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Summary: The optimal treatment and organization of care for people with obesity is one of the greatest challenges facing today's health services. While surgery and pharmacotherapy offer effective treatment options for some people with obesity, behavioral interventions are important to support long‐term behavioral change. However, little is known about the most effective components of behavioral interventions, and this is especially the case for people with complex or severe obesity (i.e. body mass index [BMI] > 35 kg/m2). Accordingly, the current rapid review aimed to identify which behavior change techniques (BCTs) are effective for weight loss in adults with (severe) obesity. A secondary aim was to review the effects of BCTs on dietary behaviors and physical activity, and psychological outcomes, recognizing that behavioral interventions commonly target these. A search of Scopus, Ovid Medline, and Web of Science resulted in 1227 results, with 22 reviews eligible for inclusion. The most commonly reported BCTs were self‐monitoring and goal setting, but these had variable effects on weight in adults with obesity. Combining these BCTs with other self‐regulatory techniques led to increased weight loss. Further, for adults with severe obesity, so‐called 'nudge' techniques and self‐regulatory techniques were associated with greater weight loss. Three reviews also found that while self‐monitoring increased physical activity, behavioral commitments increased changes to dietary behaviors. BCTs were not associated with psychological well‐being. The review confirms that behavioral interventions have an impact in weight management, including for individuals with more complex or severe obesity, but highlights the need for further investigation of their use within clinical settings. [ABSTRACT FROM AUTHOR]

Background: The term 'care‐experienced' refers to anyone who is currently in care or has been in care at any stage in their life. A complex interplay of factors leads to care‐experienced children and young people (CECYP) experiencing poorer oral health and access to dental care than their peers. A rapid review of the co‐production of health and social care research with vulnerable children and young people (CYP) was carried out to inform the development of a co‐produced research project exploring the oral health behaviours and access to dental services of CECYP. Here, 'co‐production' refers to the involvement of CYP in the planning or conduct of research with explicit roles in which they generate ideas, evidence and research outputs. Aim: To learn how to meaningfully involve vulnerable CYP in the co‐production of health and social science research. Objectives: To identify: Different approaches to facilitating the engagement of vulnerable CYP in co‐production of health and social science research; different activities carried out in such approaches, challenges to engaging vulnerable CYP in co‐production of health and social science research and ways to overcome them and areas of best practice in relation to research co‐production with vulnerable CYP. Search Strategy: A rapid review of peer‐reviewed articles was conducted in six databases (MEDLINE, Embase, SocINDEX, CINAHL, PsycINFO and Web of Science) and grey literature to identify studies that engaged vulnerable CYP in co‐approaches to health and social research. Main Results: Of 1394 documents identified in the search, 40 were included and analysed. A number of different approaches to co‐production were used in the studies. The CYP was involved in a range of activities, chiefly the development of data collection tools, data collection and dissemination. Individual challenges for CYP and researchers, practical and institutional factors and ethical considerations impacted the success of co‐production. Discussion and Conclusion: Co‐production of health and social science with vulnerable CYP presents challenges to researchers and CYP calling for all to demonstrate reflexivity and awareness of biases, strengths and limitations. Used appropriately and well, co‐production offers benefits to researchers and CYP and can contribute to research that reflects the needs of vulnerable CYP. Adherence to the key principles of inclusion, safeguarding, respect and well‐being facilitates this approach. Patient and Public Contribution: Members of our patient and public involvement and stakeholder groups contributed to the interpretation of the review findings. This manuscript was written together with a young care leaver, Skye Boswell, who is one of the authors. She contributed to the preparation of the manuscript, reviewing the findings and their interpretation. [ABSTRACT FROM AUTHOR]

Aims: This scoping review aimed to explore three research questions: 1. What is the dental care access for children and young people (CYP) in care and care leavers? 2. What factors influence CYP in care and care leavers' access to dental care? 3. What pathways have been developed to improve access to oral health care for CYP in care and care leavers? Methods: Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, SocINDEX and Dentistry and Oral Sciences Source) and grey literature sources were systematically searched. Articles relating to CYP in care or care leavers aged 0–25 years old, published up to January 2023 were included. Abstracts, posters and publications not in the English language were excluded. The data relating to dental care access were analysed using thematic analysis. Results: The search identified 942 articles, of which 247 were excluded as duplicates. A review of the titles and abstracts yielded 149 studies. Thirty-eight were eligible for inclusion in the review: thirty-three peer-reviewed articles, one PhD thesis and four grey literature sources. All papers were published from very high or medium Human Development Index countries. The studies indicate that despite having higher treatment needs, CYP in care and care leavers experience greater difficulty in accessing dental services than those not care-experienced. Organisational, psycho-social and logistical factors influence their access to dental care. Their experience of dental care may be impacted by adverse childhood events. Pathways to dental care have been developed, but little is known of their impact on access. There are very few studies that include care leavers. The voices of care-experienced CYP are missing from dental access research. Conclusions: care-experienced CYP are disadvantaged in their access to dental care, and there are significant barriers to their treatment needs being met. [ABSTRACT FROM AUTHOR]

Background: Children and young people (CYP) in care experience poorer physical health and overall wellbeing in comparison to their peers. Despite this, relatively little is known about what their oral health needs and behaviours are. The aim of this scoping review was to provide a global perspective on the oral health status and behaviours of CYP in care and care leavers. It also aimed to synthesise interventions that have been trialled in this population to improve oral health. Methods: Five databases were searched, Ovid Embase, Ovid MEDLINE, CINAHL (EBSCOhost), SocINDEX (EBSCOhost) and Dentistry and Oral Sciences Source (EBSCOhost), alongside grey literature sources up to January 2023. Eligibility criteria were studies that (i) reported on children and adolescents aged 25 years or younger who are currently in formal/informal foster or residential care and care leavers, (ii) pertained to oral health profile, behaviours or oral health promotion interventions (iii) and were published in the English language. Thematic analysis was used to develop the domains for oral health behaviours and interventions. Results: Seventy-one papers were included. Most papers were published from very high or medium Human Development Index countries. CYP in care were found to experience high levels of decay, dental trauma, periodontal disease and poorer oral health-related quality of life. Oral health behaviours included limited oral health self-care behaviours and a lack of oral health-based knowledge. The trialled interventions involved oral health education, supervised brushing and treatment or preventative dental care. Conclusions: This scoping review reveals that CYP in care experience poorer oral health in comparison to their peers. They are also less likely to carry out oral health self-care behaviours. This review highlights a scarcity of interventions to improve the oral health of this population and a paucity of evidence surrounding the oral health needs of care leavers. [ABSTRACT FROM AUTHOR]

This article explores “literature sickness”, a term coined by the contemporary Iranian-American writer Azareen Van der Vliet Oloomi and developed, I suggest, in her novel Call Me Zebra (2018). In doing so, it aims to offer not only an account of this novel, but to consider the radical potential of the condition Van der Vliet Oloomi outlines. This potential lies in the challenge to the dualism of reality and representation posed by literature sickness, an idea I develop comparatively via Call Me Zebra and the reflections on exile and, specifically, world literature in the work of Edward Said and Erich Auerbach. To develop these ideas further, I explore key concepts relating to the politics of world literature – exile, marginalization, and dissent. I focus on the work of Pascale Casanova to show how the concept of literature sickness that I develop in my readings of the novel relates to current debates in world literature theory. I position Call Me Zebra within a wider critical debate in order to argue that this novel offers a distinctive response to the Kantian dualism evoked in much contemporary world literature theory, one that I unpack using Gilles Deleuze and Bruno Latour. Deleuze’s philosophy of literature is central to my reading of Call Me Zebra, as it has distinct parallels with Zebra’s own theoretical musings. I use Deleuze to illustrate how, in the novel, Zebra’s exile gives her an especial perspective on oppression and marginalization, revealing literature’s capacity for imagining new futures and ways of belonging, and making Call Me Zebra a paradigmatic text of literature sickness and its radical potential. [ABSTRACT FROM AUTHOR]

Careers in academic dentistry are failing to attract a new generation of academics to steer dental education and research. Dental academia is further limited by inadequacies in levels of ethnic diversity. There is a stark contrast between the diversity of graduates entering the dental profession and those in academic positions, especially in senior ranks. Dentistry is not the only field in academia, which lacks representation and lessons may be drawn from other faculties. This paper focuses on what is known about dental academia in the United Kingdom, where there are formal research training pathways. There is an emerging recognition of the requirement for action, and it is hoped this will stimulate debate and impetus for research across Europe. The terminology used throughout this piece follows the United Kingdom Cabinet Office recommendations for writing about ethnicity (Writing about ethnicity, 2021; https://www.ethnicity‐facts‐figures.service.gov.uk/style‐guide/writing‐about‐ethnicity). Where cited sources have employed less acceptable terms (Please don't call me BAME or BME!: Civil service, 2019; https://civilservice.blog.gov.uk/2019/07/08/please‐dont‐call‐me‐bame‐or‐bme/), these have been changed. [ABSTRACT FROM AUTHOR]

Introduction: Harmonising education to support workforce mobility has been a policy objective for the European Union. However, alignment across varied national contexts presents challenges in dental education. Methods: A systematic literature review with narrative synthesis. Searches of the electronic databases Embase [Ovid]; MEDLINE [Ovid]; Scopus; CINAHL; AMED and PsycINFO were conducted for relevant material published between 2000 and 2019 on undergraduate curricula, quality standards and learning outcomes in dentistry. Results: Seventy‐six papers met the inclusion criteria. Fifty‐three papers were commentaries or editorials, twenty‐one were research studies, and two were literature reviews on specific dental subfields. Eighteen of the research studies reported surveys. The literature contains extensive proposals for undergraduate curricula or learning outcomes, either broadly or for subfields of dentistry. Included papers demonstrated the importance of EU policy and educator‐led initiatives as drivers for harmonisation. There is limited evidence on the extent to which proposed pan‐European curricula or learning outcomes have been implemented. The nature and extent of dental students' clinical experience with patients is an area of variance across European Union member states. Arrangements for the quality assurance of dental education differ between countries. Discussion: Harmonisation of European dental education has engaged educators, as seen in the publication of proposed curricula and learning outcomes. However, differences remain in key areas such as clinical experience with patients, which has serious implications if graduate dentists migrate to countries where different expectations exist. Mutual recognition of professional qualifications between countries relies on education which meets certain standards, but institutional autonomy makes drawing national comparisons problematic. [ABSTRACT FROM AUTHOR]

Aim: To systematically review current evidence comparing the use of mineral trioxide aggregate and calcium hydroxide for direct pulp capping in permanent teeth with mature root development. Materials and methods: A search of multiple databases was undertaken for randomised controlled trials comparing use of mineral trioxide aggregate and calcium hydroxide for direct pulp capping. Other sources, including trial registries and reference lists, were also searched. Three reviewers independently conducted the screening, data extraction and critical appraisal. Following screening, four studies were identified and analysed. Results: Three of the four studies were identified as being at high risk of bias. Two studies reported statistically significant superiority of mineral trioxide aggregate over calcium hydroxide, although one of these studies had the highest risk of bias. Two studies demonstrated the superiority of mineral trioxide aggregate over calcium hydroxide for direct pulp capping, which was not statistically significant. Conclusions: There is evidence from the randomised controlled trials that mineral trioxide aggregate performs better than calcium hydroxide for direct pulp capping of permanent teeth with complete root development following pulp exposure during caries removal, but not in cases of iatrogenic or traumatic exposures. This supports the European Society of Endodontology 2019 position statement on the management of deep caries and the exposed pulp. There are indications that the superiority of mineral trioxide aggregate over calcium hydroxide for direct pulp capping becomes more pronounced over time; the need for longer-term studies is questionable given the weight of evidence already available from short- to medium-term randomised controlled trials. [ABSTRACT FROM AUTHOR]

Background: Autistic children and young people (CYP) experience oral health (OH) inequalities. They are at high risk of dental disease and show significant levels of unmet need in relation to OH and access to dental care. Aim: This study aimed to gather evidence on the factors that influence OH behaviours, access to and delivery of dental care for autistic CYP. Design: This was a mixed‐methods narrative systematic review. Data Sources: Embase, Web of Science, Dentistry & Oral Sciences Source, MEDLINE, Psychinfo, Scopus, CINAHL, SocINDEX and grey literature were the data sources for this study. Review Methods: A systematic search was conducted for qualitative, quantitative and mixed‐methods research studies from countries with a High Development Index that related to OH behaviours, access to and delivery of dental care for autistic CYP. Results were analysed using narrative synthesis. Results: From 59 eligible studies, 9 themes were generated: (1) affordability and accessibility; (2) autism‐related factors and cognitive or motor skill differences; (3) the dental environment; (4) managing CYP's behaviour; (5) responding and adapting to the needs of the autistic CYP and their parent/carer; (6) attitude of dental health professionals (DHPs) towards autistic CYP and their parents/carers; (7) knowledge of how to care for and support CYP's OH; (8) empowerment of parents/carers and collaboration with DHPs; and (9) communication and building rapport. Conclusion: The adoption of healthy OH behaviours and access to dental care by autistic CYP is impacted by a range of factors including those intrinsically related to a diagnosis of autism, for example, communication and those often associated with autism, for example, sensory sensitivities. Access to better OH and dental care can be facilitated by responding to the individual needs of autistic CYP through accommodation, education and adaptation. This necessitates greater awareness and knowledge of autism amongst DHPs and the provision of appropriate services. More methodologically robust intervention studies are needed to identify effective ways to support autistic CYP in achieving good OH and access to dental care. Patient and Public Contribution: The review protocol was developed with members of the project patient and public involvement group who provided the autistic voice, contributing to the interpretation of the review findings and writing of the manuscript. [ABSTRACT FROM AUTHOR]

Background: People experiencing homelessness have an increased risk of hepatitis C virus (HCV) infection, with rates higher than the general population. However, their access to HCV diagnosis is limited and treatment uptake is low. Objectives: To identify and describe the barriers and facilitators for HCV screening and treatment for adults with lived experience of homelessness in highly developed countries. Methods: Bibliographic databases (Embase, MEDLINE, CINAHL and SocINDEX) and grey literature (Google, EThOS, the Health Foundation, Social Care Online, the World Health Organisation, Shelter, Crisis and Pathway) were searched. Two reviewers independently screened and appraised all studies. The Critical Appraisal Skills Programme tool and the Joanna Briggs Institute checklist were used. The analysis involved a three‐stage process: coding, theme generation and theme mapping under Penchansky and Thomas's modified access model. Results: Twelve papers/reports were included in the review. Several interacting factors influence access of people with lived experience of homelessness to HCV testing and treatment. Some mirror those identified for the general population. The precarious conditions associated with the lived experience of homelessness along with the rigidity of hospital settings and lack of awareness emerged as dominant barriers. Flexibility, outreach, effective communication, tailoring and integration of services were found to be important facilitators. Evidence from Black, Asian and minority ethnic groups is limited. Conclusions: People experiencing homelessness face multiple barriers in accessing and completing HCV treatment, relating to both their lived experience and characteristics of health systems. Although some barriers are readily amenable to change, others are more difficult to modify. The facilitators identified could inform future targeted measures to improve HCV diagnosis and treatment for people experiencing homelessness. Research is warranted into successful models to promote screening, diagnosis and treatment. Patient or Public Contribution: Our team includes a peer advocate, a hepatology nurse and a community volunteer, all with significant experience in promoting and engaging in HCV care and outreach for people experiencing homelessness. They contributed to the protocol, interpretation and reporting of the review findings. [ABSTRACT FROM AUTHOR]

Aim: To explore the oral care experiences of palliative care patients and of those who support or deliver oral care to these patients: nurses, doctors, dentists, their relatives and carers. Data Sources: An electronic search of the databases included: Embase, MEDLINE, DOSS, AMED and PsycINFO was performed. Data selection: Six articles were included in the final synthesis. Data extraction: Thematic analysis was applied by two researchers. Data synthesis: Three themes were identified: 'performing oral care', 'effects on oral health' and 'challenges in palliative care'. Conclusions: Despite similarities of oral care experiences, this review identified some differences, crucially in terms of the wider impact of oral symptoms, namely social interactions with others and challenges to oral care. This confirms the need to investigate these topics further in relation to different stakeholders, such as nurses; and to have consistent guidance to facilitate the provision of effective oral care to palliative care patients. [ABSTRACT FROM AUTHOR]

Background: Asthma Health Related Quality of Life (HRQoL) is an outcome important to patients with severe asthma and can provide clinicians with additional insight into the benefits of treatment. The aim of this systematic review is to examine the use and reporting of HRQoL questionnaires within randomised controlled trials (RCTs) of biologics, fevipiprant and bronchial thermoplasty. Methods: We followed the guidelines on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Of the 2380 retrieved articles, 52 studies were identified for inclusion. Results: Sixty-three percent included an asthma HRQoL questionnaire. It was a secondary outcome in the majority of cases (73%). The proportion of studies including an asthma HRQoL questionnaire did not change significantly over a 20-year period. While the Asthma Quality of Life Questionnaire (AQLQ) was used in 45% of studies, 55% used a variety of 4 questionnaires. Most (70%) of the studies that included a HRQoL questionnaire did not report its subscale scores. Approximately half (52%) of studies that used HRQoL reported this in the abstract of the paper. A higher proportion of studies used an asthma control questionnaire compared to a HRQoL questionnaire (71% vs 63%). Conclusion: In order to increase the use of asthma HRQoL questionnaires in RCTs of severe asthma treatments, the drivers and barriers to their use must first be understood. At present, the patients' perspective is underrepresented in RCTs of biologics, fevipiprant and bronchial thermoplasty for severe asthma. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to identify and conceptualize the barriers and enablers to accessing dental services for people experiencing homelessness in the United Kingdom. Methods: A literature search for studies relevant to homelessness and dental care was conducted. The PRISMA and ENTREQ guidelines were followed. Electronic databases (EMBASE, MEDLINE, DOSS, CINAHL, SOCINDEX and PsycINFO) and grey literature sources (Electronic Theses Online Service – EThOS, Kings Fund, NICE Evidence, Open Grey, Google and the Health Foundation) were searched up to 28 August 2018. The critical appraisal was conducted using CASP and an adjusted version of a JBI Critical Appraisal tool. Thematic analysis was used to develop the themes and domains. Results: Twenty‐eight papers were included. Barriers to homeless people accessing dental care stemmed both from the lived experience of homelessness and the healthcare system. Within homelessness, the themes identified included complexity, emotions and knowledge. Regarding the healthcare system, identified themes included staff encounter, accessibility and organization issues. Conclusion: Homelessness can actively contribute to both an increased need for dental care and barriers to accessing that care. The arrangement of dental healthcare services can also act as barriers to care. This is the first systematic review to conceptualize the factors associated with access to dental care for people who are homeless. It provides a set of recommendations for overcoming the main barriers for homeless people to accessing dental care. It also offers directions for future research, policy and commissioning. [ABSTRACT FROM AUTHOR]

Background: Many economic evaluations of human papillomavirus vaccination should ideally consider multiple disease outcomes, including anogenital warts, respiratory papillomatosis and non-cervical cancers (eg, anal, oropharyngeal, penile, vulvar and vaginal cancers). However, published economic evaluations largely relied on estimates from single studies or informal rapid literature reviews.Methods: We conducted a systematic review of articles up to June 2016 to identify costs and utility estimates admissible for an economic evaluation from a single-payer healthcare provider's perspective. Meta-analyses were performed for studies that used same utility elicitation tools for similar diseases. Costs were adjusted to 2016/2017 US$.Results: Sixty-one papers (35 costs; 24 utilities; 2 costs and utilities) were selected from 10 742 initial records. Cost per case ranges were US$124-US$883 (anogenital warts), US$6912-US$52 579 (head and neck cancers), US$12 936-US$51 571 (anal cancer), US$17 524-34 258 (vaginal cancer), US$14 686-US$28 502 (vulvar cancer) and US$9975-US$27 629 (penile cancer). The total cost for 14 adult patients with recurrent respiratory papillomatosis was US$137 601 (one paper).Utility per warts episode ranged from 0.651 to 1 (12 papers, various utility elicitation methods), with pooled mean EQ-5D and EQ-VAS of 0.86 (95% CI 0.85 to 0.87) and 0.74 (95% CI 0.74 to 0.75), respectively. Fifteen papers reported utilities in head and neck cancers with range 0.29 (95% CI 0.0 to 0.76) to 0.94 (95% CI 0.3 to 1.0). Mean utility reported ranged from 0.5 (95% CI 0.4 to 0.61) to 0.65 (95% CI 0.45 to 0.75) (anal cancer), 0.59 (95% CI 0.54 to 0.64) (vaginal cancer), 0.65 (95% CI 0.60 to 0.70) (vulvar cancer) and 0.79 (95% CI 0.74 to 0.84) (penile cancer).Conclusions: Differences in values reported from each paper reflect variations in cancer site, disease stages, study population, treatment modality/setting and utility elicitation methods used. As patient management changes over time, corresponding effects on both costs and utility need to be considered to ensure health economic assumptions are up-to-date and closely reflect the case mix of patients. [ABSTRACT FROM AUTHOR]

This article considers the challenge posed by Gayatri Spivak to rethink world literature along postcolonial lines as an ethical encounter with alterity. Read in this way, Spivak participates in a reframing of world literature that retains the critical gains made by postcolonial theory and suggests that the work of world literary analysis ought not necessarily be de/prescriptive (classifying and ordering) but might involve a contestation of the power relations that structure the world. In developing this argument, I draw on four further perspectives: Pascale Casanova's problematic assertion of literary singularity inThe World Republic of Letters; Fredric Jameson's theorization of “third world literature” as counterpoint to Casanova's limiting understanding of national literature; Gilles Deleuze, who offers a way to rethink world literature in a process of becoming; and Édouard Glissant, whose work proposes a “relational” vision of difference that, like that of Spivak, demands an ethical, imaginative response to literature as literature. [ABSTRACT FROM AUTHOR]

In his fictional recreation of the People’s Temple massacre,Jonestown, Harris presents us with a protagonist who counter-actualizes the trauma that wounds him, living creatively out of the event and constructing an alternative present-future. Drawing on Deleuzian philosophy, this essay argues for a re-conceptualization ofJonestownin terms that evoke not only Deleuze’s philosophy of time and immanence but also his distinction, via Nietzsche, between active and reactive forces. By means of a character (Francisco Bone) who embraces the power of transformation, creation and difference-in-itself, Harris demonstrates the value of active forces that do not depend on external recognition or dialectical negation in order to be for a postcolonial philosophy of the imagination. [ABSTRACT FROM PUBLISHER]

The article reports on writing style of a writer Wilson Harris from Guyana and discusses his work on emerging debates about globalizing world and postcolonial literatures. It explores the relational, pluralistic approach to both spatial and temporal imaginaries that Harris has developed in his poetics and philosophy. It informs that mutualities of living and textual landscapes frequently surfaces in Harris's fiction.

To date, critical analyses of the impact of surrealism on the development of Caribbean literature have tended to restrict their focus to the francophone Caribbean. This article outlines the wider dissemination of surrealism through a focus on the writings of Wilson Harris. Harris's appropriation of a number of surrealist tropes is revealed through a comparative reading of his novels Palace of the Peacock and The Ghost of Memory with Pierre Mabille's surrealist work Mirror of the Marvellous. [ABSTRACT FROM AUTHOR]

The article focuses on the disparate culture experienced by the Caribbean population and creates discussions on creolization. It states that creolization is rooted in the New World and distinct from hybridity's problematic associations with Victorian theories of inter-racial mixing. It also explores the critical application of the term through writings of creolization's contemporary theorists and exposes its processes to reveal its relevance to European philosophies of immanence. It suggests that the link to creolization theory is vital and postcolonial identities are produced through creolization.