Systematic Reviews Of Interventions Research Articles

Improving healthcare professionals’ interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators

Improving healthcare professionals’ interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators

Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs.

The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. PROSPERO registration no. CRD42022303255.

What has been done for social workers’ self-care practice? A systematic review of interventions

Improving mental well-being is essential for social workers. Self-care services are often facilitated to enhance it, but there is limited research exploring their characteristics and effectiveness. We conducted a systematic review of self-care interventions targeting the mental well-being of social workers. A comprehensive search of four English and one Chinese databases yielded 2969 studies for initial screening. Fourteen eligible studies were finally included and reviewed. The results underscored mindfulness as prevalent and effective, with social work students being the main service recipients. Although with limitations, the findings inform future research and self-care services for social workers.

Identification of application and interpretation errors that can occur in pairwise meta-analyses in systematic reviews of interventions: a systematic review

ObjectivesTo generate a bank of items describing application and interpretation errors that can arise in pairwise meta-analyses in systematic reviews of interventions. Study Design and SettingMEDLINE, Embase, and Scopus were searched to identify studies describing types of errors in meta-analyses. Descriptions of errors and supporting quotes were extracted by multiple authors. Errors were reviewed at team meetings to determine if they should be excluded, reworded, or combined with other errors, and were categorized into broad categories of errors and subcategories within. ResultsFifty articles met our inclusion criteria, leading to the identification of 139 errors. We identified 25 errors covering data extraction/manipulation, 74 covering statistical analyses, and 40 covering interpretation. Many of the statistical analysis errors related to the meta-analysis model (eg, using a two-stage strategy to determine whether to select a fixed or random-effects model) and statistical heterogeneity (eg, not undertaking an assessment for statistical heterogeneity). ConclusionWe generated a comprehensive bank of possible errors that can arise in the application and interpretation of meta-analyses in systematic reviews of interventions. This item bank of errors provides the foundation for developing a checklist to help peer reviewers detect statistical errors.

Analysing the Potential of Neighbourhoods in Sustainable Development: A Systematic Review of Interventions

Between 1950 and 2018, the global urban population spiralled four-fold from about 0.8 billion accounting for just 30% of the total world population to 4.2 billion in 2018 with a 55.3% share in the world population. At present, it is estimated that 57.4% of the total global population is urban and is projected to cross 60% by 2030. Given the growth and scale of urbanization, this brings forth irreversible challenges, limiting land and water resources at its disposal. This makes it difficult to meet the increasing demand for affordable housing and viable infrastructure besides other challenges. In this context, the local-level planning and development approaches that have been experimented with globally are studied to understand the potential of neighbourhoods in sustainable development. The authors conducted a systematic literature review based on the SCOPUS database to identify relevant scholarly literature. The study identified the most significant associations within various domains based on phased iterations with the VOSviewer analyser tool to gain confirmatory results. The study has explored planning interventions at the neighbourhood level that would assist in sustainable development. The article concludes that there is a lot of scope for stakeholders to channel their efforts innovatively for leveraging the potential of neighbourhoods in sustainable development.

Preventing suicide by jumping in public locations: a systematic review of interventions

Preventing suicide by jumping in public locations: a systematic review of interventions

Systematic Review of Interventions with Some School Involvement for School Refusal in High School–Age Adolescents

Abstract Chronic absenteeism is a public health concern. School refusal due to emotional distress is one reason students exhibit chronic absenteeism. The objective of this systematic review was to determine potential aspects of interventions, in school settings or involving a school-based component, that are successful in addressing school refusal among high school–age adolescents. After duplicated records were excluded, 1,864 studies were identified from searches. The abstracts and full text articles were independently reviewed and received two votes from each of the five reviewers using the eligibility criteria. Two reviewers independently evaluated the remaining articles and met to discuss findings with a third reviewer. The 10 articles included eight studies that noted techniques in cognitive–behavioral therapy (CBT) as promising and two studies that considered CBT as effective as other approaches. The study design for three studies were randomized controlled trials. The remaining seven studies were quasiexperimental. Only three of the 10 studies received a high rating using the Quality Appraisal Tool. There was a limited number of quality studies that used rigorous scientific methods and variation in how each study engaged schools. Further exploration and development of interventions with an integral school-based component are needed.

An exploration of the relationship between land governance and development through a systematic review of interventions

The importance of land governance to economic development is a theme that usually receives less attention than it is due in academic production. Land, being a physically limited resource, is increasingly under pressure by the expanding world population and climate change and, thus, an constitutes an important subject of inquiry for academics and policymakers. In this paper we investigate the relationship between land governance and economic development through a systematic review of the literature on land governance interventions and its impacts regarding three main areas (socioeconomic, environmental and gender). While we found out that most of the impacts analyzed were positive (76 %), there are still lots of gaps regarding the geographic distribution of the intervention studies, the focus of intervention analyses (most studied socioeconomic variables) and difficulties dealing with bias control. Moreover, we discuss other methodological difficulties and limitations of the study to propose future research agendas in the theme.

Addressing mental health challenges among it professionals: A systematic review of interventions and policies

Addressing mental health challenges among it professionals: A systematic review of interventions and policies

Evaluation of ‘implications for research’ statements in systematic reviews of interventions in advanced cancer patients – a meta-research study

BackgroundImplications for research (IfR) sections are an important part of systematic reviews (SRs) to inform health care researchers and policy makers. PRISMA 2020 recommends reporting IfR, while Cochrane Reviews require a separate chapter on IfR. However, it is unclear to what extent SRs discuss IfR.We aimed i) to assess whether SRs include an IfR statement and ii) to evaluate which elements informed IfR statements.MethodsWe conducted a meta-research study based on SRs of interventions in advanced cancer patients from a previous project (CRD42019134904).As suggested in the Cochrane Handbook, we assessed if the following predefined variables were referred to in IfR statements: patient, intervention, control, outcome (PICO) and study design; concepts underlying Grading of Recommendations, Assessment, Development and Evaluation (GRADE) domains: risk of bias, inconsistency, indirectness, imprecision, publication bias. Data were independently extracted by three reviewers after piloting the data extraction form. Discrepancies were resolved in weekly in-depth discussions.ResultsWe included 261 SRs. The majority evaluated a pharmacological intervention (n = 244, 93.5%); twenty-nine were Cochrane Reviews (11.1%).Four out of five SRs included an IfR statement (n = 210, 80.5%). IfR statements commonly addressed ‘intervention’ (n = 121, 57.6%), ‘patient ‘ (n = 113, 53.8%), and ‘study design’ (n = 107, 51.0%). The most frequent PICO and study design combinations were ‘patient and intervention ‘ (n = 71, 33.8%) and ‘patient, intervention and study design ‘ (n = 34, 16.2%).Concepts underlying GRADE domains were rarely used for informing IfR recommendations: ‘risk of bias ‘ (n = 2, 1.0%), and ‘imprecision ‘ (n = 1, 0.5%), ‘inconsistency ‘ (n = 1, 0.5%).Additional elements informing IfR were considerations on cost effectiveness (n = 9, 4.3%), reporting standards (n = 4, 1.9%), and individual patient data meta-analysis (n = 4, 1.9%).ConclusionAlthough about 80% of SRs included an IfR statement, the reporting of PICO elements varied across SRs. Concepts underlying GRADE domains were rarely used to derive IfR. Further work needs to assess the generalizability beyond SRs in advanced cancer patients. We suggest that more specific guidance on which and how IfR elements to report in SRs of interventions needs to be developed. Utilizing PICO elements and concepts underlying GRADE according to the Cochrane Handbook to state IfR seems to be a reasonable approach in the interim.RegistrationCRD42019134904.

Transitional care model for older adults with multiple chronic conditions: An evaluation of benefits utilising an umbrella review.

To synthesise and describe the combined evidence from systematic reviews of interventions using elements from the Transitional Care Model, on the content and timeframe of the interventions and the related improvement of outcomes for older patients with multiple chronic conditions. The population of older patients with multiple chronic conditions is increasing worldwide and trajectories are often complicated by risk factors. The Transitional Care Model may contain elements to support transitions between hospital and home. An umbrella review. A comprehensive search in five electronic databases was performed in April 2021 based on the search terms: 'Patients ≥60 years,' 'multi-morbidity,' 'Transitional care model,' 'Transitional care,' and 'Systematic review.' PRISMA guidelines was used. Five systematic reviews published from 2011 to 2020 comprising 62 intervention studies (59 randomised controlled trials and three quasi-experimental trials) were included in the review. The synthesis predominantly revealed significant improvements in decreasing re-admissions and financial costs and increasing patients' quality of life and satisfaction during discharge. The results of the review indicate that multiple elements from the Transitional Care Model have achieved significant improvements in older patients' transitions from hospital to home. Especially a combination of coordination, communication, collaboration and continuity of care in transitions, organised information and education for patients and pre-arranged structured post-discharge follow-ups. The transition from hospital to home is a complex process for older patients with multiple chronic conditions. A specific focus on coordination, continuity, and patient education should be implemented in the discharge process. Nurses with specialised knowledge in transitional care are needed to ensure safe transitions. The umbrella review is part of a larger research program which involved a patient expert advisory board, which participated in discussing the relevance of the elements within the umbrella review.

Clinical and methodological implications for research elements in systematic reviews on COVID-19 treatment were often unstructured and under-reported: a metaresearch study

ObjectivesNumerous systematic reviews (SRs) have been published in the first months of the COVID-19 pandemic and clinical trials were designed rapidly highlighting the importance of informative implications for research (IfRs) sections in SRs. IfR is one item of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist and the Cochrane Handbook suggests considering population, intervention, control, outcome (PICO) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) domains when developing IfR. We aimed (1) to assess whether SRs on COVID-19 treatments included any IfR statements and, for SRs with an IfR statement, (2) to examine which elements informed the IfR statement. Study Design and SettingWe conducted a metaresearch study based on SRs on COVID-19 treatment identified in the Living OVerview of the Evidence COVID-19 database in May 2021 as part of another research project (CRD42021240423). We defined an IfR statement as at least one sentence that contained at least one bit of information that could be informative for planning future research. We extracted any IfR statements anywhere in the SRs on predefined IfR variables, in particular PICO elements, study design, and concepts underlying GRADE domains. Three authors extracted data independently after piloting the data extraction form. We resolved discrepancies in weekly discussions to ensure a high-quality data extraction. ResultsWe included 326 SRs, of which 284 SRs (87.1%) stated IfR. Of these 284 SRs, 201 (70.8%) reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses and 66 (23.2%) using GRADE. IfR statements (n = 284) addressing PICO were unstructured and commonly reported ‘population’ (n = 195, 68.7%), ‘intervention’ (n = 242, 85.2%), and ‘outcome’ (n = 127, 44.7%) but not ‘control’ (n = 29, 10.2%). Concepts underlying GRADE domains were infrequently reported in IfR statements of SRs (n = 284): ‘risk of bias’ (n = 14, 4.9%), ‘imprecision’ (n = 8, 2.8%), ‘inconsistency’ (n = 7, 2.5%), ‘publication bias’ (n = 3, 1.1%), and ‘indirectness’ (n = 1, 0.4%). Additional IfR elements mentioned in IfR were ‘better reporting’ of future studies (n = 17, 6.0%) and ‘standardization of procedures in clinical trials’ (n = 12, 4.2%). ConclusionAlmost 90% of SRs on COVID-19 treatments reported IfR. IfR statements addressing PICO were unstructured across SRs and concepts underlying GRADE were rarely reported to inform IfR. Further work is needed to assess generalizability beyond COVID-19 and to define more precisely which IfR elements should be considered, and how they should be reported in SRs of interventions. Until then, considering PICO elements and concepts underlying GRADE to derive IfR seems to be a sensible starting point.

Most systematic reviews reporting adherence to AMSTAR 2 had critically low methodological quality: a cross-sectional meta-research study

ObjectivesTo analyze the methodological quality and characteristics of systematic reviews (SRs) that reported they were conducted in line with the AMSTAR 2 (A MeaSurement Tool to Assess Systematic Reviews). Study Design and SettingThis was a cross-sectional meta-research study. We searched MEDLINE and Embase. We included full reports of SRs reporting the study was conducted, prepared, or designed in line with the AMSTAR 2. Eligible SRs were those published from January 1, 2018, until May 3, 2022. We assessed the methodological quality of the included SRs using AMSTAR 2. ResultsWe included a total of 45 records. There were 43 SRs and 2 SR protocols. Among them, most were SRs of interventions that included primary studies on humans. More than half had a meta-analysis. According to our overall AMSTAR 2 assessments of included SRs, 35 SRs were of critically low confidence, 7 SRs were of low confidence, and one SR was of high confidence. There were no SRs of moderate confidence. ConclusionEven when authors indicate in their manuscripts that the SR was conducted/prepared/designed in line with the AMSTAR 2, it does not necessarily imply it is of high or even moderate confidence according to AMSTAR 2. A self-assessment with AMSTAR 2 could be required for submission and carefully checked by the editors/peer reviewers.

Overview of systematic reviews on periodontal-orthodontic interactions: A comprehensive literature analysis.

The aims of this research were to investigate the methodological quality of systematic reviews on periodontal-orthodontic interactions (i.e. reviews of primary research broadly defined as any including both periodontic and orthodontic components) and to provide a mapping of the researched topics. We searched four major databases (PubMed, Lilacs, Web of Science, and Embase) for systematic reviews of periodontal-orthodontic interactions. We used the AMSTAR-2 tool (the acronym is derived from 'a measurement tool to assess systematic reviews') to assess the methodological quality of the included systematic reviews. Individual AMSTAR-2 ratings were tabulated, and the percentage per item was calculated. To assess the association between the AMSTAR-2 percentage score and the overall confidence in the systematic review results, an ordinal regression model was used. We initially retrieved 973 documents, and 43 systematic reviews were included. Systematic reviews of interventions were the most prevalent (n = 26, 60.5%). Most of the systematic reviews did not report a meta-analysis (n = 25, 58.1%). In addition, most of the studies included in the systematic reviews had an unclear or high risk of bias. Most of the systematic reviews were rated as having critically low or low overall confidence (n = 34, 79.1%). A significant correlation was found between the AMSTAR-2 percentage score and overall confidence in the results. The methodological quality of systematic reviews on periodontal-orthodontic interactions can be improved. The limitations of our study include potential language bias and an arbitrary classification of the topics researched.

Comparison of different cesarean delivery techniques: A systematic review and meta-analysis

<b>Background: </b>The purpose of this systematic review and meta-analysis study was to compare various caesarean delivery methods.<br /> <b>Methods: </b>A search for available articles published since January 2023 was accomplished in PubMed, Medline, Embase, and Cochrane literature databases. The search method that encompassed all pertinent publications was developed using terms from the medical subject headings thesaurus and keywords from related literature. We also used the PICO method (where P is population, I is intervention, C is comparator/control, and O is outcome for our study) to establish research question. Whereas Cochrane handbook of “systematic reviews of interventions” was used for risk of bias assessment.<br /> <b>Results: </b>The results showed a significant difference in patient gratification between the gentle/natural/skin-to-skin contact caesarean and the traditional/conventional/standard caesarean. In assessing the satisfaction with delivery mode, the mean variance for these studies similarly revealed a significant difference between the natural caesarean and the conventional one. A skin-to-skin contact caesarean delivery takes less time to start nursing than a conventional delivery, according to the results of the study on the time of breastfeeding initiation after a natural caesarean. There was a low-risk bias among the selected studies.<br /> <b>Conclusions: </b>As a result of greater satisfaction with delivering experience the natural caesarean delivery was most preferred method. The enhanced skin-to-skin contact and breastfeeding suggested that natural caesarean is beneficial over the conventional method.

Systematic Review of Intervention and Prevention Programs to Tackle Homophobic Bullying at School: a Socio-emotional Learning Skills Perspective

AbstractHomophobia is a persisting and changing phenomenon globally affecting the educational system. Data clearly shows that school is not perceived as a safe environment for sexual and gender minority youth (SGMY). This work aims to systematically review the intervention and prevention programs designed to specifically address bullying behaviors at school towards SGMY, providing an analysis of the socio-emotional learning (SEL) components included in the interventions, to understand which socio-emotional skills can enhance students’ capabilities to prevent homophobic behaviors and promote safe environments for all students. The literature research was completed in February 2023 on NCBI PubMed, Web of Science, Scopus, and PsycINFO databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and diagram. A total of 408 studies were evaluated. 24 studies were selected as eligible for the final review. Each study was coded according to the targeted population: students, teachers, or to a whole school; moreover, the SEL model components were used as further classification criteria. The majority of interventions were targeted to students and to enhance social awareness. The literature review reported the lack of whole-school approaches, and most programs were not explicitly designed according to a SEL taxonomy despite the importance of socio-emotional skills in preventing prejudicial bullying. The review highlights the relevance of a socio-ecological approach to universal and targeted interventions.

Reducing unplanned hospital admissions from care homes: a systematic review

Background Care homes predominantly care for older people with complex health and care needs, who are at high risk of unplanned hospital admissions. While often necessary, such admissions can be distressing and provide an opportunity cost as well as a financial cost. Objectives Our objective was to update a 2014 evidence review of interventions to reduce unplanned admissions of care home residents. We carried out a systematic review of interventions used in the UK and other high-income countries by synthesising evidence of effects of these interventions on hospital admissions; feasibility and acceptability; costs and value for money; and factors affecting applicability of international evidence to UK settings. Data sources We searched the following databases in December 2021 for studies published since 2014: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Health Management Information Consortium; Medline; PsycINFO; Science and Social Sciences Citation Indexes; Social Care Online; and Social Service Abstracts. ‘Grey’ literature (January 2022) and citations were searched and reference lists were checked. Methods We included studies of any design reporting interventions delivered in care homes (with or without nursing) or hospitals to reduce unplanned hospital admissions. A taxonomy of interventions was developed from an initial scoping search. Outcomes of interest included measures of effect on unplanned admissions among care home residents; barriers/facilitators to implementation in a UK setting and acceptability to care home residents, their families and staff. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. We used published frameworks to extract data on intervention characteristics, implementation barriers/facilitators and applicability of international evidence. We performed a narrative synthesis grouped by intervention type and setting. Overall strength of evidence for admission reduction was assessed using a framework based on study design, study numbers and direction of effect. Results We included 124 publications/reports (30 from the UK). Integrated care and quality improvement programmes providing additional support to care homes (e.g. the English Care Homes Vanguard initiatives and hospital-based services in Australia) appeared to reduce unplanned admissions relative to usual care. Simpler training and staff development initiatives showed mixed results, as did interventions aimed at tackling specific problems (e.g. medication review). Advance care planning was key to the success of most quality improvement programmes but do-not-hospitalise orders were problematic. Qualitative research identified tensions affecting decision-making involving paramedics, care home staff and residents/family carers. The best way to reduce end-of-life admissions through access to palliative care was unclear in the face of inconsistent and generally low-quality evidence. Conclusions Effective implementation of interventions at various stages of residents’ care pathways may reduce unplanned admissions. Most interventions are complex and require adaptation to local contexts. Work at the interface between health and social care is key to successful implementation. Limitations Much of the evidence identified was of low quality because of factors such as uncontrolled study designs and small sample size. Meta-analysis was not possible. Future work We identified a need for improved economic evidence and the evaluation of integrated care models of the type delivered by hospital-based teams. Researchers should carefully consider what is realistic in terms of study design and data collection given the current context of extreme pressure on care homes. Study registration This study is registered as PROSPERO database CRD42021289418. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (award number NIHR133884) and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 18. See the NIHR Journals Library website for further project information.

Promoting Psychosocial Well-Being and Empowerment of Immigrant Women: A Systematic Review of Interventions.

This systematic review (SLR), based on the PRISMA 2020 guidelines, aims to present a current overview of interventions aimed at promoting the psychosocial well-being and/or empowerment (PWE) of immigrant women in order to guide future projects. Data collection was performed in the SCOPUS and Web of Science databases, with studies published between 2012 and 20 March 2023 in English, Portuguese, and Spanish. Inclusion and exclusion criteria were based on the PICO guidelines: (P) immigrant women, (I) interventions to improve PWE, (C) comparison between the initial and final phases, and (O) evaluated results for PWE. Risk of bias was assessed, and most of the studies met more than 80% of the JBI bias criteria and had moderate quality on GRADE. Thirteen studies with 585 participants were included, mostly non-randomized, non-equivalent, and with an experimental-control group design. The main components of interventions were health education/psychoeducation, counseling, cognitive restructuring, and expressive therapies. A descriptive synthesis of qualitative and quantitative data was made to evaluate the results of the interventions in PWE. In the experimental studies, results assessed improvements mainly in mood and depression levels, and stress reduction. Empowerment components were less covered. Experimental groups performed better in almost all variables in the comparison with control groups. The strongest interventions were psychoeducation and cognitive restructuring techniques. The main limitations of the studies were the lack of quality of several studies, sample size and representativeness, language, and the possibility of response bias. Even taking this into account, this article makes an original contribution by advocating for evidence-based practice and offering significant implications for health professionals, policy makers, and researchers that work with the integrative health of immigrant women. This SLR is registered in PROPESRO Registration: CRD42023399683. PS is a research fellow of the Foundation for Science and Technology (FCT) of Portugal.

Tele-orthodontics and sensor-based technologies: a systematic review of interventions that monitor and improve compliance of orthodontic patients.

Recent advances in orthodontics offer appealing tools to monitor compliance and designate protocols to enhance it. This systematic review of systematic reviews (SRs) aimed to assess the effectiveness of digitized communication methods and sensor-based devices that track compliance in orthodontic patients. Five electronic databases (PubMed, Web of Science, MEDLINE, PsycINFO, and EMBASE) were searched from database inception up to 4 December 2022. SRs using digitized systems and sensor-based technologies to monitor and/or improve compliance with orthodontic treatment or during an active retention phase were included. Study selection, data extraction, and risk of bias assessment using the AMSTAR 2 tool were performed independently by two review authors. A qualitative synthesis of outcomes from moderate- and high-quality SRs was provided, and evidence was graded in accordance with a scale of statements. A total of 846 unique citations were retrieved. After study selection, 18 SRs met the inclusion criteria, and 9 moderate- and high-quality reviews were further integrated into the qualitative synthesis. Digitized communication methods were found to be effective in improving compliance with oral hygiene practices and adherence to orthodontic appointments. Monitoring removable appliance wear with microsensors revealed sub-optimal levels of compliance with wear instructions of intra-oral and extra-oral appliances. One review discussed the informational value of social media platforms and their importance in guiding the decision-making process to seek orthodontic treatment and compliance-related experiences. The variability in the quality of included SRs and the limited number of primary studies on certain outcomes present as limitations within this overview. The integration of tele-orthodontics and sensor-based technologies to improve and monitor compliance within orthodontic practices is promising. There is sufficient evidence that establishing communication channels with orthodontic patients through reminders and audiovisual systems positively impact their oral hygiene practices throughout orthodontic treatment. However, understanding the informational value of social media as communication channels between clinicians and their patients, and their overall effect on modulating compliance is still insufficient. CRD42022331346.

Pregnancy Nutrition Core Outcome Set (PRENCOS): A core outcome set development study.

To develop a core outcome set for pregnancy nutrition. Mixed-methods core outcome set development study. Online. Healthcare professionals, researchers and women with experience of pregnancy. Candidate outcomes were identified from a systematic review of intervention and observational studies. One-to-one semi-structured interviews with women with experience of pregnancy (n = 26) were transcribed and analysed using inductive thematic analysis. Outcomes were consolidated, organised into domains and categorised using the Core Outcome Measures in Effectiveness Trials taxonomy. A two-round, modified Delphi survey (May-August 2021) was conducted. Participants voted on how critical each outcome was to include using a nine-point Likert scale. All outcomes that did not reach consensus were discussed at a consensus meeting. Critical outcomes to include in the core outcome set. A total of 53 091 articles were identified. Outcomes were extracted from 427 articles. The qualitative data yielded 45 outcomes. An additional 24 outcomes came from the literature. In round one, 82 participants ranked 30 outcomes. One new outcome was included in round two, during which participants (n = 60) voted 12/31 outcomes as critical to include. The remaining 20 outcomes were discussed at the consensus meeting and two outcomes were included. Maternal outcomes included: pregnancy complications; delivery complications; maternal wellbeing; gestational weight change; maternal vitamin and mineral status; mental health; diet quality; nutritional intakes; need for treatments, interventions, medications and supplements; pregnancy loss or perinatal death; birth defects or congenital anomalies; neonatal complications; and newborn anthropometry and body composition. The use of the Pregnancy Nutrition Core Outcome Set (PRENCOS) will ensure researchers measure what matters most from the perspective of key stakeholders.