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Background: Robin sequence (RS) is characterized by micrognathia, glossoptosis, and upper airway obstruction, and is often combined with a cleft palate. It is unclear whether RS negatively impacts the development of velopharyngeal incompetence (VPI) and attainable speech outcomes. This study systematically reviewed speech outcomes in patients with cleft and isolated RS (IRS) compared with only isolated cleft palate (ICP).Methods: A literature search following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was performed using the PubMed and EMBASE databases. Articles reporting speech outcomes following primary palatoplasty in patients with IRS only or IRS versus ICP were identified. Study characteristics and methods, primary- and VPI palatoplasty, speech measurements, and post-operative complications were collected. Primary outcomes included VPI and need for speech correcting surgery (SCS). Methodological quality was appraised using the methodological index for non-randomized studies (MINORS) criteria (range: 0-16 and 0-24).Results: Nineteen studies reported VPI event rates that varied between 14% and 88% for IRS and 0% and 62% for ICP. Five out of 8 studies (67%) comparing VPI event rates between IRS and ICP found no significant difference. SCS rates varied between 0% and 48% for IRS and 0% and 24% for ICP. Six out of 9 studies (67%) comparing SCS rates between IRS and ICP, found no significant difference. Combined VPI event rates were 36.1% for the IRS group and 26% for the ICP group, for SCS rates this was 20% for IRS and 13% for ICP.Conclusion: Most articles found no significant difference between the VPI and SCS rates indicating that speech outcomes might be similar in patients with IRS and ICP. To better compare these groups a standardized international protocol is needed.

Complementary feeding is the process of introducing solid foods to milk‐fed infants (also known as weaning). Current UK guidance states that complementary feeding should occur around 6 months but not before 4 months. This systematic review explores how parents in the UK, with an infant under 24 months of age, engage with sources of information and advice about complementary feeding. Engaging with sources of information can influence parents' feeding choices and so a better understanding of parents' information behaviours can improve service provisions. Six databases were searched, identifying 15 relevant qualitative studies with the predefined criteria. Data from each study were coded line by line allowing for a synthesis of higher analytical themes. Using thematic synthesis, four main themes were observed: (1) trust and rapport—parents valued information from a trusted source (2), accessibility—information needs were often time sensitive, and parents showed varying levels of understanding, (3) adapting feeding plans—often influenced by practicalities (4), being a good parent—feeding plans were changed to comply with societal ideas of 'good parenting'. The review concluded that parents receive information and advice about complementary feeding from multiple sources and are highly motivated to seek further information. The scope of this novel review explored the parental experience of finding, receiving and engaging with information sources and how this may or may not have influenced their feeding behaviours. The review has provided a new perspective to add to the growing body of literature that focuses on the experience of feeding an infant. Key messages: This review found that parents held the NHS services in high regard but did not always seek information from healthcare providers due to accessibility issues, preferring the instant nature of online sources.Parents were more likely to accept information or advice if a rapport was built and non‐judgemental approach was adopted as it protected the parental identity while providing information about complementary feeding.Accessibility of information was important as sources were not always convenient for parents to access or in an understandable format which may reduce adherence to complementary feeding guidelines. [ABSTRACT FROM AUTHOR]

In order to meet the growing need for mental health provision for young people, more attention has turned to schools to provide evidence-based interventions. Acceptance and Commitment Therapy (ACT) has been demonstrated in recent reviews and meta-analyses to be effective with young people, however to date no systematic reviews have examined the use of ACT as a school-based intervention. This systematic review aimed to evaluate the methodological quality and examine the effectiveness of all peer-reviewed literature on ACT interventions based in secondary schools. The PsycInfo, Scopus and Web of Science databases were searched for studies published in any year reporting on the use of ACT interventions based in secondary schools aiming to prevent or reduce mental health difficulties or promote wellbeing. Both universal and targeted studies were eligible for inclusion. Nine studies met inclusion criteria, with a total of 1324 participants across studies (age range 13–21 years). Outcomes measured across all studies were depression, anxiety, anger, psychological capital, stress, wellbeing, life satisfaction, psychological health, emotional problems and mental health symptoms. Six studies also used process measures to explore different constructs linked to psychological flexibility, the mechanism of change in ACT. There was significant variation in methodological quality across studies. Despite methodological weaknesses across studies, there are some promising results to show support for the use of ACT as a school-based intervention. As existing studies were heterogeneous with regard to design and outcomes measured, this review was unable to draw firm conclusions regarding the efficacy of ACT or the moderating influence of program type, program format or program delivery. More highly powered studies comparing ACT to other active treatments are needed in order to explore these questions further. • This review examines use of Acceptance and Commitment Therapy as a school-based intervention for mental health and wellbeing. • There are methodological weaknesses across studies, likely due to the infancy of this area of research. • Existing studies were heterogeneous with regard to design and outcomes measured. • At this time, it is difficult to draw firm conclusions regarding efficacy or moderating factors. • More highly powered studies comparing ACT to other active treatments are needed in order to explore the area further. [ABSTRACT FROM AUTHOR]

Background: Per- and polyfluoroalkyl (PFAS) substances are a group of anthropogenic organic chemicals. PFAS have numerous applications in the industrial and commercial fields. They have become abundant in the environment and have been detected in the blood of humans and animals. PFAS exposure likely increases the risk of certain diseases. In recent years, there has been a steep rise in related primary and secondary articles. Objectives: We aim to collate narrative and systematic reviews including both qualitative and quantitative synthesis on biological, environmental, or medical aspects of PFAS exposure and burdens, and to create an evidence review map to fulfil three main objectives. 1) Mappingto reveal what evidence on PFAS has been systematically reviewed and where synthesis may be needed. 2) Bibliometrics: to characterise the interdisciplinarity, independence and connectedness of the reviews. 3) Critical appraisal: to assess the included reviews for the reliability of conclusions and methodological transparency. This overview of reviews will inform future research and policy making. Search and study eligibility: We will perform a systematic search on Scopus, Web of Science, PubMed, and the ‘grey literature’. To be included in the map, a study must be a review from the systematic review family and focus on at least one of predefined 31 PFAS. We will limit inclusions to peer-reviewed publications, pre-prints, and theses without any language restrictions. At least two authors will scan title, abstract and keywords, followed by full-text screening of included reviews. Critical appraisal of reviews and synthesis methods: We will assess each review of the systematic review family referencing the AMSTAR2 checklist. We will collect information on conflict-of-interest statements, funding sources and availability of raw data and analysis code. We will extract relevant data from full texts and bibliographic records, conduct bibliometric analyses, and display findings as tables, figures and a narrative synopsis.