing policy and legal frameworks on occupational heat exposure among outdoor workers.

MATERIALS AND METHODS

In this systematic review, we searched scientific databases including Scopus (N = 855), Web of Science (N = 828), and PubMed (N = 202). Additionally, we identified relevant studies on climate change and heat-stress control measures through Google Scholar (N = 116) using specific search terms. In total, we monitored 2001 articles pertaining to worker populations (men = 2921; women = 627) in various outdoor climate conditions across 14 countries. After full-text assessment, 55 studies were selected for inclusion, and finally, 29 eligible papers were included for data extraction.

RESULTS

Failure to implement effective control strategies for outdoor workers will result in decreased resilience to thermal stress. The findings underscore a lack of awareness regarding certain adaptation strategies and interventions aimed at preventing and enhancing resilience to the impact of climate change on heat stress prevalence among workers in outdoor tropical and subtropical environments. However, attractive alternative solutions from the aspects of economic and ecological sustainability in the overall assessment of heat stress resilience can be referred to acclimatization, shading, optimized clothing properties and planned breaks.

CONCLUSION

The integration of climate change adaptation strategies into occupational health programs can enhance occupational heat resilience among outdoor workers. Conducting cost-benefit evaluations of health and safety measures for thermal stress adaptation strategies among outdoor workers is crucial for professionals and policymakers in low- and middle-income tropical and subtropical countries. In this respect, complementary measures targeting hydration, work-rest regimes, ventilated garments, self-pacing, and mechanization can be adopted to protect outdoor workers. Risk management strategies, adaptive measures, heat risk awareness, practical interventions, training programs, and protective policies should be implemented in hot-dry and hot-humid climates to boost the tolerance and resilience of outdoor workers.

Body image of university students: a systematic review of the characteristics of interventions

BACKGROUND

Body image is the mental representation of the body and can be influenced by cognitive, biological, behavioral, sociocultural, and environmental factors. University students often encounter challenges related to it.

OBJECTIVE

This systematic review examined interventions aimed at holistically developing a positive body image within this population.

METHODS

The PRISMA 2020 guidelines and the PICO method were employed to identify, select, assess, and synthesize studies. The consulted databases included Scopus, Web of Science, and PsycINFO, with inclusion criteria targeting body image interventions for university students aged 18 to 39. Study quality was evaluated using the QATSDD tool.

RESULTS

Twenty-one relevant studies were identified, primarily from the United States, mostly employing quantitative methods, with a focus on female participants. Various intervention strategies were utilized, including cognitive-behavioral approaches, media literacy, and physical/resistance training, with a growing use of technology like mobile applications. The majority of studies reported effective outcomes, such as reduced body dissatisfaction and increased self-esteem following interventions. Nevertheless, literature gaps were identified, such as the scarcity of formative interventions and limited use of qualitative approaches.

CONCLUSION

While technology in interventions offers promising opportunities, careful assessments and judicious selection of evaluation instruments are fundamental for reliable results. Future research should focus on addressing identified gaps, such as exploring more formative interventions and incorporating qualitative methodologies to provide a more comprehensive understanding of the effectiveness of body image interventions among university students.

Towards an improved dementia care experience in clinical radiography practice: A state-of-the-art review

INTRODUCTION

The increasing global incidence rate of dementia and associated co/multimorbidity has consequently led to a rise in the number of people with dementia (PwD) requiring clinical radiography care services. This review aims to explore and integrate findings from diverse settings with a focus on the experiences of PwD and stakeholders, towards the development of a holistic approach for dementia care and management within the context of radiography services.

METHOD

An electronic search was performed across the following databases: PUBMED, CINAHL, Medline, SCOPUS, and ScienceDirect for articles published from January 2009 and June 2023. Articles were included if they fulfilled a predefined criteria mainly focused on experiences of PwD and/or other stakeholders when using the radiography services. Data obtained from the included studies were analysed using a result-based convergent synthesis.

RESULT

Eleven studies from diverse settings met the inclusion criteria. A mix of both positive and negative experiences of PwD and stakeholders were reported following visits to radiology and radiotherapy departments were highlighted across settings. The findings were themed around the need for: person-centred care, effective communication, attitudinal changes of staff, specialised and improved clinical environment and inclusion of caregivers for the care of PwD.

DISCUSSION

This study emphasise the critical importance of adopting holistic approaches to caring for PwD. This involves adopting a person-centred approach, actively involving caregivers, effective communication, and adequate training for radiographers to provide quality services, all in dementia-friendly environments.

CONCLUSION

The experiences of various stakeholders highlight the need for a more holistic approach and strategy for the care and management of PwD within the context of the radiography services. This calls for an urgent need for a comprehensive strategy that includes awareness creation of staff to enhance the quality of care and the overall experience for PwD using the radiography services.

Health Care Professional Education on Cancer Screening of SGM Individuals: An Integrative Review

Sexual and gender minority (SGM) individuals are disproportionately affected by cancer. Health care professional (HCP) and health sciences education rarely includes content on cancer screening in this population. This article aims to synthesize literature on educational programs for HCPs and health sciences students related to cancer screening for SGM individuals. An integrative review methodology guided a systematic search of five databases: CINAHL, PubMed, Embase, PsycInfo, and ERIC. Articles were included if they were empirically-based and described educational programs targeted at HCPs and health sciences students with content of cancer screening for SGM people. Eleven studies met the inclusion criteria. Of these, three were pilot studies and the majority of the articles (n = 9) used pre- and post-test designs. All of the interventions showed efficacy in increasing knowledge, attitudes, skills, and behavior. However, the vastly different programs and the fact that most of the cancer screening content was embedded in programs with broad SGM issues content limit the ability to make firm recommendations for any one particular program. In-person didactic content delivered multiple times incorporating modalities such as standardized patient encounters, case studies, and guest speakers increased knowledge, attitude, and skills of participants. Future studies should incorporate behavioral theories, develop more consistent aspects of educational programs, report demographic and pertinent data on participants, and utilize established instruments to measure outcomes when conducting educational interventions on HCPs and students in this area.

Surgical Sabermetrics: A Scoping Review of Technology-enhanced Assessment of Nontechnical Skills in the Operating Room

OBJECTIVE

To evaluate the current evidence for surgical sabermetrics: digital methods of assessing surgical nontechnical skills and investigate the implications for enhancing surgical performance.

BACKGROUND

Surgeons need high-quality, objective, and timely feedback to optimize performance and patient safety. Digital tools to assess nontechnical skills have the potential to reduce human bias and aid scalability. However, we do not fully understand which of the myriad of digital metrics of performance assessment have efficacy for surgeons.

METHODS

A systematic review was conducted by searching PubMed, EMBASE, CINAHL, and PSYCINFO databases following PRISMA-ScR guidelines. MeSH terms and keywords included "Assessment," "Surgeons," and "Technology". Eligible studies included a digital assessment of nontechnical skills for surgeons, residents, and/or medical students within an operative context.

RESULTS

From 19,229 articles screened, 81 articles met the inclusion criteria. The studies varied in surgical specialties, settings, and outcome measurements. A total of 122 distinct objective, digital metrics were utilized. Studies digitally measured at least 1 category of surgical nontechnical skill using a single (n=54) or multiple objective measures (n=27). The majority of studies utilized simulation (n=48) over live operative settings (n=32). Surgical Sabermetrics has been demonstrated to be beneficial in measuring cognitive load (n=57), situation awareness (n=24), communication (n=3), teamwork (n=13), and leadership (n=2). No studies measured intraoperative decision-making.

CONCLUSIONS

The literature detailing the intersection between surgical data science and operative nontechnical skills is diverse and growing rapidly. Surgical Sabermetrics may provide a promising modifiable technique to achieve desirable outcomes for both the surgeon and the patient. This study identifies a diverse array of measurements possible with sensor devices and highlights research gaps, including the need for objective assessment of decision-making. Future studies may advance the integration of physiological sensors to provide a holistic assessment of surgical performance.

Policy Approaches for Increasing Adolescent HPV Vaccination Coverage: A Systematic Review

CONTEXT

US jurisdictions have enacted a wide range of policies to address low human papillomavirus (HPV) vaccination coverage among adolescents, but it is unclear which policies are effective.

OBJECTIVE

To systematically review the impact of governmental policies on adolescent HPV vaccination coverage.

DATA SOURCES

PubMed, Embase, and Scopus databases.

STUDY SELECTION

Eligible studies, published from 2009 to 2022, evaluated the impact of governmental policies on HPV vaccination coverage among adolescents ages 9 to 18.

DATA EXTRACTION

Two investigators independently extracted data on study sample, study design and quality, policy characteristics, and HPV vaccination outcomes. We summarized findings by policy type: school-entry requirements (SERs), federally-funded policies related to the Vaccines for Children program and Medicaid, educational requirements, and others.

RESULTS

Our search yielded 36 eligible studies. A majority of studies evaluating HPV vaccine SERs found positive associations between SERs and HPV vaccination coverage (8 of 14), particularly for SERs in Rhode Island and Washington, DC. All studies evaluating SERs for other adolescent vaccines observed positive spillover effects for HPV vaccination (7 of 7). Federally-funded policies related to Vaccines for Children and Medicaid were consistently associated with higher HPV vaccination coverage (7 of 9). Relatively few studies found associations between educational requirements and HPV vaccination coverage (2 of 8).

LIMITATIONS

Studies used limited vaccination data sources and non- or quasi-experimental designs. Some studies had no or poorly matched comparison groups.

CONCLUSIONS

Our findings suggest promise for SERs and federally-funded policies, but not educational requirements, for increasing HPV vaccination coverage among adolescents.

Rural Patients' Experiences with Synchronous Video Telehealth in the United States: A Scoping Review

Background: Telehealth can help increase rural health care access. To ensure this modality is accessible for rural patients, it is necessary to understand rural patients' experiences with telehealth. Objectives of this scoping review were to explore how rural patients' telehealth experiences have been measured, assess relevant research, and describe rural telehealth patient experiences. Methods: We searched five databases for articles published from 2016 through 2022. Primary research reports assessing rural adult patient experiences with synchronous video telehealth in the United States in any clinical area were included. Data collected pertained to study characteristics and patient experience assessment characteristics and outcomes. Quality of included studies was assessed using the Quality Assessment with Diverse Studies tool. Review findings were presented in a narrative synthesis. Results: There were 740 articles identified for screening, and 24 met review inclusion criteria. Most studies (70%, n = 16) assessed rural telehealth patient experience using questionnaires; studies employed interviews (n = 11) alone or in combination with surveys. The majority of surveys were study developed and not validated. Quantitative patient experience outcomes fell under categories of patient satisfaction, telehealth care characteristics, patient-provider rapport, technology elements, and access. Qualitative themes were most often presented as telehealth benefits or facilitators, and drawbacks or barriers. Conclusions: Available research indicates positive patient experiences with rural telehealth services. However, study weaknesses limit generalizability of findings. Future research should apply established definitions for participant rurality and clearly group samples by rurality. Efforts should be made to use validated telehealth patient experience measures.

Parental perspectives on oral health-related quality of life in children and adolescents with autism spectrum disorder: A systematic review

BACKGROUND

Children with autism spectrum disorder (ASD) face unique challenges related to oral health, which can negatively impact their day-to-day lives, significantly compromising their overall quality of life. Primary caregivers of children with ASD have a critical role in delivering and seeking oral health care. Hence, it is vital to study their perspective towards their children's oral health and its impact on their quality of life.

AIM

To explore the parental perception of oral health-related quality of life in children with autism.

METHODS

A systematic electronic and manual search was conducted in Medline (via PubMed), Embase, Google Scholar, Scopus, and LILACS of articles published from January 2003 to May 2023 using appropriate MeSH terms, keywords, and other terms. A four-phase study selection process was followed according to PRISMA guidelines, and data extraction and synthesis were performed using an extraction form. The selected studies were critically appraised using the QATSDD and Crombie's assessment tool. The inter-reviewer agreement was assessed using the kappa with a linear weighting coefficient.

RESULTS

Out of the 885 results, 15 studies were included in the review after the two selection phases, and the study characteristics were summarized in tabular form. Study quality varied considerably, and out of a total possible QATSDD score of 42, scores for the individual studies ranged from 14 to 40. The risk of bias for the seven criteria was found to be low.

CONCLUSION

The parental perception of the OHRQoL in children with ASD is poor, and the most significant perceived impact is on the child's functional and social well-being aspects. Parental-Caregiver Perception Questionnaire was the most commonly used. The most frequent symptoms include bad breath, food lodgment, mouth breathing and night grinding. The familial impact and influence on the OHRQoL of siblings were also studied.

Identifying Healthcare Professionals With Lower Human Papillomavirus (HPV) Vaccine Recommendation Quality: A Systematic Review

PURPOSE

Strengthening healthcare professionals' (HCPs) communication is an evidence-based approach to increasing human papillomavirus (HPV) vaccine uptake among adolescents. To better target future interventions, we sought to synthesize evidence on HCP subgroups who most need to improve their HPV vaccine recommendation quality.

METHODS

We searched five databases for quantitative studies published from 2012 to 2022 on HPV vaccine recommendation quality, including recommendation consistency and strength, for United States adolescents. Two coders independently abstracted data from each eligible study, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We summarized variation in recommendation quality by clinical and HCP characteristics.

RESULTS

The 28 eligible studies indicated that relatively low proportions of HCPs used higher-quality recommendation practices (median: 61% across 30 measures) and that recommendation quality varied across HCP subgroups. The most consistent findings were that more pediatric HCPs used higher-quality recommendations than family medicine HCPs (8 of 11 studies, 2-60 percentage point difference) and that HPV-related knowledge was associated with higher recommendation quality (four of seven studies). Most studies observed no differences in recommendation quality by clinical role (e.g., provider vs. nurse) or HCP demographics (e.g., gender, age, race/ethnicity).

DISCUSSION

Studies suggest a substantial need to improve HCPs' recommendation quality, with opportunities for targeting future interventions.

Artificial Intelligence through Wireless Sensors Applied in Restorative Dentistry: A Systematic Review

The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners.

Lack of consistency in measurement methods and semantics used for network measures in adolescent health behaviour studies using social network analysis: a systematic review

BACKGROUND

Social network analysis (SNA) is often used to examine how social relationships influence adolescent health behaviours, but no study has documented the range of network measures used to do so. We aimed to identify network measures used in studies on adolescent health behaviours.

METHODS

We conducted a systematic review to identify network measures in studies investigating adolescent health behaviours with SNA. Measures were grouped into eight categories based on network concepts commonly described in the literature: popularity, position within the network, network density, similarity, nature of relationships, peer behaviours, social norms, and selection and influence mechanisms. Different subcategories were further identified. We detailed all distinct measures and the labels used to name them in included articles.

RESULTS

Out of 6686 articles screened, 201 were included. The categories most frequently investigated were peer behaviours (n=201, 100%), position within the network (n=144, 71.6%) and popularity (n=110, 54.7%). The number of measurement methods varied from 1 for 'similarity on popularity' (within the 'similarity' category) to 28 for the 'characterisation of the relationship between the respondent and nominated peers' (within the 'nature of the relationships' category). Using the examples of 'social isolation', 'group membership', 'individuals in a central position' (within the 'position within the network' category) and 'nominations of influential peers' (sub within the 'popularity' category), we illustrated the inconsistent reporting and heterogeneity in measurement methods and semantics.

CONCLUSION

Robust methodological recommendations are needed to harmonise network measures in order to facilitate comparison across studies and optimise public health intervention based on SNA.

Delayed discharge in inpatient psychiatric care: a systematic review

BACKGROUND

Delayed discharge is problematic. It is financially costly and can create barriers to delivering best patient care, by preventing return to usual functioning and delaying admissions of others in need. This systematic review aimed to collate existing evidence on delayed discharge in psychiatric inpatient settings and to develop understanding of factors and outcomes of delays in these services.

METHODS

A search of relevant literature published between 2002 and 2022 was conducted on Pubmed, PsycInfo and Embase. Studies of any design, which published data on delayed discharge from psychiatric inpatient care in high income countries were included. Studies examining child and adolescent, general medical or forensic settings were excluded. A narrative synthesis method was utilised. Quality of research was appraised using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Eighteen studies from England, Canada, Australia, Ireland, and Norway met the inclusion criteria. Six main reasons for delayed discharge were identified: (1) accommodation needs, (2) challenges securing community or rehabilitation support, (3) funding difficulties, (4) family/carer factors, (5) forensic considerations and (6) person being out of area. Some demographic and clinical factors were also found to relate to delays, such as having a diagnosis of schizophrenia or other psychotic disorder, cognitive impairment, and increased service input prior to admission. Being unemployed and socially isolated were also linked to delays. Only one study commented on consequences of delays for patients, finding they experienced feelings of lack of choice and control. Four studies examined consequences on services, identifying high financial costs.

CONCLUSION

Overall, the findings suggest there are multiple interlinked factors relevant in delayed discharge that should be considered in practice and policy. Suggestions for future research are discussed, including investigating delayed discharge in other high-income countries, examining delayed discharge from child and forensic psychiatric settings, and exploring consequences of delays on patients and staff. We suggest that future research be consistent in terms used to define delayed discharge, to enhance the clarity of the evidence base.

REVIEW REGISTRATION NUMBER ON PROSPERO

292515.

DATE OF REGISTRATION

9th December 2021.

Bidirectional Violence in Intimate Relationships: A Systematic Review

Intimate partner violence is a public health problem with significant consequences at different levels. Over the years, the literature has shown that most violence is not unidirectional and perpetrated by men against women but rather bidirectional, in which both couple elements may be victims, perpetrators, or both. In this systematic literature review, we aimed to systematize the empirical knowledge to assess the prevalence of bidirectional violence, the most reported types of violence, and the influence of sex and sexual orientation on this phenomenon. The search for this systematic review was conducted in four databases, and we included studies that showed the prevalence of bidirectional violence in samples aged over 18 years, in articles written in English or Portuguese, and published between 2012 and 2022. In the qualitative synthesis, 42 empirical studies were included. The results showed that bidirectional violence is the most common pattern of violence, with psychological violence being the most reported type of bidirectional violence; men and women reported bidirectional violence at similar rates, and homosexual couples reported higher percentages of bidirectional violence than heterosexual couples. These results contradict the patriarchalist view of violence that assigns the exclusivity role of the victim to women and of the perpetrator to men, demonstrating that violence occurs regardless of sex or sexual orientation. The practical implications and future directions at the level of public policies to give visibility to the phenomenon will be duly discussed.

Assessment in Undergraduate Competency-Based Medical Education: A Systematic Review

BACKGROUND

Studies that have methodically compiled the body of research on the competency-based medical education (CBME) assessment procedure and pinpointed knowledge gaps about the structure of the assessment process are few. Thus, the goals of the study were to create a model assessment framework for competency-based medical education that would be applicable in the Indian setting as well as to thoroughly examine the competency-based medical education assessment framework.

METHODS

PubMed, MEDLINE (Ovid), EMBASE (Ovid), Scopus, Web of Science, and Google Scholar were the databases that were searched. The search parameters were restricted to English language publications about competency-based education and assessment methods, which were published between January 2006 and December 2020. A descriptive overview of the included research (in tabular form) served as the foundation for the data synthesis.

RESULTS

Databases provided 732 records; out of which 36 fulfilled the inclusion and exclusion criteria. Thirty-six studies comprised a mix of randomized controlled trials, focus group interviews, and questionnaire studies, including cross-sectional studies, qualitative studies (03), mixed-method studies, etc. The papers were published in 10 different journals. The greatest number was published in BMC Medical Education (18). The average quality score for included studies was 62.53% (range: 35.71-83.33%). Most authors are from the UK (07), followed by the USA (05). The included studies were grouped into seven categories based on their dominant focus: moving away from a behavioristic approach to a constructive approach of assessment (01 studies), formative assessment (FA) and feedback (10 studies), the hurdles in the implementation of feedback (04 studies), utilization of computer or online based formative test with automated feedback (05 studies), video feedback (02 studies), e-learning platforms for formative assessment (04 studies), studies related to workplace-based assessment (WBA)/mini-clinical evaluation exercise (mini-CEX)/direct observation of procedural skills (DOPS) (10 studies).

CONCLUSIONS

Various constructivist techniques, such as concept maps, portfolios, and rubrics, can be used for assessments. Self-regulated learning, peer feedback, online formative assessment, an online computer-based formative test with automated feedback, the use of a computerized web-based objective structured clinical examination (OSCE) evaluation system, and the use of narrative feedback instead of numerical scores in mini-CEX are all ways to increase student involvement in the design and implementation of the formative assessment.

Substance use disorder and lifetime suicidal behaviour: A scoping review

BACKGROUND

Suicidal behaviours are prevalent in substance use disorder (SUD) patients. These behaviours have a negative impact on the psychopathological profile of these patients. However, few studies have evaluated suicide as a continuum (i.e. starting with ideation, followed by attempts and ending with death) and its evolution during treatment. The aim of this scoping review was to explore what is known about suicidal behaviour in individuals undergoing clinical treatment for SUD.

METHODS

The PsycINFO, Web of Science (Core Collection and MEDLINE), Scopus, and Cochrane Library databases were searched. After screening the records based on eligibility and exclusion criteria, 30 studies were ultimately selected for inclusion.

RESULTS

Most of the studies were conducted in the USA and Europe. Only three studies evaluated suicidal behaviour with a specific instrument. The prevalence of suicidal ideation (SI) in people being treated for SUD ranged from 20 % to 62.2 %, and the prevalence of suicide attempts (SA) ranged from 15.8 % to 52.1 %. Only one study reported death by suicide.

CONCLUSIONS

Despite the high prevalence of suicidal behaviours and their harmful consequences, the assessment of this phenomenon is scarce and heterogeneous. There is a need to assess suicidal behaviour with standardized criteria in order to develop tailored SUD treatment.

Acceptance and Commitment Therapy for Anger, Irritability, and Aggression in Children, Adolescents, and Young Adults: A Systematic Review of Intervention Studies

The onset of childhood disruptive behaviors is one of the most common presenting difficulties to clinics worldwide. Acceptance and commitment therapy (ACT) has shown to be effective in the reduction of anger and aggression among adults, however to date there has been no systematic review that has examined the effectiveness of ACT in addressing anger and aggression among children, adolescents, and young adults. The current systematic review aimed to evaluate the methodological standing and effectiveness of the peer-reviewed literature of ACT on anger and aggression for this population. PsycINFO, PubMed, and MEDLINE databases were searched systematically in June 2022 to identify studies in English published on the use of ACT for anger and aggression in children, adolescents, and young adults. Seven studies met the inclusion criteria with a combined sample of 305 participants across the interventions. The most common outcome measures used were self-report ratings of anger among participants. Studies were characterized by poor methodological rigor and findings were mixed as regards the effectiveness of ACT in addressing anger and aggression in this population. Some evidence suggests that group ACT may be effective in reducing self-report measures of anger, but no firm conclusions can be drawn from the extant literature due to the heterogeneous nature of the studies, and limited information about ACT protocols and treatment delivery. Further higher-powered studies comparing ACT to treatment as usual or waitlist are needed to clarify what ACT may add as a treatment to anger and aggression in this population.

Systematic review study protocol of literature from 2018 to end of 2022 of stated preference studies about HIV care and prevention services around the world

BACKGROUND

There are currently over 38 million individuals around the globe living with the HIV and AIDS. As many HIV prevention and care services emerging for public use services become available to a wider audience, there is a growing need for more information about willingness to engage in these care and services. Stated preference research methods have been shown to be useful methods to help predict factors that influence health behaviours in the future.

RESEARCH QUESTION

This is a systematic review of findings from stated preference studies regarding the choices of people living with HIV or people at risk of contracting HIV to engage in HIV prevention or care.

METHODS

Our team plans to compile stated preference studies studying the choice to engage in HIV prevention or care services. Studies will be included from 1 January 2018 until 28 October 2022. There will be no restrictions on the language or location of the study. We will search databases including PubMed, PsycINFO, Embase, Scopus, Tufts CEA registry and CINAHL. Two researchers will review each article's title, abstract, then full-text and finally extract relevant data based on a predetermined process. Data will be presented in a narrative review and in an exploratory meta-analysis by subgroups of studies.

ETHICS AND DISSEMINATION OF RESEARCH

There is no need for an ethical review process of this study since all data used is available publicly. The findings of this study will be reported in relevant conferences and submitted for publication in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42023397785.

Effects of forest walking on physical and mental health in elderly populations: a systematic review

There is a growing awareness that spending time in nature is associated with improvement of well-being; nevertheless, the prescription of forest bathing is still limited. The aim of this systematic review was to explore the physiological and psychological benefits of different forest therapies on healthy and pathological elderly populations (>60 years) to identify the most-effective type, duration, and frequency of these interventions. A search for literature was carried out in December 2021 using PubMed, EMBASE, ResearchGate, Google Scholar and Web of Science. Grey literature was searched as well. After removal of the duplicates, within the 214 articles identified, ten met the inclusion criteria. The methodological quality of the selected studies was rated. Forest walking, alone and in combination with other activities is the most effective intervention. The selected studies reported a positive impact on physical components, including reduction in blood pressure and heart rate and improvements in cardiopulmonary and neurochemical parameters. Favorable modifications have also been noted in the psychological field, with improvements in depression, stress levels and in quality of life perception. In conclusion, forest walking may play an important role in promoting physical and mental health in healthy and pathological elderly populations. However, the lack of high-quality studies limits the strength of the results, calling for more trials.

Neurocognitive functioning among children and young people with Duchenne Muscular Dystrophy: A systematic review and meta-analysis

Objective: The neurocognitive aspects of DMD have received less attention than the physiological sequalae. This study conducted a systematic review and meta-analysis of available literature on the neurocognitive profile of children and young people with DMD. Method: Five databases (EMBASE, Medline, PsycInfo, Scopus and Web of Science) and the grey literature was searched on 27th January 2023. Eligible articles were available in English and reported neurocognitive outcomes. Neurocognitive domains reported in a comparable way across a minimum of three studies were included. The neurocognitive domains of Full-Scale IQ (FSIQ), Verbal IQ (VIQ), Performance IQ (PIQ) and Working memory (WMI) derived from Wechsler scales and receptive vocabulary ability derived from the Peabody Picture Verbal Test (PPVT) were included. A single mean meta-analysis was completed. Results: Relevant data was extracted and presented for 38 eligible studies; 2 of which are from grey literature. Results suggest children with DMD perform around 1SD below non-clinical norms for FSIQ, PIQ, VIQ and WMI. Unlike VIQ, scores derived from the PPVT were within the non-clinical norms. Studies were of moderate - high quality, there was significant heterogeneity and no publication bias. Conclusion: A systematic review of working memory has not previously been completed, it appears that children with DMD perform around 1SD below the mean, like FSIQ, PIQVIQ and WMI. The PPVT is a measure of receptive verbal ability and caution is recommended around the interchangeability of PPVT scores and the wider construct of verbal intelligence.

Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions

The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.

What tools should be used to identify women in need of additional support in pregnancy?

OBJECTIVE

This study aimed to identify and inform recommendation of self-report and interview-based instruments that are feasible, reliable and valid to evaluate the quality of the maternal-fetal relationship (MFR).

BACKGROUND

Several constructs predicting parent-infant interaction and later infant adjustment are used to assess mothers' thoughts and feelings towards their unborn baby, including reflective functioning, mind-mindedness, representation, and fetal attachment. As yet, there is no existing review comparing the quality and accessibility of instruments across each of these constructs.

METHODS

A systematic literature review was undertaken to synthesise psychometric information on measures reporting on the MFR. Searches of six databases were conducted. English articles were selected based on inclusion and exclusion criteria. The QATSDD checklist was used to assess study quality.

RESULTS

 Of 669 studies identified, 28 met inclusion criteria. Thirteen different instruments were identified for evaluation. Reported reliability and validity varied significantly across instruments, as well as availability for research and/or clinical use.

CONCLUSION

Suggestions for research and clinical practice include further evaluation of the psychometric properties of tools, particularly for self-report measures of reflective functioning, use of interviews to scaffold reflexivity, and development of clinical policies and procedures to clarify care pathways for expectant mothers needing further support.

Graduate competencies, employability and the transnational Radiography workforce shortage: A systematic literature review of current pre-registration Radiography education and training models

INTRODUCTION

Transnational mobility of the Radiography workforce is challenged due to issues with standardisation of current education and training models which has added to the workforce shortage. To address the growing volume, scope and complexity of clinical Radiography service delivery, educational models need to be given a critical look for transnational relevance in modern times. This study aims to synthesise the characteristics of current pre-registration radiography educational programmes linked with effective knowledge, skill acquisition, and graduate employability to address the current workforce challenges through the development of newer training models.

METHODS

Using a mixed methods systematic review approach, secondary data was obtained from an EBSCOhost search involving key databases including MEDLINE, CINAHL, Academic Search Ultimate, ScienceDirect, and SCOPUS. Themes were developed following a result-based convergent data synthesis.

RESULTS

Forty articles met the predefined inclusion criteria following the study identification and screening phases. The included studies were conducted from across diverse settings including both low- and middle-income countries (LMIC) and high-income countries (HIC). Two broad themes were developed from the findings including: 1. Factors influencing graduate employability and 2) Radiography education and training programme characteristics.

CONCLUSION

The findings highlight and advocate for an innovative model for Radiography education and underscores the significance of graduates possessing multi-modality skills, varied competencies, and effective accreditation processes for training. Prioritising alignment with industry needs and holistic skill development is vital to closing the employability gap, ultimately improving graduate skills and competencies to address workforce shortage while improving patient care outcomes.

IMPLICATIONS FOR PRACTICE

Radiography training institutions should explore the development of new innovative models for multi-modality pre-registration education. This should offer adaptable routes that align seamlessly with the evolving regulatory, technological, and clinical trends.

Workplace violence in medical radiation science: A systematic review

INTRODUCTION

According to World Health Organization (WHO), workplace violence (WPV) is a significant issue in healthcare. However, no systematic review on WPV in medical radiation science (MRS) has been published yet. The purpose of this paper is to systematically review prevalence of WPV in MRS and its risk factors.

METHODS

Electronic scholarly publication databases, namely EBSCOhost/Cumulative Index of Nursing and Allied Health Literature Ultimate, PubMed/Medline, ScienceDirect, Scopus, and Wiley Online Library were used for literature search to identify articles about WPV in MRS published over last 10 years as per preferred reporting items for systematic reviews and meta-analyses guidelines. To facilitate comparisons of the WPV prevalence and relative importance of individual risk factors across the included studies, their reported absolute figures of findings were used to synthesize respective percentages (if not stated).

RESULTS

Twelve papers met the selection criteria and were included. This review shows that the WPV prevalence were 69.2-100 % (whole career) and 46.1-83.0 % (last 12 months) in diagnostic radiography, 63.0-84.0 % (whole career) in radiation therapy, 57.6 % in medical sonography (last 12 months), and 46.8 % (last 6 months) in nuclear medicine. The identified WPV risk factors included intoxicated patients, staff stress, feeling of inadequacy resulting in self-protection, more vulnerable practitioners (female, <40 years old and <5-year experience), working in radiation therapy treatment room, emergency department, examination room, general radiography, public hospital, and non-examination and waiting areas, long patient waiting time, night shift, overcrowding environment, unable to meet patients'/family members' expectations, miscommunication, patient handling, inadequate staff and security measures, interaction with colleagues, and lone working.

CONCLUSION

The WPV risk in diagnostic radiography and radiation therapy appears extremely high as a result of the aforementioned risk factors. Nevertheless, these study findings should be used with caution due to potential non-response bias.

IMPLICATIONS FOR PRACTICE

A WPV policy should be developed in every clinical workplace. Even if such policy is available, its enforcement including policy awareness boosting, and encouraging incident reporting and support seeking will be essential for reducing WPV. More survey studies based on WHO WPV questionnaire should be conducted for strengthening evidence base.

Research and evidence-based practice in clinical radiography: A systematic review of barriers and recommendations for a new direction

INTRODUCTION

Existing literature provides valuable insight into the application of evidence-based practice (EBP) in Radiography; however, it primarily focuses on localised, context-specific scenarios within individual countries or institutions. This review aims to systematically explore the barriers to EBP and research implementation in clinical Radiography practice internationally.

METHODOLOGY

A mixed-method systematic review was implemented to obtain data from primary studies of qualitative, quantitative and mixed-methods designs. Articles were searched between June and July 2023 from the following scientific databases: PubMed, Medline, CINAHL, Science Direct and manual search dating from 2003 to July 2023. The reviewed studies were subjected to data extraction and results-based convergent synthesis.

RESULTS

A total of 376 articles were identified through electronic database search and citation screening after the removal of duplicates. Thirty-one studies met the predetermined inclusion criteria and were included for this review. The challenges to EBP implementation in clinical Radiography are broadly themed around professional and personal obligations, motivation and organisational culture, knowledge and skill gaps, resources and opportunities, and institutional governance.

CONCLUSION

Globally, clinical radiographers perceived a high level of motivation and interest towards research activities. However, numerous barriers were reported such as insufficient time allocation for research, lack of resources, lack of research culture and inadequate research-related skills and knowledge. A transition towards greater evidence-based practice precipitates the quality of clinical Radiography services, augmenting efficiency in the workflow process and enriching patient experience.

IMPLICATIONS FOR PRACTICE

Radiography managers must develop strategies that aim to stimulate radiographers to initiate research projects. Beyond allocation of protected time, managers should inspire staff participation in research activities through implementation of effective departmental level culture and governance for quality service delivery and improved patient care.

Experiences and perceptions of men following breast cancer diagnosis: a mixed method systematic review

BACKGROUND

Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts.

METHODS

All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from January 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines.

RESULTS

Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1-Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2- Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3-Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures.

CONCLUSIONS

Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials.

TRIAL REGISTRATION

PROSPERO Registration No. CRD42021228778.

A systematic review of parental burnout and related factors among parents

BACKGROUND

Parenting is both a complex and stressful endeavor, so parents sometimes experience parenting burnout. The main objective of this study was to provide an overview of factors related to general parental burnout (PB) among parents with at least one child based on the Ecological Systems Theory (EST).

METHODS

PubMed, Web of Science, EBSCO, CNKI and WanFang were systematically searched for studies published from 2010 to July 2023 for peer-reviewed articles using keywords extracted from Medical Subject Headings such as "parenting", "parental", "burnout", "psychological burnout", "burn-out syndrome". Studies were included if they described associations between factors and PB among parents of children aged 0-18 years old in the general population, and published in an English or Chinese language peer-reviewed journal. The Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was employed to assess the risk of bias of included studies.

RESULTS

Of 2037 articles, 26 articles met the inclusion criteria. Based on the Ecological Systems Theory (EST), we found that microsystem-individual factors such as gender, educational level, income, parental personality, internalization of maternal parental motivation, unmitigated communion, self-compassion and concern for others, alexithymia, anxiety and depressive symptoms, parental perfectionism, resilience, low self-esteem and high need for control, mother's attachment style were identified as being associated with parenting burnout. Mesosystem-interpersonal factors involve parent-child relationship and marital satisfaction. The exosystem-organizational or community factors include the number of children in the household, neighborhood and the number of hours spent with children, child's illness, child's behavior problems and social support. The macrosystem-society/policy or culture factors are mainly personal values and cultural values.

CONCLUSIONS

This systematic review found several factors that have been investigated in relation to PB. However, the majority of the factors were reported by one or two studies often implementing a cross-sectional design. Nevertheless, we still recommend that health policymakers and administrators relieve parenting burnout among parents with children by adjusting these modifiable factors.

Exploring Screening Practices for Child Sexual Abuse in School Settings: An Integrative Review

Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention.

Factors associated with spontaneous vaginal birth in nulliparous women: A descriptive systematic review

PROBLEM

Spontaneous vaginal birth (SVB) rates for nulliparous women are declining internationally.

BACKGROUND

There is inadequate understanding of factors affecting this trend overall and limited large-scale responses to improve women's opportunity to birth spontaneously.

AIM

To undertake a descriptive systematic review identifying factors associated with spontaneous vaginal birth at term, in nulliparous women with a singleton pregnancy.

METHODS

Quantitative studies of all designs, of nulliparous women with a singleton pregnancy and cephalic presentation, who experienced a SVB at term were included. Nine databases were searched (inception to October 2022). Two reviewers undertook quality appraisal; Randomised Controlled Trials (RCTs) with high risk of bias (ROB 2.0) and other designs with (QATSDD) scoring ≤ 50% were excluded.

FINDINGS

Data were abstracted from 90 studies (32 RCTs, 39 cohort, 9 cross-sectional, 4 prevalence, 5 case control, 1 quasi-experimental). SVB rates varied (13%-99%). Modifiable factors associated with SVB included addressing fear of childbirth, low impact antenatal exercise, maternal positioning during second-stage labour and midwifery led care. Complexities arising during pregnancy and regional analgesia were shown to decrease SVB and other interventions, such as routine induction of labour were equivocal.

DISCUSSION

Antenatal preparation (low impact exercise, childbirth education, addressing fear of childbirth) may increase SVB, as does midwifery continuity-of-care. Intrapartum strategies to optimise labour progression emerged as promising areas for further research.

CONCLUSION

Declining SVB rates may be improved through multi-factorial approaches inclusive of maternal, fetal and clinical care domains. However, the variability of SVB rates testifies to the complexity of the issue.

Mapping the terrain: a scoping review of empirical studies on the big five personality traits and QoL in China

The relationship between personality traits and Quality of Life (QoL) has garnered increasing scholarly attention, particularly within the context of China. This scoping review synthesizes existing literature on the connection between the Big Five personality traits (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) and QoL among the Chinese population. The review explores correlations, measurement instruments, and theoretical frameworks employed in these studies. The study's significance lies in the profound implications for healthcare policies, organizational behavior, and social welfare programs in China, where rapid social and economic changes impact well-being. Investigating personality traits' impact on QoL can inform tailored interventions benefiting diverse Chinese subpopulations. This review addresses three primary research questions: (1) How do the Big Five personality traits correlate with QoL in different Chinese subpopulations, and what are the mediating or moderating factors? (2) What instruments assess these traits and QoL in the Chinese cultural context, and how are they validated? (3) What theoretical or disciplinary frameworks guide this research in China? Following a systematic PRISMA-ScR framework and a customized "C-BFQLC" protocol, the study identified 170 relevant documents. After rigorous screening, ten studies met the inclusion criteria, constituting 5.03% of the initial records. This scoping review critically examines the interplay between the Big Five personality traits and QoL in China, a context marked by rapid socioeconomic changes and cultural diversity. Employing a systematic approach guided by the PRISMA-ScR framework and our unique 'C-BFQLC' protocol, we meticulously analyzed 170 documents, selecting nine that met our rigorous inclusion criteria. Despite the emerging nature of this research area in the Chinese context, our study reveals significant insights into how individual personality traits influence various dimensions of well-being. The implications of these findings are profound, extending beyond academic discourse to inform healthcare policies, organizational behavior, and social welfare programs in China. Our review not only offers a comprehensive synthesis of the current research landscape but also identifies critical gaps in the literature. It emphasizes the urgent need for further culturally nuanced research to understand the complex dynamics of personality traits and QoL in China. This work lays a foundational framework for future investigations and the development of tailored interventions aimed at enhancing the well-being of diverse Chinese populations, including the elderly, people with disabilities, and specific occupational groups.

Climate Change and Occupational Heat Strain Among Women Workers: A Systematic Review

Climate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot-humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change.

Biological activities of endophytic fungi isolated from Annona muricata Linnaeus: a systematic review

Abstract This systematic review integrates the data available in the literature regarding the biological activities of the extracts of endophytic fungi isolated from Annona muricata and their secondary metabolites. The search was performed using four electronic databases, and studies' quality was evaluated using an adapted assessment tool. The initial database search yielded 436 results; ten studies were selected for inclusion. The leaf was the most studied part of the plant (in nine studies); Periconia sp. was the most tested fungus (n = 4); the most evaluated biological activity was anticancer (n = 6), followed by antiviral (n = 3). Antibacterial, antifungal, and antioxidant activities were also tested. Terpenoids or terpenoid hybrid compounds were the most abundant chemical metabolites. Phenolic compounds, esters, alkaloids, saturated and unsaturated fatty acids, aromatic compounds, and peptides were also reported. The selected studies highlighted the biotechnological potentiality of the endophytic fungi extracts from A. muricata. Consequently, it can be considered a promising source of biological compounds with antioxidant effects and active against different microorganisms and cancer cells. Further research is needed involving different plant tissues, other microorganisms, such as SARS-CoV-2, and different cancer cells.

Craving inclusion: a systematic review on the experiences and needs of people with disability eating out

Purpose: To systematically review the research relating to views and experiences of people with disability eating out in cafés, restaurants, and other settings; and identify factors that impede or enhance accessibility of eating out experiences, inform future inclusive research, and guide policy development.Materials and Methods: This study involved systematic search and review procedures with qualitative metasynthesis of the barriers to and facilitators for participation and inclusion in eating/dining-out activities. In total, 36 studies were included.Results: Most studies reviewed related to people with physical or sensory disability eating out, with few studies examining the dining experiences of adults with intellectual or developmental disability, swallowing disability, or communication disability. People with disability encountered negative attitudes and problems with physical and communicative access to the venue. Staff lacked knowledge of disability. Improvements in the design of dining spaces, consultation with the disability community, and staff training are needed.Conclusion: People with disability may need support for inclusion in eating out activities, as they encounter a range of barriers to eating out. Further research within and across both a wide range of populations with disability and eating out settings could guide policy and practice and help develop training for hospitality staff.

Toward an Interdisciplinary Approach to Constructing Care Delivery Pathways From Electronic Health Care Databases to Support Integrated Care in Chronic Conditions: Systematic Review of Quantification and Visualization Methods

BACKGROUND

Electronic health care databases are increasingly used for informing clinical decision-making. In long-term care, linking and accessing information on health care delivered by different providers could improve coordination and health outcomes. Several methods for quantifying and visualizing this information into data-driven care delivery pathways (CDPs) have been proposed. To be integrated effectively and sustainably into routine care, these methods need to meet a range of prerequisites covering 3 broad domains: clinical, technological, and behavioral. Although advances have been made, development to date lacks a comprehensive interdisciplinary approach. As the field expands, it would benefit from developing common standards of development and reporting that integrate clinical, technological, and behavioral aspects.

OBJECTIVE

We aimed to describe the content and development of long-term CDP quantification and visualization methods and to propose recommendations for future work.

METHODS

We conducted a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. We searched peer-reviewed publications in English and reported the CDP methods by using the following data in the included studies: long-term care data and extracted data on clinical information and aims, technological development and characteristics, and user behaviors. The data are summarized in tables and presented narratively.

RESULTS

Of the 2921 records identified, 14 studies were included, of which 13 (93%) were descriptive reports and 1 (7%) was a validation study. Clinical aims focused primarily on treatment decision-making (n=6, 43%) and care coordination (n=7, 50%). Technological development followed a similar process from scope definition to tool validation, with various levels of detail in reporting. User behaviors (n=3, 21%) referred to accessing CDPs, planning care, adjusting treatment, or supporting adherence.

CONCLUSIONS

The use of electronic health care databases for quantifying and visualizing CDPs in long-term care is an emerging field. Detailed and standardized reporting of clinical and technological aspects is needed. Early consideration of how CDPs would be used, validated, and implemented in clinical practice would likely facilitate further development and adoption.

TRIAL REGISTRATION

PROSPERO CRD42019140494; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=140494.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2019-033573.

The implementation, use and impact of patient reported outcome measures in value-based healthcare programmes: A scoping review

BACKGROUND

Value-Based Healthcare (VBHC) focuses on the value of patient outcomes and is achieved by ensuring resources already available are managed to realise the best possible individual and population health outcomes. Patient reported outcome measures (PROMs) measure the impact of illnesses from the patient perspective. We conducted a scoping review to understand how PROMs were implemented and used, and their impact in the context of VBHC.

METHODS

Arksey and O'Malley's overarching framework supplemented by principles from mixed-methods Framework Synthesis were used. CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, Web of Science, Google Scholar and reference lists were searched. An a priori data extraction framework was created using the review question and objectives as key domains against which to extract data. Mixed-methods data were organised, integrated and preserved in original format and reported for each domain.

RESULTS

Forty-three studies were included with 60,200 participants. Few studies reported a well-developed programme theory and we found little robust evidence of effect. PROMs were universally considered to have the potential to increase patient satisfaction with treatment and services, enhance patient awareness of symptoms and self-management, and improve health outcomes such as quality of life and global health status. Evidence is currently limited on how PROMs work and how best to optimally implement PROMs to achieve the target outcome. Implementation challenges commonly prevented the realisation of optimal outcomes and patients generally needed better and clearer communication about why PROMs were being given and how they could optimally be used to support their own self-management.

CONCLUSION

PROMSs have yet to demonstrate their full potential in a VBHC context. Optimal PROMs implementation is poorly understood by clinicians and patients. Future studies should explore different models of PROM implementation and use within VBHC programmes to understand what works best and why for each specific context, condition, and population.

The Impact of Food-Shaping Techniques on Nutrition, Mealtime Experiences, and Quality of Life for Older Adults in Aged Care Settings: A Systematic Review

OBJECTIVE

Food-shaping methods, particularly for texture-modified foods, present numerous opportunities to improve the visual appeal of food and potentially the nutrition of older people with dysphagia (swallowing difficulty). This review appraises and synthesizes the evidence on the use of food-shaping methods to enhance nutrition in older adults with swallowing difficulties.

METHODS

In August 2022, five electronic databases (PubMed, CINAHL, Scopus, Cochrane Library, and Web of Science) were searched for original research related to the intersection of nutrition, food shaping, and older adults with swallowing difficulties. Characteristics of included studies were described and data from results and findings extracted for analysis across studies.

RESULTS

Eighteen studies met the inclusion criteria and encompassed a variety of settings, including aged care settings (n = 15) and food science laboratories (n = 3). Qualitative and quantitative findings demonstrated a variety of impacts of food shaping for the older adult with swallowing difficulty, including enhanced nutrition and wellbeing. The content themes identified across studies were: links between food shaping and nutrition, shaping food for individual choice, food shaping for enjoyment, a combination of supporting factors, collaborative inter-disciplinary teams and roles, and implementation aligns with local contexts.

CONCLUSION

With recent growth in research on food shaping, the body of studies reviewed identified an influence of food-shaping methods on the nutritional status of older adults with swallowing difficulties. Given the identified potential benefit of food shaping and attention to the visual appeal of food for older people, further research examining links between food shaping and nutrition are warranted.