Technology-delivered personalized nutrition intervention on dietary outcomes among adults with overweight and obesity: A systematic review, meta-analysis, and meta-regression.

The prevalence of overweight and obesity has continued to increase globally, and one-size-fits-all dietary recommendations may not be suitable for different individual characteristics. A personalized nutrition intervention may be a potential solution. This review aims to evaluate the effects of the technology-delivered personalized nutrition intervention on energy, fat, vegetable, and fruit intakes among adults with overweight and obesity. A three-step comprehensive search strategy was performed from 10 databases and seven clinical registries in published and unpublished trials. A total of 46 randomized controlled trials (RCTs) involving 19,670 adults with overweight and obesity from 14 countries are included. Subgroup and meta-regression analyses were conducted. Meta-analyses showed a reduction of energy intake (-128.05, 95% CI: -197.08, -59.01) and fat intake (-1.81% energy/days, 95% CI: -3.38, -0.24, and -0.19 scores, 95% CI: -0.40, 0.02) in the intervention compared with the comparator. Significant improvements in vegetable and fruit intakes with 0.12-0.15 servings/day were observed in the intervention. Combined one- and two-way interactions had a greater effect on energy intake reduction compared with their counterparts. Meta-regression analyses revealed that no significant covariates were found. Given that the certainty of the evidence was rated as low or very low, further well-designed RCTs with long-term follow-up are warranted.

High body mass index and sleep problems during pregnancy: A meta-analysis and meta-regression of observational studies.

Despite the well-established correlation of weight and sleeping problems, little is known about the nature of the association. The present study examined whether pregnant women with high body mass index have a risk of developing sleep problems, and identified any covariates that affect this relationship. We systematically searched electronic databases, specialized journals, various clinical trial registries, grey literature databases and the reference list of the identified studies. All observational studies were obtained from inception until 9 August 2020. The Newcastle-Ottawa Scale was adopted to assess the quality of studies. Stata software was used to conduct meta-analysis and meta-regression. Forty-six observational studies involving 2,240,804 participants across 16 countries were included. Quality assessment scores ranged from 4 to 10 (median = 6). Meta-analyses revealed that the risk of sleep apnea, habitual snoring, short sleep duration and poor sleep quality is increased in pregnant women with high body mass index, but not for daytime sleepiness, insomnia or restless legs syndrome. Subgroup differences were detected on body mass index between different regions, nature of population, year of publication, age group and study quality. Random-effects meta-regression analyses showed that year and quality of publication were covariates on the relationships between pre-pregnant body mass index and sleep apnea risk. Our review shows that sleep apnea, habitual snoring, short sleep duration and poor sleep quality are important concerns for pregnant women with high body mass index. Developing screening and targeted interventions is recommended to promote efficacious perinatal care.

Evaluating the effectiveness of interprofessional advanced cardiac life support training: a sequential mixed-methods approach.

Interprofessional advanced cardiac life support (IP-ACLS) training is a holistic learning experience; thus, our research team incorporated this training into an undergraduate programme. Considering that IP-ACLS training is a new paradigm in nursing education, evaluating its effectiveness is essential. This research aimed to (1) evaluate the effectiveness of this training on improving the perceived level of interprofessional collaboration, self-efficacy and emotion regulation and (2) explore the learning experience of nursing students during training. The study design adopted a sequential mixed-method approach comprising a two-group pretest and posttest design amongst 120 students, followed by nine focus group discussions. Quantitative results demonstrated significant improvements in the perceived level of interprofessional collaboration, self-efficacy and emotion regulation at post-intervention and follow-up. Qualitative data were collected through video recording and field notes. Thematic analysis was performed following the method of Braun and Clarke. Qualitative analysis of focus group transcripts identified three themes: synergistic partnership, clinical readiness and improving further training. Quantitative and qualitative results were integrated in accordance with the mixed data analysis framework. These results complemented one another. The training provided an authentic learning experience and a good steppingstone to nursing students who are preparing to work interprofessionally in the future.

Humanoid robot-assisted interventions among children with diabetes: A systematic scoping review.

BACKGROUND: Although the humanoid robot is highly engaging for children, whether humanoid robot-assisted interventions could help in diabetes management is still unclear. OBJECTIVES: This review aimed to elucidate the roles of humanoid robot in managing diabetes and observe the effects of humanoid robot-assisted interventions among children with type I diabetes mellitus. METHODS: Arksey and O'Malley's methodological framework was used to conduct this scoping review. DATA RESOURCE: We conducted a comprehensive search in 10 databases, including IEEE Xplore Digital Library, CINAHL, Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, ProQuest, WanFang, and CNKI, from May 1, 1989 to February 1, 2020. The reference lists of key texts were examined and citation chaining was conducted. In addition, our team searched gray literature and relevant journals to maximise the searching. REVIEW METHODS: Two independent reviewers examined all full articles for fitness with the eligibility criteria. Items of data extraction included the characteristics of articles, description of intervention, and mechanism of humanoid robot in improving the management of children with diabetes. RESULTS: A total of 2,755 articles were retrieved, 22 of which were included from five countries across different ethnicities. Five roles of humanoid robots in managing diabetes among children with type I diabetes mellitus were identified: disease manager, educator, advocator, emotional supporter, and communicator. To some extent, effects seem to be related to the positive improvement of affective, experiential, relational, cognitive, and behavioral perspectives from humanoid robot-assisted intervention. CONCLUSIONS: The roles of humanoids have been designed to perform their multidomain functionality. Although many positive effects were observed, the majority of selected articles have methodological issues. Future studies need an improved methodology for large-scale controlled trials.

Personalised eHealth interventions in adults with overweight and obesity: A systematic review and meta-analysis of randomised controlled trials.

Given that many existing electronic health (eHealth) interventions with a general approach have limited effects, a personalised approach is necessary. We aimed to evaluate the effectiveness of personalised eHealth interventions in reducing body weight and identify the effective key features of such interventions. We searched seven databases for randomised controlled trials (RCTs) from inception until September 6, 2018. Of the 26,733 records identified, 15 RCTs were included. Meta-analysis revealed a significant reduction (-2.77 kg, 95% confidence interval - 3.54 to -2.00 kg) in the personalised eHealth intervention group compared with that in the control group (Z = -7.04, p < .001). The duration of the interventions ranged from 14 weeks and three trials had follow-up assessments at 6 and 12 months. Our subgroup analyses highlighted several crucial design elements of future personalised eHealth interventions by utilising a combination of tailored content and customised feedback with human feedback, usage of theoretical basis, short message service, device, reminder, self-monitoring, goal setting and synchronous communication for 12 to 14 weeks. Egger's regression asymmetry test suggested no evidence of publication bias (p = .458). Using meta-regression we found evidence that a statistically significant impact of age and year of publication on the effectiveness of intervention. The overall evidence grade of outcomes ranged from very low to low, hence future trials should use well-designed RCTs.