Background: For people with diabetes mellitus to achieve optimal glycaemic control, motivation to perform self-management is important. The research team wanted to determine whether or not psychological interventions are clinically effective and cost-effective in increasing self-management and improving glycaemic control. Objectives: The first objective was to determine the clinical effectiveness of psychological interventions for people with type 1 diabetes mellitus and people with type 2 diabetes mellitus so that they have improved (1) glycated haemoglobin levels, (2) diabetes self-management and (3) quality of life, and fewer depressive symptoms. The second objective was to determine the cost-effectiveness of psychological interventions. Data sources: The following databases were accessed (searches took place between 2003 and 2016): MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PsycINFO, EMBASE, Cochrane Controlled Trials Register, Web of Science, and Dissertation Abstracts International. Diabetes conference abstracts, reference lists of included studies and Clinicaltrials.gov trial registry were also searched. Review methods: Systematic review, aggregate meta-analysis, network meta-analysis, individual patient data meta-analysis and cost-effectiveness modelling were all used. Risk of bias of randomised and non-randomised controlled trials was assessed using the Cochrane Handbook (Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928). Design: Systematic review, meta-analysis, cost-effectiveness analysis and patient and public consultation were all used. Setting: Settings in primary or secondary care were included. Participants: Adolescents and children with type 1 diabetes mellitus and adults with types 1 and 2 diabetes mellitus were included. Interventions: The interventions used were psychological treatments, including and not restricted to cognitive–behavioural therapy, counselling, family therapy and psychotherapy. Main outcome measures: Glycated haemoglobin levels, self-management behaviours, body mass index, blood pressure levels, depressive symptoms and quality of life were all used as outcome measures. Results: A total of 96 studies were included in the systematic review (n = 18,659 participants). In random-effects meta-analysis, data on glycated haemoglobin levels were available for seven studies conducted in adults with type 1 diabetes mellitus (n = 851 participants) that demonstrated a pooled mean difference of –0.13 (95% confidence interval –0.33 to 0.07), a non-significant decrease in favour of psychological treatment; 18 studies conducted in adolescents/children with type 1 diabetes mellitus (n = 2583 participants) that demonstrated a pooled mean difference of 0.00 (95% confidence interval –0.18 to 0.18), indicating no change; and 49 studies conducted in adults with type 2 diabetes mellitus (n = 12,009 participants) that demonstrated a pooled mean difference of –0.21 (95% confidence interval –0.31 to –0.10), equivalent to reduction in glycated haemoglobin levels of –0.33% or ≈3.5 mmol/mol. For type 2 diabetes mellitus, there was evidence that psychological interventions improved dietary behaviour and quality of life but not blood pressure, body mass index or depressive symptoms. The results of the network meta-analysis, which considers direct and indirect effects of multiple treatment comparisons, suggest that, for adults with type 1 diabetes mellitus (7 studies; 968 participants), attention control and cognitive–behavioural therapy are clinically effective and cognitive–behavioural therapy is cost-effective. For adults with type 2 diabetes mellitus (49 studies; 12,409 participants), cognitive–behavioural therapy and counselling are effective and cognitive–behavioural therapy is potentially cost-effective. The results of the individual patient data meta-analysis for adolescents/children with type 1 diabetes mellitus (9 studies; 1392 participants) suggest that there were main effects for age and diabetes duration. For adults with type 2 diabetes mellitus (19 studies; 3639 participants), baseline glycated haemoglobin levels moderated treatment outcome. Limitations: Aggregate meta-analysis was limited to glycaemic control for type 1 diabetes mellitus. It was not possible to model cost-effectiveness for adolescents/children with type 1 diabetes mellitus and modelling for type 2 diabetes mellitus involved substantial uncertainty. The individual patient data meta-analysis included only 40–50% of studies. Conclusions: This review suggests that psychological treatments offer minimal clinical benefit in improving glycated haemoglobin levels for adults with type 2 diabetes mellitus. However, there was no evidence of benefit compared with control interventions in improving glycated haemoglobin levels for people with type 1 diabetes mellitus. Future work: Future work should consider the competency of the interventionists delivering a therapy and psychological approaches that are matched to a person and their life course. Study registration: This study is registered as PROSPERO CRD42016033619. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 28. See the NIHR Journals Library website for further project information.

Attending university is a time of considerable change, and there are rising concerns about the mental health and well-being of university students, leading to calls for a whole-university approach to student support. Resilience interventions offer an opportunity to improve mental health and well-being, whilst also developing a much sought-after graduate attribute. We conducted a systematic review of interventions designed to increase university students’ levels of resilience and examined the impact of these on students’ mental health and well-being. Five databases identified 1377 unique records, 47 of which were eligible for inclusion. Eligible studies were drawn from a range of countries and adopted different designs, with the most common being the randomised controlled trial (RCT). Interventions were classified into mindfulness, skills-based, psychoeducation, and coaching, with delivery both online and face-to-face. The most common outcomes were depression, anxiety, stress, and well-being. The ‘Quality Assessment Tool for Before-After (Pre-/Post) Studies’ was used to assess the risk of bias with most studies rated as fair. Overall, the studies indicated that there is little evidence of a positive effect on depression, but stress and anxiety may be reduced following interventions. Well-being data were inconclusive. Interestingly, most interventions did not impact measures of resilience or mindfulness, despite the training targeting these constructs. The available research is currently limited and there is a need for more high-quality designs providing descriptions of interventions.

There is increasing pressure within universities to address student mental health. From a whole university or settings-based perspective, this could include curriculum-embedded approaches. There is little research about how this should work or what approaches might be most effective. Semi -structured interviews were conducted with fifty-seven undergraduate students from five disciplines (Psychology, English studies, Nursing, International Politics, and War Studies) to understand students’ perspectives. Students reflected on wellbeing module content and, more broadly, on curriculum processes (teaching, pedagogy, assessment) within their degree. Reflexive thematic analysis was applied to transcripts, generating three themes: embedding wellbeing in the curriculum; assessment, challenge, and academic support; and social connection and interaction. The findings provide evidence for teaching, pedagogy, and assessment practices supporting higher education student wellbeing. These align with recommended good teaching practices, such as considering appropriate assessment methods followed by effective feedback. Students saw the benefits of being academically challenged if scaffolded appropriately. Strong peer connection, teacher-student interaction, and communication were crucial to learning and wellbeing. These findings provide implications for future curriculum design that can support learning and wellbeing.

Aim: We conducted a systematic review aggregate and network meta‐analysis of psychological interventions for people with type 1 diabetes to assess their effectiveness in improving glycaemic levels.Methods: We searched the following databases from 1 January 2003 to 1 July 2018: MEDLINE, CINAHL, PsycINFO, Embase, Cochrane Controlled Trials, Web of Science, clinicaltrials.gov, Dissertation Abstract International. We included randomized controlled trials (RCT) of psychological interventions for children and adults with type 1 diabetes reported in any language. We extracted data on publications, participant characteristics at baseline, intervention and control group, and data for the primary outcome, change in glycaemic control [HbA_1c (mmol/mol/%)]. Study authors were contacted for missing data. The review was registered with international prospective register of systematic reviews registration (PROSPERO) CRD42016033619.Results: Twenty‐four adult RCTs and 23 of children with type 1 diabetes were included in the systematic review. In aggregate meta‐analysis there was no overall effect of psychological intervention compared with control on HbA_1c [adults, nine RCTs, n = 1102, pooled mean difference −0.12, 95% confidence intervals (CI) −0.27 to 0.03, I² = 29.0%, P = 0.19; children, 20 RCTs, n = 2567, −0.09, 95% CI −0.22 to 0.04, I²=54.0% P=0.002]. Network meta‐analysis suggested that probability and rank‐ordering of effectiveness is highest for attention control groups (b = −0.47, 95% CI −0.80 to −0.12) followed by cognitive behavioural therapy (CBT) (−0.26, 95% CI −0.45 to −0.06) compared with usual care for adults.Conclusions: Overall psychological interventions for children and adults with type 1 diabetes do not improve glycaemic control. For adults, CBT‐based interventions have the potential to be effective.

In educational research, the complexity of interventions and the diversity of contexts challenge the adequacy of existing reporting standards, primarily tailored for health interventions and randomised controlled trials. Recognising the critical need for appropriate tools to support education research, we developed two checklists: the CheckList Of Standards of reporting in Education Research (CLOSER) and the Checklist for Intervention Description of Education Research (CIDER). CLOSER was designed to guide the comprehensive reporting of quantitative educational intervention research from the abstract to the discussion for multiple study designs. Concurrently, CIDER details the precise features of educational interventions. The final refinements of CLOSER and CIDER comprise of 34 and 17 items, respectively, developed through a five-stage process, including tool adaptation, expert feedback, a 2-round modified Delphi consensus survey, and final refinements. These checklists aim to enhance the clarity of educational intervention research findings, facilitating their replicability and subsequent meaningful translation into practice and policy. This addresses the gap in educational research reporting standards and sets the stage for a more robust, evidence-informed approach to educational intervention development and evaluation.