Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Art of persuasion: an analysis of techniques used to market foods to children. Using qualitative comparative analysis in a systematic review of a complex intervention Do patients have to choose between ejaculation and miction? A systematic review about ejaculation preservation technics for benign prostatic obstruction surgical treatment Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits Using a behaviour change techniques taxonomy to identify active ingredients within trials of implementation interventions for diabetes care Developing a targeted, theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors: a case study to improve the management of mild traumatic brain injury in the emergency department Using logic model methods in systematic review synthesis: describing complex pathways in referral management interventions Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review Strategies to Promote Physical Activity During Pregnancy Dietetic guidelines: diet in secondary prevention of cardiovascular disease. Processes of behavior change and weight loss in a theory-based weight loss intervention program: a test of the process model for lifestyle behavior change Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Breaking bad habits by improving executive function in individuals with obesity Is Larval (Maggot) Debridement Effective for Removal of Necrotic Tissue From Chronic Wounds? Update on AUA guideline on the management of benign prostatic hyperplasia. PROBAST: A Tool to Assess Risk of Bias and Applicability of Prediction Model Studies: Explanation and Elaboration Is Video-Based Education an Effective Method in Surgical Education? A Systematic Review. More Informative Abstracts of Articles Describing Clinical Practice Guidelines The potential for central monitoring techniques to replace on-site monitoring: findings from an international multi-centre clinical trial Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol Identifying, documenting, and examining heterogeneity in systematic reviews of complex interventions. Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol
Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : AIM Persuasive marketing techniques , such as promotional characters , influence children 's food preferences and requests for foods . The aim of this research was to describe the techniques used to market unhealthy foods and beverages to children on Sydney free-to-air television . METHODS Marketing techniques design ed to appeal to children were identified from international literature and summarised into a systematic coding tool . Using this tool , the marketing techniques used in a r and om sample of 100 unique food advertisements , broadcasted on Sydney free-to-air television , were coded . Frequency of marketing techniques was analysed overall and for use in advertisements marketing unhealthy foods , emotionally or verbally appealing to parents , or featuring child actors . RESULTS Advertisers ' use of persuasive techniques generally did not differ by type of food advertised . Marketing techniques with greater prominence in unhealthy food advertising were palatability ( 54 % of unhealthy food advertisements ) , convenience ( 52 % ) , fantasy/imagination ( 28 % ) , fun/happiness ( 17 % ) and cartoon characters ( 9 % ) . Advertisements emotionally appealing to parents ( 24 % ) were significantly more likely to make general health or nutrition statements ( 38 % vs. 17 % ) , and appealed to children concurrently through fun/happiness and fantasy/imagination appeals . Children were depicted in advertisements as eating with friends or family , situated within the home and frequently snacking on less healthy foods . CONCLUSIONS Food and beverage advertisers use a range of visual , audio and emotive techniques to appeal to children and their parents that do not discriminate by the type of food advertised . The range and complexity of these techniques complicate the restriction of their use in food advertising to children Background Systematic review s evaluating complex interventions often encounter substantial clinical heterogeneity in intervention components and implementation features making synthesis challenging . Qualitative comparative analysis ( QCA ) is a non-probabilistic method that uses mathematical set theory to study complex phenomena ; it has been proposed as a potential method to complement traditional evidence synthesis in review s of complex interventions to identify key intervention components or implementation features that might explain effectiveness or ineffectiveness . The objective of this study was to describe our approach in detail and examine the suitability of using QCA within the context of a systematic review . Methods We used data from a completed systematic review of behavioral interventions to improve medication adherence to conduct two substantive analyses using QCA . The first analysis sought to identify combinations of nine behavior change techniques/components ( BCTs ) found among effective interventions , and the second analysis sought to identify combinations of five implementation features ( e.g. , agent , target , mode , time span , exposure ) found among effective interventions . For each substantive analysis , we reframed the review ’s research questions to be design ed for use with QCA , calibrated sets ( i.e. , transformed raw data into data used in analysis ) , and identified the necessary and /or sufficient combinations of BCTs and implementation features found in effective interventions . Results Our application of QCA for each substantive analysis is described in detail . We extended the original review findings by identifying seven combinations of BCTs and four combinations of implementation features that were sufficient for improving adherence . We found reasonable alignment between several systematic review steps and processes used in QCA except that typical approaches to study abstract ion for some intervention components and features did not support a robust calibration for QCA . Conclusions QCA was suitable for use within a systematic review of medication adherence interventions and offered insights beyond the single dimension stratifications used in the original completed review . Future prospect i ve use of QCA during a review is needed to determine the optimal way to efficiently integrate QCA into existing approaches to evidence synthesis of complex interventions Purpose Ejaculatory dysfunction is the most common side effect related to surgical treatment of benign prostatic obstruction ( BPO ) . Nowadays , modified surgical techniques and non-ablative techniques have emerged with the aim of preserving ante grade ejaculation . Our objective was to conduce a systematic review of the literature regarding efficacy on ejaculatory preservation of modified endoscopic surgical techniques , and mini-invasive non-ablatives techniques for BPO management . Methods A systematic review of the literature was carried out on the PubMed data base using the following MESH terms : “ Prostatic Hyperplasia/surgery ” and “ Ejaculation ” , in combination with the following keywords : “ ejaculation preservation ” , “ photoselective vaporization of the prostate ” , “ photoselective vapo-enucleation of the prostate ” , “ holmium laser enucleation of the prostate ” , “ thulium laser ” , “ prostatic artery embolization ” , “ urolift ” , “ rezum ” , and “ aquablation ” . Results The ejaculation preservation rate of modified-TURP ranged from 66 to 91 % . The ejaculation preservation rate of  modified-prostate photo-vaporization  ranged from 87 to 96 % . The only high level of evidence studies available compared prostatic urethral lift ( PUL ) and aquablation versus regular TURP in prospect i ve r and omized-controlled trials . The ejaculation preservation rate of either PUL or aquablation compared to regular TURP was 100 and 90 versus 34 % , respectively . Conclusions Non-ablative therapies and modified endoscopic surgical techniques seemed to be reasonable options for patients eager to preserve their ejaculatory functions Background The prevalence of obesity in men is rising , but they are less likely than women to engage in existing weight management programmes . The potential of professional sports club setting s to engage men in health promotion activities is being increasingly recognised . This paper describes the development and optimization of the  Football Fans in Training ( FFIT ) programme , which aims to help overweight men ( many of them football supporters ) lose weight through becoming more active and adopting healthier eating habits . Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases . In Phase 1 , a multidisciplinary working group developed the pilot programme ( p-FFIT ) and used a scoping review to summarize previous research and identify the target population . Phase 2 involved a process evaluation of p-FFIT  in 11 Scottish Premier League ( SPL ) clubs . Participant and coach feedback , focus group discussion s and interviews explored the utility/acceptability of programme components and suggestions for changes . Programme session observations identified examples of good practice and problems/issues with delivery . Together , these findings informed redevelopment of the optimized programme ( FFIT ) , whose components were mapped onto specific behaviour change techniques using an evidence -based taxonomy . Results p-FFIT comprised 12 , weekly , gender-sensitised , group-based weight management classroom and ‘ pitch-side ’ physical activity sessions . These in-stadia sessions were complemented by an incremental , pedometer-based walking programme . p-FFIT was targeted at men aged 35 - 65 years with body mass index ≥ 27 kg/m2 . Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components , and valued the camaraderie and peer-support offered by the programme . Coaches appreciated the simplicity of the key healthy eating and physical activity messages . Suggestions for improvements that were incorporated into the optimized FFIT programme included : more varied in-stadia physical activity with football-related components ; post-programme weight management support ( emails and a reunion session ) ; and additional training for coaches in SMART goal setting and the pedometer-based walking programme . Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches , and is appropriate for evaluation in a r and omised controlled trial Background Method ological guidelines for intervention reporting emphasise describing intervention content in detail . Despite this , systematic review s of quality improvement ( QI ) implementation interventions continue to be limited by a lack of clarity and detail regarding the intervention content being evaluated . We aim ed to apply the recently developed Behaviour Change Techniques Taxonomy version 1 ( BCTTv1 ) to trials of implementation interventions for managing diabetes to assess the capacity and utility of this taxonomy for characterising active ingredients . Methods Three psychologists independently coded a r and om sample of 23 trials of healthcare system , provider- and /or patient-focused implementation interventions from a systematic review that included 142 such studies . Intervention content was coded using the BCTTv1 , which describes 93 behaviour change techniques ( BCTs ) grouped within 16 categories . We supplemented the generic coding instructions within the BCTTv1 with decision rules and examples from this literature . Results Less than a quarter of possible BCTs within the BCTTv1 were identified . For implementation interventions targeting providers , the most commonly identified BCTs included the following : adding objects to the environment , prompts/cues , instruction on how to perform the behaviour , credible source , goal setting ( outcome ) , feedback on outcome of behaviour , and social support ( practical ) . For implementation interventions also targeting patients , the most commonly identified BCTs included the following : prompts/cues , instruction on how to perform the behaviour , information about health consequences , restructuring the social environment , adding objects to the environment , social support ( practical ) , and goal setting ( behaviour ) . The BCTTv1 mapped well onto implementation interventions directly targeting clinicians and patients and could also be used to examine the impact of system-level interventions on clinician and patient behaviour . Conclusions The BCTTv1 can be used to characterise the active ingredients in trials of implementation interventions and provides specificity of content beyond what is given by broader intervention labels . Identification of BCTs may provide a more helpful means of accumulating knowledge on the content used in trials of implementation interventions , which may help to better inform replication efforts . In addition , prospect i ve use of a behaviour change techniques taxonomy for developing and reporting intervention content would further aid in building a cumulative science of effective implementation interventions Background Despite the availability of evidence -based guidelines for the management of mild traumatic brain injury in the emergency department ( ED ) , variations in practice exist . Interventions design ed to implement recommended behaviours can reduce this variation . Using theory to inform intervention development is advocated ; however , there is no consensus on how to select or apply theory . Integrative theoretical frameworks , based on syntheses of theories and theoretical constructs relevant to implementation , have the potential to assist in the intervention development process . This paper describes the process of applying two theoretical frameworks to investigate the factors influencing recommended behaviours and the choice of behaviour change techniques and modes of delivery for an implementation intervention . Methods A stepped approach was followed : ( i ) identification of locally applicable and actionable evidence -based recommendations as targets for change , ( ii ) selection and use of two theoretical frameworks for identifying barriers to and enablers of change ( Theoretical Domains Framework and Model of Diffusion of Innovations in Service Organisations ) and ( iii ) identification and operationalisation of intervention components ( behaviour change techniques and modes of delivery ) to address the barriers and enhance the enablers , informed by theory , evidence and feasibility/acceptability considerations . We illustrate this process in relation to one recommendation , prospect i ve assessment of post-traumatic amnesia ( PTA ) by ED staff using a vali date d tool . Results Four recommendations for managing mild traumatic brain injury were targeted with the intervention . The intervention targeting the PTA recommendation consisted of 14 behaviour change techniques and addressed 6 theoretical domains and 5 organisational domains . The mode of delivery was informed by six Cochrane review s. It was delivered via five intervention components : ( i ) local stakeholder meetings , ( ii ) identification of local opinion leader teams , ( iii ) a train-the-trainer workshop for appointed local opinion leaders , ( iv ) local training workshops for delivery by trained local opinion leaders and ( v ) provision of tools and material s to prompt recommended behaviours . Conclusions Two theoretical frameworks were used in a complementary manner to inform intervention development in managing mild traumatic brain injury in the ED . The effectiveness and cost-effectiveness of the developed intervention is being evaluated in a cluster r and omised trial , part of the Neurotrauma Evidence Translation ( NET ) program Background There is increasing interest in innovative methods to carry out systematic review s of complex interventions . Theory-based approaches , such as logic models , have been suggested as a means of providing additional insights beyond that obtained via conventional review methods . Methods This paper reports the use of an innovative method which combines systematic review processes with logic model techniques to synthesis e a broad range of literature . The potential value of the model produced was explored with stakeholders . Results The review identified 295 papers that met the inclusion criteria . The papers consisted of 141 intervention studies and 154 non-intervention quantitative and qualitative articles . A logic model was systematic ally built from these studies . The model outlines interventions , short term outcomes , moderating and mediating factors and long term dem and management outcomes and impacts . Interventions were grouped into typologies of practitioner education , process change , system change , and patient intervention . Short-term outcomes identified that may result from these interventions were changed physician or patient knowledge , beliefs or attitudes and also interventions related to changed doctor-patient interaction . A range of factors which may influence whether these outcomes lead to long term change were detailed . Dem and management outcomes and intended impacts included content of referral , rate of referral , and doctor or patient satisfaction . Conclusions The logic model details evidence and assumptions underpinning the complex pathway from interventions to dem and management impact . The method offers a useful addition to systematic review method ologies . Trial registration number PROSPERO registration number : CRD42013004037 Background Computerized clinical decision support systems are information technology-based systems design ed to improve clinical decision-making . As with any healthcare intervention with cl aims to improve process of care or patient outcomes , decision support systems should be rigorously evaluated before widespread dissemination into clinical practice . Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake . The objective of this research was to form a partnership of healthcare providers , managers , and research ers to review r and omized controlled trials assessing the effects of computerized decision support for six clinical application areas : primary preventive care , therapeutic drug monitoring and dosing , drug prescribing , chronic disease management , diagnostic test ordering and interpretation , and acute care management ; and to identify study characteristics that predict benefit . Methods The review was undertaken by the Health Information Research Unit , McMaster University , in partnership with Hamilton Health Sciences , the Hamilton , Niagara , Haldim and , and Brant Local Health Integration Network , and pertinent healthcare service teams . Following agreement on information needs and interests with decision-makers , our earlier systematic review was up date d by search ing Medline , EMBASE , EBM Review data bases , and Inspec , and review ing reference lists through 6 January 2010 . Data extraction items were exp and ed according to input from decision-makers . Authors of primary studies were contacted to confirm data and to provide additional information . Eligible trials were organized according to clinical area of application . We included r and omized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a  computerized clinical decision support system compared with patient care without such a system . Results Data will be summarized using descriptive summary measures , including proportions for categorical variables and means for continuous variables . Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates . When reporting results from individual studies , we will cite the measures of association and p-values reported in the studies . If appropriate for groups of studies with similar features , we will conduct meta-analyses . Conclusion A decision-maker- research er partnership provides a model for systematic review s that may foster knowledge translation and uptake Physical activity during pregnancy has been associated with significant health benefits ; however , most women in the United States do not meet the current guidelines . This systematic review evaluates evidence for interventions to improve physical activity during pregnancy in order to identify best practice s and inform future research . Electronic data bases ( PubMed , CINAHL , SportD ISCUS , Embase , ERIC , Psych Info , and ISI Web of Science ) were search ed in July 2011 for peer- review ed journal articles . Studies were included if they were English- language r and omized control trials that measured the efficacy of an intervention targeted at pregnant women and were design ed to change physical activity as a primary or secondary outcome . Out of 777 studies identified through the systematic search , 9 interventions were selected for inclusion by multiple review ers . Data were abstract ed using an abstract ion form modeled after the “ Guide to Community Preventive Services . ” Of the 9 interventions included in the review , 3 reported statistically significant positive results for physical activity . Although the interventions included a variety of strategies and techniques , none were uniquely associated with positive outcomes . Overall , this review suggests that little is known about the efficacy of interventions for physical activity during pregnancy . This study provides several recommendations for future research and intervention design AIM To produce dietetic guidelines summarizing the systematic review evidence on dietary advice for secondary prevention of cardiovascular disease . METHODS The Cochrane Library , MEDLINE and EMBASE were comprehensively search ed for systematic review s on aspects of diet and heart health . Review s were included if they search ed systematic ally for r and omised controlled trials relating to diet and secondary prevention of cardiovascular disease . Two members of the UK Heart Health and Thoracic Dietitians Group critically appraised each review . The quality and results of each review were discussed and summarized in a whole group meeting . The guidelines were trialled in seven dietetic departments and modified where necessary . RESULTS Providing evidence -based dietary information ( including increasing omega-3 fat plus fruit and vegetable intake ) to all people after myocardial infa rct ion will save more lives than concentrating dietary advice on those in need of weight loss or lipid lowering . The practice of prioritizing dietetic time to those with raised lipids is out of date since the advent of statin therapy . CONCLUSION There is good systematic review evidence that dietary advice to those with cardiovascular disease can reduce mortality and morbidity as well as modify risk factors .  Dietary advice that does this most effectively should be prioritized Background Process evaluation is important for improving theories of behavior change and behavioral intervention methods . The present study reports on the process outcomes of a pilot test of the theoretical model ( the Process Model for Lifestyle Behavior Change ; PMLBC ) underpinning an evidence -informed , theory-driven , group-based intervention design ed to promote healthy eating and physical activity for people with high cardiovascular risk . Methods 108 people at high risk of diabetes or heart disease were r and omized to a group-based weight management intervention targeting diet and physical activity plus usual care , or to usual care . The intervention comprised nine group based sessions design ed to promote motivation , social support , self-regulation and underst and ing of the behavior change process . Weight loss , diet , physical activity and theoretically defined mediators of change were measured pre-intervention , and after four and 12 months . Results The intervention result ed in significant improvements in fiber intake ( M between-group difference = 5.7 g/day , p < .001 ) but not fat consumption ( −2.3 g/day , p = 0.13 ) , that were predictive of weight loss at both four months ( M between-group difference = −1.98 kg , p < .01 ; R2 = 0.2 , p < 0.005 ) , and 12 months ( M difference = −1.85 kg , p = 0.1 ; R2 = 0.1 , p < 0.01 ) . The intervention was successful in improving the majority of specified mediators of behavior change , and the predicted mechanisms of change specified in the PMBLC were largely supported . Improvements in self-efficacy and underst and ing of the behavior change process were associated with engagement in coping planning and self-monitoring activities , and successful dietary change at four and 12 months . While participants reported improvements in motivational and social support variables , there was no effect of these , or of the intervention overall , on physical activity . Conclusions The data broadly support the theoretical model for supporting some dietary changes , but not for physical activity . Systematic intervention design allowed us to identify where improvements to the intervention may be implemented to promote change in all proposed mediators . More work is needed to explore effective mechanisms within interventions to promote physical activity behavior BACKGROUND Correctly staging lung cancer is important because the treatment options and prognosis differ significantly by stage . Several noninvasive imaging studies and invasive tests are available . Underst and ing the accuracy , advantages , and disadvantages of the available methods for staging non-small cell lung cancer is critical to decision-making . METHODS Test accuracies for the available staging studies were up date d from the second iteration of the American College of Chest Physicians Lung Cancer Guidelines . Systematic search es of the MEDLINE data base were performed up to June 2012 with the inclusion of selected meta-analyses , practice guidelines , and review s. Study design s and results are summarized in evidence tables . RESULTS The sensitivity and specificity of CT scanning for identifying mediastinal lymph node metastasis were approximately 55 % and 81 % , respectively , confirming that CT scanning has limited ability either to rule in or exclude mediastinal metastasis . For PET scanning , estimates of sensitivity and specificity for identifying mediastinal metastasis were approximately 77 % and 86 % , respectively . These findings demonstrate that PET scanning is more accurate than CT scanning , but tissue biopsy is still required to confirm PET scan findings . The needle techniques endobronchial ultrasound-needle aspiration , endoscopic ultrasound-needle aspiration , and combined endobronchial ultrasound/endoscopic ultrasound-needle aspiration have sensitivities of approximately 89 % , 89 % , and 91 % , respectively . In direct comparison with surgical staging , needle techniques have emerged as the best first diagnostic tools to obtain tissue . Based on r and omized controlled trials , PET or PET-CT scanning is recommended for staging and to detect unsuspected metastatic disease and avoid noncurative resections . CONCLUSIONS Since the last iteration of the staging guidelines , PET scanning has assumed a more prominent role both in its use prior to surgery and when evaluating for metastatic disease . Minimally invasive needle techniques to stage the mediastinum have become increasingly accepted and are the tests of first choice to confirm mediastinal disease in accessible lymph node stations . If negative , these needle techniques should be followed by surgical biopsy . All abnormal scans should be confirmed by tissue biopsy ( by whatever method is available ) to ensure accurate staging . Evidence suggests that more complete staging improves patient outcomes Background Two primary factors that contribute to obesity are unhealthy eating and sedentary behavior  . These behaviors are particularly difficult to change in the long-term because they are often enacted habitually . Cognitive Remediation Therapy has been modified and applied to the treatment of obesity ( CRT-O ) with preliminary results of a r and omized controlled trial demonstrating significant weight loss and improvements in executive function . The objective of this study was to conduct a secondary data analysis of the CRT-O trial to evaluate whether CRT-O reduces unhealthy habits that contribute to obesity via improvements in executive function . Method Eighty participants with obesity were r and omized to CRT-O or control . Measures of executive function ( Wisconsin Card Sort Task and Trail Making Task ) and unhealthy eating and sedentary behavior habits were administered at baseline , post-intervention and at 3 month follow-up . Results Participants receiving CRT-O demonstrated improvements in both measures of executive function and reductions in both unhealthy habit outcomes compared to control . Mediation analyses revealed that change in one element of executive function performance ( Wisconsin Card Sort Task perseverance errors ) mediated the effect of CRT-O on changes in both habit outcomes . Conclusion These results suggest that the effectiveness of CRT-O may result from the disruption of unhealthy habits made possible by improvements in executive function . In particular , it appears that cognitive flexibility , as measured by the Wisconsin Card Sort task , is a key mechanism in this process . Improving cognitive flexibility may enable individuals to capitalise on interruptions in unhealthy habits by adjusting their behavior in line with their weight loss goals rather than persisting with an unhealthy choice . Trial registration The RCT was registered with the Australian New Zeal and Registry of Clinical Trials ( trial i d : ACTRN12613000537752 ) Background Debridement is considered an essential component of wound bed preparation . Multiple techniques for removing necrotic tissue from wounds have been identified , but evidence concerning the efficacy and indications for each technique varies . Objectives We sought to identify evidence related to the efficacy of  maggot ( larval ) debridement  for the removal of necrotic tissue and its impact on wound healing . Search Strategy A systematic review of electronic data bases was undertaken using the following key words : ( 1 ) debridement , ( 2 ) maggot therapy , and ( 3 ) larval therapy . All prospect i ve and retrospective studies published between January 1960 and February 2008 that compared maggot ( larval ) debridement therapy for pressure ulcers , leg ulcers , or burn wounds to autolytic debridement or other debridement techniques  were included in the review . Results The evidence base for the efficacy of  maggot debridement therapy ( MDT ) in the management of necrotic wounds is sparse . There is insufficient evidence to conclude that  MDT  is as effective as or more effective than other debridement methods , or that MDT promotes wound healing . Implication s for Practice Even though clinical evidence supporting the use of MDT for debridement of wounds is lacking , clinical experience strongly suggests that this technique is an effective and safe method of debridement for selected patients . Expert clinicians with extensive experience using this technique usually advocate MDT as a last resort treatment when conservative means for wound bed preparation prove unsuccessful or when surgery is not feasible owing to comorbid conditions or other considerations PURPOSE To revise the 2003 version of the American Urological Association 's ( AUA ) Guideline on the management of benign prostatic hyperplasia ( BPH ) . MATERIAL S AND METHODS From MEDLINE ® search es of English language publications ( January 1999 through February 2008 ) using relevant MeSH terms , articles concerning the management of the index patient , a male ≥45 years of age who is consulting a healthcare provider for lower urinary tract symptoms ( LUTS ) were identified . Qualitative analysis of the evidence was performed . Selected studies were stratified by design , comparator , follow-up interval , and intensity of intervention , and meta-analyses ( quantitative synthesis ) of outcomes of r and omized controlled trials were planned . Guideline statements were drafted by an appointed expert Panel based on the evidence . RESULTS The studies varied as to patient selection ; r and omization ; blinding mechanism ; run-in periods ; patient demographics , comorbidities , prostate characteristics and symptoms ; drug doses ; other intervention characteristics ; comparators ; rigor and intervals of follow-up ; trial duration and timing ; suspected lack of applicability to current US practice ; and techniques of outcomes measurement . These variations affected the quality of the evidence review ed making formal meta- analysis impractical or futile . Instead , the Panel and extractors review ed the data in a systematic fashion and without statistical rigor . Diagnosis and treatment algorithms were adopted from the 2005 International Consultation of Urologic Diseases . Guideline statements concerning pharmacotherapies , watchful waiting , surgical options and minimally invasive procedures were either up date d or newly drafted , peer review ed and approved by AUA Board of Directors . CONCLUSIONS New pharmacotherapies and technologies have emerged which have impacted treatment algorithms . The management of LUTS/BPH continues to evolve Prediction models in health care aim to predict for an individual whether a particular outcome , such as disease , is present ( diagnostic models ) or whether it will occur in the future ( prognostic models ) ( 16 ) . Diagnostic models can be used to refer patients for further testing , to initiate treatment , or to inform patients . Prognostic models can be used to aid decisions about preventive lifestyle changes , therapeutic interventions , or monitoring strategies or to stratify risk in r and omized trial design and analysis ( 7 , 8) . Potential users of prediction models include health care professionals , policymakers , guideline developers , patients , and the general public . The medical literature contains thous and s of studies developing and validating prediction models and often has numerous prediction models for the same target population and outcomes . For example , more than 60 models address breast cancer prognosis ( 9 ) , more than 250 exist in obstetrics ( 10 ) , and nearly 800 predict outcomes in patients with cardiovascular disease ( 11 ) . This proliferation of prediction models will increase further with the growth of personalized or precision medicine . Systematic review s are considered the most reliable form of evidence when addressing r and omized therapeutic studies and studies of diagnostic test accuracy ( 12 ) . In the era of personalized and precision medicine , interest in systematic review s of prediction model studies is rapidly growing , as exemplified by the formation of the Cochrane Prognosis Methods Group to support systematic review s of prognosis , including prediction model studies ( 13 , 14 ) . Guidance to facilitate systematic review s of prediction models has been developed ( Table 1 ) , including for search strategies ( 15 , 4143 ) , formulation of the review question ( 16 , 17 ) , data extraction ( 16 ) , and meta- analysis ( 17 , 2225 , 40 , 44 , 45 ) . Table 1 . Guidance on Conducting Systematic Review s of Prediction Model Studies  Assessment of risk of bias ( ROB ) is an essential step in any systematic review . Shortcomings in study design , conduct , and analysis can result in study estimates being at ROBthat is , at risk of results being flawed or distorted . When interpreting results from a systematic review , readers can draw stronger conclusions from a review based on primary studies at low ROB than from one based on studies at high or unclear ROB ( 46 ) . Identifying the studies most relevant to the setting s and population s targeted in the review ( based on the applicability of primary studies to the review question ) is also important . We therefore developed PROBAST ( Prediction model Risk Of Bias ASsessment Tool ) to address the lack of suitable tools design ed specifically to assess ROB and applicability of primary prediction model studies . PROBAST consists of 4 domains containing 20 signaling questions to facilitate ROB assessment ( 39 ) . The structure and rating system are similar to those in tools design ed to assess ROB in r and omized trials ( revised Cochrane ROB Tool [ ROB 2.0 ] ) , diagnostic accuracy studies ( QUADAS-2 [ Quality Assessment of Diagnostic Accuracy Studies 2 ] ) , and systematic review s ( ROBIS ) ( 37 , 47 , 48 ) . Although PROBAST was design ed for use in systematic review s of prediction model studies , it can also be used as a general tool for critical appraisal of ( primary ) prediction model studies . Here , we describe the rationale behind the domains and signaling questions , how to use them , and how to reach domain-level and overall judgments about ROB and applicability of primary studies to a review question . At the Web site ( www.probast.org ) , 5 filled-in examples from across the medical field illustrate these processes . Because this is an area of active research , the tool , examples , and accompanying guidance will be up date d when needed , and the latest version of PROBAST should always be downloaded from the Web site . Focus of PROBAST PROBAST is design ed to assess primary studies that develop , vali date , or up date ( for example , extend ) multivariable prediction models for diagnosis or prognosis ( Boxes 1 and 2 ) . A multivariable prediction model is defined as any combination or equation of 2 or more predictors ( such as age , sex , symptoms , signs , disease stage , or biomarkers ) for estimating for an individual the probability or risk of having ( diagnosis ) or developing ( prognosis ) a particular outcome ( 1 , 4 , 68 , 49 , 50 ) . Other names for prediction model include risk prediction model , predictive model , prediction index or rule , and risk score ( 1 , 38 , 4951 ) . Box 1 . Types of diagnostic and prognostic modeling studies or reports addressed by PROBAST . Adopted from the TRIPOD ( Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis ) and CHARMS ( CHecklist for critical Appraisal and data extraction for systematic Review s of prediction Modelling Studies ) guidance ( 8 , 16 ) . Box 2 . Differences between diagnostic and prognostic prediction model studies . PROBAST = Prediction model Risk Of Bias ASsessment Tool . Diagnostic and Prognostic Models Diagnostic prediction models estimate the probability that a certain outcome , the target condition , is currently present . Diagnostic prediction model studies typically include individuals who are suspectedbut not yet knownto have the target condition . Prognostic prediction models estimate the probability that a future outcome or event will occur , such as death , disease recurrence , disease complication , or therapy response . The time period of prediction can vary from hours ( for example , preoperatively predicting postoperative nausea and vomiting ) to years ( for example , predicting lifelong risk for a coronary event ) . Although many prognostic models enroll patients with an established diagnosis , this does not have to be the starting point , as seen in models for predicting development of diabetes in pregnant women ( 52 ) or of osteoporotic fractures in the general population ( 53 ) . Consistent with the TRIPOD ( Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis ) statement ( 7 , 8) , PROBAST thus broadly defines prognostic models as those predicting a future outcome in persons at risk for that outcome . Diagnostic and prognostic model studies often use different terms for predictors and outcomes ( Box 2 ) . The cancer literature frequently distinguishes between prognostic and predictive models , such that predictive models identify individuals with differential treatment effects ( 54 ) . These types of ( predictive ) models are outside the scope of this article . Types of Predictors , Outcomes , and Modeling Techniques PROBAST can be used to assess any type of diagnostic or prognostic prediction model aim ed at individualized predictions regardless of the predictors used ; outcomes being predicted ; or methods used to develop , vali date , or up date ( for example , extend ) the model . Predictors range from demographic characteristics , medical history , and physical examination results ; to imaging results , electrophysiology , blood , urine , or tissue measurements , and disease stages or characteristics ; to results from omics and other new biological measurements . Predictors are also called covariates , risk indicators , prognostic factors , determinants , index test results , or independent variables ( 4 , 68 , 49 , 50 , 55 , 56 , 57 ) . PROBAST distinguishes between c and i date predictors and predictors included in the final model ( 57 ) . C and i date predictors are variables considered potentially predictive of the outcome presence ( diagnosis ) or occurrence (prognosis)that is , all those evaluated in the study regardless of whether they are included in the final multivariable model . PROBAST primarily addresses prediction models for binary and time-to-event outcomes because these are the most common in medicine . However , the tool can also be used to assess models predicting nonbinary outcomes , such as continuous scores ( for example , pain scores or cholesterol levels ) or categorical outcomes ( for example , the Glasgow Coma Scale ) . Almost all PROBAST signaling questions apply equally to continuous and categorical outcomes , except questions addressing number of outcome events per predictor and certain measures of model performance ( such as the c-statistic ) , which are not relevant to continuous outcomes . Prediction models usually involve regression modeling techniques , such as logistic regression or survival models . Prediction models may also be developed or vali date d using nonregression techniques , such as neural networks , r and om forests , or support vector machines . As the use of routine care ( and big ) data increases , additional modeling techniques are becoming more common , including machine and artificial learning models . The main differences between studies using regression and other types of prediction modeling include the methods of data analysis ; nonregression development models can often have greater risks of overfitting when data are sparse , and the potential lack of transparency can affect the applicability and usability of the models . In the section on tailoring PROBAST with additional signaling questions , we provide guidance about how PROBAST can be adapted to address other types of outcomes and modeling techniques . Types of Review Questions PROBAST can be used to assess different types of systematic review questions . For some review questions , all prediction model studies are relevant ( including both development and validation ) , but for other questions only validation studies are relevant . Box 3 gives examples of potential review questions for both prognostic and diagnostic prediction models where PROBAST is applicable . CHARMS ( CHecklist for critical Appraisal and data extraction for systematic Review s of prediction Modelling Studies ) and Table 2 provide explicit guidance on how to frame a focused question for review s of prediction model studies ( 16 , 17 ) . Box 3 . Examples of systematic review questions for which PROBAST is suitable . There are various different questions that systematic review s OBJECTIVE Visual signs draw more attention during the learning process . Video is one of the most effective tool including a lot of visual cues . This systematic review set out to explore the influence of video in surgical education . We review ed the current evidence for the video-based surgical education methods , discuss the advantages and disadvantages on the teaching of technical and nontechnical surgical skills . METHODS This systematic review was conducted according to the guidelines defined in the preferred reporting items for systematic review s and meta-analyses statement . The electronic data bases : the Cochrane Library , Medline ( PubMED ) , and ProQuest were search ed from their inception to the 30 January 2016 . The Medical Subject Headings ( MeSH ) terms and keywords used were " video , " " education , " and " surgery . " We analyzed all full-texts , r and omised and nonr and omised clinical trials and observational studies including video-based education methods about any surgery . " Education " means a medical resident 's or student 's training and teaching process ; not patients ' education . We did not impose restrictions about language or publication date . RESULTS A total of nine articles which met inclusion criteria were included . These trials enrolled 507 participants and the total number of participants per trial ranged from 10 to 172 . Nearly all of the studies review ed report significant knowledge gain from video-based education techniques . The findings of this systematic review provide fair to good quality studies to demonstrate significant gains in knowledge compared with traditional teaching . Additional video to simulator exercise or 3D animations has beneficial effects on training time , learning duration , acquisition of surgical skills , and trainee 's satisfaction . CONCLUSION Video-based education has potential for use in surgical education as trainees face significant barriers in their practice . This method is effective according to the recent literature . Video should be used in addition to st and ard techniques in the surgical education Patients hope that their doctors will correctly identify health problems , clearly articulate sensible options for managing each problem , wisely interpret the best available evidence about probable outcomes associated with each option , sensitively solicit patient preferences for each outcome , and thereby implement practice s that are likely to achieve the results patients care about . Groups of patients hope that doctors will work to prevent , detect , and treat health problems in a way that maximizes the public good achieved with available health care re sources . To meet these dual expectations , doctors face forbidding tasks of clinical decision making . Improved methods for preparing , appraising , and abstract ing overviews of available evidence about a clinical topic can bring a broader range of high- quality information within the busy practitioner 's grasp [ 1 - 4 ] . However , even well- design ed overviews often do not synthesize information about benefits , harms , and costs of medical practice s in a way that facilitates clinical decision making . Clinical practice guidelines have been defined as systematic ally developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances [ 5 ] . Guidelines that are based on sound scientific evidence , and a trustworthy process for judging the value of alternative practice s , could help physicians deal with the information overload they face . Existing practice guidelines , however , vary widely in their quality , and clinicians should carefully consider the validity and applicability of each guideline they read . We propose a structured format for abstract s of articles describing practice guidelines that is based on emerging principles of guideline development and evaluation [ 6 - 13 ] . The proposal is design ed to help readers obtain the key information needed to assess the applicability , importance , and validity of any guideline . The proposed structure for more informative abstract s of articles describing clinical practice guidelines has been review ed and pilot-tested by guideline developers , evaluators , and implementors and by groups of practicing clinicians . Early versions of the proposal were sent to consultants at the National Library of Medicine , the Institute of Medicine , the American College of Physicians ( ACP ) , and the Agency for Health Care Policy and Research . Subsequent versions of the proposal were pilot tested on various published guidelines and were assessed by selected health care organizations for applicability to guidelines under development . An improved proposal was sent to 82 persons active in guideline development , evaluation , and implementation . The Internal Medicine Center to Advance Research and Education circulated the proposal to volunteer practitioners , and the authors solicited feedback from physician and health administrator participants at three national workshops about practice guidelines . The proposal that follows represents an integration of the collective wisdom of our external review ers . ( A glossary of terms used in articles on clinical practice guidelines is supplied in the Appendix . ) Proposed Structure and Content for Abstract s of Articles Describing Clinical Practice Guidelines The proposed structure for abstract s of papers describing clinical practice guidelines is summarized in Table 1 . Key elements of the guideline development process are captured with statements about the principal objective and target of the guideline , the main practice options and outcomes that were considered , the nature of the evidence and values that were analyzed , the main benefits and harms expected from guideline implementation , the key recommendations , and a statement of whether the recommendations have been tested and by whom they have been endorsed . If details about guideline development methods or supporting evidence are published separately , then the abstract should indicate the existence of supporting documents and the most relevant parts of those should be summarized in the abstract . To be included in their entirety in the online bibliographic data bases of the National Library of Medicine , structured abstract s of clinical practice guidelines should not exceed 4096 characters ( approximately 500 words ) in length . Individual journals may have different requirements . Table 1 . Proposed Format for Structured Abstract s of Clinical Practice Guidelines Objective The abstract should state the objective of the guideline by identifying the targeted health problem , the targeted patients and physicians , and the main reason or reasons for developing new recommendations concerning this problem for this population . For guidelines primarily concerned with the management of health conditions , the stage of illness and intent to prevent , diagnose , treat , or palliate the disorder should be specified . For guidelines primarily concerned with health procedures , an intervention and its role in patient management should be defined . Targeted providers , setting s , and patients should be specified so that readers can tell who should do what , where it should be done , and to whom . A statement of objective also may specify why a new guideline is needed and how it should be used . Practice guidelines may be written to clarify or resolve clinical controversies , to communicate important new findings from clinical studies , or to promote more effective , efficient , or consistent physician practice s at less cost or risk to patients . Guidelines may be used concurrently to help physicians and patients make choices ( for example , clinical algorithms ) , retrospectively to compare physician choices to pre-established criteria ( for example , utilization review ) , or prospect ively to set limits on physician choices ( for example , preprocedure approval ) . Options Clinical practice guidelines pertain to clinical decisions . The nature of those decisions should be made explicit by disclosing the main management options considered . The abstract should list principal alternative preventive , diagnostic , or therapeutic strategies available to targeted clinicians and patients . Outcomes The abstract also should specify which health outcomes , such as death , morbidity , quality of life , economic costs , or changes in the process of health care were considered . Evidence To estimate the probable effect of a health intervention on an outcome , relevant data must be defined , gathered , and appraised . Readers need to know what kind of evidence was considered and what methods were used to select and combine evidence from different sources . Potential sources of evidence about clinical outcomes include the results of clinical studies ( published or unpublished ) , expert opinion , information contained in public or private health data bases , and direct input from patients or providers . Potential sources of evidence about economic outcomes include the results of cost-effectiveness studies , various fee schedules , and information contained in public or private health cl aims data bases . Potential methods of gathering evidence include computerized search es for articles that satisfy predetermined criteria , review s of bibliographies of relevant articles , and surveys of relevant persons or organizations [ 1 ] . The abstract should state whether explicit methods were used to combine results from scientific studies ( for example , meta- analysis ) or opinions of experts ( for example , Delphi technique ) [ 14 , 15 ] . The abstract may also indicate whether specific criteria were used to gauge the quality of information from different sources [ 16 , 17 ] . Scientific evidence regarding the likelihood of certain outcomes is often missing or conflicting . It is desirable for the strength of evidence supporting a guideline to be gauged in some way [ 16 ] . If gaps in the evidence were bridged formally ( for example , through use of decision- analysis models ) or informally ( for example , best guess of clinical experts ) , then major assumptions or areas of uncertainty should be acknowledged [ 11 ] . Because of the extraordinary time required to properly assemble and review evidence and then to achieve consensus about practice recommendations , the abstract of a practice guideline should specify the publication date s of the most recent evidence considered . If a sensitivity analysis was performed , then any major vulnerability of the guideline to weaknesses in the evidence should be acknowledged . These considerations may be summarized by qualifying a guideline as provisional by specifying date s for expiration or review , by listing studies in progress that could affect the guideline , or by identifying key research priorities . Values The declaration of a recommended practice presumes an implicit or explicit process for judging the relative desirability of the health , economic , and process outcomes associated with alternative practice s. These are matters of opinion and value . For example , in developing guidelines for breast cancer screening , it is necessary to weigh the value of preventing a death from breast cancer against the value of avoiding unnecessary harm or anxiety in women who do not have breast cancer . A high value placed on maximizing detection of asymptomatic malignancy may motivate an organization to recommend teaching self-examination of breasts to young women [ 18 ] . A relatively greater value placed on avoiding false-positive results may motivate others to not promote such programs [ 19 ] . Consequently , the principal sources of such values and the method by which judgments were made should be reported in guideline abstract s. At a minimum , the abstract should identify the major groups that participated in the process of assigning values to outcomes ( for example , generalist or specialist physicians , other health care providers , insurers , representatives of health organizations , and special-interest groups ) and whether patient preferences were represented . The abstract may also indicate the method used to synthesize opinions from Background Compliance with Good Clinical Practice ( GCP ) guidelines should ensure the safety of trial participants and the reliability of trial results . Over the last decade , increasing emphasis has been placed on the role of costly on-site monitoring and source data verification as processes to demonstrate that GCP is being followed , despite a lack of empirical evidence that these are effective . Purpose To assess whether findings from on-site monitoring of a recent international multi-centre clinical trial could have been identified using central data review and other central ised monitoring techniques . Methods Findings documented in a sample of site monitoring reports , and Programme Management Board Executive ( PMBe ) reports , from the Microbicides Development Programme ( MDP ) 301 trial – a r and omised placebo-controlled trial of a microbicide gel to prevent vaginally acquired HIV infection conducted in four countries in East and Southern Africa – were extracted and individually assessed to determine whether they could have been detected in the trial data base or through other central means . Results Four site visit reports contained 268 monitoring findings from a review of 104 participant files covering 324 study visits . Of the 268 findings , 76 ( 28.4 % ) were also identified in the study data base . Central checks , had these been in place ( such as central receipt and review of back-translated documents , enrolment and testing logs , informed consent , and more complex data base queries ) , could have identified a further 179 ( 66.8 % ) ; 13 ( 4.9 % ) other findings ( all minor ) could have been identified through a review of the participant folder at site . The four PMBe reports review ed included six major and three critical findings from a review of over 1000 participant files : only two of these ( both major ) were assessed as unlikely to be identified using central monitoring techniques . Limitations The study data used were not collected with this retrospective review in mind . It suggests that prospect i ve work is needed to compare monitoring practice s in real time . Conclusions While there may be some categories of findings that it is not possible to identify central ly , the very large majority of findings review ed in this analysis could be identified using central monitoring strategies . These data suggest that with better central and targeted on-site monitoring , it should be possible to identify and address most protocol and procedural compliance issues without performing intensive and costly routine on-site data monitoring Background Bruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition . The two clinical manifestations of the condition ( sleep and awake bruxism ) are thought to have unrelated aetiologies but are palliated using similar techniques . The lack of a definitive treatment has prompted renewed interest in biofeedback , a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs . This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism ; to assess the efficacy and acceptability of  biofeedback therapy in management of awake bruxism and , separately , sleep bruxism in adults ; and to compare findings between the two variants . Methods A systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults . We will search electronic data bases and the grey literature using a predefined search strategy to identify r and omised and non-r and omised studies , technical reports and patents . Search es will not be restricted by language or date and will be exp and ed through contact with authors and experts , and by following up reference lists and citations . Two authors , working independently , will conduct screening of search results , study selection , data extraction and quality assessment and a third will resolve any disagreements . The primary outcomes of acceptability and effectiveness will be assessed using only r and omised studies , segregated by bruxism subtype . A meta- analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met , otherwise the data will be summarized in narrative form . Data from non-r and omised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues . PROSPERO registration number : CRD42013006880 . Discussion Biofeedback is not new , but its place in the clinical management of bruxism remains unclear . New research , and the availability of miniaturized consumer- grade devices , makes a systematic review timely to guide treatment decisions and inform future research This article describes approaches for planning , dealing , and analyzing heterogeneity in a systematic review of complex interventions . Approaches aim to generate a priori hypotheses of the mechanism of action of a complex intervention to identify the key variables that might contribute to variation among studies and guide statistical analysis . In addition to characteristics related to the population , intervention , and outcomes , we describe study -related variables , such as the way the interventions have been implemented and the context and conduct of studies . These approaches will guide review ers planning a meta- analysis and provide a rationale for not meta-analyzing data if there is too much variability . Potential difficulties in applying meta-analytical techniques to examine statistical association among study results and sources of potential heterogeneity are described ; these include the selection of a fixed or r and om-effects model , the risk of multiple testing and confounding when studies include different aspects of a complex intervention or different sub sample s of the intended participant pool Background Meeting the needs of the growing number of older people is a challenge for health and social care services . Home-based interventions aim ing to modify health-related behaviours of frail older people have the potential to improve functioning and well-being . Previous review s have focused on whether such interventions are effective , rather than what might make them effective . Recent advances in behavioural science make possible the identification of potential ‘ active ingredients ’ of effective interventions , such as component behaviour change techniques ( BCTs ) , and intended intervention functions ( IFs ; e.g. to educate , to impart skills ) . This paper reports a protocol for a systematic review that seeks to ( a ) identify health behaviour change interventions for older frail people , ( b ) describe the content of these interventions , and ( c ) explore links between intervention content and effectiveness . The protocol is reported in accordance with Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol s ( PRISMA -P ) 2015 guidelines . Methods / design Studies will be identified through a systematic search of 15 electronic data bases , supplemented by citation tracking . Studies will be retained for review where they report r and omised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community setting s , written in English , and either published from 1980 onwards , or , for registered trials only , unpublished but completed with results obtainable from authors . Interventions will be coded for their content ( BCTs , IFs ) and for evidence of effectiveness ( outcome data relating to behavioural and health outcomes ) . Analyses will describe characteristics of all interventions . Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence . The potential for each intervention characteristic to contribute to change in behaviour or health outcomes will be estimated by calculating the percentage of all interventions featuring those characteristics that have shown effectiveness . Discussion Results will reveal the strategies that have been drawn on within home-based interventions to modify the health behaviours of frail older people , and highlight those more associated with positive changes in behaviour and health . Findings from this review will provide a useful basis for underst and ing , developing , and implementing behaviour change interventions in this field . Systematic review registration PROSPERO
A wide range of techniques have been evaluated and some show promise for use in weight management interventions .
OBJECTIVE This systematic review aim ed to ( a ) identify and categorize techniques used to modify or manage impulsive processes associated with unhealthy eating behavior , ( b ) describe the mechanisms targeted by such techniques , and ( c ) summarize available evidence on the effectiveness of these techniques .