No / To determine the accuracy of radiographers red dot or triage of accident and emergency (A&E) radiographs in clinical practice. MATERIALS AND METHODS Eligible studies assessed radiographers red dot or triage of A&E radiographs in clinical practice compared with a reference standard and provided accuracy data to construct 2×2 tables. Data were extracted on study eligibility and characteristics, quality, and accuracy. Pooled sensitivities and specificities and chi-square tests of heterogeneity were calculated. RESULT Three red dot and five triage studies were eligible for inclusion. Radiographers' red dot of A&E radiographs in clinical practice compared with a reference standard is 0.87 [95% confidence interval (CI) 0.85¿0.89] and 0.92 (0.91¿0.93) sensitivity and specificity, respectively. Radiographers' triage of A&E radiographs of the skeleton is 0.90 (0.89¿0.92) and 0.94 (0.93¿0.94) sensitivity and specificity, respectively; and for chest and abdomen is 0.78 (0.74¿0.82) and 0.91 (0.88¿0.93). Radiographers' red dot of skeletal A&E radiographs without training is 0.71 (0.62¿0.79) and 0.96 (0.93¿0.97) sensitivity and specificity, respectively; and with training is 0.81 (0.72¿0.87) and 0.95 (0.93¿0.97). Pooled sensitivity and specificity for radiographers without training for the triage of skeletal A&E radiographs is 0.89 (0.88¿0.91) and 0.93 (0.92¿0.94); and with training is 0.91 (0.88¿0.94) and 0.95 (0.93¿0.96). CONCLUSION Radiographers red dot or triage of A&E radiographs in clinical practice is affected by body area, but not by training.

Yes / This systematic review of reviews aims to investigate how brief interventions (BIs) are defined, whether they increase physical activity, which factors influence their effectiveness, who they are effective for, and whether they are feasible and acceptable. We searched CINAHL, Cochrane database of systematic reviews, DARE, HTA database, EMBASE, MEDLINE, PsycINFO, Science Citation Index-Expanded and Social Sciences Citation Index, and Scottish Intercollegiate Guidelines Network from their inception until May 2015 to identify systematic reviews of the effectiveness of BIs aimed at promoting physical activity in adults, reporting a physical activity outcome and at least one BI that could be delivered in a primary care setting. A narrative synthesis was conducted. We identified three specific BI reviews and thirteen general reviews of physical activity interventions that met the inclusion criteria. The BI reviews reported varying definitions of BIs, only one of which specified a maximum duration of 30 min. BIs can increase self-reported physical activity in the short term, but there is insufficient evidence about their long-term impact, their impact on objectively measured physical activity, and about the factors that influence their effectiveness, feasibility and acceptability. Current definitions include BIs that are too long for primary care consultations. Practitioners, commissioners and policy makers should be aware of this when interpreting evidence about BIs, and future research should develop and evaluate very brief interventions (of 5 min or less) that could be delivered in a primary care consultation. / This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0608-10079). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The funder had no role in study design, data collection, data analysis, data interpretation, the writing of the manuscript, and decision to submit the manuscript for publication.

Yes / Person-centered care (PCC) has been the subject of several intervention studies, reporting positive effects on people with dementia. However, its impact on staff’s outcomes remains unclear. The purpose of this systematic review was to assess the impact of PCC approaches on stress, burnout and job satisfaction of staff caring for people with dementia in care homes. The databases PubMed, Web of Knowledge, Scopus and EBSCO and reference lists from relevant publications, were searched between December 2012 and March 2013. The review was limited to experimental and quasi-experimental studies, published in English and involving direct care workers (DCWs). Seven studies were included, addressing different PCC approaches: dementia care mapping (n=1); stimulation-oriented approaches (n=2); emotion-oriented approaches (n=2) and behavioral-oriented approaches (n=2). Five studies reported benefits on DCWs, suggesting a tendency towards the effectiveness of PCC on staff. However, methodological weaknesses and heterogeneity among studies make it difficult to draw firm conclusions. / Portuguese Foundation for Science and Technology

Yes / Obesity interventions rely predominantly on managing dietary intake and/or increasing physical activity but sustained adherence to behavioural regimens is often poor. Avatar technology is well established within the computer gaming industry and evidence suggests that virtual representations of self may impact real-world behaviour, acting as a catalyst for sustained weight loss behaviour modification. However, the effectiveness of avatar technology in promoting weight loss is unclear. Aims: We aimed to assess the quantity and quality of empirical support for the use of avatar technologies in adult weight loss interventions. Method: A systematic review of empirical studies was undertaken. The key objectives were to determine if: (i) the inclusion of avatar technology leads to greater weight loss achievement compared to routine intervention; and (ii) whether weight loss achievement is improved by avatar personalisation (avatar visually reflects self). Results: We identified 6 papers that reported weight loss data. Avatar-based interventions for weight loss management were found to be effective in the short (4–6 weeks) and medium (3–6 months) term and improved weight loss maintenance in the long term (12 months). Only 2 papers included avatar personalisation, but results suggested there may be some added motivational benefit. Conclusions: The current evidence supports that avatars may positively impact weight loss achievement and improve motivation. However, with only 6 papers identified the evidence base is limited and therefore findings need to be interpreted with caution. / National Institute for Health Research (NIHR) [RfPB programme (project reference PB-PG-1215-20016)].

Yes / Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status. Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0-5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity. The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval - 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; - 0.64, 3.36) and smallest for Down syndrome (0.38; - 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings. Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving. / Sarah Masefeld was supported by a match funded studentship from the University of York and the Health e-Research Centre ref PhD2016PP2.

Yes / This study aimed to explore more on contributing factors and prevention of overweight and obesity among Pacific islanders. Methods: Using Cochrane library guideline, four electronic databases, PubMed, Embase, Scopus and CINAHL, were systematically searched from 2010 to 2020. Search strategy included key concepts, free text terms, and database-controlled vocabulary terms to identify articles on determinants and preventative strategies of overweight and obesity in the Pacific countries. A data extraction sheet was developed to extract relevant information required for analysis and theme development for this study. Results: A total of 22 articles were summarized and categorized. Determinants of overweight and obesity identified two themes: environmental related factors 13.6% (3/22) and sociocultural related factors 27.3% (6/22). The preventative strategies of overweight and obesity was categorized into behavioural change 22.7% (5/22), school-related 18.2% (4/22), and policies 50% (11/22). The quality assessment of articles showed “Good” 68.2% (15/22), and “Fair” 31.8% (7/22). Conclusion: This study highlighted two contributing, non-medication factors affecting overweight and obesity are both environmental and socio-cultural issues. Overweight and obesity preventative strategies identified in the Pacific context considered behavioural change, knowledge enhancement, and policy development. Further research should aim at exploring the current preventative strategies in-depth, to appreciate the most feasible and recommended preventative approach within the Pacific society.

Yes / This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses. This study applied a systematic review design. Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review. Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.

Yes / Water is essential in everyday life hence, there is a need for it to be available in quality and quantity to all. This study aimed to review relevant published studies on water accessibility and safety in Ghana from 2015 to 2022 to determine the plausibility of Ghana achieving Sustainable Development Goal 6.1 by 2030. METHODOLOGY A systematic review was conducted based on the PRISMA guidelines using four databases including ProQuest, Science Direct, Web of Science and Scopus. Studies with data on specified keywords and published in English from January 2015 to June 2022 were included in this study. Duplicated titles were removed and the title, and full text of remained studies were reviewed by two independent coders. Thematic analysis was conducted to identify themes. RESULTS Ten studies met the criteria and the majority of them used qualitative design (60%). Five main themes were identified including; causes of water contamination, the prevalence of waterborne diseases, types of water sources, implemented policies and challenges for policy implementation. The government implemented policies to provide safe and potable drinking water for the citizen and now, about 72% of the population have access to treated pipe water. Some challenges facing implemented policies include political interest in illegal mining, inadequate waste disposal facilities, and poverty. CONCLUSION This study shows that Ghana can achieve Sustainable Development Goal 6.1 which is "Access to clean and affordable water for all" by 2030. The government, public health organizations and stakeholders should work together to alleviate the challenges faced in achieving this goal.

Yes / A literature review is a key part of all academic research that informs researchers of the existing body of knowledge. Reviews conducted systematically are becoming more appealing to the researcher about two reasons. Firstly, they are robust, strong, comprehensive and reproducible and can appropriately serve the review of any primary research. Secondly, they are qualified to be a stand-alone piece of academic work that contributes to the scientific body of knowledge. Although researchers and students in higher education who wish to write their dissertations are informed about the need for generating a literature review for primary research, when it comes to conducting a full systematic review, they may have some confusion and doubt on the distinction between a traditional literature review and a systematic review. This paper aims to clarify what a systematic review entails and take the readers' attention through the practical steps in conducting a systematic review. So, more of a practical step-by-step guide, rather than theoretical discussion of content, has been included. This paper would benefit early-career researchers, undergraduate students and many post-graduate students who wish to write their papers or dissertations based on a systematic review.

Background: The coronavirus disease 2019 (COVID-19) presents diagnostic evaluation and patient management challenges, including uncertainty regarding the role of imaging tests. This series of reviews from the suite of Cochrane ‘living systematic reviews’ aims to evaluate the accuracy of chest imaging (computed tomography (CT), X-ray and ultrasound) for diagnosis and management of individuals with suspected COVID-19. Methods: The Bern COVID-19 Living Database, Cochrane COVID-19 Register, and CDC Library were searched through 30 September 2020 (for review version 3) and 17 February 2021 (for review version 4). Diagnostic accuracy studies involving participants with suspected COVID-19 were included. Screening, data extraction, and risk of bias assessments (using the QUADAS-2 tool) were completed independently, in duplicate. Pooled accuracy estimates and 95% confidence intervals (CIs) were determined using a bivariate random effects model. Results: In the third version of the review, chest CT (41 studies, 16133 participants, 8110 (50%) cases) had a pooled sensitivity of 87.9% (95%CI 84.6-90.6) and specificity of 80.0% (74.9-84.3). Chest X-ray (9 studies, 3694 participants, 2111 (57%) cases) had a pooled sensitivity of 80.6% (69.1-88.6) and specificity of 71.5% (59.8-80.8). Ultrasound of the lungs (5 studies, 446 participants, 211 (47%) cases) had a pooled sensitivity of 86.4% (72.7-93.9) and specificity of 54.6% (35.3-72.6). Indirect comparisons showed that chest CT gave higher specificity (P=0.0052) and similar sensitivity (P=0.77) compared to ultrasound. There were no differences (P≥0.05) in accuracy between CT and X‐ray, or X‐ray and ultrasound. In the fourth version of the review, chest CT (69 studies, 28285 participants, 14342 (51%) cases) had a pooled sensitivity of 86.9% (83.6-89.6) and specificity of 78.3% (73.7-82.3). Chest X‐ray (17 studies, 8530 participants, 5303 (62%) cases) had a pooled of sensitivity=73.1% (64.1-80.5) and specificity of 73.3% (61.9-82.2). Ultrasound of the lungs (15 studies, 2410 participants, 1158 (48%) cases) had a pooled sensitivity of 88.9% (84.9-92.0) and specificity of 72.2% (58.8-82.5). Indirect comparisons showed that chest CT and ultrasound had similar sensitivities (P=0.42), and each gave higher sensitivities than X-ray (P=0.0003 and P=0.001, respectively). All modalities had similar specificities (P≥0.05). Conclusion: The most recent evidence indicates that both chest CT and ultrasound of the lungs are sensitive and moderately specific for diagnosing individuals with suspected COVID-19, while chest X-ray is moderately sensitive and moderately specific. Chest CT and ultrasound may be useful for ruling out COVID‐19, but not for distinguishing COVID-19 from other illnesses. Research assessing the prognostic value of imaging for predicting morbidity and mortality in individuals with COVID-19 is underway and will also be published in the suite of Cochrane ‘living' systematic reviews.