This study aimed to review and synthesize the need estimates for psychiatric beds, explore how they changed over time and compare them against the prevalence of actually existing beds. We searched PubMed, Embase classic and Embase, PsycINFO and PsycIndex, Open Grey, Google Scholar, Global Health EBSCO and Proquest Dissertations, from inception to September 13, 2022. Publications providing estimates for the required number of psychiatric inpatient beds were included. Need estimates, length of stay, and year of the estimate were extracted. Need estimates were synthesized using medians and interquartile ranges (IQRs). We also computed prevalence ratios of the need estimates and the existing bed capacities at the same time and place. Sixty-five publications with 98 estimates were identified. Estimates for bed needs were trending lower until 2000, after which they stabilized. The twenty-six most recent estimates after 2000 were submitted to data synthesis (n = 15 for beds with unspecified length of stay, n = 7 for short-stay, and n = 4 for long-stay beds). Median estimates per 100 000 population were 47 (IQR: 39 to 50) beds with unspecified length of stay, 28 (IQR: 23 to 31) beds for short-stay, and 10 (IQR: 8 to 11) for long-stay beds. The median prevalence ratio of need estimates and the actual bed prevalence was 1.8 (IQR: 1.3 to 2.3) from 2000 onwards. Historically, the need estimates for psychiatric beds have decreased until about 2000. In the past two decades, they were stable over time and consistently higher than the actual bed numbers provided.

Differences in cultures, religious beliefs, and philosophical views suggest that leadership ethics may vary between Western and Eastern perspectives. However, ethical leadership scales are mostly rooted in Western conceptualization. This systematic review explores the cultural contributions, philosophical perspectives, and underlying theories shaping the measures of ethical leadership. A comprehensive search across Scopus, Web of Science, ProQuest Management, and Emerald Insight from 1990 to 2021 yielded over 3900 articles, with only 15 focusing on an Eastern conceptualization of ethical leadership. Findings reveal that Eastern ethical leadership encompasses unique dimensions, including leaders’ responsibility and concern for long-term sustainability, often overlooked in existing measures. Despite some similarities in virtues and values between Eastern and Western philosophical views, past studies predominantly employed Western theoretical perspectives to explain ethical leadership. This review highlights the imperative for measures that authentically capture Eastern cultural distinctions, crucial for advancing ethical leadership research amid the East’s increasing global influence.

The social defeat hypothesis posits that low status and repeated humiliation increase the risk for psychotic disorders (PDs) and psychotic experiences (PEs). The purpose of this paper was to provide a systematic review of studies on risk of PDs and PEs among lesbian, gay, or bisexual (LGB) people and a quantitative synthesis of any difference in risk. PubMed, PsycINFO, Embase, and Web of Science were searched from database inception until January 30, 2024. Two independent reviewers assessed the eligibility and quality of studies, extracted effect sizes, and noted the results of mediation analyses. Using a random effects model we computed pooled odds ratios (ORs). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search identified seven studies of PDs and six of PEs. As for PDs, the unadjusted (2.13; 95% confidence interval 0.72–6.34) and covariate-adjusted pooled OR (2.24; 1.72–3.53) were not significantly increased for LGB individuals. After exclusion of a study of limited quality, both the unadjusted pooled OR (2.77; 1.21–6.32) and the covariate-adjusted pooled OR (2.67; 1.53–4.66) were significantly increased. The pooled ORs were increased for PEs: unadjusted, pooled OR = 1.97 (1.47–2.63), covariate-adjusted, pooled OR = 1.85 (1.50–2.28). Studies of PE that examined the mediating role of several variables reported that the contribution of drug abuse was small compared to that of psychosocial stressors. The results of a study in adolescents suggested a protective effect of parental support. These findings suggest an increased psychosis risk for LGB people and support the social defeat hypothesis.

This systematic review maps the trends of computer-assisted pronunciation training (CAPT) research based on the pedagogy of second language (L2) pronunciation instruction and assessment. The review was limited to empirical studies investigating the effects of CAPT on healthy L2 learners’ pronunciation. Thirty peer-reviewed journal articles published between 1999 and 2022 were selected based on specific inclusion and exclusion criteria. Data were collected about the studies’ contexts, participants, experimental designs, CAPT systems, pronunciation training scopes and approaches, pronunciation assessment practices, and learning measures. Using a pedagogically informed codebook, the pronunciation training and assessment practices were classified and evaluated based on established L2 pronunciation teaching guidelines. The findings indicated that most of the studies focused on the pronunciation training of adult English learners with an emphasis on the production of segmental features (i.e. vowels and consonants) rather than suprasegmental features (i.e. stress, intonation, and rhythm). Despite the innovation promised by CAPT technology, pronunciation practice in the studies reviewed was characterized by the predominant use of drilling through listen-and-repeat and read-aloud activities. As for assessment, most CAPT studies relied on human listeners to measure the accurate production of discrete pronunciation features (i.e. segmental and suprasegmental accuracy). Meanwhile, few studies employed global pronunciation learning measures such as intelligibility and comprehensibility. Recommendations for future research are provided based on the discussion of these results.

In this systematic review, we scrutinise adolescent nutrition in Nigeria, focusing on dietary patterns, intake, and nutritional status. Through a systematic examination of observational studies across three major databases, we analysed data from 67,844 adolescents. Our exploration revealed 102 studies, predominantly cross-sectional, addressing various nutritional dimensions. However, only 13% of these studies demonstrated low risk of bias, with none offering national representation and most concentrated in specific, school-based regions. The findings underscore a complex nutritional landscape with widespread malnutrition and highlight the critical need for high-quality, comprehensive data. The dominance of cross-sectional designs and regional biases in existing research calls for cautious interpretation and suggests a pressing need for more robust, nationally representative studies to guide future nutritional interventions and policy-making in Nigeria.

Vitamin D deficiency in infants is widely prevalent. Most paediatric professional associations recommend routine vitamin D prophylaxis for infants. However, the optimal dose and duration of supplementation are still debated. We aimed to compare the efficacy and safety of different vitamin D supplementation regimens in term and late preterm neonates. For this systematic review and network meta-analysis, we searched MEDLINE, the Cochrane Central Register of Controlled Trials and Embase. Randomised and quasi-randomised clinical trials that evaluated any enteral vitamin D supplementation regimen initiated within 6 weeks of life were included. Two researchers independently extracted data on study characteristics and outcomes and assessed quality of included studies. A network meta-analysis with a Bayesian random-effects model was used for data synthesis. Certainty of evidence (CoE) was assessed using GRADE. Primary outcomes were mean serum vitamin D concentrations and the proportion of infants with vitamin D insufficiency (VDI). We included twenty-nine trials that evaluated fourteen different regimens of vitamin D supplementation. While all dosage regimens of ≥400 IU/d increased the mean 25(OH)D levels compared with no treatment, supplementation of ≤250 IU/d and 1400 IU/week did not. The CoE varied from very low to high. Low CoE indicated that 1600 IU/d, compared with lower dosages, reduced the proportion of infants with VDI. However, our results indicated that any dosage of ≥800 IU/d increased the risk of hypervitaminosis D and hypercalcaemia. Data on major clinical outcomes were sparse. Vitamin D supplementation of 400–600 IU/d may be the most effective and safest in infants.

The mental health benefits of exposure to green spaces are well known. This systematic review summarizes the evidence of green space exposure for people with schizophrenia spectrum disorders (SSDs), focusing on incidence and mental health outcomes, including mental health symptoms and health service use. The study was pre-registered (PROSPERO ID: CRD42023431954), and conducted according to PRISMA guidelines. Seven databases, reference lists, and gray literature sources were searched. Methodological quality was assessed using The Quality Assessment Tool for Quantitative Studies. 126 studies were screened, and 12 studies were eligible for inclusion. Seven studies found that exposure to green space was associated with a reduced risk of schizophrenia (lowest to highest green space exposure: HRs = 0.62–0.37; IRRs = 1.52–1.18), with five studies reporting a dose-response relationship. Of these studies, four examined childhood exposure and the remainder examined adult exposure. Regarding health service use, proximity to green space was not significantly associated with length of hospital admission, though greater green space exposure was associated with reduced hospital admission rates. Three studies found reduced symptoms of anxiety (d = −0.70–2.42), depression (d = −0.97–1.70) and psychosis (d = −0.94) with greater green space exposure. Exposure to green space reduces the risk of schizophrenia, and there is emerging evidence of the potential benefits of green space for reducing symptoms and health service use among people with SSDs. Future research using experimental and longitudinal designs will provide more robust evidence of the benefits of green space for people with SSDs.

Virtual reality (VR) is a technology that allows to interact with recreated digital environments and situations with enhanced realism. VR has shown good acceptability and promise in different mental health conditions. No systematic review has evaluated the use of VR in Bipolar Disorder (BD). This PRISMA-compliant systematic review searched PubMed and Web of Science databases (PROSPERO: CRD42023467737) to identify studies conducted in individuals with BD in which VR was used. Results were systematically synthesized around four categories (cognitive and functional evaluation, clinical assessment, response to VR and safety/acceptability). Eleven studies were included (267 individuals, mean age = 36.6 years, 60.7% females). Six studies using VR to carry out a cognitive evaluation detected impairments in neuropsychological performance and delayed reaction times. VR was used to assess emotional regulation. No differences in well-being between VR-based and physical calm rooms were found. A VR-based stress management program reduced subjective stress, depression, and anxiety levels. VR-based cognitive remediation improved cognition, depressive symptoms, and emotional awareness. 48.7% of the individuals with BD considered VR-based cognitive remediation ‘excellent’, whereas 28.2% considered it ‘great’. 87.2% of individuals did not report any side effects. 81.8% of studies received a global quality rating of moderate. Emerging data point towards a promising use of VR in BD as an acceptable assessment/intervention tool. However, multiple unstudied domains as comorbidity, relapse and prodromal symptoms should be investigated. Research on children and adolescents is also recommended. Further research and replication of findings are required to disentangle which VR-interventions for which populations and outcomes are effective.

Young people (YP) (between 10 and 24 years) are disproportionally vulnerable to developing and being affected by mental health conditions due to physical, social and emotional risk factors. YP in low-and middle-income countries (LMICs) have poorer access to, and quality of, mental health services compared to those in high-income countries. Digital mental health interventions (DMHIs) have been proposed as tools to address this burden of disease and reduce the global treatment gap in youth mental health outcomes. This study aimed to examine the evidence for DMHIs for treating mental disorders in YP based in LMICs. To do this, the author searched academic databases (MEDLINE, PsycINFO, Embase and Web of Science) for primary studies on DMHIs targeting YP in LMICs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed. The quality of the studies was assessed using the Critical Appraisal Skills Programme) framework. A narrative synthesis methodology was used to summarise and explain the findings. The authors identified 287 studies of which 7 were eligible in the final review. The authors found evidence of the effectiveness of multiple forms of DMHI (especially internet-based cognitive behavioural therapy) on anxiety and depression outcomes. Studies reported a lack of long-term benefits of treatment, high dropout rates, and did not include key geographical settings or data on cost-effectiveness. No studies were judged to be of high quality. This review highlights the available evidence showing that DMHIs can improve mental health outcomes for YP in LMICs, but due to the limited number of studies and lack of high-quality data, increased adoption and scaling up of digital interventions require more rigorous studies showing clinical effectiveness and ability to provide return on investment.

International migrants face barriers when accessing health-care in their destination countries. For older migrants, there are additional difficulties due to their age and associated health conditions. Chinese migrants are an understudied group with culture-specific barriers in addition to those shared with other migrant groups. This review aims to understand the barriers and facilitators to health-care access faced by older Chinese migrants in high-income countries. Literature from MEDLINE, Web of Science, EMBASE, Scopus, CINAHL Plus and ProQuest (1 January 2000 to 6 October 2021) were retrieved. Quantitative, qualitative and mixed-methods studies focusing on older Chinese migrants' access to, utilisation of and satisfaction with health-care services in high-income countries were included. Studies were appraised using checklists from the Joanna Briggs Institute and the Critical Appraisal Skills Programme. Qualitative and quantitative data were extracted and analysed narratively to identify barriers and facilitators to accessing health-care, then applied to Levesque's five-step health-care access journey framework. We included 33 studies in the analysis. Qualitative evidence identified barriers and facilitators to health-care access in four categories: health-care system, social factors, personal factors and health-care interactions. Quantitative studies found that health status and having insurance were positively associated with using non-preventive care, while time of residence and physician's recommendations were positively associated with using preventive care. Factors that influence older Chinese migrants' access to health care include practical barriers (communication, time and cost), social support (family and community), perceptions of health and care needs (beliefs and knowledge) and interactions with health-care professionals (patient–physician trust and support from physicians). Efforts to overcome universal barriers, acknowledgement of cultural contexts, improvements in translation services, and involvement of Chinese families and communities in health-care outreach will benefit this population.

The Dietary Approaches to Stop Hypertension (DASH) diet is highly effective in controlling blood pressure (BP). Although Na restriction is not a primary focus within the DASH diet, it is recommended that it be added to control BP. Therefore, we aimed to systematically review the characteristics and BP-lowering effects of Na-restricted DASH diet interventions. We searched thirteen databases, namely, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, KoreaMed, KISS, KMbase, RISS, CINAHL, Scopus, ClinicalTrials.gov, Grey Literature Report, OpenGrey and PQDT Global, for articles published through May 2023. The randomised controlled trials assessing the BP-lowering effect of the Na-restricted DASH diet in adults aged 18 years and older were included. The study protocol was registered in the PROSPERO registry (CRD42023409996). The risk of bias in the included studies was also assessed. Nine articles were included in this review. Interventions were categorised into three types: feeding, provision and education, and the study results were compared by intervention type. BP was significantly reduced in two of the three feeding studies, one of the three provisional studies and none of the educational studies. In eight studies, effect sizes varied among both systolic BP (–7·7 to −2·4) and diastolic BP (–8·3 to 0·1). Six studies showed an overall high risk of bias. In conclusion, Na-restricted DASH may have beneficial effects on BP control. Additionally, compared with control interventions, feeding interventions appeared to have a greater BP-lowering effect. Further high-quality studies are needed to improve the quality of the evidence.

This paper aims to identify gaps between the reflection frameworks and students’ practice. Through a systematic literature review (PRISMA) and a qualitative survey of students, 12 reflection frameworks were reviewed, and the 13 challenges students faced at design projects in two design schools were identified. The results indicate three gaps between theory and students’ practice: skills of designers, granularities of reflection items, and supports of bridging reflection to next actions. This study provides insights for future development of support tools to bridge the gaps in design education.

Social engagement is considered a relevant modifiable factor for older adults' wellbeing. Theory and policies highlight its importance for ageing well. Empirical evidence shows that social activities are associated with positive psychological outcomes and might buffer wellbeing declines in late life. Despite growing research, social engagement lacks conceptual clarity, it is difficult to adopt standardised measures and findings are sometimes inconsistent. Previous systematic reviews either take a different approach to this topic or were published over a decade ago. Therefore, the present study aimed to review the literature systematically regarding the relationship between social engagement and wellbeing in community-dwelling older adults. Papers published from 2000 to 2021 were searched in five databases using a combination of terms. The reviewers screened the records according to predefined inclusion and exclusion criteria. After identifying eligible articles, the authors extracted data and produced a narrative synthesis covering conceptualisation, measurement and main findings. The review includes 42 papers. Despite great conceptual and methodological diversity, research supports that older adults with higher participation in social activities have improved wellbeing. Findings also suggest that these associations are stronger for individuals with disadvantages and have a cumulative nature whereby the greater the social engagement, the higher the wellbeing. Conversely, for more demanding activities, there might be optimal participation levels. Regardless of accumulating knowledge, social engagement remains diffuse and difficult to measure. This paper summarises the current state of research on this topic, showing encouraging evidence of social engagement benefits, but also questions that deserve further inquiry. Future studies should be anchored in a clear conceptual framework, use robust measures, and explore hedonic and eudaimonic wellbeing. Social engagement can be an important developmental resource for social interventions and policies aimed at improving people's lives.

The aim of this article is to critically review the scientific literature about the changes in travel behaviour and mobility amongst older adults caused by the COVID-19 pandemic across various countries, identify unmet travel needs and highlight patterns of inequalities in older adults' mobility. We have collected articles from four academic databases: PubMed, Scopus, Transportation Research International Documentation (TRID) and Web of Science. Papers were considered for inclusion if they were published online in 2020 or later, written in English, and referred to urban or rural changes in travel behaviour and mobility of older adults over 50 years old. We examined the pre-existing models developed before the outbreak and classified the articles based on Musselwhite and Haddad's hierarchy of older adults' travel needs. The synthesis of the selected 25 articles shows a general decline in literal mobility amongst older adults, an increased share of virtual travel and their decreased capacity to fulfil different levels of travel needs. Findings also indicate an increased gap in older adults' mobility across geographical regions with various levels of transport infrastructure and digital capital. We conclude the paper with the lessons learned, the opportunities ahead, and the challenges that must be overcome to achieve sustainable development and the United Nations Decades of Healthy Ageing goals in the post-pandemic world.

Obsessive-compulsive disorder (OCD) is a prevalent condition with multifactorial etiology involving genetic and environmental factors. The present study aims to summarize the correlates of stressful life events (SLEs) in OCD by reviewing studies comparing OCD associated or not with SLEs before its onset. To do so, a systematic review was performed by searching PubMed, Web of Science, Scopus, and PsycINFO databases for studies published between the database’s inception and November 27, 2023. Studies including individuals whose OCD was precipitated or not by SLEs (SLEs OCD and NSLEs OCD, respectively) were assessed. Effect sizes or odds ratios were then calculated to identify the strength of association between SLEs and clinical characteristics, such as gender, age of onset, family history of OCD, severity of OCD symptoms, depressive symptoms, and mood comorbidities among patients with OCD. Out of the 4083 records initially identified, 5 studies met the inclusion criteria and 3 were comparable through a meta-analysis. Notably, the analyses were limited by the small number of studies available in the literature. The meta-analysis demonstrated SLEs OCD to be associated with female gender, later OCD onset, and increased comorbidity rates with mood disorders. Despite the cross-sectional nature of the reviewed studies, women may be more vulnerable to develop a later onset of OCD following SLEs, which may also lead to mood disorders. Caution is needed to avoid prematurely classifying this presentation as a distinct subtype of OCD.