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Abstract The characterisation of novel materials presents a challenge that requires new and original developments. To face some of these demands for making measurements at the nanoscale, a new microsphere-assisted white light interference nanoscope performing local reflectance mapping is presented. This technique presents the advantages of being non-destructive, full-field and label-free. A 145 μm diameter microsphere, glued to the end of an optical fiber, is inserted inside the white light interference microscope to improve the lateral resolution from 940 nm to 520 nm. The acquisition and the Fourier transform processing of a stack of interference images superimposed on the virtual image produced by the microsphere allows the extraction of the local reflectance over a wavelength range of 460 nm to 900 nm and a field of view of 8 μm in diameter. The enhancement in the lateral resolution of the reflectance is demonstrated through the spectral distinction of neighboring ripples on a laser-textured colored stainless-steel sample that cannot be resolved without the microsphere, on regions with a surface of 279 × 279 nm2 horizontally spaced 279 nm apart. Future improvements could potentially lead to a lateral resolution of reflectance measurement over a 100 nm diameter area in air, paving the way to sub-diffraction reflectance mapping.

Light microscopes are the most widely used devices in life and material sciences that allow the study of the interaction of light with matter at a resolution better than that of the naked eye. Conventional microscopes translate the spatial differences in the intensity of the reflected or transmitted light from an object to pixel brightness differences in the digital image. However, a phase microscope converts the spatial differences in the phase of the light from or through an object to differences in pixel brightness. Interference microscopy, a phase-based approach, has found application in various disciplines. While interferometry has brought nanometric axial resolution, the lateral resolution in quantitative phase microscopy (QPM) has still remained limited by diffraction, similar to other traditional microscopy systems. Enhancing the resolution has been the subject of intense investigation since the invention of the microscope in the 17th century. During the past decade, microsphere-assisted microscopy (MAM) has emerged as a simple and effective approach to enhance the resolution in light microscopy. MAM can be integrated with QPM for 3D label-free imaging with enhanced resolution. Here, we review the integration of microspheres with coherence scanning interference and digital holographic microscopies, discussing the associated open questions, challenges, and opportunities.

Abstract Background Good communication is central to effective social work practice, helping to develop constructive working relationships and improve the outcomes of people in receipt of social work services. There is strong consensus that the teaching and learning of communication skills for social work students is an essential component of social work qualifying courses. However, the variation in communication skills training and its components is significant. There is a sizeable body of evidence relating to communication skills training therefore a review of the findings helps to clarify what we know about this important topic in social work education. We conducted this systematic review to determine whether communication skills training for social work students works and which types of communication skills training, if any, were more effective and lead to the most positive outcomes. Objectives This systematic review aimed to critically evaluate all studies which have investigated the effectiveness of communication skills training programmes for social work students. The research question which the review posed is: ‘What is the effectiveness of communication skills training for improving the communicative abilities of social work students?’ It was intended that the review would provide a robust evaluation of communication skills training for social work students and help explain variations in practice to support educators and policy‐makers to make evidence‐based decisions in social work education, practice and policy. Search Methods We conducted a search for published and unpublished studies using a comprehensive search strategy that included multiple electronic databases, research registers, grey literature sources, and reference lists of prior reviews and relevant studies. Selection Criteria Study selection was based on the following characteristics: Participants were social work students on generic (as opposed to client specific) qualifying courses; Interventions included any form of communication skills training; eligible studies were required to have an appropriate comparator such as no intervention or an alternative intervention; and outcomes included changes in knowledge, attitudes, skills and behaviours. Study selection was not restricted by geography, language, publication date or publication type. Data Collection and Analysis The search strategy was developed using the terms featuring in existing knowledge and practice reviews and in consultation with social work researchers, academics and the review advisory panel, to ensure that a broad range of terminology was included. One reviewer conducted the database searches, removing duplicates and irrelevant records, after which each record was screened by title and abstract by both reviewers to ensure robustness. Any studies deemed to be potentially eligible were retrieved in full text and screened by both reviewers. Main Results Fifteen studies met the inclusion criteria. Overall, findings indicate that communication skills training including empathy can be learnt, and that the systematic training of social work students results in some identifiable improvements in their communication skills. However, the evidence is dated, methodological rigour is weak, risk of bias is moderate to high/serious or incomplete, and extreme heterogeneity exists between the primary studies and the interventions they evaluated. As a result, data from the included studies were incomplete, inconsistent, and lacked validity, limiting the findings of this review, whilst identifying that further research is required. Authors’ Conclusions This review aimed to examine effects of communication skills training on a range of outcomes in social work education. With the exception of skill acquisition, there was insufficient evidence available to offer firm conclusions on other outcomes. For social work educators, our understanding of how communication skills and empathy are taught and learnt remain limited, due to a lack of empirical research and comprehensive discussion. Despite the limitations and variations in educational culture, the findings are still useful, and suggest that communication skills training is likely to be beneficial. One important implication for practice appears to be that the teaching and learning of communication skills in social work education should provide opportunities for students to practice skills in a simulated (or real) environment. For researchers, it is clear that further rigorous research is required. This should include using validated research measures, using research designs which include appropriate counterfactuals, alongside more careful and consistent reporting. The development of the theoretical underpinnings of the interventions used for the teaching and learning of communication skills in social work education is another area that researchers should address.

Advancements in precision agriculture technologies enable producers to achieve higher yields; however, in some cases, these innovations have not reached widespread adoption despite years of availability. We sought to understand producers’ adoption experiences with two precision agriculture technologies: Nitrogen (N)-Rich Strips and the Sensor Based Nitrogen Rate Calculator (SBNRC). These technologies can help producers optimize their application of nitrogen fertilizer on growing crops, especially small grains such as wheat. Using Rogers’ (2003) diffusion of innovations theory as an explanatory framework, this descriptive-exploratory study examined the adoption behaviors of producers from two midwestern states. Rogers’ (2003) theoretical lens guided instrument development and interpretation of results. To better understand the effects of change agents’ actions and potential adopters’ behaviors during the innovation-decision process, more research is needed regarding disenchantment discontinuance and replacement discontinuance, the potential for pro-innovation bias, and of the innovation attribute compatibility. The future development of precision agriculture technology with the perceptions of potential adopters in mind, especially those averse to adoption and continuance, may assist in overcoming barriers to widespread diffusion.

Abstract Background Philanthropists, charity leaders and policy-makers have increasingly recognised that the process of giving resources needs to be grounded in evidence—sometimes referred to as ‘evidence-based’ or ‘data-driven’ philanthropy. Yet few philanthropists practise evidence-based philanthropy, and some contend that there is insufficient evidence on which to base their funding decisions. This review aims to identify factors that promote or limit the use of evidence by philanthropists and to rigorously evaluate all existing research on this issue. Objectives To identify, synthesise, and evaluate appropriate and rigorous research, examining factors which act as barriers to or facilitators of the use of evidence by philanthropists. Methods This review was conducted according to Cochrane standards and reported following PRISMA guidelines. The review protocol was pre-registered ( dx.doi.org/10.17504/protocols.io.wbsfane ). We searched 10 interdisciplinary databases using a highly sensitive search strategy, developed in consultation with an information scientist. We also contacted experts and searched a range of websites. Studies were included if they comprised primary research into or systematic reviews of the barriers to and facilitators of the use of evidence by philanthropists or funders when determining which charities (including health charities or programmes) to fund. All studies were appraised for quality, and the results synthesised using thematic analysis. Results Of 686 studies identified through database and hand searching, nine met inclusion criteria. The thematic summary identified three main barriers to philanthropists or funders using evidence: (1) inadequate knowledge transfer and difficulties accessing evidence, (2) challenges in understanding the evidence and (3) insufficient resources. The three key factors that expedite the use of evidence are (1) improved knowledge transfer and more accessible/relevant high-quality information, (2) access to professional advisors and networks and (3) broadening the definition of what counts as credible evidence along with standardisation of reporting. Conclusions The authors of this review found several compelling arguments for promoting the use of evidence by philanthropists to inform their philanthropy. If evidence-based philanthropy is to flourish, then they recommed the following actions: Firstly, philanthropy should be underpinned by a commitment to 'do no harm'. Secondly, the definition of evidence should be expanded and funding decisions based upon consideration of 'all available evidence'. Finally, there should be more investment in synthesizing evidence and in the infrastructure for knowledge transfer.

Social work and allied professions can struggle to accurately assess child neglect. Our research project is developing a new child neglect measurement tool for use by multi-agencies to address this issue. Phase two of this project employed a Delphi study to gather the views of a range of experts to help develop it. There were two important stages to inform the Delphi study: a systematic review of child neglect measures, and three online focus groups with a purposive sample of 16 participants with expertise in child neglect (academics, practitioners, and experts by experience). We then conducted a three-round modified online Delphi study with a purposive sample of 60 international panellists with expertise in child neglect. We followed the CREDES guidelines for the rigorous application of the Delphi technique. The panel generated salient items for the tool and scaled these for importance. The panel reached consensus for 18 items and 15 elements for the tool. The items included neglect type, chronicity, and severity. The elements included hyperlinks to research and the use of 10-point scales. The draft tool is short and may be useable by a range of practitioners in multi-agency settings. It is inclusive of social harms, such as poverty and social isolation. It will now be piloted.

Late Devonian time was a period of rapid upheaval in the Earth system, including climate change, sea level changes, widespread ocean anoxia, and the Frasnian-Famennian mass extinction; the cause(s) of these changes remain(s) uncertain. The Lennard Shelf of the Canning Basin in Western Australia contains carbonate reef sections spanning much of the Late Devonian Epoch and has been sampled for paleomagnetic analysis with studies by Hansma and colleagues in 2015 and Playton and colleagues in 2016. However, previous paleomagnetic directions were scattered and their use for magnetostratigraphy has been questioned. Here, rock magnetic data and magnetostratigraphy for a late Devonian drill-core from the Lennard Shelf were analyzed. Three magnetostratigraphic interpretations were made using different paleopoles that showed good correlation with each other and the earlier interpretations by Playton and colleagues in 2016. Additionally, the rock magnetic data revealed the samples contain various mixtures of detrital and diagenetic minerals, the former of which should be viable recorders of primary magnetic signatures. Even in samples with these detrital phases, paleomagnetic data were often noisy and produced ambiguous polarity assignments, likely due to the anomalously weak Devonian field. Because of this ambiguity and the absence of a robust paleopole, broader correlations for this critical time-period will be difficult without additional paleomagnetic data from the late Devonian Period. Expanded data for this interval could eventually shed light on the timing, causes, and rates of the Frasnian-Famennian mass extinction and other environmental shifts in the late Devonian Epoch.

Abstract Background Studies published in languages other than English are often neglected when research teams conduct systematic reviews. Literature on how to deal with non-English studies when conducting reviews have focused on the importance of including such studies, while less attention has been paid to the practical challenges of locating and assessing relevant non-English studies. We investigated the factors which might predict the inclusion of non-English studies in systematic reviews in the social sciences, to better understand how, when and why these are included/excluded. Methods We appraised all Campbell Collaboration systematic reviews (n = 123) published to July 2016, categorising each by its language inclusiveness. We sought additional information from review authors via a questionnaire and received responses concerning 47 reviews. Data were obtained for 17 factors and we explored correlations with the number of non-English studies in the reviews via statistical regression models. Additionally, we asked authors to identify factors that support or hinder the inclusion of non-English studies. Results Of 123 reviews, 108 did not explicitly exclude, and of these, 17 included non-English language studies. One factor correlated with the number of included non-English studies across all models: the number of countries in which the members of the review team work (B-value = 0.56; SE B = 0.24; 95% CI = 0.07–1.03; p = 0.02). This indicates that reviews which included non-English studies were more likely to be produced by international review teams. Our survey showed a dominance of researchers from English-speaking countries (52.9%) and review teams consisting only of team members from these countries (65.9%). The most frequently mentioned challenge to including non-English studies was a lack of resources (funding and time) followed by a lack of language resources (e.g. professional translators). Conclusion Our findings may indicate a connection between the limited inclusion of non-English studies and a lack of resources, which forces review teams to rely on their limited language skills rather than the support of professional translators. If unaddressed, review teams risk ignoring key data and introduce bias in otherwise high-quality reviews. However, the validity and interpretation of our findings should be further assessed if we are to tackle the challenges of dealing with non-English studies.

Abstract Background The third sector is becoming a growing provider of public, social, and health services. However, there is little evidence on the effectiveness of third sector organisations (TSOs), and their capacity to implement evidence-based interventions (EBIs). Understanding implementation aspects of service delivery remains an important issue in clinical practice, but is poorly understood in the context of TSOs. This is problematic, since implementation issues are known to be critical for effective intervention outcomes. Objectives To identify and synthesise existing research on what barriers and facilitators influence the implementation process of TSOs delivering EBIs. Methods This review is reported according to PRISMA guidelines and was pre-registered in PROSPERO. Key databases were searched using relevant terms, experts in the field were contacted, and websites were reviewed. All identified studies were double-screened, and data were extracted independently by two authors. Included studies were synthesised using thematic analysis and were quality appraised. Results Thirty-one studies were included, most of which were conducted in North America. The thematic synthesis identified resource limitations, in particular staff and finance, to be the most reported barrier to TSOs implementing EBIs. Organisational culture, including factors such as alignment between the mission of the TSO and EBI, and support/prioritisation of the implementation process were the most reported facilitators. These findings generalise across the included studies and are robust to study quality assessment. Conclusions While it is often assumed that good outcomes follow when implementing interventions that have been developed and tested according to best practice, little attention has been paid to how EBIs are best transported, contextualised, and implemented by third sector providers. This systematic review found that TSOs faced considerable challenges in implementing EBIs, which were primarily a lack of support and expertise, and unclear/insufficient guidelines on how to adapt EBIs to different populations. To address these challenges, it is important to engage with central stakeholders, such as funders, researchers, policymakers, and practitioners, to discuss how these needs can be met. Trial registration PROSPERO: CRD42017073090.

Abstract Background The CONSORT (Consolidated Standards of Reporting Trials) Statement was developed to help biomedical researchers report randomised controlled trials (RCTs) transparently. We have developed an extension to the CONSORT 2010 Statement for social and psychological interventions (CONSORT-SPI 2018) to help behavioural and social scientists report these studies transparently. Methods Following a systematic review of existing reporting guidelines, we conducted an online Delphi process to prioritise the list of potential items for the CONSORT-SPI 2018 checklist identified from the systematic review. Of 384 international participants, 321 (84%) participated in both rating rounds. We then held a consensus meeting of 31 scientists, journal editors, and research funders (March 2014) to finalise the content of the CONSORT-SPI 2018 checklist and flow diagram. Results CONSORT-SPI 2018 extends 9 items (14 including sub-items) from the CONSORT 2010 checklist, adds a new item (with 3 sub-items) related to stakeholder involvement in trials, and modifies the CONSORT 2010 flow diagram. This Explanation and Elaboration (E&E) document is a user manual to enhance understanding of CONSORT-SPI 2018. It discusses the meaning and rationale for each checklist item and provides examples of complete and transparent reporting. Conclusions The CONSORT-SPI 2018 Extension, this E&E document, and the CONSORT website (www.consort-statement.org) are helpful resources for improving the reporting of social and psychological intervention RCTs.

Abstract Background Randomised controlled trials (RCTs) are used to evaluate social and psychological interventions and inform policy decisions about them. Accurate, complete, and transparent reports of social and psychological intervention RCTs are essential for understanding their design, conduct, results, and the implications of the findings. However, the reporting of RCTs of social and psychological interventions remains suboptimal. The CONSORT Statement has improved the reporting of RCTs in biomedicine. A similar high-quality guideline is needed for the behavioural and social sciences. Our objective was to develop an official extension of the Consolidated Standards of Reporting Trials 2010 Statement (CONSORT 2010) for reporting RCTs of social and psychological interventions: CONSORT-SPI 2018. Methods We followed best practices in developing the reporting guideline extension. First, we conducted a systematic review of existing reporting guidelines. We then conducted an online Delphi process including 384 international participants. In March 2014, we held a 3-day consensus meeting of 31 experts to determine the content of a checklist specifically targeting social and psychological intervention RCTs. Experts discussed previous research and methodological issues of particular relevance to social and psychological intervention RCTs. They then voted on proposed modifications or extensions of items from CONSORT 2010. Results The CONSORT-SPI 2018 checklist extends 9 of the 25 items from CONSORT 2010: background and objectives, trial design, participants, interventions, statistical methods, participant flow, baseline data, outcomes and estimation, and funding. In addition, participants added a new item related to stakeholder involvement, and they modified aspects of the flow diagram related to participant recruitment and retention. Conclusions Authors should use CONSORT-SPI 2018 to improve reporting of their social and psychological intervention RCTs. Journals should revise editorial policies and procedures to require use of reporting guidelines by authors and peer reviewers to produce manuscripts that allow readers to appraise study quality, evaluate the applicability of findings to their contexts, and replicate effective interventions.

Abstract Background The third sector is becoming a more common provider of social and health services, but little is known about how third sector organisations (TSOs) evaluate their activities. Past research has reported that the third sector is under increasing pressure to evaluate its impact and performance by government and other commissioning bodies. However, in responding to this increased pressure to undertake evaluation, research suggests that many TSOs struggle to evaluate their activities following the principles of evidence-based practice (EBP). Yet, there has been no systematic effort to investigate why the third sector is struggling to provide good quality evidence of its effects. Methods This systematic review is reported following the PRISMA guidelines. Ten interdisciplinary databases were searched using a search string developed following best practice and in consultation with an information systems expert. Included studies were primary research of any research design investigating barriers to and facilitators of the evaluation process of TSOs as identified by practitioners. All studies were quality appraised, and the results were synthesised as a thematic summary. Results Twenty-four studies were included, which mainly investigated TSOs working within health and social services. The thematic summary identified the main barriers for TSOs to undertake evaluation to be related to the (1) lack of financial resources, (2) lack of technical capability and evaluation literacy and (3) challenges around identifying relevant evaluation systems and outcome indicators. Key facilitating factors involved (1) getting the appropriate support, (2) having an organisational culture that supports evaluation and (3) the motivation to be accountable to stakeholders. These findings were robust to study quality. Conclusions This review constitutes the first systematic effort to synthesise existing literature on factors supporting and preventing evaluation by TSOs. The prevalence of factors revolving around the lack of support, resources and clarity on appropriate outcome indicators suggests that many of the identified challenges may be met by applying evidence-based and stakeholder-inclusive strategies to develop shared evaluation requirements. Future efforts should address the application of EBP as part of the commissioning process of TSOs.

Abstract There is an increasing body of research documenting flaws in many published systematic reviews’ methodological and reporting conduct. When good systematic review practice is questioned, attention is rarely turned to the composition of the team that conducted the systematic review. This commentary highlights a number of relevant articles indicating how the composition of the review team could jeopardise the integrity of the systematic review study and its conclusions. Key biases require closer attention such as sponsorship bias and researcher allegiance, but there may also be less obvious affiliations in teams conducting secondary evidence-syntheses. The importance of transparency and disclosure are now firmly on the agenda for clinical trials and primary research, but the meta-biases that systematic reviews may be at risk from now require further scrutiny.

Abstract We present quantitative three dimensional images of grooves on a writable Blu-ray Disc based on a single objective Mirau type interferometric microscope, enhanced with a microsphere which is considered as a photonic nanojet source. Along the optical axis the resolution of this microsphere assisted interferometry system is a few nanometers while the lateral resolution is around 112 nm. To understand the physical phenomena involved in this kind of imaging we have modelled the interaction between the photonic jet and the complex disc surface. Agreement between simulation and experimental results is demonstrated. We underline that although the ability of the microsphere to generate a photonic nanojet does not alone explain the resolution of the interferometer, the nanojet can be used to try to understand the imaging process. To partly explain the lateral super-resolution, the potential role of coherence is illustrated. The presented modality may have a large impact on many fields from bio-medicine to nanotechnology.

Abstract Background The management of menstruation has come to the fore as a barrier to girls’ education attainment in low income contexts. Interventions have been proposed and piloted, but the emerging nature of the field means limited evidence is available to understand their pathways of effect. Methods This study describes and compares schoolgirls’ experiences of menstruation in rural Uganda at the conclusion of a controlled trial of puberty education and sanitary pad provision to elucidate pathways of effect in the interventions. Semi-structured interviews were undertaken with schoolgirls who participated in the Menstruation and the Cycle of Poverty trial concurrent with the final set of quantitative surveys. A framework approach and cross-case analysis were employed to describe and compare the experiences of 27 menstruating girls across the four intervention conditions; education (n = 8), reusable sanitary pads (n = 8), education with reusable sanitary pads (n = 6), and control (n = 5). Results Themes included: menstrual hygiene, soiling, irritation and infection, physical experience, knowledge of menstruation, psychological, social and cultural factors, and support from others. Those receiving reusable pads experienced improvements in comfort and reliability. This translated into reduced fears around garment soiling and related school absenteeism. Other menstrual hygiene challenges of washing, drying and privacy remained prominent. Puberty education improved girls’ confidence to discuss menstruation and prompted additional support from teachers and peers. Conclusions Findings have important implications for the development and evaluation of future interventions. Results suggest the provision of menstrual absorbents addresses one core barrier to menstrual health, but that interventions addressing broader needs such as privacy may improve effectiveness. Puberty education sessions should increase attention to body awareness and include strategies to address a wider range of practical menstrual challenges, including pain management. Interviews revealed possibilities for improving quantitative surveys in future research. Trial registration Pan-African Clinical Trials Registry PACTR201503001044408

Through rigorous electromagnetic simulations, the natural coupling of high-spatial-frequency evanescent waves from the near field to the far field by dielectric microspheres is studied in air. The generation of whispering gallery modes inside the microspheres is shown independently of any resonance. In addition, the conversion mechanism of these evanescent waves into propagating waves is analysed. This latter point leads to key information that allows a better physical understanding of the super-resolution phenomenon in microsphere-assisted microscopy where sub-diffraction-limit revolving power is achieved.

Omega-3 fatty acids are central to brain-development of children. Evidence from clinical trials and systematic reviews demonstrates the potential of long-chain Omega-3 supplementation for learning and behavior. However, findings are inconclusive and in need of robust replication studies since such work is lacking.Replication of the 2012 DOLAB 1 study findings that a dietary supplementation with the long-chain omega-3 docosahexaenoic acid (DHA) had beneficial effects on the reading, working memory, and behavior of healthy schoolchildren.Parallel group, fixed-dose, randomized (minimization, 30% random element), double-blind, placebo-controlled trial (RCT).Mainstream primary schools (n = 84) from five counties in the UK in 2012-2015.Healthy children aged 7-9 underperforming in reading (

[This corrects the article DOI: 10.1371/journal.pone.0181722.].

This Campbell systematic review examines the effects of programmes on the economic self‐sufficiency and well‐being of resettled refugees. The review identified 23 relevant studies but none of these could be included in the analysis due weaknesses in study design. No studies met the inclusion criteria of this review. Twenty‐three studies were identified which were not included in the review because their design meant that the effects measured could not be clearly attributed to the programmes. Synopsis/Abstract OBJECTIVES This systematic review sought to identify and evaluate all available high‐quality evidence as to whether interventions affect the economic self‐sufficiency and well‐being of resettled refugees. METHODS We searched 18 electronic databases, examined relevant websites, and contacted researchers in an attempt to identify any relevant published or unpublished reports. No language restrictions were applied, and the search was completed in Sept 2013. Inclusion criteria were: (a) prospective, controlled methodology; (b) participants who were resettled refugees aged 18‐64 at the time of the intervention; (c) intervention designed to increase the economic self‐sufficiency and well‐being of resettled refugees; and, (d) included at least one of the following outcomes: labour force participation rate; employment rate; use of cash assistance; income; job retention; or quality of life. RESULTS A total of 9,260 records were inspected, and 26 records summarising 23 unique studies were screened. No studies met the review's inclusion criteria. CONCLUSIONS The available evidence was insufficient to determine if programmes affect the economic self‐sufficiency and well‐being of resettled refugees as no studies met the review's inclusion criteria. More research with rigorous designs, such as prospective, controlled studies, is needed to determine which interventions affect the economic self‐sufficiency and well‐being of resettled refugees. Executive Summary BACKGROUND Globally, 51.2 million individuals are forcibly displaced and approximately 11.7 million of these have crossed the border of their country of origin and are classified as refugees of concern by the United Nations High Commissioner for Refugees (UNHCR, 2014). A minority of these refugees are moved through resettlement programmes to a third country. In 2012, 26 different countries offered refugee resettlement, with the goals of improving economic self‐sufficiency and well‐being for those resettled refugees. There are a myriad of programmes that may act to improve the economic self‐sufficiency and well‐being of refugees, including employment training, education, and interventions delivered by mental health services. OBJECTIVES This systematic review sought to identify and evaluate all available evidence as to whether interventions designed to improve the economic self‐sufficiency and well‐being of resettled refugees affect participants' labour force participation rate, employment rate, use of cash assistance, income, job retention, and quality of life. SEARCH STRATEGY We searched 18 databases and the websites of relevant research, policy, and governmental organisations. We also contacted researchers in attempt to identify any relevant published or unpublished reports. Key search terms were (resettle* OR re‐settle* OR refuge* OR force* ADJ *migrant* OR asylum* OR humanitar* ADJ entrant* OR humanitar* ADJ settle*) AND (economic OR job* OR employ* OR mone* OR work* OR labor OR labour OR well‐being OR wellbeing OR well ADJ being OR quality NEAR life) AND (outcome* OR evaluat* OR effect* OR efficacy OR compar* OR experiment* OR trial OR control* OR random* OR study OR studies OR assessment OR impact* OR research*). We completed final searches in September 2013. SELECTION CRITERIA Studies were eligible for inclusion if they: (a) included a prospective, controlled methodology such as randomised controlled trial design, a quasi‐randomised controlled trial design, or a nonrandomised controlled design which provided information on, and adjusted for, baseline comparability; (b) included participants who were refugees who had been served by a refugee resettlement entity and were between the ages of 18 and 64 at the time of the intervention; (c) evaluated an intervention designed to increase the economic self‐sufficiency and well‐being of resettled refugees compared to a control or comparison group; and, (d) included at least one primary or secondary outcome (labour force participation rate, employment rate, use of cash assistance, income, job retention, and quality of life). DATA COLLECTION AND ANALYSIS We inspected 8,264 records derived from the database search and 996 records derived from other sources. Initially, 26 records summarising 23 unique studies were screened. An additional 13 abstracts were also reviewed and one additional study was screened. The review authors independently examined the search results. RESULTS No studies met the review criteria. The data collection process appeared sensitive. Of the 9,273 records identified, 27 records (corresponding to 24 studies) were inspected in full text. We attempted to contact the authors of three studies that were potentially eligible for inclusion; two of these responded and their studies were excluded on the basis of the information they provided. Of the papers reviewed in full text, 21 records (18 studies) were excluded because they did not meet the methodology criteria, 5 records (7 studies) did not meet the population criteria, and 3 records (3 studies) did not meet the outcome criteria; one was excluded because the author did not respond. Several papers were excluded for more than one reason. Two papers were systematic reviews; all of the included studies from these were checked. AUTHORS' CONCLUSIONS This review indicated a need for further research on the economic self‐sufficiency and well‐being of resettled refugees. Such research needs to be sufficiently rigorous to indicate if and how interventions affect these outcomes. The authors recommend the use of randomised controlled trial designs, quasi‐randomised controlled trial designs, or nonrandomised controlled trial designs that adjust for baseline comparability. The lack of knowledge about the effects of interventions on these outcomes is surprising given the long‐term investments in programmes designed to assist resettled refugees, the number of refugees resettled, and the political importance of this subject. For practitioners and policymakers, it is important to point out this review did not find any evidence for or against any intervention.

Objective To systematically review and critically appraise the evidence for the effects of interventions to improve the performance of community health workers (CHWs) for community-based primary healthcare in low- and middle-income countries.Design Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Methods 19 electronic databases were searched with a highly sensitive prespecified strategy and the grey literature examined, completed July 2016. Randomised controlled trials evaluating interventions to improve CHW performance in low- and middle-income countries were included and appraised for risk of bias. Outcomes were biological and behavioural patient outcomes (primary), use of health services, quality of care provided by CHWs and CHW retention (secondary).Results Two reviewers screened 8082 records; 14 evaluations were included. Due to heterogeneity and lack of clear outcome data, no meta-analysis was conducted. Results were presented in a narrative summary. The review found one study showing no effect on the biological outcomes of interest, though these moderate quality data may not be indicative of all biological outcomes. It also found moderate quality evidence of the efficacy of performance improvement interventions for (1) improving behavioural outcomes for patients, (2) improving use of services by increasing the absolute number of patients who access services and, perhaps, better identifying those who would benefit from such services and (3) improving CHW quality of care in terms of upstream measures like completion of prescribed activities and downstream measures like adherence to treatment protocols. Nearly half of studies were compound interventions, making it difficult to isolate the effects of individual performance improvement intervention components, though four specific strategies pertaining to recruitment, supervision, incentivisation and equipment were identified.Conclusions Variations in recruitment, supervision, incentivisation and equipment may improve CHW performance. Practitioners should, however, assess the relevance and feasibility of these strategies in their health setting prior to implementation. Component selection experiments on a greater range of interventions to improve performance ought to be conducted.

A key to the pathogenic success of Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, is the capacity to survive within host macrophages. Although several factors required for this survival have been identified, a comprehensive knowledge of such factors and how they work together to manipulate the host environment to benefit bacterial survival are not well understood. To systematically identify Mtb factors required for intracellular growth, we screened an arrayed, non-redundant Mtb transposon mutant library by high-content imaging to characterize the mutant-macrophage interaction. Based on a combination of imaging features, we identified mutants impaired for intracellular survival. We then characterized the phenotype of infection with each mutant by profiling the induced macrophage cytokine response. Taking a systems-level approach to understanding the biology of identified mutants, we performed a multiparametric analysis combining pathogen and host phenotypes to predict functional relationships between mutants based on clustering. Strikingly, mutants defective in two well-known virulence factors, the ESX-1 protein secretion system and the virulence lipid phthiocerol dimycocerosate (PDIM), clustered together. Building upon the shared phenotype of loss of the macrophage type I interferon (IFN) response to infection, we found that PDIM production and export are required for coordinated secretion of ESX-1-substrates, for phagosomal permeabilization, and for downstream induction of the type I IFN response. Multiparametric clustering also identified two novel genes that are required for PDIM production and induction of the type I IFN response. Thus, multiparametric analysis combining host and pathogen infection phenotypes can be used to identify novel functional relationships between genes that play a role in infection.

This Campbell systematic review assesses the effectiveness of home visits in preventing impairment, institutionalization, and death in older adults, as well as identifying factors that may moderate effects. The review summarises findings from 64 studies. Overall, home visits are not effective in maintaining the health and autonomy of community‐dwelling older adults. Preventive home visits did not reduce absolute mortality, and did not have a significant overall effect on the number of people who were institutionalised. There is high‐quality evidence of no effect on falls from interventions targeting fall prevention. There is low‐quality evidence of small statistically significant positive effects for functioning and quality of life. It is possible that some programmes have modest effects on institutionalisation and hospitalisation. However, heterogeneity in target population and intervention design, as well as poor reporting of in studies of design, implementation and the control condition make this difficult to determine. Executive summary BACKGROUND Home visits by health and social care professionals aim to prevent cognitive and functional impairment, thus reducing institutionalisation and prolonging life. Visitors may provide health information, investigate untreated or sub‐optimally treated problems, encourage compliance with medical care, and provide referrals to services. Previous reviews have reached varying conclusions about their effectiveness. This review sought to assess the effectiveness of preventive home visits for older adults (65+ years) and to identify factors that may moderate effects. OBJECTIVES To systematically review evidence on the effectiveness of preventive home visits for older adults, and to identify factors that may moderate effects. SEARCH STRATEGY We searched the following electronic databases through December 2012 without language restrictions: British Nursing Index and Archive, C2‐SPECTR, CINAHL, CENTRAL, EMBASE, IBSS, Medline, Nursing Full Text Plus, PsycINFO, and Sociological Abstracts. Reference lists from previous reviews and from included studies were also examined. SELECTION CRITERIA We included randomised controlled trials enrolling persons without dementia aged over 65 years and living at home. Interventions included visits at home by a health or social care professional that were not directly related to recent hospital discharge. Interventions were compared to usual care, wait‐list, or attention controls. DATA COLLECTION AND ANALYSIS Two authors independently extracted data from included studies in pre‐specified domains, assessed risk of bias using the Cochrane Risk of Bias tool, and rated the quality of evidence using GRADE criteria. Outcomes were pooled using random effects models. We analyzed effects on mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. RESULTS Sixty‐four studies with 28642 participants were included. There was high quality evidence that home visits did not reduce absolute mortality at longest follow‐up (Risk ratio=0.93 [0.87 to 0.99]; Risk difference=0.00 [‐0.01 to 0.00]). There was moderate quality evidence of no clinically or statistically significant overall effect on the number of people who were institutionalised (Risk ratio=1.02 [0.88, 1.18]) or hospitalised (Risk ratio=0.96 [0.91, 1.01]) during the studies. There was high quality evidence of no statistically significant effect on the number of people who fell (Odds ratio=0.86 [0.73, 1.01]). There was low quality evidence of statistically significant effects for quality of life (Standardised mean difference=‐0.06 [‐0.11, ‐0.01]) and very low quality evidence of statistically significant effects for functioning (SMD=‐0.10 [‐0.17, ‐0.03]), but these overall effects may not be clinically significant. However, there was heterogeneity in settings, types of visitor, focus of visits, and control groups. We cannot exclude the possibility that some programmes were associated with meaningful benefits. AUTHORS' CONCLUSIONS We were unable to identify reliable effects of home visits overall or in any subset of the studies in this review. It is possible that some home visiting programmes have beneficial effects for community‐dwelling older adults, but poor reporting of how interventions and comparisons were implemented prevents more robust conclusions. While it is difficult to draw firm conclusions given these limitations, estimates of treatment effects are statistically precise, and further small studies of multi‐component interventions compared with usual care would be unlikely to change the conclusions of this review. If researchers continue to evaluate these types of interventions, they should begin with a clear theory of change, clearly describe the programme theory of change and implementation, and report all outcomes measured.

BACKGROUND:Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. METHODS:We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. RESULTS:Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. CONCLUSIONS:There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people appear to be increasingly using social media to communicate distress, particularly to peers. The focus should now be on how specific mediums' (social media, video/image sharing) might be used in therapy and recovery. Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment. A protocol for this review was registered with the PROSPERO systematic review protocol registry: (http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42015019518).

While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1) beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2) approaches to evidence generation and evaluation used in systems and policy change, and (3) how better evidence-generation can be undertaken and supported within social innovation in health.Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs). Data were analysed using a Framework Analysis Approach.While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers.How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

Do youth empowerment programs improve adolescents' self‐esteem and self‐efficacy? A Campbell systematic review of international research suggests that there is not enough reliable evidence to substantiate the popular expectation that these programs are effective. Only three studies met all of the review's criteria. Executive summary/Abstract BACKGROUND Governments, funders, and charity organizations increasingly demand that young people be involved in the processes that affect their lives and communities. Youth empowerment programs (YEPs) are designed to build on the assets of young people through a focus on active participation, mastery experiences, and positive connections in order to improve developmental outcomes and positive transitions to adulthood. Proponents of YEPs suggest that they may constitute an effective, theory‐based approach to youth development. OBJECTIVES To report the state of the high‐quality evidence on the impacts of YEPs on adolescents' (ages 10‐19) sense of self‐efficacy and self‐esteem, as well as other social and behavioral outcomes. To determine if the available evidence indicates best practices among YEPs or differential effects according to particular subgroups of adolescents. To identify directions for further research. SEARCH STRATEGY The investigators conducted an international search that included twelve major academic electronic databases, twelve additional relevant institutional web‐based publication databases, and a professional outreach for published and unpublished evaluations. SELECTION CRITERIA Randomized controlled trials or quasi‐experimental trials using a prospectively assigned control group. Controls could have included no intervention, wait‐list, or a comparison intervention without a significant empowerment component. Interventions must have regularly involved youth in program decision‐making and met other basic youth empowerment standards. The review included interventions outside of formal education, juvenile detention, residential, and therapeutic systems. DATA COLLECTION AND ANALYSIS 8,789 citations were identified and screened independently and crosschecked by two reviewers. Sixty‐eight studies were reviewed in‐depth. RESULTS Three studies met the review's full inclusion criteria; two of which measured self‐efficacy outcomes that could be aggregated in a meta‐analysis. The limited data meta‐analyzed did not show a combined intervention effect on self‐efficacy (z = 1.21; 95% CI ‐0.12 to 0.49). None of the three studies independently showed significant intervention effects on the review's primary outcomes. Mixed effects were demonstrated by results for secondary outcomes. There was no evidence of harm, in that no study's results revealed statistically significant adverse intervention effects for any of its measured outcomes. AUTHORS' CONCLUSIONS The review reveals an insufficient evidence‐base from experimental or quasi‐experimental studies to substantiate the expectation that YEPs have an impact on developmental assets such as self‐efficacy and self‐esteem. Further research into YEPs using rigorous impact study designs is needed. Researchers should further develop methods and measures to enable high‐quality, mixed‐methods process studies to complement impact studies of YEPs so as to provide more useful evidence for practitioners and policy‐makers.

Personal assistance is here defined as paid support of at least 20 hours per week for people with impairments. This Cochrane/Campbell systematic review investigated the effectiveness of personal assistance versus any other form of care for adults with both physical and intellectual impairments. A literature search identified 2 studies that met the inclusion criteria, which included 1,002 participants. They suggested that personal assistance may be preferred over other services; however, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and their informal caregivers. Paid assistance might substitute for informal care and cost government more than alternative arrangements; however, the relative total costs to recipients and society are unknown. Abstract Background There is a high incidence of impairments among working age adults, and their prevalence is increasing in the West. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. Objectives To assess the effectiveness of personal assistance for adults with physical and intellectual impairments, and the impacts of personal assistance on others, compared to other interventions. Search methods Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Selection criteria Adults (19‐64) with permanent physical and intellectual impairments living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Data collection and analysis Titles and abstracts were examined by two reviewers. Outcome data were extracted. Because no two studies made the same comparison, studies were not combined for meta‐analyses. Studies were assessed for bias. Results and potential sources of bias are presented for included studies. Results Two studies involving 1002 participants compared personal assistance versus usual care. Whilst personal assistance was generally preferred over other services, some people prefer other services. Personal assistance may have some benefits for some recipients and may benefit caregivers. Paid assistance probably substitutes for informal care and may cost government more than alternatives; however, some evidence suggests it may reduce costs. The total costs to recipients and society are unknown. Authors’ conclusions Research in this field is limited. Personal assistance is expensive and difficult to organise, especially in places that do not already have services in place, but its total cost relative to other services is unknown. When implementing new programmes, recipients could be randomly assigned to different forms of assistance (e.g. organised by individual users versus organised through a cooperative). While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of assistance are most effective and efficient for particular people.

Studies urgently needed to assess effects of Personal Assistance for children and teens with physical impairments. Personal assistance is here defined as paid support of at least 20 hours per week for people with impairments. This review investigated the effectiveness of personal assistance versus any other form of care for children and adolescents with physical impairments. A literature search identified no studies that met the inclusion criteria. This review is part of a series of reviews; evidence from related reviews about different populations might be informative to researchers and practitioners. Abstract Background There is a high and increasing prevalence of impairments among children and adolescents in the West. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. Objectives To assess the effectiveness of personal assistance for children and adolescents with both physical and intellectual impairments, and the impacts of personal assistance on others, compared to other interventions. Search methods Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Selection criteria Children and adolescents with both physical and intellectual impairments (0‐18 years) living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities due to permanent impairments. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Data collection and analysis Titles and abstracts were examined by two reviewers. 130 full papers were examined. None met the inclusion criteria. Results No eligible studies were found. Authors’ conclusions Research in this field is limited, though one related review provides some evidence of the effectiveness of personal assistance for children and adolescents with intellectual impairments. When implementing new programmes, recipients could be randomly assigned to different forms of assistance. While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of personal assistance are most effective and efficient for particular people.

This systematic review investigated the effectiveness of personal assistance versus any other form of care for adults with physical impairments. A literature search identified one study that met the inclusion criteria, which included 817 participants. It suggests that personal assistance may be preferred over other services; however, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and their informal caregivers. Paid assistance might substitute for informal care and cost government more than alternative arrangements; however, the relative total costs to recipients and society are unknown. Abstract Background There is a high incidence of impairments among working age adults. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. Objectives To assess the effectiveness of personal assistance for adults with physical impairments, and the impacts of personal assistance on others, compared to other interventions. Search methods Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Selection criteria Adults (19‐64) with physical impairments living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities due to permanent impairments. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Data collection and analysis Titles and abstracts were examined by two reviewers. Outcome data were extracted. Studies were assessed for the possibility of bias. Results and potential sources of bias are presented for included studies. Results One randomised controlled trial involving 817 participants compared personal assistance versus usual care was identified. Whilst personal assistance was generally preferred over other services, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and may benefit caregivers. Whilst paid assistance probably substitutes for informal care and may cost government more than alternatives, the total costs to recipients and society are currently unknown. Authors’ conclusions Research in this field is limited. When implementing new programmes, recipients could be randomly assigned to different forms of assistance. While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of personal assistance are most effective and efficient for particular people.

Studies urgently needed to assess effects of Personal Assistance for children and teens with physical impairments. Personal assistance is here defined as paid support of at least 20 hours per week for people with impairments. This review investigated the effectiveness of personal assistance versus any other form of care for children and adolescents with physical impairments. A literature search identified no studies that met the inclusion criteria. This review is part of a series of reviews; evidence from related reviews about different populations might be informative to researchers and practitioners. Abstract Background There is a high and increasing prevalence of impairments among children and adolescents in the West. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. Objectives To assess the effectiveness of personal assistance for children and adolescents with physical impairments, and the impacts of personal assistance on others, compared to other interventions. Search methods Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Selection criteria Children and adolescents with physical impairments (0‐18 years) living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities due to permanent impairments. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Data collection and analysis Titles and abstracts were examined by two reviewers. 130 full papers were examined. None met the inclusion criteria. Results No eligible studies were found. Authors’ conclusions Research in this field is limited. When implementing new programmes, recipients could be randomly assigned to different forms of assistance. While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of personal assistance are most effective and efficient for particular people.

This review investigated the effectiveness of personal assistance versus any other form of care for children and adolescents with intellectual impairments. Personal assistance is here defined as paid support of at least 20 hours per week for people with impairments. A literature search identified one study that met the inclusion criteria, which included 1,002 participants. It suggested that personal assistance may be preferred over other services; however, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and their informal caregivers. Paid assistance might substitute for informal care and cost government more than alternative arrangements; however, the relative total costs to recipients and society are unknown. One study supports use of Personal Assistance for children and teens with intellectual impairments: more research is needed. Abstract Background There is a high and increasing prevalence of intellectual impairments among children and adolescents in the West. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. Objectives To assess the effectiveness of personal assistance for children and adolescents with intellectual impairments, and the impacts of personal assistance on others, compared to other interventions. Search methods Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Selection criteria Children and adolescents with intellectual impairments (0‐18 years) living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities due to permanent impairments. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Data collection and analysis Titles and abstracts were examined by two reviewers. Outcome data were extracted. Studies were assessed for the possibility of bias. Results and potential sources of bias are presented for included studies. Results One included study randomised 1002 participants to personal assistance or usual care. Whilst personal assistance was generally preferred over other services, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and may benefit caregivers. However, near complete dependence on proxy respondents raises concerns about the validity of these results. Paid assistance probably substitutes for informal care and may cost government more than alternatives; however, the total costs to recipients and society are currently unknown. Authors’ conclusions Research in this field is limited. When implementing new programmes, recipients could be randomly assigned to different forms of assistance. While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of personal assistance are most effective and efficient for particular people.

BACKGROUND:Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls. OBJECTIVES:To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls' education, work and psychosocial wellbeing in low and middle income countries. METHODS:Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers. RESULTS:Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads). A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11). Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms. CONCLUSIONS:There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further research is needed to establish the role of menstruation hygiene management in education performance, employment and other psychosocial outcomes. This review provides a concise summary of present trials and highlights improvements for future work.

Poor menstrual knowledge and access to sanitary products have been proposed as barriers to menstrual health and school attendance. In response, interventions targeting these needs have seen increasing implementation in public and private sectors. However, there has been limited assessment of their effectiveness.Assess the impact of providing reusable sanitary pads and puberty education on girls' school attendance and psychosocial wellbeing outcomes.A cluster quasi-randomised controlled trial was conducted across 8 schools, including 1124 girls, in rural Uganda. Schools were allocated to one of four conditions: the provision of puberty education alone; reusable sanitary pads alone; puberty education and reusable sanitary pads; and a control (no intervention). The primary outcome was school attendance. Secondary outcomes reflected psychosocial wellbeing.At follow-up, school attendance had worsened for girls across all conditions. Per-protocol analysis revealed that this decline was significantly greater for those in the control condition d = 0.52 (95%CI 0.26-0.77), with those in control schools having a 17.1% (95%CI: 8.7-25.5) greater drop in attendance than those in any intervention school. There were no differences between the intervention conditions. High rates of school drop-out and transfer meant the trial suffered from substantial participant drop-out. Intention-to-treat analyses using two different imputation strategies were consistent with the main results, with mean differences of 5.2% attendance in best-case and 24.5% in worst-case imputations. Results were robust to adjustments for clustering. There was no impact of the interventions on girls' self-reported shame or insecurity during menstruation.Results of the trial support the hypothesised positive impact of providing sanitary pads or puberty education for girls' school attendance in a developing country context. Findings must be interpreted with caution in light of poor participant retention, intervention fidelity, and the attendance measures used.Pan African Clinical Trials Registry PACTR201503001044408.

BackgroundHome visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services.Methods and findingsData sourcesTen databases including CENTRAL and Medline searched through December 2012.Study selectionRandomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge.Data extraction and synthesisTwo authors independently extracted data. Outcomes were pooled using random effects.Main outcomes and measuresMortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness.ResultsSixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [-0.01 to 0.00]). There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18]) or hospitalized (RR = 0.96 [0.91 to 1.01]). There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01]), but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = -0.06 [-0.11 to -0.01]) and physical functioning (SMD = -0.10 [-0.17 to -0.03]) respectively, but these may not be clinically important.ConclusionsHome visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programs that are associated with consistent benefits. Due to poor reporting of intervention components and delivery, we cannot exclude the possibility that some programs may be effective.

BACKGROUND: Previous reviews show that reporting guidelines have improved the quality of trial reports in medicine, yet existing guidelines may not be fully suited for social and psychological intervention trials. OBJECTIVE/DESIGN: We conducted a two-part study that reviewed (1) reporting guidelines for and (2) the reporting quality of social and psychological intervention trials. DATA SOURCES: (1) To identify reporting guidelines, we systematically searched multiple electronic databases and reporting guideline registries. (2) To identify trials, we hand-searched 40 journals with the 10 highest impact factors in clinical psychology, criminology, education, and social work. ELIGIBILITY: (1) Reporting guidelines consisted of articles introducing a checklist of reporting standards relevant to social and psychological intervention trials. (2) Trials reported randomised experiments of complex interventions with psychological, social, or health outcomes. RESULTS: (1) We identified 19 reporting guidelines that yielded 147 reporting standards relevant to social and psychological interventions. Social and behavioural science guidelines included 89 standards not found in CONSORT guidelines. However, CONSORT guidelines used more recommended techniques for development and dissemination compared to other guidelines. (2) Our review of trials (n = 239) revealed that many standards were poorly reported, such as identification as a randomised trial in titles (20% reported the information) and abstracts (55%); information about blinding (15%), sequence generation (23%), and allocation concealment (17%); and details about actual delivery of experimental (43%) and control interventions (34%), participant uptake (25%), and service environment (28%). Only 11 of 40 journals referenced reporting guidelines in "Instructions to Authors." CONCLUSION: Existing reporting guidelines have important limitations in content, development, and/or dissemination. Important details are routinely missing from trial publications; most leading journals in social and behavioural sciences do not ask authors to follow reporting standards. Findings demonstrate a need to develop a CONSORT extension with updated standards for social and psychological intervention trials.

Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA), especially DHA (docosahexaenonic acid) are essential for brain development and physical health. Low blood Omega-3 LC-PUFA have been reported in children with ADHD and related behavior/learning difficulties, as have benefits from dietary supplementation. Little is known, however, about blood fatty acid status in the general child population. We therefore investigated this in relation to age-standardized measures of behavior and cognition in a representative sample of children from mainstream schools.493 schoolchildren aged 7-9 years from mainstream Oxfordshire schools, selected for below average reading performance in national assessments at age seven.Whole blood fatty acids were obtained via fingerstick samples. Reading and working memory were assessed using the British Ability Scales (II). Behaviour (ADHD-type symptoms) was rated using the revised Conners' rating scales (long parent and teacher versions). Associations were examined and adjusted for relevant demographic variables.DHA and eicosapentaenoic acid (EPA), accounted for only 1.9% and 0.55% respectively of total blood fatty acids, with DHA showing more individual variation. Controlling for sex and socio-economic status, lower DHA concentrations were associated with poorer reading ability (std. OLS coeff. = 0.09, p =

BACKGROUND: There is concern that the internet is playing an increasing role in self-harm and suicide. In this study we systematically review and analyse research literature to determine whether there is evidence that the internet influences the risk of self-harm or suicide in young people. METHODS: An electronic literature search was conducted using the PsycINFO, MEDLINE, EMBASE, Scopus, and CINAHL databases. Articles of interest were those that included empirical data on the internet, self-harm or suicide, and young people. The articles were initially screened based on titles and abstracts, then by review of the full publications, after which those included in the review were subjected to data extraction, thematic analysis and quality rating. RESULTS: Youth who self-harm or are suicidal often make use of the internet. It is most commonly used for constructive reasons such as seeking support and coping strategies, but may exert a negative influence, normalising self-harm and potentially discouraging disclosure or professional help-seeking. The internet has created channels of communication that can be misused to 'cyber-bully' peers; both cyber-bullying and general internet use have been found to correlate with increased risk of self-harm, suicidal ideation, and depression. Correlations have also been found between internet exposure and violent methods of self-harm. CONCLUSIONS: Internet use may exert both positive and negative effects on young people at risk of self-harm or suicide. Careful high quality research is needed to better understand how internet media may exert negative influences and should also focus on how the internet might be utilised to intervene with vulnerable young people.

Unaccompanied asylum-seeking children (UASC) have experienced multiple traumas and are a high-risk group for posttraumatic stress disorder (PTSD). The effects of trauma are known to be associated with sleep problems; indeed sleeping problems are core features of PTSD. However, there has been no systematic research examining the sleep of this high risk group of children. This study presents the first evidence on the sleeping patterns of Afghan UASC living in the UK. A total of 222 male Afghan children, aged 13-18, were interviewed using validated self-report questionnaires measuring sleeping patterns and PTSD. Overall, UASC patterns for bed time and rise time appear acculturated to the country of asylum. Mean UASC sleep onset latency scores were approximately 20 minutes greater compared with normative scores, which may be a reflection of UASC pre-migration and post-migration experiences. As expected, UASC who screened above the clinical cut-off for PTSD reported significantly greater sleep onset latency, increased nightmares, and less total sleep time compared to the non-PTSD group. The results may be of particular interest to clinicians given that, compared to screening for PTSD, screening for sleep problems may be a less culturally disputed form of initial assessment indicating distress in UASC. Similarly, the field of UASC and refugee child interventions is largely focused on trauma, yet sleep may provide a novel avenue for equally or more effective treatment.

BACKGROUND: There is no specific guidance for the reporting of Cochrane systematic reviews that do not have studies eligible for inclusion. As a result, the reporting of these so-called "empty reviews" may vary across reviews. This research explores the incidence of empty systematic reviews in The Cochrane Database of Systematic Reviews (The CDSR) and describes their current characteristics. METHODOLOGY/PRINCIPAL FINDINGS: Empty reviews within The CDSR as of 15 August 2010 were identified, extracted, and coded for analysis. Review group, original publication year, and time since last update, as well as number of studies listed as excluded, awaiting assessment, or on-going within empty reviews were examined. 376 (8.7%) active reviews in The CDSR reported no included studies. At the time of data collection, 45 (84.9%) of the Cochrane Collaboration's 53 Review Groups sustained at least one empty review, with the number of empty reviews for each of these 45 groups ranging from 1 to 35 (2.2-26.9%). Time since original publication of empty reviews ranged from 0 to 15 years with a mean of 4.2 years (SD = 3.4). Time since last assessed as up-to-date ranged from 0 to 12 years with a mean of 2.8 years (SD = 2.2). The number of excluded studies reported in these reviews ranged from 0 to 124, with an average of 9.6 per review (SD = 14.5). Eighty-eight (23.4%) empty reviews reported no excluded studies, studies awaiting assessment, or on-going studies. CONCLUSIONS: There is a substantial number of empty reviews in The CDSR, and there is some variation in the reporting and updating of empty reviews across Cochrane Review Groups. This variation warrants further analysis, and may indicate a need to develop guidance for the reporting of empty systematic reviews in The CDSR.

Omega-3 fatty acids are dietary essentials, and the current low intakes in most modern developed countries are believed to contribute to a wide variety of physical and mental health problems. Evidence from clinical trials indicates that dietary supplementation with long-chain omega-3 may improve child behavior and learning, although most previous trials have involved children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) or developmental coordination disorder (DCD). Here we investigated whether such benefits might extend to the general child population.To determine the effects of dietary supplementation with the long-chain omega-3 docosahexaenoic acid (DHA) on the reading, working memory, and behavior of healthy schoolchildren.Parallel group, fixed-dose, randomized, double-blind, placebo-controlled trial (RCT).Mainstream primary schools in Oxfordshire, UK (n = 74).Healthy children aged 7-9 years initially underperforming in reading (≤ 33(rd) centile). 1376 invited, 362 met study criteria.600 mg/day DHA (from algal oil), or taste/color matched corn/soybean oil placebo.Age-standardized measures of reading, working memory, and parent- and teacher-rated behavior.ITT analyses showed no effect of DHA on reading in the full sample, but significant effects in the pre-planned subgroup of 224 children whose initial reading performance was ≤ 20(th) centile (the target population in our original study design). Parent-rated behavior problems (ADHD-type symptoms) were significantly reduced by active treatment, but little or no effects were seen for either teacher-rated behaviour or working memory.DHA supplementation appears to offer a safe and effective way to improve reading and behavior in healthy but underperforming children from mainstream schools. Replication studies are clearly warranted, as such children are known to be at risk of low educational and occupational outcomes in later life.ClinicalTrials.gov NCT01066182 and Controlled-Trials.com ISRCTN99771026.

BACKGROUND: Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education. METHODS: A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance. RESULTS: After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p

BACKGROUND: Abstinence-plus (comprehensive) interventions promote sexual abstinence as the best means of preventing HIV, but also encourage condom use and other safer-sex practices. Some critics of abstinence-plus programs have suggested that promoting safer sex along with abstinence may undermine abstinence messages or confuse program participants; conversely, others have suggested that promoting abstinence might undermine safer-sex messages. We conducted a systematic review to investigate the effectiveness of abstinence-plus interventions for HIV prevention among any participants in high-income countries as defined by the World Bank. METHODS AND FINDINGS: Cochrane Collaboration systematic review methods were used. We included randomized and quasi-randomized controlled trials of abstinence-plus programs for HIV prevention among any participants in any high-income country; trials were included if they reported behavioural or biological outcomes. We searched 30 electronic databases without linguistic or geographical restrictions to February 2007, in addition to contacting experts, hand-searching conference abstracts, and cross-referencing papers. After screening 20,070 abstracts and 325 full published and unpublished papers, we included 39 trials that included approximately 37,724 North American youth. Programs were based in schools (10), community facilities (24), both schools and community facilities (2), health care facilities (2), and family homes (1). Control groups varied. All outcomes were self-reported. Quantitative synthesis was not possible because of heterogeneity across trials in programs and evaluation designs. Results suggested that many abstinence-plus programs can reduce HIV risk as indicated by self-reported sexual behaviours. Of 39 trials, 23 found a protective program effect on at least one sexual behaviour, including abstinence, condom use, and unprotected sex (baseline n = 19,819). No trial found adverse program effects on any behavioural outcome, including incidence of sex, frequency of sex, sexual initiation, or condom use. This suggests that abstinence-plus approaches do not undermine program messages encouraging abstinence, nor do they undermine program messages encouraging safer sex. Findings consistently favoured abstinence-plus programs over controls for HIV knowledge outcomes, suggesting that abstinence-plus programs do not confuse participants. Results for biological outcomes were limited by floor effects. Three trials assessed self-reported diagnosis or treatment of sexually transmitted infection; none found significant effects. Limited evidence from seven evaluations suggested that some abstinence-plus programs can reduce pregnancy incidence. No trial observed an adverse biological program effect. CONCLUSIONS: Many abstinence-plus programs appear to reduce short-term and long-term HIV risk behaviour among youth in high-income countries. Programs did not cause harm. Although generalisability may be somewhat limited to North American adolescents, these findings have critical implications for abstinence-based HIV prevention policies. Suggestions are provided for improving the conduct and reporting of trials of abstinence-plus and other behavioural interventions to prevent HIV.