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Objectives\ud \ud To identify the themes to inform the content of a new generic measure, the EQ-HWB (EQ Health and Wellbeing), that can be used in economic evaluation across health, social care, and public health, based on the views of users and beneficiaries of these services including informal carers.\ud \ud \ud \ud Methods\ud \ud A qualitative review was undertaken. Systematic and citation searches were undertaken focusing on qualitative evidence of the impact on quality of life from reviews for selected health conditions, informal carers, social care users, and primary qualitative work used in the development of selected measures. A subset of studies was included in the review. Framework analysis and synthesis were undertaken based on a conceptual model.\ud \ud \ud \ud Results\ud \ud A total of 42 reviews and 24 primary studies were selected for inclusion in the review. Extraction and synthesis resulted in 7 high-level themes (with subthemes): (1) feelings and emotions (sadness, anxiety, hope, frustration, safety, guilt/shame); (2) cognition (concentration, memory, confusion, thinking clearly); (3) self-identity (dignity/respect, self-esteem); (4) “coping, autonomy, and control” relationships; (5) social connections (loneliness, social engagement, stigma, support, friendship, belonging, burden); (6) physical sensations (pain, discomfort, sleep, fatigue); and (7) activity (self-care, meaningful activities, mobility, communication, hearing, vision). Apart from physical sensations, most of the other themes and subthemes were relevant across both health and social care, including for informal carers.\ud \ud \ud \ud Conclusions\ud \ud The findings from this broad review identified themes that go beyond health and that are relevant to patients, informal carers, and social care users. The themes and subthemes informed the domains for the EQ-HWB.

Background & Aims\ud \ud Poor nutritional outcomes are observed in people with Amyotrophic Lateral Sclerosis (pwALS) including weight loss and poor dietary intake. Surveys of healthcare professionals have highlighted the lack of evidence and knowledge regarding nutritional management of ALS throughout the disease course. Furthermore, national evidence-based guidance is lacking. This mapping review aims to understand the structure and input of nutritional management services for pwALS.\ud \ud \ud \ud Methods\ud \ud Systematic searches were conducted across eight electronic databases to identify qualitative and quantitative research on structure and input of nutritional care in ALS. Supplementary searches included grey literature, citation and reference list searching of included studies and key reviews, web searching and contacting experts and organisations that provide ALS services to identify guidelines. Study selection and data extraction were undertaken independently by at least two reviewers. Data was synthesised using a narrative approach.\ud \ud \ud \ud Results\ud \ud One hundred and nine documents were identified. These consisted of journal articles, guidelines and related documents that contributed evidence towards mapping of nutritional management of pwALS. No evidence on commissioning of nutritional care was identified. Guidelines provided high-level overviews and gave general guidance or recommendations for care; however, these typically focused on gastrostomy with limited guidance on broader aspects, including oral nutrition support. Evidence from primary studies found nutritional care delivery in ALS consisted of multiple types of nutritional management, at different time points during the disease course and involving a range of professionals. There was little evidence relating to proactive nutritional care. Details of healthcare setting, number of professionals involved in care, team composition and how services were delivered in community settings were sparse. Although the role of the speech and language therapist in swallowing assessment and provision of advice on the management of swallowing difficulties was consistent; there was limited evidence on care provided by dietitians. In addition, a small number of studies reported on the use of screening tools. Overall, evidence was consistent that weight management, including monitoring of weight change by professionals and patients, was central and recommended that this should be part of nutritional assessment and follow-up.\ud \ud \ud \ud Conclusions\ud \ud The evidence identified in this mapping review has highlighted the requirement for further primary research providing specific details on how nutritional management of pwALS is structured and delivered.

This systematic review evaluates the diagnostic accuracy of conventional oral examination (COE) versus incisional or excisional biopsy for the diagnosis of malignant and/or dysplastic lesions in patients with clinically evident lesions. Searches were conducted across five electronic databases from inception to January 2020. Meta-analyses were undertaken, where appropriate. Among 18 included studies, 14 studies were included in the meta-analysis, giving summary estimates for COE of 71% sensitivity and 85% specificity for the diagnosis of dysplastic and/or malignant lesions. The pooled diagnostic accuracy of identifying malignant-only lesions was reported in seven studies, giving a pooled estimate of 88% sensitivity and 81% specificity. Diagnostic accuracy of different types of dental/medical professionals in identifying dysplastic or malignant lesions gave varying estimates of sensitivity and specificity across three studies. Further research is needed to improve the diagnostic accuracy of COE for early detection of dysplastic and malignant oral lesions.

Aim\ud \ud To conduct a systematic review of published studies reporting on the longitudinal impacts of hypoglycaemia on quality of life (QoL) in adults with type 2 diabetes.\ud \ud \ud Method\ud \ud Database searches with no restrictions by language or date were conducted in MEDLINE, Cochrane Library, CINAHL and PsycINFO. Studies were included for review if they used a longitudinal design (e.g. cohort studies, randomised controlled trials) and reported on the association between hypoglycaemia and changes over time in patient-reported outcomes related to QoL.\ud \ud \ud Results\ud \ud In all, 20 longitudinal studies published between 1998 and 2020, representing 50,429 adults with type 2 diabetes, were selected for review. A descriptive synthesis following Synthesis Without Meta-analysis guidelines indicated that self-treated symptomatic hypoglycaemia was followed by impairments in daily functioning along with elevated symptoms of generalised anxiety, diabetes distress and fear of hypoglycaemia. Severe hypoglycaemic events were associated with reduced confidence in diabetes self-management and lower ratings of perceived health over time. Frequent hypoglycaemia was followed by reduced energy levels and diminished emotional well-being. There was insufficient evidence, however, to conclude that hypoglycaemia impacted sleep quality, depressive symptoms, general mood, social support or overall diabetes-specific QoL.\ud \ud \ud Conclusions\ud \ud Longitudinal evidence in this review suggests hypoglycaemia is a common occurrence among adults with type 2 diabetes that impacts key facets in the physical and psychological domains of QoL. Nonetheless, additional longitudinal research is needed—in particular, studies targeting diverse forms of hypoglycaemia, more varied facets of QoL and outcomes assessed using hypoglycaemia-specific measures.

Aim\ud To scope the evidence on interventions used to help mental health nurses cope with stressful working environments.\ud \ud Background\ud Nursing managers may implement interventions to support mental health nurses cope in their role. However, the evidence supporting these interventions has not been recently reviewed.\ud \ud Methods\ud A scoping review was conducted which entailed searching and selecting potential studies, undertaking data extraction and synthesis.\ud \ud Results\ud Eighteen studies published since 2000 were identified. They employed different designs, ten used quasi‐experimental methods. Interventions involving active learning appeared beneficial, for example stress reduction courses and mindfulness. However, small sample sizes, short follow‐up periods and variation in outcome measures make it difficult to identify the optimum interventions. No studies have considered cost‐effectiveness.\ud \ud Conclusion\ud There is some evidence that mental health nurses benefit from interventions to help them cope with stressful working environments. However, higher quality research is needed to establish the effectiveness and cost‐effectiveness of different interventions.\ud \ud Implications for Nursing Management\ud Managers should provide opportunities and encourage mental health nurses to engage in active learning interventions, for example mindfulness to help them cope with stressful working environments. Nurses also want managers to address organisational issues; however, no research on these types of interventions was identified.

Background Non-invasive ventilation (NIV) prolongs survival and quality of life in amyotrophic lateral sclerosis (ALS); however, its benefits depend upon the optimisation of both ventilation and adherence. We aimed to identify factors associated with effective initiation and ongoing use of NIV in ALS to develop evidence-based guidance and identify areas for further research.\ud \ud \ud \ud Methods We searched eleven electronic databases (Jan 1998 – May 2018) for all types of quantitative and qualitative studies. Supplementary grey literature searches were conducted. Records were screened against eligibility criteria, data were extracted from included studies and risk of bias was assessed. We present findings using a narrative synthesis.\ud \ud \ud \ud Results We screened 2430 unique records and included 52 quantitative and 6 qualitative papers. Factors reported to be associated with NIV optimisation included: co-ordinated multidisciplinary care, place of initiation, selection of interfaces, ventilator modes and settings appropriate for the individual patient, and adequate secretion management. The literature indicated that patients with significant bulbar dysfunction can still derive considerable benefit from NIV if their needs are met. Research emphasises that obstructive airway events, mask leak and uncontrolled secretions should be addressed by adjustments to the interface and machine settings, and the concomitant use of cough augmentation.\ud \ud \ud \ud Conclusion This review highlights that NIV optimisation requires an individualised approach to respiratory management tailored to the differing needs of each patient. Ultimately this should lead to improved survival and quality of life. This review expands on recommendations in current international guidelines for NIV use in ALS and identifies areas for future research.

Access to safe, good quality affordable housing is essential to wellbeing and housing related factors\ud can have an important influence on neighbourliness and sense of community belonging. A recent\ud scoping review on housing and wellbeing identified a lack of review-level evidence around the\ud impact of housing interventions on wellbeing of people who are vulnerable to discrimination or\ud exclusion in relation to housing (Preston et al., 2016). This systematic review was commissioned to\ud address that gap. We synthesise and consider the quality of evidence on how housing interventions\ud can contribute to improving the lives of adults who are vulnerable in relation to the security of their\ud housing tenure (‘housing-vulnerable’ adults).\ud

Multilayered Muszyna regional model was constructed in the ArcGIS and the GMS environment. Among the several methods for implementing the model in the GMS system the LPF method was used to create a structure of the model. Conceptual model is a spatial arrangement of the fixed structure, which can be automatically divided in grid blocks of different densities. The studied area is located within an open hydrogeological structure in the Carpathian mountain basin. Regional model takes into account the presence of complex fold and fault structures as well as the interaction between groundwater, and surface water as well as fresh water with mineral water. Within the model were separated 10 layers with different hydrogeological characteristics. The first layer includes Pleistocene–Holocene deposits. All other layers are built of fissured-porous flysch rocks. The hydraulic conductivities in studied flysch rocks decreases exponentially with depth. The most permeable subsurface zone is about 100 m thick. The experience gained from modelling for the Muszyna region show effectiveness of the principles of the creation of regional hydrogeological models. Such a quasi 3D model seems to be a good tool to carry out the rational exploitation of fresh and mineral water in a complex groundwater flow system.

In the Nowy Sącz Basin, newly exposed Middle Miocene deposits have been studied and sam pled in the Kamienica Nawojowska, Poprad and Dunajec rivers. The calcareous nannoplankton of the fresh water to marine deposits was examined. Pale grey and brown clayey shales with plant remains and thin seams of lignite represent the freshwater deposits of the Biegonice Formation. These deposits pass upwards into ca. 50 m thick packet of brackish and marine deposits, represented mainly by dark marly shales with bivalves and gastropods of the Iwkowa and Niskowa formations. These deposits contain relatively rich late Badenian to Sarmatian calcareous nannoplakton (NN6/7Zone).