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Purpose: To explore the effect of nurse-led psychological interventions on diabetes distress, depression, and glycemic control in individuals with type 2 diabetes mellitus (T2DM). Method: Seven databases were systematically searched. Outcome measures were diabetes distress, depression, and hemoglobin A1c (HbA1c) level. RoB 2.0 was used for risk of bias assessment. Data were synthesized using Review Manager 5.4 software. Results: Fourteen studies were included from 2,837 articles. Five studies pooled in the meta-analysis demonstrated reduction in diabetes distress (standard mean difference = −0.36, 95% confidence interval [–0.49, −0.24], p < 0.001), favoring nurse-led psychological interventions over controls. Effects of the interventions on depression and HbA1c level were inconsistent across studies. Conclusion: Nurse-led psychological interventions demonstrated the effect of reducing diabetes distress and some promising benefits for depression and glycemic control. Integrating nurse-led psychological interventions into usual care will be beneficial for individuals with T2DM in the future. [Journal of Psychosocial Nursing and Mental Health Services, 63(3), 11–18.] [ABSTRACT FROM AUTHOR]

Aims: To summarize evidence on effective knowledge translation (KT) interventions to increase evidence-based practice among pediatric rehabilitation professionals. Methods: The PRISMA 2020 Checklist was used for search, selection, and data extraction. The Mixed Methods Appraisal Tool assessed quality, while the Cochrane Effective Practice and Organization of Care described KT interventions. Results: Our search yielded 7233 records; 29 met the inclusion criteria. Two studies used educational materials alone. The remaining 27 studies used multifaceted KT interventions, combining education with local opinion leaders or knowledge brokers (n = 12), continuous quality improvement (n = 11), reminders (n = 6), communities of practice (n = 6), provider performance monitoring (n = 5), audit and feedback (n = 2), information and communication technology (n = 2), clinical practice guideline (n = 1), or routine patient-reported outcome measures (n = 1). Significant improvements in knowledge (n = 10), skills (n = 6), adherence and use (n = 4), perceptions (n = 3), intentions of use (n = 2), confidence level (n = 1), beliefs and attitudes (n = 3), and professional behavior change (n = 2) were reported. Included studies had a moderate to high-risk bias. Conclusion: Educational and local opinion leaders were common in multifaceted KT interventions, the majority resulting in improved professional knowledge, skills, attitudes and beliefs, and behaviors. Rigorous study designs are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28–34) for depression, 29% (24–34) for anxiety, 20% (17–24) for suicidal ideation, 20% (13–28) for post-traumatic stress disorder, 47% (40–55) for stigma, 44% (31–56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV. [ABSTRACT FROM AUTHOR]

Background: Involving husbands in pregnancy, childbirth, and postpartum care improves the outcomes for mothers and babies. In most developing countries involvement of husbands towards antenatal care follow up is influenced by different socio-cultural and traditional factors. In Ethiopia, the degree of husband involvement as indicated by several research varied greatly. Objective: The aim of this study is to measure the overall prevalence of husband involvement during antenatal care follow up of pregnant women in Ethiopia. Methods: Five databases including PubMed, Scopus, EMBASE, SAGE and Google Scholar were reviewed for relevant articles retrieved from 2011 to 2023. Literature search used keywords, including "male partner involvement," "husband involvement," "spouse involvement" "antenatal care," and "perinatal care" and "Ethiopia". The Joanna Briggs Institute guidelines were used for appraisal review of journals. Thirteen articles were included in the final systematic review and meta-analysis and random effect model was used to analyze. The presence of statistical heterogeneity was tested using I2, and publication bias was examined by various factors. Result: Thirteen studies were finally identified and included in this systematic review and meta-analysis. The pooled estimated proportion of husband involvement during antenatal care follow up in Ethiopia was found to be 39.3[95%-CI (38.2, 40.4)]. Cochran Q test indicates that there is heterogeneity since I2 is 98.6%. Egger's and Begg's tests were conducted to check possible publication bias and p-value = 0.679 and 0.807 respectively, which indicates that there is no possible publication bias. Conclusion: It was discovered that the total pooled proportion of Ethiopian husbands' involvement towards antenatal care follow up was low. This demands that the nation take action to evaluate the health care policy in order to encourage husbands to participate in antenatal care and yield positive outcomes for the health of mothers and children. [ABSTRACT FROM AUTHOR]

Overweight and obesity are common in school-age children. Policy, system, and environmental (PSE) approaches—which entail making upstream changes to a school's context—can be leveraged to reduce childhood obesity. Nurses can advance PSE approaches in schools to promote healthy living habits. This review examines the effect of nurse-involved PSE interventions globally to promote healthy nutrition and reduce obesity in schools. We conducted a literature search using multiple databases from 2010 to 2023 for nurse-involved studies that implemented interventions focused on PSE change related to promoting healthy nutrition or reducing obesity in school settings. Twenty interventions globally were included in the systematic review synthesis. Improvements in anthropometrics, health and nutrition knowledge, attitudes, and beliefs were observed. PSE interventions can be leveraged to promote healthy nutrition and reduce obesity in school settings. Nurses in varying roles are uniquely qualified to advocate for and implement school-based interventions focused on PSE change. [ABSTRACT FROM AUTHOR]

Objectives: Self-compassion, the capacity to hold a compassionate attitude towards oneself without self-criticism when in distress, has been conceptualized to originate from receiving secure caregiving. Attachment theory offers a framework to explain self-compassion as effective coping with resources from healthy activation of the attachment system. Recent research has increasingly explored the connections between self-compassion and attachment security. Our meta-analysis seeks to consolidate existing evidence by statistically synthesizing findings on the relationship between self-compassion and the two dimensions of attachment: anxiety and avoidance. Methods: A systematic literature search was conducted, and based on the inclusion criteria, the authors found data from 46 studies with a total size of 17,650 participants. Inclusion criteria were peer-reviewed journals and dissertations published in English that used quantitative and validated methods to measure attachment and self-compassion in participants aged 16 years and older. Results: We found robust negative correlations between self-compassion and both attachment anxiety (r = −.42) and avoidance (r = −.32), with age significantly moderating the relationship between avoidance and self-compassion. Subscale analyses suggested that each of the six components of self-compassion is significantly associated with attachment insecurity. Conclusions: The results highlight the robust associations between self-compassion and adult attachment, as well as significant associations between the individual components of self-compassion and adult attachment. Additionally, age emerges as a potentially influential moderator. Future research should further examine the causal mechanism of these associations and include correlations for self-compassion's individual dimensions. [ABSTRACT FROM AUTHOR]

Accessible summary: What Is Known on the Subject: Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care.This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. What the Paper Adds to Existing Knowledge: The findings of this review contribute valuable information to inform evidence‐based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings.In addition, the review illuminates the far‐reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. What Are the Implications for Practice: Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them.In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery.Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity‐focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. Introduction: Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting. Aim: To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings. Methods: The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta‐analyses. Results: This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient. Discussion: The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings. Implication for Practice: Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting. [ABSTRACT FROM AUTHOR]

Objectives: We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity. Method: A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted. Results: Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1–25.5%), including 21.7% among women (95% CI: 16.1–27.4%) and 16.3% among men (95% CI: 10.6–21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes. Conclusion: About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries. [ABSTRACT FROM AUTHOR]

Autism diagnoses in adulthood have risen substantially over recent years. While providing potential benefits, many autistic adults struggle to navigate their new diagnosis. Our review aimed to synthesise the evidence for post-diagnostic support for autistic adults without intellectual disability diagnosed in adulthood in the UK: investigating availability, efficacy, and autistic adults' experiences. A systematic search of four biomedical and three grey literature databases was conducted to identify UK-based studies published since 2012. A total of 27,581 records were screened in duplicate, with 19 studies regarding post-diagnostic support included. A narrative synthesis was undertaken due to anticipated heterogeneity. A service mapping exercise also provided a summary of post-diagnostic service provision currently available across the UK. Findings indicate that many services across the UK provide information and signposting as their primary form of post-diagnostic support, whereas autistic adults desire low-level support services, psychoeducation, and peer support. Evidence regarding the efficacy of post-diagnostic support was unavailable. This review highlights the need for adequate support to alleviate post-diagnostic challenges and improve autistic adults' quality of life. Low-level support services, psychoeducation, and peer support appear acceptable and feasible, with a preference often indicated for autistic-led support. Future research should develop manualised post-diagnostic support programmes and assess their efficacy. More adults than ever before are seeking an autism diagnosis in adulthood. While receiving a diagnosis may be beneficial, many autistic people struggle to navigate their new diagnosis, and require support. This study conducted a systematic review of previous research on the support available after diagnosis (post-diagnostic support) for autistic adults without intellectual disability who were diagnosed in adulthood in the UK. A systematic review is a pre-planned method of searching for all relevant studies, before combining these to answer a larger question. The study aimed to investigate the availability of such support and its effectiveness, and to explore autistic adults' experiences of accessing support. We also used publicly available information to create a map of the post-diagnostic support services currently available across the UK. A systematic search of seven databases was conducted, to identify UK-based studies published after 2012. Nineteen studies were eligible to be included in the study. Although some form of post-diagnostic support is available across most areas in the UK, this mostly consists of providing information and 'signposting' the person to other services. These options may not meet the needs of autistic people, who want services such as psychoeducation (therapy whereby an individual receives education about their diagnosis to improve understanding and self-management), and peer support. Findings highlight the need for adequate support to alleviate the post-diagnostic challenges autistic adults face. The study could not evaluate the effectiveness of support options in the UK due to a lack of information about this in published research. Research shows that autistic adults would like low-level support services, psychoeducation, and peer support, and may also prefer autistic-led support. Further research is required to develop and evaluate post-diagnostic support programmes which include these elements. [ABSTRACT FROM AUTHOR]

Introduction: Few interventions have focused on Latino family caregivers to persons with dementia, addressing their unique needs. This review aimed to identify best practices in cultural adaptation to make recommendations for adapting interventions for Latino family caregivers of persons living with dementia. Method: This scoping review was conducted following the Joanna Briggs Institute Scoping Review guidelines, with findings extracted and summarized from 17 studies addressing cultural adaptation. Results: Frameworks guiding the adaptations were comprehensive, addressing cultural values and traditions and the social context faced by Latino family caregivers. Features of the adaptations included diverse teams of researchers and community members, including Latino family caregivers, to inform the integration of cultural values into the content, mode, and place of intervention delivery. Discussion: Culturally adapting evidence-based interventions will increase the number of available interventions for Latino family caregivers to persons living with dementia, thus reducing inequities in caregiver support. [ABSTRACT FROM AUTHOR]

Character strengths and development is one of the most important and influential areas of positive psychology. Yet most of this research involves – as per the field generally – research in high income countries, with relatively little awareness of its dynamics in low- and middle-income countries (LMICs). However, there is a burgeoning research base in such countries, but this has hitherto been neither consolidated nor widely disseminated. To remedy this lacuna, this paper reports on a systematic review of the peer-reviewed journal articles on character development in LMICs, analysing 164 articles selected from 1,507 initial abstracts. Our analysis shows that research into character in LMICs is developing rapidly, noting various significant trends with respect to countries, populations, outcomes, and interventions. We also point where further efforts are needed, showing how research on this important topic can continue to prosper in regions that have been relatively neglected in the literature. [ABSTRACT FROM AUTHOR]

Purpose: Early language intervention is essential for children with indicators of language delay. Enhanced milieu teaching (EMT) is a naturalistic intervention that supports the language development of children with emerging language. We conducted a systematic review and meta-analysis of all qualifying singlecase and group design studies that evaluate the experimental effects of EMT on child outcomes. Method: We evaluated the risk of bias in the included studies and conducted a descriptive analysis of study quality, effect sizes, and demographics. We reviewed a total of 29 single-case and 17 group design studies in which 1,590 children participated. Results: Out of 46 studies, 39 met the What Works Clearinghouse standards without reservations, showing low levels of risk of bias. The effects were comparable when EMT was implemented alone and when it was implemented with another intervention component, and EMT was more effective when implemented by caregivers than when implemented by therapists. Most studies did not report sufficient participant demographics. Conclusions: The EMT research literature published thus far is of high study quality; the effects across studies are comparable; and the intervention has been studied via a wide range of delivery modalities, contexts, implementers, and samples. Future research could systematically examine the effects of EMT and explore these varying intervention delivery, implementer, and learner characteristics as moderators. [ABSTRACT FROM AUTHOR]

Objective Neonatology quality improvement (QI) projects can improve the safety and value of health care, but the scholarly impact of published QI projects is unclear. We measured scholarly citation and media attention garnered by published neonatology QI projects and analyzed project or publication characteristics associated with increased impact metrics. Study Design We identified publications between 2016 and 2019 using mapping review methodology. We correlated project characteristics with measures of scholarly citation in Scopus and Google Scholar, and media attention as measured by Altmetrics. We collected Citation and Altmetric data in 2023. Results The search identified 148 eligible articles, with a median citation count of 7 based on Scopus (or 12, based on Google Scholar) and a median Altmetric score of 2. Notably, 66% of articles published in a journal with an Impact Factor (IF) had more citations per year than would be expected from the IF value. Higher scientific citations were associated with articles reporting process and cost outcomes; implementing interventions that addressed family education or organizational change; and using regression analysis. Higher media attention was associated with multicenter projects, longer intervention periods, and projects scoring higher on the Quality Improvement Minimum Quality Criteria Set (QI-MQCS) rubric. Conclusion Published neonatology QI projects are well cited in subsequent scientific publications, with the choice of project outcome, interventions, and analytic strategy influencing citation metrics. Adherence to QI-MQCS guidelines was favorably associated with media attention, but not with scholarly citations. Key Points Neonatology QI publications are frequently cited. Projects with cost data receive more citations. Citation and media mention predictors differ. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review aims to advance the understanding of the complicated effects of segregation on older adults' cognition and provide guidance for future research. Method: A systematic review using the Social Determinants of Health framework to examine the relationship between segregation and cognition across the selected literature. Results: Eight papers met the criteria for inclusion. All selected studies examined the influence of living in a segregated area on older adults' cognition, covering older adults from different racial/ethnic groups. The association between segregation and cognition was found in different directions across different racial/ethnic groups. The effects can be varied depending on race/ethnicity, level of education, neighborhood socioeconomic status, or social context. Conclusion: This review identified existing gaps in understanding the relationship between segregation and cognition. Future studies should carefully adopt the segregation measures, acknowledge the varying segregation experience among different racial/ethnic groups, and consider more social determinant factors in research. [ABSTRACT FROM AUTHOR]

This review evaluated single-case experimental design research that examined challenging behavior interventions utilizing punishment elements. Thirty articles published between 2013 and 2022 met study inclusion criteria. Study quality was also assessed. Through multiple levels of analysis (e.g., descriptive statistics, non-parametric statistics), we examined (a) participant and study trends, (b) differential outcomes related to temporal reinforcement approaches (antecedent, consequent, or combined reinforcement) applied alongside punishment element(s), (c) differential outcomes related to the punishment type (negative, positive) applied alongside reinforcement, and (d) effect sizes associated with study rigor across peer-reviewed and gray literature. Our results may tentatively suggest that, for certain situations, concurrently applying punishment with antecedent reinforcement approaches may coincide with significantly larger effect sizes compared to combined temporal reinforcement approaches, while positive punishment applied concurrently with reinforcement may coincide with larger but non-significant intervention effects. Most featured articles met rigor criteria, but larger effects were seen in peer-reviewed literature. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the impacts of water exercise training on functional and hemodynamic responses in HF patients. Methods: A systematic review and meta-analysis were conducted until February 15, 2024, using multiple databases. Mean difference (MD) with corresponding 95% confidence intervals (CIs) were calculated. Results: Sixteen studies, comprising 349 participants with HF, were included. Water exercise led to enhancements in peak VO2 (MD, 2.85 mL/kg/min; 95% CI, 1.89 to 3.80; p <.00001) and resting heart rate (MD, −4.16 bm; 95% CI, −6.85 to −1.46; p =.002) compared to no exercising controls. Water plus land exercise reduced resting heart rate (MD, −1.41 bm; 95% CI, −2.13 to −0.69; p =.0001) compared to land exercise alone. Furthermore, acute water exercises decreased resting heart rate (MD, −3.85 bm; 95% CI, −6.49 to −1.21; p =.004) and increased stroke volume (MD, 14.68 mL/beat; 95% CI, 8.57 to 20.79; p <.00001) and cardiac output (MD, 0.5 L/min; 95% CI, 0.27 to 0.73; p <.00001) compared to baseline. Conclusion: These findings suggest that water exercise holds promise as an effective intervention for enhancing functional capacity and hemodynamic parameters in individuals with HF, highlighting the importance of further research to optimize its implementation and elucidate long-term benefits. [ABSTRACT FROM AUTHOR]

Aims: To identify the safety incident reporting systems and processes used within care homes to capture staff reports of safety incidents, and the types and characteristics of safety incidents captured by safety incident reporting systems. Design: Systematic review following PRISMA reporting guidelines. Methods: Databases were searched January 2023 for studies published after year 2000, written in English, focus on care homes and incident reporting systems. Data were extracted using a bespoke data extraction tool, and quality was assessed. Data were analysed descriptively and using narrative synthesis, with types and characteristics of incidents analysed using the International Classification for Patient Safety. Data Sources: Databases were CINAHL, MEDLINE, PsycINFO, EMBASE, HMIC, ASSISA, Nursing and Allied Health Database, MedNar and OpenGrey. Results: We identified 8150 papers with 106 studies eligible for inclusion, all conducted in high‐income countries. Numerous incident reporting processes and systems were identified. Using modalities, typical incident reporting systems captured all types of incidents via electronic computerized reporting, with reports made by nursing staff and captured information about patient demographics, the incident and post‐incident actions, whilst some reporting systems included medication‐ and falls‐specific information. Reports were most often used to summarize data and identify trends. Incidents categories most often were patient behaviour, clinical process/procedure, documentation, medication/intravenous fluids and falls. Various contributing and mitigating factors and actions to reduce risk were identified. The most reported action to reduce risk was to improve safety culture. Individual outcomes were often reported, but social/economic impact of incidents and organizational outcomes were rarely reported. Conclusions: This review has demonstrated a complex picture of incident reporting in care homes with evidence limited to high‐income countries, highlighting a significant knowledge gap. The findings emphasize the central role of nursing staff in reporting safety incidents and the lack of standardized reporting systems and processes. Implications for the Profession and/or Patient Care: The findings from this study can inform the development or adaptation of safety incident reporting systems in care home settings, which is of relevance for nurses, care home managers, commissioners and regulators. This can help to improve patient care by identifying common safety issues across various types of care home and inform learning responses, which require further research. Impact: This study addresses a gap in the literature on the systems and processes used to report safety incidents in care homes across many countries, and provides a comprehensive overview of safety issues identified via incident reporting. Reporting Method: PRISMA. Patient or Public Contribution: A member of the research team is a patient and public representative, involved from study conception. [ABSTRACT FROM AUTHOR]

Purpose: The current review examined the application of artificial intelligence (AI) and machine learning (ML) techniques in palliative care, specifically focusing on models used to identify potential beneficiaries of palliative services among individuals with chronic and terminal illnesses. Methods: A systematic review was conducted across four electronic databases. Five studies met inclusion criteria, all of which applied AI/ML models to predict outcomes relevant to palliative care, such as mortality or the need for services. Results: Of 1,504 studies screened, five studies used supervised ML algorithms, whereas one used natural language processing with a deep learning model to identify potential palliative care candidates. The most common AI/ML algorithms included neural network–based models, logistic regression, and tree-based models. Conclusion: AI and ML models offer promising avenues for identifying palliative care beneficiaries. As AI continues to evolve, its potential to reshape palliative care through early identification is significant, providing opportunities for timely and targeted care interventions. [Journal of Gerontological Nursing, 51(1), 7–14.] [ABSTRACT FROM AUTHOR]

We examined the association between low‐calorie sweeteners (LCS) consumption during preconception, pregnancy, and breastfeeding and child health outcomes. A systematic search of electronic databases in PubMed, Embase, Cumulated Index to Nursing and Allied Health Literature, the Cochrane Library, Scopus, Web of Science, PsycINFO, ProQuest Health and Medical, ClinicalTrials.gov, and Google Scholar was conducted up to 21 September 2023. A random effects model with restricted maximum likelihood estimation was used for the meta‐analysis. Seventeen eligible studies were included. The standardised mean difference (SMD) and 95% confidence interval (CI) in birth weight between those who frequently consumed LCS (≥1 serve/day) during pregnancy and those who did not consume LCS was 0.04 (0.00, 0.08) (four cohort studies). Any LCS consumption during pregnancy compared with no consumption was not associated with birth weight [SMD (95% CI) = 0.03 (−0.03, 0.08)] (four cohort studies). Any LCS consumption during pregnancy was not associated with body mass index z‐scores. The weighted mean difference (95% CI) was 0.00 (−0.05, 0.06) at birth, 0.06 (−0.29, 0.40) at 6 months, −0.04 (−0.19, 0.10) at 1 year, 0.00 (−0.16, 0.17) at 3 years, and 0.10 (−0.15, 0.34) at 7 years of the child age, compared with no intake (five cohort studies). The odds of being overweight at 1 year among children exposed to LCS during pregnancy was 1.19 (OR [95% CI]: 1.19 [0.81, 1.58]) compared with unexposed children (two cohort studies). The effect sizes were not precise for all the outcomes as the 95% CI indicated the effect estimates could range from small protective to a higher risk. The effect of LCS consumption on child behaviour and cognition was inconsistent. There is not enough evidence to confirm LCS consumption during pregnancy affects birth weight and risk of overweight in children. However, frequent consumption increased birth weight and the risk of overweight at different ages, though the effects were imprecise. More robust research evidence is required as the quality of evidence is low. Key messages: Evidence regarding the effect of perinatal low‐calorie sweeteners (LCS) consumption and child health is limited and inconclusive.Our systematic review and meta‐analysis showed that any LCS consumption during pregnancy was not associated with birth weight and the risk of overweight in childhood. However, frequent LCS consumption during pregnancy was associated with a small but imprecise increase in birth weight and body mass index z‐score at different ages.Evidence regarding the effect of maternal LCS consumption on child behaviour, cognition, and the risk of other chronic disease is limited.The overall quality of the evidence remains low, warranting further high‐quality research. [ABSTRACT FROM AUTHOR]

Breastfeeding practices require improvement. We performed a systematic review of randomised controlled trials (RCTs) and analytic observational studies to assess effects of mobile applications (apps) aiming to support and promote breastfeeding targeting pregnant women, mothers of infants or their partners, on breastfeeding outcomes. We searched MEDLINE, EMBASE, Cochrane CENTRAL and Association of Computing Machinery Digital Library from 1 July 2008 to 29 November 2022, with lack of coverage of the most recent period before publication date being a limitation of this review. We performed meta‐analyses of findings from RCTs on primary outcomes, namely early breastfeeding initiation, exclusive and any breastfeeding rates. Joanna Briggs Institute tools were used for risk of bias assessment. Six RCTs, one quasi‐experimental and two cohort studies, mainly from high‐income countries, were included. Most studies focused on maternal app usage starting from pregnancy. One study targeted fathers as app‐users. Population characteristics, such as parity or delivery mode, apps scope of content and applied active components varied between studies. Main methodological limitations of studies were baseline differences between groups and lack of blinding. Compared to controls, app usage tended to increase the odds of exclusive breastfeeding. This nonsignificant effect was most pronounced at 1–1.5 months (n = 1294, odds ratio 1.45 (95% Confidence Interval, CI 0.83, 2.54), with considerable heterogeneity between studies [I2 77%]), but less so at 3 and 6 months post‐partum. The odds of early breastfeeding initiation, any breastfeeding at all time points were similar among groups. However, two cohort studies reported increased odds of exclusive and/or any breastfeeding at different time points. In conclusion, evidence is insufficient to show sustained beneficial effects of breastfeeding promotion and support through mobile apps on breastfeeding rates. Key messages: Interventions aiming to promote and support breastfeeding through mobile apps are heterogeneous in terms of scope of content, active components used and mechanisms of action.Parental app usage tended to increase the odds of early exclusive breastfeeding, but no effects were observed on any breastfeeding.As development of digital interventions advances, more studies are needed to investigate the effects of digital tools on breastfeeding practices. These studies should take into account quality of such interventions and different clinical settings such as low‐ and middle‐income countries. [ABSTRACT FROM AUTHOR]

Household food insecurity (HFI) has been related to adverse maternal‐child health outcomes and mental health worsening during pregnancy. Few studies evaluated the temporal association between HFI and anxiety and depressive symptoms in pregnant women, and this association remains not completely understood. This study aimed to systematically review the association between HFI and symptoms of depression and anxiety in pregnant individuals. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022373615). Systematic searches were conducted on 10 electronic databases and grey literature. Two researchers independently conducted the study selection, data extraction process, and the risk of bias assessment. Random‐effects meta‐analysis models were used, and I2 > 40% indicated high heterogeneity across studies. Eighteen articles were included for the systematic review, comprising n = 27,882, and a total of 18,987 pregnant individuals aged between 14 and 45 years were included in the meta‐analysis. The prevalence of HFI reported in studies ranged from 12.6% to 62.1% (n = 17). The prevalence of depressive and anxiety symptoms ranged from 18% to 49% (n = 11) and 23% to 34% (n = 2), respectively. HFI during pregnancy was associated with increased odds of experiencing symptoms of depression [(OR: 2.52; 95% CI: 2.11–3.02), I2 = 73.23%]. The quality of evidence was very low due to high heterogeneity. Our findings highlighted the association between HFI and depression symptoms during pregnancy. Findings from this study suggest the importance of assessing HFI and mental health during pregnancy. Key messages: Increased anxiety and depressive symptoms frequently manifest in households with lower income levels, highlighting a notable correlation between socioeconomic status and mental health challenges.Household food insecurity (HFI) is associated with increased odds of experiencing depressive symptoms during pregnancy, presenting the intricate relationship between insufficient access to food resources and the exacerbation of mental health issues during pregnancy.Improving public policies focused on ensuring food security for pregnant individuals holds the potential to enhance positive psycho‐emotional health outcomes during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: This study examines the efficacy of positive psychology interventions (PPIs) for patients with chronic pain through a systematic review and meta-analysis. PPIs are defined as strategies that involve focusing on positive emotions, thoughts, and behaviors that improve mental health by increasing mental well-being and reducing psychological distress. Design: The search was conducted using the PubMed, Scopus, PsycINFO, and Cochrane Library databases. Main Outcome Measures: Subjective, psychological, and social well-being were used as indicators of mental well-being, and depression, anxiety, and stress symptoms were used as indicators of psychological distress. Results: Nine studies were included. Eight studies evaluated subjective well-being, seven evaluated depression, and three evaluated anxiety symptoms. No studies examined psychological well-being, social well-being, or stress. PPIs were found to be effective in promoting subjective well-being post-treatment (Hedges' g = 0.40; 95% CI [0.06, 0.73]) and reducing anxiety (Hedges' g = −0.32, 95% CI [-0.59, −0.06]), but no significant results were found for depression (Hedges' g = −0.23, 95% CI [-0.50, 0.04]). Conclusion: The included investigations, while limited, suggest the utility of PPIs in mitigating the psychological consequences of chronic pain. Researchers and practitioners are encouraged to implement PPI practices. [ABSTRACT FROM AUTHOR]

Resistance training is the most effective strategy to modify muscle architecture, enhancing sport performance and reducing injury risk. The aim of this study was to compare the effects of high loads (HL) versus lower loads (LL), maximal versus submaximal efforts, and high frequency (HF) versus low frequency (LF) on quadriceps architectural adaptations in team sports players. Five databases were searched. Vastus lateralis thickness, fascicle length and pennation angle, and rectus femoris thickness were analyzed as main outcomes. Overall, resistance training significantly improved muscle thickness and pennation angle, but not fascicle length. LL led to greater fascicle length adaptations in the vastus lateralis compared to HL (p=0.01), while no substantial differences were found for other load comparisons. Degree of effort and training frequency did not show meaningful differences (p>0.05). In conclusion, LL lengthen the fascicle to a greater extent than HL, and training with LL twice a week could maximize architectural adaptations, whereas the degree of effort does not appear to be a determinant variable on quadriceps architectural adaptations. [ABSTRACT FROM AUTHOR]

Trauma-related beliefs are theorized to contribute to the development and maintenance of psychosis symptoms. However, the evidence for this proposal has yet to be systematically reviewed. This article is the first to synthesize and meta-analyze studies examining associations between trauma-related beliefs and psychosis symptoms, including hallucinations, delusions, paranoia, and negative symptoms. A systematic database search of Medline, PsychINFO, Embase, Web of Science, CINHAL, and Cochrane identified a total of 15 articles that met the inclusion criteria for systematic review and 11 articles which met the inclusion criteria for meta-analysis. Separate random-effects meta-analyses were conducted for each psychosis symptom. Meta-analytic findings demonstrated a small to moderate association between trauma-related beliefs and hallucination severity (k = 7, r = 0.25, 95% CI 0.10–0.39), a moderate to large association with delusion severity (k = 8, r = 0.43, 95% CI 0.31–0.54), and large association with paranoia severity (k = 4, r = 0.58, 95% CI 0.49–0.66). Narrative synthesis findings indicate that evidence for an association between negative symptoms and trauma-related beliefs was inconclusive. The meta-analytic findings provide support for an association between trauma-related beliefs and positive psychosis symptoms. This provides evidence suggesting trauma therapies for psychosis that target these beliefs may improve distressing psychosis. However, further research adopting longitudinal designs and controlling for confounders is required to better establish causality, including mediation analysis of therapy trials. [ABSTRACT FROM AUTHOR]

Public health restrictions to protect physical health during the COVID-19 pandemic had unintended effects on mental health, which may have disproportionately affected some potentially vulnerable groups. This scoping review of qualitative research provides a narrative synthesis of new mothers' perspectives on their mental health during COVID-19 pandemic restrictions through pregnancy to the postpartum period. Database searches in PubMed, CINAHL, and PsycINFO sought primary research studies published until February 2023, which focused on new mothers' self-perceived mental health during the pandemic (N = 55). Our synthesis found that new mothers' mental health was impacted by general public health restrictions resulting in isolation from family and friends, a lack of community support, and impacts on the immediate family. However, public health restrictions specific to maternal and infant healthcare were most often found to negatively impact maternal mental health, namely, hospital policies prohibiting the presence of birthing partners and in-person care for their infants. This review of qualitative research adds depth to previous reviews that have solely examined the quantitative associations between COVID-19 public health restrictions and new mothers' mental health. Here, our review demonstrates the array of adverse impacts of COVID-19 public health restrictions on new mothers' mental health throughout pregnancy into the postpartum period, as reported by new mothers. These findings may be beneficial for policy makers in future public health emergency planning when evaluating the impacts and unintended consequences of public health restrictions on new mothers. [ABSTRACT FROM AUTHOR]

Purpose: This study had three objectives: (a) to verify if Grodzinsky et al.'s (1993) findings of worse comprehension of personal than reflexive pronouns can be replicated in a larger meta-analysis of individual participant data, (b) to examine if the heterogeneity found in the patterns of pronoun comprehension in agrammatism can be attributed to task effects, and (c) to evaluate the risk of bias in the reviewed studies. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic literature search was performed to identify studies examining the personal--reflexive pronoun dissociation in agrammatic comprehension. Seven studies met the search criteria and were included in the meta-analysis. For each participant, individual accuracy scores for the comprehension of personal and reflexive pronouns were extracted in addition to information on the study methods. Individual accuracy data were analyzed using the Fisher's exact test and the binomial test. The risk of bias in the studies was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. Results: The meta-analysis had three main findings: (a) The majority of the persons with agrammatic aphasia (89%) had no dissociation between the comprehension of personal and reflexive pronouns; (b) 8% revealed a pattern consistent with a neuropsychological dissociation, faring worse on the comprehension of personal than reflexive pronouns; and (c) 2% performed worse on reflexive than personal pronouns. The type of the task used affected pronoun comprehension accuracy and accounted for the heterogeneity in the patterns of pronoun comprehension attested across the different participants. Conclusions: Taken together, the meta-analysis did not support a dissociation between personal and reflexive pronoun comprehension in agrammatic comprehension. When confirmed, the dissociation was driven by task effects. The clinical implications of these findings were discussed together with implications to minimize the risk of bias in future examinations of the topic. [ABSTRACT FROM AUTHOR]

Purpose: Most LGBTQIA + 2 studies focus on the core sexually and gender diverse population without exploring the peripheral familial perspectives. Current research needs to explore parental experiences of parenting a LGBTQIA+2 child, since parents undergo an identity change after their child's disclosure. This parental identity change may affect parental well-being and add to the existing stress of parenting a LGBTQIA + 2 child. Methods: This paper uses the identity process theory (IPT) to review 18 studies on parental narratives to highlight the change in parental identity. Databases were searched for first-hand parenting experiences and shortlisted articles were qualitatively synthesized. Findings: We identified six main themes: I) Parental identity change is triggered by a child's disclosure. II) Parental identity change drives parental emotions that evolve from initial anger, shock, fear, concern, grief, etc. to eventual acceptance of their child. III) Parental identity and emotions change, as for any life change process, across assimilation, accommodation, adjustment, and evaluation phases of the IPT. IV) Parental identity change is motivated by continuity, coherence, self-efficacy, belongingness, distinctiveness, meaning and self-esteem principles of the IPT. V) Parental identity influences parental micro-individual, meso-interactional and macro-societal interactions of the IPT framework. VI) Parental mental well-being may be affected across the assimilation, accommodation, adjustment phases of the IPT before eventual acceptance of the child in the evaluation phase. Conclusions: Parental lived experiences require a stronger consideration today within the wider, non-white, contexts. The effect of identity change on parental mental well-being and its intergenerational effect needs to be explored within the context of the IPT. Parental narratives will contribute towards creating appropriate counselling toolkits and interventions for health care providers and parents of LGBTQIA + 2 children. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic began in early 2020 and became a global health crisis with devastating impacts. This scoping review maps the key findings of research about the pandemic that has operationalized intersectional research methods around the world. It also tracks how these studies have engaged with methodological tenets of oppression, comparison, relationality, complexity, and deconstruction. Methods: Our search resulted in 14,487 articles, 5164 of which were duplicates, and 9297 studies that did not meet the inclusion criteria were excluded. In total, 14 articles were included in this review. We used thematic analysis to analyse themes within this work and Misra et al. (2021) intersectional research framework to analyse the uptake of intersectional methods within such studies. Results: The research related to the COVID-19 pandemic globally is paying attention to issues around the financial impacts of the pandemic, discrimination, gendered impacts, impacts of and on social ties, and implications for mental health. We also found strong uptake of centring research in the context of oppression, but less attention is being paid to comparison, relationality, complexity, and deconstruction. Conclusions: Our findings show the importance of intersectional research within public health policy formation, as well as room for greater rigour in the use of intersectional methods. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The use of restrictive interventions is described as a violation of patients' rights and autonomy. It must only be used as a last resort to manage dangerous behaviour, to prevent or reduce the risk of mental health patients harming themselves or others.International mental health policy and legislation agree that when restrictive interventions are applied, the least restrictive alternative should be chosen. What the paper adds to existing knowledge?: The results are ambiguous, as to which restrictive intervention is preferred over others, but there are tendencies towards the majority preferring observation, with mechanical restraint being the least preferred.To make the experience less intrusive and restrictive, certain factors are preferred, such as a more pleasant and humane seclusion room environment, staff communicating during the application and staff of same gender applying the intervention. What are the implications for practice?: When applying restrictive interventions, mental health professionals should consider environment, communication and duration factors that influence patient preferences, such as the opportunity to keep some personal items in the seclusion room, or, when using restraint, to communicate the reason and explain what is going to happen.More research is needed to clarify patients' preferences regarding restrictive interventions and their views on which are the least restrictive. Preferably, agreement is needed on standard measures, and global use of the same definition of restrictive interventions. Introduction: The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well‐known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective. Aim: To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital. Method: An integrative review informed by the PRISMA statement and thematic analysis were undertaken. Results: There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences. Discussion: There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions. Implications for Practice: More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions. [ABSTRACT FROM AUTHOR]

Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread musculoskeletal pain and various associated symptoms. Non-pharmacological interventions have gained attention for managing FMS and improving patient outcomes. We reviewed past research to investigate the effects of traditional Chinese martial arts (TCMA) and stretching training (ST) on symptoms of patients with FMS. We searched Web of Science, Medline via PubMed, the Cochrane Library, and EMBASE from their inceptions to June 1, 2023. Across selected studies, we evaluated TCMA and ST using Fibromyalgia Impact Questionnaire (FIQ) scores, pain symptoms, fatigue levels, and sleep quality as outcome measures. Compared with control groups, participants receiving TCMA and ST interventions showed significantly lower FIQ scores (Standard Mean Difference (SMD) = -3.01, 95% Confidence Interval (CI) [−4.83,−1.19]), improved pain symptoms (SMD = −0.77, 95% CI [−1.07,−0.47]), less fatigue (SMD = 1.31, 95% CI [0.50,2.11]), and enhanced sleep quality (SMD = −0.55, 95% CI [−0.97,−0.12]). Subgroup analyses revealed that, irrespective of intervention duration, both TCMA and ST interventions were effective in relieving pain symptoms in these patients. ST interventions showed significant improvement in fatigue symptoms, while TCMA interventions positively influenced sleep quality. These findings highlight potential non-pharmalogical benefits of TCMA and ST interventions in managing FMS. However, future research should explore the optimal duration, frequency, intensity, and types of interventions for TCMA and ST and design targeted exercise intervention programs to study the effects of these interventions on different characteristics of FMS patients. Attention should be given to the effects of short-term interventions on improving fatigue symptoms, sleep quality, and pain relief, to provide more personalized and effective FMS treatment plans. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize current literature regarding the impact of social vulnerability on pregnancy-related substance use detection in the United States and highlight disparities in substance use detection practices. Clinicaltrials.gov, Google Scholar, PubMed (includes MEDLINE), and Cochrane Library databases were searched using the following Medical Subject Headings (MeSH): (["pregnancy" or "prenatal"] AND ["substance use screening" or "urine toxicology testing" or "toxicology testing" or "urine drug screening" or "CRAFFT" or "4P's" or "4P's Plus" or "NIDA Quick Screen" or "DAST-10" or "SURP-P" or "WIDUS"], AND ("bias" or "disparities" or "social vulnerability"]). The search included systematic reviews, prospective and retrospective studies, randomized controlled trials, case studies, and qualitative and quantitative research from January 2014 through November 2023. Selected literature was limited to studies published in English, which included a study population of either pregnant individuals or pregnancy health care providers in the United States, and that were focused on inequities in pregnancy substance use detection. Using Covidence, three authors screened abstracts, and two screened full articles for inclusion. The included studies were evaluated for quality of evidence using the mixed methods appraisal tool. The search yielded 4,188 manuscripts; 37 were eligible for full review. A total of 18 manuscripts were included based on the relevancy of the topic. The most common social vulnerability domain identified was minority status (17/18), followed by socioeconomic status (11/18), household characteristics (8/18), and housing type (1/18). Social vulnerability plays a role in substance use detection among pregnant individuals. Most notably, race and ethnicity, age, and public insurance lead to increased rates of detection, though most individual factors need to be studied in greater depth. This study was registered with PROSPERO (PROSPERO ID CRD42022352598), the International Prospective Register of Systematic Reviews. Key Points Socially vulnerable pregnant individuals are more likely to receive substance use screening or urine toxicology testing. Race, ethnicity, age, and insurance influence substance use detection disparities. More research is needed to understand how other characteristics influence disparities in substance use detection. [ABSTRACT FROM AUTHOR]

Romantic relationships are key to our health, yet recent reviews of relationships research show that sexual and/or gender diverse people and other traditionally under-represented groups are frequently excluded. Articles published from 2016 to 2020 in four relationships journals were reviewed to address the overall representation of sexual and gender minority (SGM) respondents (k = 891), and discuss the specific social identities included in U.S. samples (k = 505). First, only 37% of samples reported gender and sexual orientation, 21% of samples included SGM respondents in analyses, and 6% of samples excluded SGM respondents from the data. Second, samples were, on average, 77.4% White, 13.3% Hispanic, 58.8% (cisgender) women, 41.0% (cisgender) men, and 89.6% heterosexual. Consideration of intersecting identities was rare. We make recommendations to improve reporting and the representation of diverse identities. For social science to reflect the diversity of experiences present in society at large requires more intentional, reflective, and consistent consideration of diverse identities. [ABSTRACT FROM AUTHOR]

Aims: Cognitive frailty refers to the coexistence of physical frailty and cognitive impairment in older adults, without a concurrent diagnosis of Alzheimer's disease or other dementias. This review aims to evaluate the prevalence of CF subtypes and identify influencing factors among Chinese older adults. Methods: The following databases were searched: PubMed/Medline, Embase, Cochrane Library, WOS, PsycINFO and CNKI et al (1 January 2001 to 20 October 2022). The risk of bias was assessed using the Agency for Healthcare Research and Quality Evidence‐based Practice Center Methods Guide. Stata 17.0 software was used to pool the prevalence of cognitive frailty, and the pooled odds ratio and 95% CI of the influencing factors were calculated. Results: The meta‐analysis (56 studies and 80,320 participants) revealed the following prevalence rates: CF (18.9%), reversible CF (19.5%), potentially reversible CF (17.5%), CF in community‐dwelling older adults (14.3%), CF in nursing homes (22.7%) and CF in older inpatients (25.2%). Influential factors identified included age, gender, education, nutrition, depression, exercise, sleep and comorbidity. Conclusions: The prevalence of CF among Chinese older adults is notably high, and it probably underestimates the prevalence of reversible cognitive frailty. It is crucial to encourage adherence to healthy behaviours, as it can effectively reduce and delay the onset of cognitive frailty. Summary statement: What is already known about this topic? (Include key points and/or knowledge gaps) Older patients with cognitive frailty (CF) face higher risks of mortality, dementia and disability.CF has two subtypes: reversible cognitive frailty (RCF) and potential reversible cognitive frailty (PRCF). What this paper adds (research findings/key new information): The prevalence of CF is high in China, especially RCF.The incidence of CF in hospitalized older individuals is higher than that in community‐dwelling and nursing home older individuals. The implications of this paper (how findings influence or can be used to change policy/practice/research/education): Screening for CF should focus on RCF, and timely intervention and multidimensional management during the pre‐frailty and subjective cognitive decline stages are crucial.Routine screening for CF among hospitalized older adults is crucial.It is essential to focus on CF in non‐geriatric individuals with coexisting chronic diseases. [ABSTRACT FROM AUTHOR]

Aim: To explore what is known about nurses' experiences and perceptions of running nurse‐led clinics. Background: Nurse‐led clinics were established to address health care needs. In collaboration with medical practitioners, advanced practice nurses may take a selected group of patients and manage their ongoing healthcare independently. Their experiences in running nurse‐led clinics directly impact patient satisfaction and clinical outcomes. Design: Scoping review of the peer‐reviewed literature. Data Source: Systematic search through CINAHL, Medline, PsycINFO and Web of Science databases from January 2010 to September 2023. Review Methods: This scoping review is guided by the updated methodological guidance for the conduct of scoping review from Joanna Briggs Institute. Results: Of 2747 retrieved articles, 15 were included in this review. Synthesis of the findings revealed that nurses believed implementing nurse‐led clinics was beneficial to themselves, patients, and healthcare systems. However, they faced challenges in running nurse‐led clinics, including insufficient support, teamwork obstacles and lack of role recognition. Conclusion: Nurses need to be proactive in promoting their clinics and overcoming challenges. Healthcare organizations are responsible for creating a positive culture to support nurse‐led services. Future research should focus on ways to increase global awareness of nurse‐led clinics. Summary statement: What is already known about this topic? Nurse‐led clinics were introduced to reduce medical practitioners' workload, bridge care gaps and address the pressures of healthcare systems.Nurses manage their own patient caseload and have increased autonomy.Nurses' experiences and perceptions of running nurse‐led clinics directly impact on patient satisfaction and clinical outcomes. What this paper adds? There are limited insights into experiences and perceptions of nurse‐led clinics from nurses' perspectives.Nurses perceived nurse‐led clinics empowered them personally and professionally, promoted teamwork, patient‐centred holistic care and reduced burdens on medical practitioners and healthcare systems.Nurses faced challenges in running nurse‐led clinics, including insufficient training and support and lack of role recognition. The implications of this paper: Nurse‐led clinics should be promoted globally through education and research.Healthcare organizations should provide sufficient support for nurses to implement and run nurse‐led clinics.Future studies should identify enablers and barriers of nurse‐led clinics, which will guide organizations to have strategies in place to enhance nurse‐led clinics. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of nonpharmacological therapies on nutrition status, complications and quality of life in head and neck cancer patients and to provide a basis for clinical practice. Methods: This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analysis statement. Ten databases were systematically searched for all available articles from construction to November 2023. Two researchers independently conducted literature screening, data extraction and quality evaluation. Cochrane Review Manager 5.3 was used for meta‐analysis. Results: Finally, 27 RCT studies including 2814 patients with head and neck cancer were included. Five categories of interventions were used: nutritional support, exercise, swallowing function training, psychological intervention and low‐level laser therapy. Nonpharmacological interventions can improve body weight loss in patients with HNC at the end of treatment (MD: 1.66 kg; 95% CI: 0.80 to 2.51), and subgroup analysis showed that nutritional support, psychological intervention and low‐level laser therapy were effective. Nonpharmacological interventions can also ameliorate decreases in BMI (MD: 0.71; 95% CI: 0.16 to 1.26) and reduce the incidence of malnutrition (RR: 0.76; 95% CI: 0.67 to 0.86), oral mucositis (RR: 0.54; 95% CI: 0.37 to 0.80) and gastrointestinal complications (RR: 0.61; 95% CI: 0.38 to 0.96) during radiotherapy; however, no significant differences were found in other complications and quality of life. Conclusion: Nonpharmacological interventions can improve the nutrition status of patients with head and neck cancer and reduce the incidence of severe oral mucositis and gastrointestinal complications during radiotherapy but have no significant impact on quality of life. [ABSTRACT FROM AUTHOR]

This systematic review aimed to evaluate the effectiveness of psychological behavioral therapies to improve behaviors of autistic children during dental visits. Screening, data extraction, risk-of-bias assessment, and evaluation of certainty of evidence were performed by two independent reviewers. Eighteen studies were ultimately included. On average 56% (95% confidence interval, 33.95–78.29) and 64% (95% confidence interval 47.24–81.80) of autistic children can cooperate with dental examination with an oral mirror in the first and second visits, respectively. Visual pedagogy did not improve the proportion of autistic children who can accept dental examinations. Inconsistent results were also identified for Treatment and Education of Autistic and related Communication-handicapped CHildren, Picture Exchange Communication System, Applied Behavior Analysis, video modeling, distractions, and other conventional behavioral management techniques. Many studies were of small sample size, lacked a control group, did not account for autism spectrum disorder severity, comorbidities, previous dental experience or other confounders, and had a high risk of bias. The evidence supporting the use of psychoeducation techniques to improve the dental experience of autistic children is limited and of very low certainty. Further research with larger scale studies and appropriate control groups is needed to enhance the certainty of evidence in this field. This research review looked at how well different psychological behavioral therapies help improve the behavior of autistic children during dental visits. The researchers studied 18 different studies and found that, on average, about 56% of autistic children were able to cooperate with a dental exam using an oral mirror during their first visit. The number increased to about 64% during their second visit. However, using visual pedagogies or teaching aids did not seem to make a big difference in how many children could accept the dental exams. The results for other psychological behavioral techniques were also inconsistent, including Treatment and Education of Autistic and related Communication-handicapped CHildren, Picture Exchange Communication System, Applied Behavior Analysis, video modeling, and distractions. Many of the studies were small and did not include a comparison group. They also did not consider factors like how severe the autism was, other conditions the children had, or their previous dental experiences. Because of these limitations, the evidence supporting the use of psychological behavioral techniques to improve dental visits for autistic children is limited and uncertain. More research with larger studies and proper control groups is needed to better understand this topic. [ABSTRACT FROM AUTHOR]

Betaine supplementation, a dietary practice that possesses potential effects on exercise performance, has undergone extensive study. This study aimed to systematically review and meta-analyse betaine supplementation's effects on exercise performance. We searched PubMed, Web of Science, Scopus, and Google Scholar, focusing on studies comparing chronic betaine to a placebo in healthy humans aged 15–60 years, measuring exercise outcomes. Studies with acute betaine supplementation, no control group, or animals were excluded. Quality assessment was done using the Cochrane Risk of Bias Tool, and a random-effects model was employed for the meta-analysis. The review included 17 studies with 317 participants (21% female). The results revealed a significant effect size of 0.47 (95% CI 0.04 to 0.89) for maximal strength (1RM, 3RM, maximal isokinetic or isometric force), particularly in the lower body (SMD: 0.49, 95% CI 0.01 to 0.98). No significant effects were found for upper body strength, cycling sprint power, bench press throws power, or muscular endurance. However, vertical jumping performance improved significantly (SMD: 0.36, 95% CI 0.03 to 0.69) after excluding a low-quality study. In conclusion, betaine supplementation for at least 7 days significantly enhances muscular strength, especially lower body strength, and shows potential in improving vertical jumping performance. [ABSTRACT FROM AUTHOR]

Women experiencing homelessness may face heightened vulnerabilities and encounter barriers to accessing social services, which could perpetuate their situation and exacerbate the impact on their physical and mental health. This research aims to identify barriers and opportunities for women experiencing homelessness to access social care services based on a systematic integrative literature review. The inclusion criteria encompassed scientific articles and gray literature, focusing on studies of the access to social care services for women experiencing homelessness. English and Spanish documents from the past 20 years were considered, excluding publications lacking full‐text access. The search was conducted until April 30, 2024, across 6 databases including Web of Science, Scopus, PsycINFO, Social Services Abstracts, Sociology, and Cochrane. Article quality was assessed before inclusion to mitigate bias. Data analysis employed a narrative approach using categories and subcategories. Thirty‐eight publications were included, consisting of 36 articles and 2 theses. These publications predominantly relied on qualitative methods. Two main areas and eight categories emerged, covering structural, institutional, social, and personal barriers and opportunities, with 36 subcategories identified. Study limitations include a predominance of women in the study sample who had access to social care services, making it hard to include those experiencing hidden homelessness. Nonetheless, the research underscores the significance of gender‐specific barriers and opportunities in access to social care. The need for gender‐sensitive and intersectional policies is emphasized, as well as professional practices and training, to enhance the well‐being of women experiencing homelessness and improve their access to services. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, paracetamol was widely recommended in different clinical settings, and sometimes advised over non-steroidal anti-inflammatory drugs (NSAIDs). These recommendations sparked a strong debate, with reports suggesting either potential benefits or harms for the individuals infected with SARS-CoV-2. As no systematic review is available, we performed a meta-analysis to estimate the impact of paracetamol on COVID-19 clinical outcomes compared to a placebo, no use, or NSAIDs. Methods: We searched PubMed, Scopus, Web of Science, and ClinicalTrials.gov for randomized trials or observational studies evaluating any COVID-19 clinical outcome. Data were combined using a generic inverse-variance approach. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to determine the certainty of evidence for each outcome. Results: One randomized trial and five observational studies, enrolling over 34,000 patients, were included. Overall, as compared to the patients using NSAIDs or receiving no treatment, the individuals who received paracetamol showed no significant differences in the risk of death (summary relative risks 0.93 and 0.91, respectively: both p > 0.05), need to transfer to the intensive care unit, need for respiratory support, or cardiovascular or renal complications. All studies showed a high risk of bias, with a low overall quality of evidence. Conclusions: This meta-analysis found no evidence of harmful or beneficial effects of paracetamol on main COVID-19-related outcomes. Also, the current literature does not provide sufficient data to support a preferential choice between paracetamol and NSAIDs for COVID-19 symptoms management. Further research is needed to confirm the present findings and provide critical insights on the policies to adopt in the case of future pandemics. [ABSTRACT FROM AUTHOR]

Background: A bundle is a set of three to five evidence-based interventions designed to improve the quality and outcomes of care processes. Numerous international studies have evaluated the effectiveness of Bundles/Care Bundles (BCB) in reducing morbidity and mortality. The Institute for Healthcare Improvement (IHI) has defined the concept of a bundle but has not outlined the development process. Objective: To identify the BCB development process in clinical risk scenarios from September 2005 to September 2023. Methods: A systematic review was conducted following PRISMA guidelines to identify studies describing the BCB development process in managing clinical risk situations. The databases consulted included PubMed, Embase, and CINAHL, along with manual searches on institutional websites. Relevant studies concerning the BCB development process were included. Results: A total of 1372 studies were retrieved, of which 16 were included. Duplicates were removed, and titles and abstracts were analyzed. The identified methods for BCB development include IHI guidelines, expert opinions, international guidelines, and flowcharts. The most common BCBs relate to the prevention of ventilator-associated pneumonia, surgical site infections, catheter-associated infections, and sepsis. Conclusions: This study has identified the development processes of Care Bundles (BCBs) in clinical risk scenarios, highlighting how these tools facilitate compliance monitoring among members of the healthcare team. The review has revealed effective methods for designing evidence-based BCBs. However, the scarcity of studies on the methodology for developing BCBs is a limitation, suggesting the need for further research. In Italy, there is a growing interest in the use of care packages. It is essential to encourage research that optimizes the effectiveness of intervention strategies. [ABSTRACT FROM AUTHOR]

The present study has two main goals: to conduct a systematic review of musculoskeletal injuries experienced by badminton players, and to examine the management of such injuries. Searches were conducted of the PROSPERO, PubMed, Scopus, and SPORTDiscus databases, from their inception until March 2023. The papers analysed were all based on a study population consisting of individuals aged 18 years or more, diagnosed with badminton-related injuries. The methodological quality assessments was using the Newcastle-Ottawa Scale and REVMAN. A total of 28 studies were included in the systematic review. In total, the analysis included 2435 participants. Of these athletes, 35.6% (1012) were female and 64.4% (1503) were male. By type of injury, sprains were the most commonly studied and the most prevalent, accounting for 36.06% of the sample. These were followed by muscle injuries, representing 23.86% of the total. Injuries to the joints were the least prevalent, accounting for 4.97% of the sample. Lower limb injuries accounted for 52.15% of the total. Of these, ankle injuries were the most common. Despite the generally low quality of the studies considered, the evidence suggests that musculoskeletal injuries, especially to the lower limb, most commonly affect badminton players of all levels. [ABSTRACT FROM AUTHOR]

This study verified the relationship between internal load (IL) and external load (EL) and their association on injury risk (IR) prediction considering machine learning (ML) approaches. Studies were included if: (1) participants were male professional soccer players; (2) carried out for at least 2 sessions, exercises, or competitions; (3) correlated training load (TL) with non-contact injuries; (4) applied ML approaches to predict TL and non-contact injuries. TL included: IL indicators (Rating of Perceived Exertion, RPE; Session-RPE, Heart Rate, HR) and EL indicators (Global Positioning System, GPS variables); the relationship between EL and IL through index, ratio, formula; ML indicators included performance measures, predictive performance of ML methods, measure of feature importance, relevant predictors, outcome variable, predictor variable, data pre-processing, features selection, ML methods. Twenty-five studies were included. Eleven addressed the relationship between EL and IL. Five used EL/IL indexes. Five studies predicted IL indicators. Three studies investigated the association between EL and IL with IR. One study predicted IR using ML. Significant positive correlations were found between S-RPE and total distance (TD) (r = 0.73; 95% CI (0.64 to 0.82)) as well as between S-RPE and player load (PL) (r = 0.76; 95% CI (0.68 to 0.84)). Association between IL and EL and their relationship with injuries were found. RPE, S-RPE, and HR were associated with different EL indicators. A positive relationship between EL and IL indicators and IR was also observed. Moreover, new indexes or ratios (integrating EL and IL) to improve knowledge regarding TL and fitness status were also applied. ML can predict IL indicators (HR and RPE), and IR. The present systematic review was registered in PROSPERO (CRD42021245312). [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is one of the most serious and incapacitating mental diseases that can result from trauma exposure. The exact prevalence of this disorder is not known as the literature provides very different results, ranging from 2.5% to 74%. The aim of this umbrella review is to provide an estimation of PTSD prevalence and to clarify whether the prevalence depends on the assessment methods applied (structured interview v. self-report questionnaire) and on the nature of the traumatic event (interpersonal v. not-interpersonal). A systematic search of major databases and additional sources (Google Scholar, EBSCO, Web of Science, PubMed, Galileo Discovery) was conducted. Fifty-nine reviews met the criteria of this umbrella review. Overall PTSD prevalence was 23.95% (95% confidence interval 95% CI 20.74–27.15), with no publication bias or significant small-study effects, but a high level of heterogeneity between meta-analyses. Sensitivities analyses revealed that these results do not change after removing meta-analysis also including data from underage participants (23.03%, 95% CI 18.58–27.48), nor after excluding meta-analysis of low quality (24.26%, 95% CI 20.46–28.06). Regarding the impact of diagnostic instruments on PTSD prevalence, the results revealed a lack of significant differences in PTSD prevalence when structured v. self-report instruments were applied (p = 0.0835). Finally, PTSD prevalence did not differ following event of intentional (25.42%, 95% CI 19.76–31.09) or not intentional (22.48%, 95% CI 17.22–27.73) nature (p = 0.4598). The present umbrella review establishes a robust foundation for future research and provides valuable insights on PTSD prevalence. [ABSTRACT FROM AUTHOR]

Introduction: To explore the existing research on sexual health experiences of sexual and gender minority women (SGMW) post-curative cancer treatment. Methodology: This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Four articles that focused on sexual health experiences of SGMW post-curative cancer treatment were included. Results: Four themes were identified: (a) sexual function; (b) sexual orientation and gender identity, including disclosure and health care provider reactions; (c) relationship dynamics, such as relationship status and the quality of romantic relationships; and (d) body image. Discussions: The findings underscore substantial challenges faced by SGMW cancer survivors in achieving optimal sexual well-being, impacting their access to post-treatment care. This study advocates for more expansive research efforts involving diverse participant cohorts, extending beyond breast cancer, to gain deeper insights into these critical issues. [ABSTRACT FROM AUTHOR]

Aim: To synthesize evidence regarding the effectiveness of technology‐based psychosocial interventions in improving health‐related outcomes among family caregivers of stroke survivors. Design: A systematic review and meta‐analysis was reported by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Methods: Randomized controlled trials that investigated the effects of psychosocial interventions delivered through information and communication technologies on self‐efficacy, caregiving competence, caregiver burden, perceived social support, anxiety, depression, health‐related quality of life and cost‐effectiveness were included. Two researchers independently selected studies, extracted data, and appraised the quality of the included studies. Subgroup analysis, sensitivity analysis, and narrative synthesis were conducted. Data Sources: Ten electronic databases (PubMed, CENTRAL, Web of Science, Scopus, CINHAL, Embase, Institution of Electrical Engineers Xplore, Ovid Medline, PsycINFO, ProQuest Dissertations and Thesis) were searched up to February 2023. Results: Nineteen studies involving 1717 participants fulfilled the eligibility criteria. Technology‐based psychosocial interventions significantly improved self‐efficacy (SMD =.62), caregiving competence (SMD =.55), depression (SMD = −.25) and anxiety (SMD = −.35). However, perceived social support, caregiver burden, and health‐related quality of life did not show significant improvements. Subgroup analyses revealed that the interventions, lasting from 4 to 6 weeks and encompassing comprehensive contents, exhibited larger effect sizes. None of the studies measured cost‐effectiveness. Conclusion: The technology‐based psychosocial interventions are effective in enhancing self‐efficacy and caregiving competence, as well as alleviating anxiety, and depression among family caregivers of stroke survivors. Future research should investigate interventions delivered through various digital platforms using well‐designed RCTs with in‐depth qualitative data collection and measurement of health and cost‐effectiveness outcomes. Impact: Through psychosocial interventions, healthcare providers in clinical and community settings, particularly nurses, could incorporate technologies into current stroke care practices. Patient or Public Contribution: It is not applicable as this is a systematic review. Registration: The protocol was registered on PROSPERO (CRD42023402871). [ABSTRACT FROM AUTHOR]

Background: Health‐related decision‐making is a complex process given the variability of treatment options, conflicting treatment plans, time constraints and variable outcomes. This complexity may result in patients experiencing decisional regret following decision‐making. Nonetheless, literature on decisional regret in the healthcare context indicates inconsistent characterization and operationalization of this concept. Aim(s): To conceptually define the phenomenon of decisional regret and synthesize the state of science on patients' experiences with decisional regret. Design: A concept analysis. Methods: Rodgers' evolutionary method guided the conceptualization of this review. An interdisciplinary literature search was conducted from 2003 until 2023 using five databases, PubMed, CINAHL, Embase, PsycINFO and Web of Science. The search informed how the concept manifested across health‐related literature. We used PRISMA‐ScR checklist to guide the reporting of this review. Results: Based on the analysis of 25 included articles, a conceptual definition of decisional regret was proposed. Three defining attributes underscored the negative cognitive‐emotional nature of this concept, post‐decisional experience relating to the decision‐making process, treatment option and/or treatment outcome and an immediate or delayed occurrence. Antecedents preceding decisional regret comprised initial psychological or emotional status, sociodemographic determinants, impaired decision‐making process, role regret, conflicting treatment plans and adverse treatment outcomes. Consequences of this concept included positive and negative outcomes influencing quality of life, health expectations, patient‐provider relationship and healthcare experience appraisal. A conceptual model was developed to summarize the concept's characteristics. Conclusion: The current knowledge on decisional regret is expected to evolve with further exploration of this concept, particularly for the temporal dimension of regret experience. This review identified research, clinical and policy gaps informing our nursing recommendations for the concept's evolution. No Patient or Public Contribution: This concept analysis examines existing literature and does not require patient‐related data collection. The methodological approach does not necessitate collaboration with the public. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea, or menstrual pain, is a subjective experience, and can only be assessed by patient‐reported outcomes. These instruments should be reliable, valid and responsive. Aim: To identify and critically appraise the available evidence for the measurement properties of specific patient‐reported outcome measures used for dysmenorrhea. Methods: The PRISMA statement was used to report this systematic review. Databases searched were PubMed, SCOPUS, CINAHL, Web of Science, ScienceDirect and Google Scholar (April 2021; updated on February 2023). Original studies with primary data collection, with no restriction on language and publication date that reported psychometric properties of one or more dysmenorrhea‐related patient‐reported outcome measure. The literature searches, selection of studies, data extraction and assessment of the risk of bias were performed independently by two reviewers and followed the COSMIN guidelines. Results: Thirty studies were analysed in this review, and 19 patient‐reported outcome measures were evaluated. The instruments varied in relation to the measured construct and measurement properties (validity, reliability and responsiveness). The methodological quality of the studies and the quality of evidence of the patient‐reported outcome measures were variable. Among the 13 studies that reported the development of patient‐reported outcome measures, most had inadequate methodological quality, and the overall rating was insufficient or inconsistent. Conclusions: The Dysmenorrhea Symptom Interference (DSI) scale was the only identified patient‐reported outcome measure that has the potential to be recommended because of its sufficient rating combined with moderate quality of evidence for content validity. Future studies should further evaluate the measurement properties of the existing patient‐reported outcome measures, or develop new patient‐reported outcome measures following the COSMIN methodology. Patient or public contribution: Not applicable as this is a systematic review. Trial registration: PROSPERO protocol: CRD42021244410. Registration on April 22, 2021. [ABSTRACT FROM AUTHOR]

Imagery training is well-established in sports, rehabilitation, and work settings. Both classic and recent meta-analyses confirm that it can improve motor performance and promote motor learning in adults. Findings from studies focusing on children and adolescents, however, are ambiguous, and it is not clear whether imagery training has an impact on performance and learning in individuals of younger ages. Given that the potential impact of imagery training in children and adolescents has yet to be determined, we conducted a meta-analysis to extend knowledge on the effectiveness of imagery training in this population. We included imagery training studies investigating healthy children or adolescents at an age of 6–18 and focusing on a motor task, which resulted in 19 studies and 110 effect sizes. Our analysis revealed an overall medium positive effect for imagery training of Cohen's d = 0.494, 95% CI [0.287, 0.701]. The results demonstrate that imagery training can improve motor performance in children and adolescents. Future research is needed to further differentiate the effects across age, task, or developmental aspects, and to provide more elaborate recommendations for applied settings such as physical education, rehabilitation, or competitive sports. [ABSTRACT FROM AUTHOR]

Breathing techniques are predicted to affect specific physical and psychological states, such as relaxation or activation, that might benefit physical sport performance (PSP). Techniques include slow-paced breathing (SPB), fast-paced breathing (FBP), voluntary hyperventilation (VH), breath-holding (BH), and alternate- and uni-nostril breathing. A systematic literature search of six electronic databases was conducted in April 2022. Participants included were athletes and exercisers. In total, 37 studies were eligible for inclusion in the systematic review, and 36 were included in the five meta-analyses. Random effects meta-analyses for each breathing technique were computed separately for short-term and longer-term interventions. Results showed that SPB and BH were related to improved PSP, with large and small effect sizes for longer-term interventions, respectively. In short-term interventions, SPB, BH, and VH were unrelated to PSP. There was some evidence of publication bias for SPB and BH longer-term interventions, and 41% of the studies were coded as having a high risk of bias. Due to an insufficient number of studies, meta-analyses were not computed for other breathing techniques. Based on the heterogeneity observed in the findings, further research is required to investigate potential moderators and develop standardised breathing technique protocols that might help optimise PSP outcomes. [ABSTRACT FROM AUTHOR]

Goal setting is widely applied in sport. Whereas existing reviews have addressed the performance effects of goal setting, less is known about the concurrent psychological and psychophysiological effects. Therefore, we conducted a systematic review and meta-analysis that synthesised the effects of goal setting on task performance and various psychological and psychophysiological outcomes in sport. Searches returned 17,841 articles, with 27 meeting eligibility criteria. A meta-analysis of the performance effects and a narrative synthesis of the psychological and psychophysiological effects were undertaken. Process goals had the largest effect on performance (d = 1.36) compared to performance goals (d = 0.44) and outcome goals (d = 0.09). No significant difference in performance was found between specific (d = 0.37) and non-specific goals (d = 0.72). Process goals also had large effects on self-efficacy (d = 1.11), whereas studies guided by self-regulation theory (k = 5) produced the greatest performance enhancements (d = 1.53). It was rarely possible to draw conclusions regarding the effects of goal setting on psychological/psychophysiological outcomes due to a lack of cross study evidence. Nevertheless, these findings provide important insights to guide research and practice on the use of goal setting to enhance performance and psychological/psychophysiological outcomes in sport. [ABSTRACT FROM AUTHOR]