Cochrane Database of Systematic Reviews最新文献

{"title":"Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants.","authors":"Abigale MacLellan, Austin J Cameron-Nola, Chris Cooper, Souvik Mitra","doi":"10.1002/14651858.CD015424.pub2","DOIUrl":"10.1002/14651858.CD015424.pub2","url":null,"abstract":"<p><strong>Background: </strong>The ductus arteriosus is a blood vessel connecting the main pulmonary artery and the proximal descending aorta. After birth, the ductus arteriosus usually closes completely. However, sometimes it remains patent in the neonate, which is called patent ductus arteriosus (PDA). If a PDA is clinically symptomatic, it can lead to overcirculation in the lungs, and reduced perfusion to the gut and kidneys. Most clinical practice guidelines suggest fluid restriction as a conservative management strategy for the treatment of symptomatic PDA. Restricting fluid has been shown to reduce the incidence of PDA in older preterm infants. However, aggressive restriction of fluids may affect systemic blood flow in extremely preterm infants. Given the potential adverse effects, it is important to systematically evaluate the evidence on the use of fluid restriction to treat symptomatic PDA to inform clinical decisions.</p><p><strong>Objectives: </strong>To assess the effects of fluid restriction on morbidity and mortality for symptomatic PDA in preterm infants.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, and Embase in October 2023. We also searched Clinicaltrials.gov, ICTRP, ANZCTR, and Epistemonikos. We planned to search the reference list of included studies and relevant systematic reviews for studies not identified by the database searches, but did not identify any.</p><p><strong>Selection criteria: </strong>We planned to include randomized controlled trials (RCTs), quasi-RCTs, cluster-RCTs, and cross-over RCTs. We planned to include neonates who were born preterm (less than 37 weeks' gestational age), or with low birth weight (less than 2500 g), with a symptomatic PDA, diagnosed either clinically or by echocardiographic criteria, in the neonatal period. We planned to include studies that compared therapeutic restriction of parenteral or enteral fluids, or both, with or without diuretics, with control groups that received standard fluid intake, defined as no parenteral or enteral restriction, with or without diuretic use.</p><p><strong>Data collection and analysis: </strong>We used standard Cochrane methods. Our primary outcome was closure of PDA. Other relevant outcomes were all-cause mortality by 36 weeks' postmenstrual age, need for interventional closure of the PDA, need for treatment with a cyclooxygenase inhibitor, bronchopulmonary dysplasia, severe intraventricular hemorrhage, and duration of hospitalization. We planned to use GRADE to assess the certainty of evidence for each outcome.</p><p><strong>Main results: </strong>We did not identify any completed or ongoing RCTs that met our inclusion criteria and explored the effectiveness and safety of fluid restriction to treat symptomatic PDA.</p><p><strong>Authors' conclusions: </strong>No evidence from RCTs is currently available to evaluate the benefits and harms of fluid restriction for the treatment of symptomatic patent ductus arteriosus in preterm i","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD015424"},"PeriodicalIF":8.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering of care activities for promoting development and preventing morbidity in hospitalized preterm infants.","authors":"Franciszek Borys, Marcus G Prescott, Michelle Fiander, Roger F Soll, Matteo Bruschettini","doi":"10.1002/14651858.CD016028","DOIUrl":"10.1002/14651858.CD016028","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of clustering of care activities for promoting development and preventing morbidity in preterm infants.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD016028"},"PeriodicalIF":8.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial incentives for family members of hospitalized neonates for improving family presence.","authors":"Katarzyna Wróblewska-Seniuk, Aaron Wallman-Stokes, Erika Edwards, Michelle Fiander, Matteo Bruschettini, Roger F Soll","doi":"10.1002/14651858.CD014572","DOIUrl":"10.1002/14651858.CD014572","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of financial incentives for improving family engagement on family members of neonates receiving hospitalized care.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD014572"},"PeriodicalIF":8.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher blood pressure targets for hypertension in older adults.","authors":"Jamie M Falk, Liesbeth Froentjes, Jessica Em Kirkwood, Balraj S Heran, Michael R Kolber, G Michael Allan, Christina S Korownyk, Scott R Garrison","doi":"10.1002/14651858.CD011575.pub3","DOIUrl":"10.1002/14651858.CD011575.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This is an update of the original Cochrane review, published in 2017. Eight out of 10 major antihypertensive trials in adults, 65 years of age or older, attempted to achieve a target systolic blood pressure (BP) of &lt; 160 mmHg. Collectively, these trials demonstrated cardiovascular benefit for treatment, compared to no treatment, for older adults with BP &gt; 160 mmHg. However, an even lower BP target of &lt; 140 mmHg is commonly applied to all age groups. Yet the risk and benefit of antihypertensive therapy can be expected to vary across populations, and some observational evidence suggests that older adults who are frail might have better health outcomes with less aggressive BP lowering. Current clinical practice guidelines are inconsistent in target BP recommendations for older adults, with systolic BP targets ranging from &lt; 130 mmHg to &lt; 150 mmHg. The 2017 review did not find compelling evidence of a reduction in any of the primary outcomes, including all-cause mortality, stroke, or total serious cardiovascular adverse events, comparing a lower BP target to a higher BP target in older adults with hypertension. It is important to update this review to explore if new evidence exists to determine whether older adults might do just as well, better, or worse with less aggressive pharmacotherapy for hypertension.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of a less aggressive blood pressure target (in the range of &lt; 150 to 160/95 to 105 mmHg), compared to a conventional or more aggressive BP target (of &lt; 140/90 mmHg or lower) in hypertensive adults, 65 years of age or older.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;For this update, Cochrane Hypertension's Information Specialist searched the following databases for randomised controlled trials up to June 2024: Cochrane Hypertension Specialised Register, CENTRAL, MEDLINE Ovid, and Embase Ovid, and the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov for ongoing trials. We also contacted authors of relevant papers requesting information on further published and unpublished work. The searches had no language restrictions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised trials of hypertensive older adults (≥ 65 years) that spanned at least one year, and reported the effect on mortality and morbidity of a higher or lower systolic or diastolic BP treatment target. Higher BP targets ranged from systolic BP &lt; 150 to 160 mmHg or diastolic BP &lt; 95 to 105 mmHg; lower BP targets were 140/90 mmHg or lower, measured in an ambulatory, home, or office setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two authors independently screened and selected trials for inclusion, assessed risk of bias and certainty of the evidence, and extracted data. We combined data for dichotomous outcomes using the risk ratio (RR) with 95% confidence interval (CI). For continuous outcomes, we used mean difference (MD). Primary outcomes were all-c","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD011575"},"PeriodicalIF":8.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GALAD, or des-gamma-carboxy prothrombin compared with alpha-foetoprotein for the diagnosis of hepatocellular carcinoma in people with chronic liver disease.","authors":"Merica Aralica, Tin Nadarevic, Agostino Colli, Giovanni Casazza, Luka Vranić, Mirella Fraquelli, Goran Poropat, Davor Štimac","doi":"10.1002/14651858.CD015826","DOIUrl":"10.1002/14651858.CD015826","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To estimate the diagnostic accuracy of des-gamma-carboxy prothrombin, GALAD (Gender, Age, Lens culinaris agglutinin-reactive AFP, AFP and DCP), and alpha-foetoprotein for the diagnosis of hepatocellular carcinoma of any size, and at any stage, in adults with chronic liver disease, in either a surveillance programme or a clinical setting. We acknowledge the possibility that theoretically, the accuracy of the tests in a surveillance programme may differ from that in a clinical setting due to variation in inclusion criteria and the prevalence of the target condition. However, we do not plan a separate analysis for surveillance and clinical settings, as they are not clearly distinct in current clinical practice (Forner 2018; Poustchi 2011). In routine evaluation of people with chronic liver disease, index tests, as well as ultrasound, are already part of standard procedure. Given that HCC typically presents with no symptoms and is often asymptomatic, suspicion of the disease is typically based solely on the presence of advanced chronic liver disease. However, we do plan to consider the study setting as a potential source of heterogeneity. To compare the diagnostic accuracy of des-gamma-carboxy prothrombin (DCP) alone or GALAD alone versus alpha-foetoprotein (AFP), for the diagnosis of hepatocellular carcinoma (HCC) of any size, at any stage; in adults with chronic liver disease, either in a surveillance programme or a clinical setting. Secondary objectives To estimate the diagnostic accuracy of DCP or GALAD versus AFP, for resectable HCC in people with chronic liver disease, in a surveillance programme and a clinical setting. To investigate the following predefined sources of heterogeneity for each of the index tests: study design (case-control studies compared to cross-sectional studies); inclusion of participants without cirrhosis (studies including more than 10% of participants without cirrhosis compared to studies including less than 10% of participants without cirrhosis); study location (population differences): studies conducted in North and South America and Europe compared to Asia and Africa; prevalence of the target condition (studies with hepatocellular carcinoma prevalence more than 10% compared to studies with hepatocellular carcinoma prevalence less than 10%); participant selection (participants recruited from planned surveillance programmes compared to clinical cohorts); different reference standards (histology of the explanted liver compared to liver biopsy compared to another reference standard); different aetiology: studies including at least 90% of participants with chronic viral hepatitis compared to studies including less than 90% of participants with chronic viral hepatitis.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD015826"},"PeriodicalIF":8.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of sample site and collection procedure on identification of SARS-CoV-2 infection.","authors":"Clare Davenport, Ingrid Arevalo-Rodriguez, Miriam Mateos-Haro, Sarah Berhane, Jacqueline Dinnes, René Spijker, Diana Buitrago-Garcia, Agustín Ciapponi, Yemisi Takwoingi, Jonathan J Deeks, Devy Emperador, Mariska M G Leeflang, Ann Van den Bruel","doi":"10.1002/14651858.CD014780","DOIUrl":"10.1002/14651858.CD014780","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sample collection is a key driver of accuracy in the diagnosis of SARS-CoV-2 infection. Viral load may vary at different anatomical sampling sites and accuracy may be compromised by difficulties obtaining specimens and the expertise of the person taking the sample. It is important to optimise sampling accuracy within cost, safety and accessibility constraints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare the sensitivity of different sampling collection sites and methods for the detection of current SARS-CoV-2 infection with any molecular or antigen-based test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;Electronic searches of the Cochrane COVID-19 Study Register and the COVID-19 Living Evidence Database from the University of Bern (which includes daily updates from PubMed and Embase and preprints from medRxiv and bioRxiv) were undertaken on 22 February 2022. We included independent evaluations from national reference laboratories, FIND and the Diagnostics Global Health website. We did not apply language restrictions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included studies of symptomatic or asymptomatic people with suspected SARS-CoV-2 infection undergoing testing. We included studies of any design that compared results from different sample types (anatomical location, operator, collection device) collected from the same participant within a 24-hour period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Within a sample pair, we defined a reference sample and an index sample collected from the same participant within the same clinical encounter (within 24 hours). Where the sample comparison was different anatomical sites, the reference standard was defined as a nasopharyngeal or combined naso/oropharyngeal sample collected into the same sample container and the index sample as the alternative anatomical site. Where the sample comparison was concerned with differences in the sample collection method from the same site, we defined the reference sample as that closest to standard practice for that sample type. Where the sample pair comparison was concerned with differences in personnel collecting the sample, the more skilled or experienced operator was considered the reference sample. Two review authors independently assessed the risk of bias and applicability concerns using the QUADAS-2 and QUADAS-C checklists, tailored to this review. We present estimates of the difference in the sensitivity (reference sample (%) minus index sample sensitivity (%)) in a pair and as an average across studies for each index sampling method using forest plots and tables. We examined heterogeneity between studies according to population (age, symptom status) and index sample (time post-symptom onset, operator expertise, use of transport medium) characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;This review includes 106 studies reporting 154 evaluations and 60,523 sample pair comparisons, of which 11,045 had SARS-CoV-2 infectio","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD014780"},"PeriodicalIF":8.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose reduction and discontinuation of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) for people with psoriatic arthritis in remission or low disease activity.","authors":"Helen Ramsay, Renea V Johnston, Sheila Cyril, Vanessa Glennon, Liesl Grobler, Deanne M Burgess, Bayden J McKenzie, Samuel L Whittle, Rachelle Buchbinder","doi":"10.1002/14651858.CD015880","DOIUrl":"10.1002/14651858.CD015880","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of dose reduction or discontinuation of biologic disease-modifying anti-rheumatic drugs or targeted synthetic disease-modifying anti-rheumatic drugs in adults with psoriatic arthritis who are in remission or a low disease activity state.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD015880"},"PeriodicalIF":8.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment for women with postpartum iron deficiency anaemia.","authors":"Mie Cecilie Hall Jensen, Charlotte Holm, Karsten Juhl Jørgensen, Jeppe B Schroll","doi":"10.1002/14651858.CD010861.pub3","DOIUrl":"10.1002/14651858.CD010861.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Postpartum iron deficiency anaemia is caused by antenatal iron deficiency or excessive blood loss at delivery and might affect up to 50% of labouring women in low- and middle-income countries. Effective and safe treatment during early motherhood is important for maternal well-being and newborn care. Treatment options include oral iron supplementation, intravenous iron, erythropoietin, and red blood cell transfusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of the available treatment modalities for women with postpartum iron deficiency anaemia. These include intravenous iron, oral iron supplementation, red blood cell transfusion, and erythropoietin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;A Cochrane Information Specialist searched for all published, unpublished, and ongoing trials, without language or publication status restrictions. We searched databases including CENTRAL, MEDLINE, Embase, CINAHL, LILACS, WHO ICTRP, and ClinicalTrials.gov, together with reference checking, citation searching, and contact with study authors to identify eligible studies. We applied date limits to retrieve new records since the last search on 9 April 2015 until 11 April 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included published, unpublished, and ongoing randomised controlled trials (RCTs) that compared treatments for postpartum iron deficiency anaemia with placebo, no treatment, or alternative treatments. Cluster-randomised trials were eligible for inclusion. We included RCTs regardless of blinding. Participants were women with postpartum haemoglobin ≤ 12 g/dL, treated within six weeks after childbirth. We excluded non-randomised, quasi-randomised, and cross-over trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcomes of this review were maternal mortality and fatigue. The important outcomes included persistent anaemia symptoms, persistent postpartum anaemia, psychological well-being, infections, compliance with treatment, breastfeeding, length of hospital stay, serious adverse events, anaphylaxis or evidence of hypersensitivity, flushing/Fishbane reaction, injection discomfort/reaction, constipation, gastrointestinal pain, number of red blood cell transfusions, and haemoglobin levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed risk of bias in the included studies using the Cochrane RoB 1 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Two review authors independently performed study screening, risk of bias assessment, and data extraction. We contacted trial authors for supplementary data when necessary. We screened all trials for trustworthiness and scientific integrity using the Cochrane Trustworthiness Screening Tool. We conducted meta-analyses using a fixed-effect model whenever feasible to synthesise outcomes. In cases where data were not suitable for meta-analysis, we provided a narrative summary of important findings. We evaluated the overall certainty of the evidence using GR","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD010861"},"PeriodicalIF":8.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies for enhancing the implementation of school-based policies or practices targeting diet, physical activity, obesity, tobacco or alcohol use.","authors":"Daniel Cw Lee, Kate M O'Brien, Sam McCrabb, Luke Wolfenden, Flora Tzelepis, Courtney Barnes, Serene Yoong, Kate M Bartlem, Rebecca K Hodder","doi":"10.1002/14651858.CD011677.pub4","DOIUrl":"10.1002/14651858.CD011677.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A range of school-based interventions are effective in improving student diet and physical activity (e.g. school food policy interventions and classroom physical activity interventions), and reducing obesity, tobacco use and/or alcohol use (e.g. tobacco control programmes and alcohol education programmes). However, schools are frequently unsuccessful in implementing such evidence-based interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The primary review objective is to evaluate the effectiveness of strategies aiming to improve school implementation of interventions to address students' (aged 5 to 18 years) diet, physical activity, obesity, tobacco use and/or alcohol use. The secondary objectives are to: 1. determine whether the effects are different based on the characteristics of the intervention including school type and the health behaviour or risk factor targeted by the intervention; 2. describe any unintended consequences and adverse effects of strategies on schools, school staff or students; and 3. describe the cost or cost-effectiveness of strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid), five additional databases, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the US National Institutes of Health registry (clinicaltrials.gov). The latest search was between 1 May 2021 and 30 June 2023 to identify any relevant trials published since the last published review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We defined 'implementation' as the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns within specific settings. We included any randomised controlled trial (RCT) or cluster-RCT conducted on any scale, in a school setting, with a parallel control group that compared a strategy to improve the implementation of policies or practices to address diet, physical activity, obesity, tobacco use and/or alcohol use by students (aged 5 to 18 years) to no active implementation strategy (i.e. no intervention, inclusive of usual practice, minimal support) or a different implementation strategy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We used standard Cochrane methods. Given the large number of outcomes reported, we selected and included the effects of a single outcome measure for each trial for the primary outcome using a decision hierarchy (i.e. continuous over dichotomous, most valid, total score over subscore). Where possible, we calculated standardised mean differences (SMDs) to account for variable outcome measures with 95% confidence intervals (CI). We conducted meta-analyses using a random-effects model. Where we could not combine data in meta-analysis, we followed recommended Cochrane methods and reported results in accordance with 'Synthesis without meta-analysis' (SWiM) guidelines. We conducted assessments of risk of bias and evaluated the certai","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD011677"},"PeriodicalIF":8.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in the context of interventions for improving health literacy in migrants: a qualitative evidence synthesis.","authors":"Angela Aldin, Annika Baumeister, Digo Chakraverty, Ina Monsef, Jane Noyes, Elke Kalbe, Christiane Woopen, Nicole Skoetz","doi":"10.1002/14651858.CD013302.pub2","DOIUrl":"10.1002/14651858.CD013302.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Health literacy can be defined as a person's knowledge, motivation and competence in four steps of health-related information processing - accessing, understanding, appraising and applying health-related information. Individuals with experience of migration may encounter difficulties with or barriers to these steps that may, in turn, lead to poorer health outcomes than those of the general population. Moreover, women and men have different health challenges and needs and may respond differently to interventions aimed at improving health literacy. In this review, we use 'gender' rather than 'sex' to discuss differences between men and women because gender is a broad term referring to roles, identities, behaviours and relationships associated with being male or female.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The overall objective of this qualitative evidence synthesis (QES) was to explore and explain probable gender differences in the health literacy of migrants. The findings of this QES can provide a comprehensive understanding of the role that any gender differences can play in the development, delivery and effectiveness of interventions for improving the health literacy of female and male migrants. This qualitative evidence synthesis had the following specific objectives: - to explore whether there are any gender differences in the health literacy of migrants; - to identify factors that may underlie any gender differences in the four steps of health information processing (access, understand, appraise, and apply); - to explore and explain gender differences found - or not found - in the effectiveness of health literacy interventions assessed in the effectiveness review that is linked to this QES (Baumeister 2023); - to explain - through synthesising findings from Baumeister 2023 and this QES - to what extent gender- and migration-specific factors may play a role in the development and delivery of health literacy interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We conducted electronic searches in MEDLINE, CINAHL, PsycINFO and Embase until May 2021. We searched trial registries and conference proceedings. We conducted extensive handsearching and contacted study authors to identify all relevant studies. There were no restrictions in our search in terms of gender, ethnicity or geography.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included qualitative trial-sibling studies directly associated with the interventions identified in the effectiveness review that we undertook in parallel with this QES. The studies involved adults who were first-generation migrants (i.e. had a direct migration experience) and used qualitative methods for both data collection and analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We extracted data into a form that we developed specifically for this review. We assessed methodological limitations in the studies using the CASP (Critical Appraisal Skills Programme) Qualitative Stud","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"12 ","pages":"CD013302"},"PeriodicalIF":8.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}