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The vulnerability of deafblind people is considered axiomatic; they are seen not only as a vulnerable group but also as one of the most vulnerable. This paper aims to synthesise existing knowledge to determine what is known about such vulnerability. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. An approach based on a 'hierarchy of evidence' would have reduced the amount of literature reviewed significantly, to the point where synthesis would not be possible. Included material was appraised and an interpretative rather than aggregative approach to synthesis adopted. Drawing on principles of critical interpretive synthesis, rather than being a determiner of whether material should be included or excluded, a critique of the literature is offered within the synthesis. Twenty-eight references were identified for inclusion, originating from the UK, USA, Australia, Continental Europe and the Nordic Countries. No empirical studies specifically examining the experience of vulnerability of deafblind people were found. However, deafblind people describe feelings of vulnerability in studies exploring their experiences more generally, and in personal accounts of living with the impairment. Literature produced by practitioners and specialist organisations also explores the topic. Deafblind people are identified as a population 'at risk' of various adverse outcomes, particularly when compared to the non-deafblind majority, and deafblind people describe being and feeling vulnerable in various situations. The literature largely relates to negative outcomes and includes significantly less exploration of positive risk taking, coping capacity and resilience. Deafblind people do not appear to describe themselves as being vulnerable as a permanent state, suggesting a need for greater exploration of the experience among all sections of this heterogeneous population, with consideration of the concepts of resilience and coping capacity. [ABSTRACT FROM AUTHOR]

This paper presents a meta-synthesis of the literature on community-based self-management to support experiences of people diagnosed with type 2 diabetes. The aim was to synthesise findings on both formal and informal self-management support with particular reference to the relevance and influence of the social context operating at different levels. The review forms part of EU- WISE, a project financed through EU's 7th Framework Programme. The review was performed by systematically searching MEDLINE, PubMed, EMBASE, CINAHL, Psyc INFO and Web of Science for English language publications between 2005 and 2014 presenting research conducted in Europe on the experiences and perspectives of self-management concerns of patients diagnosed with type 2 diabetes. The search yielded 587 abstracts, which were reduced through search strategy refinement and eligibility and quality criteria to 29 papers that were included in the review. This review highlights the relevance of contextual factors operating at micro- and macro-levels. The synthesis yielded six second-order thematic constructs relating to self-management: sense of agency and identity, the significance and meaning of social networks, minimal disruption of everyday life, economic hardship, the problem of assigning patients' responsibility and structural influences of primary care. Using a line of argument synthesis, these themes were revisited, and a third-order construct, connectivity emerged which refers to how links in daily life are interwoven with peoples' social networks, local communities, economic and ideological conditions in society in a way which support self-management activities. This meta-synthesis indicates a need to heed the notion of connectivity as a means of mobilising and supporting the self-management strategies of people with type 2 diabetes in everyday life. [ABSTRACT FROM AUTHOR]

The Innovative Medicines Initiative (IMI) is making great strides in promoting patient and public involvement (PPI) in health research across Europe, supporting patient organisations to be involved in the projects that it funds. Despite this, the literature around PPI in health services and research originating from European countries appears less than from the United Kingdom (UK), where PPI is well established. Therefore, we conducted a systematic review to explore the attitudes and approaches to PPI across Europe. Eight scientific databases were systematically searched and data extracted. Data quality was assessed using a checklist based on the Guidance for Reporting Involvement of Patients and the Public (GRIPP2) (Staniszewska et al., Research, Involvement and Engagement, 3, 13, 2017) and the critical appraisal guidelines developed by Wright et al. (Health Expectations, 13, 359, 2010). We included all studies reporting PPI activity in both public and private health services and research institutions in the World Health Organization European region, excluding the UK, published in the English language from 1996 to 2018. Forty studies in total were included in the analysis. The studies imply a growing interest and support for the idea of PPI in health services and, to a lesser extent, in health research. There seems to be a convergence of conceptualisations of PPI across Europe, with internationally significant areas of innovative work taking place in countries such as the Netherlands and the Scandinavian countries. However, the implementation of PPI is highly uneven, and PPI is not yet firmly embedded or adequately formalised in European healthcare systems and research, possibly due to a lack of infrastructure, guidance and support. In order to try to get a better understanding of what is happening on the ground, we are carrying out a survey with potential follow‐up interviews as the next part of this research project. This work is currently on hold due to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The objective of this rapid scoping review is to provide an overview of studies from northwest Europe that describe and evaluate community care delivered by a nurse practitioner (NP) in a team of healthcare professionals. In particular, we explore the roles of NPs within community care, the perceived impact at the patient and informal caregivers levels, and influencing factors (facilitating and impeding). This rapid scoping review was performed in accordance with Prisma RR guidelines. Data were collected from online databases between October and December 2020 and an update in March 2023. Medline was used for the search string, and the following databases were searched: Cinahl, Cochrane, Embase, Medline, and Web of Science (WoS). All studies described the roles of NPs, including their tasks and responsibilities in community care. The main findings about the roles were that NPs in community care diagnose, treat patients, and support and advise informal caregivers. They refer and perform case management for (frail) older people. They train DNs and take on project and strategic management roles. The results showed that the NP meets the increasing and complex care demands in patients' homes. The main findings about the perceived impacts were that patients and informal caregivers were generally satisfied with the deployment of the NP. Healthcare professionals experienced the benefits of NPs working in community care. Some healthcare professionals were sceptical when the role was first introduced, but attitudes improved after they worked alongside NPs. Other influencing factors were the competences of the NP, i.e., have a pioneering mentality, a clear vision, and a job profile from community care organisations, and having to collaborate with allied healthcare professionals. However, implementation of the NP in community care is still in its infancy in northwest Europe. This review will help policy makers and professionals understand the potential impact of this role and enhance it in the context of community care. [ABSTRACT FROM AUTHOR]

The number of seniors and prevalence of chronic conditions are increasing worldwide, resulting in more pressure on health systems. Health Information Technologies (HIT) present opportunities to support the healthcare needs of seniors. Although prior studies have investigated HIT and seniors, it remains unclear what factors significantly affect the adoption of different HIT by elderly people in the community. A Systematic Review (SR) was conducted between December 2017 and February 2018 (with a search update in 2018–2019) to critically appraise and synthesise existing evidence on HIT adoption factors among seniors. Following the PRISMA guidelines, five major databases were consulted (PubMed, Medline, CINAHL, Scopus and Web of Science). The inclusion criteria consisted of empirical studies, published in English, and reporting impacts of specific factors on HIT adoption among seniors in the community. A total of 41 studies were included in this review, mostly published between 2014 and 2017 in Europe and the US; the level of evidence in these studies was low to moderate. The factors that affect HIT adoption did not differ across types of technologies or age groups. The findings reveal that seniors adopt HIT that are perceived as useful and requiring low effort commitment; price/cost value were reported as adoption barriers. Social influence, facilitating conditions, senior‐friendly product design, self‐efficacy, Intrinsic Technology Quality, experience/training and technology anxiety may affect HIT adoption by seniors, although the evidence on these impacts remains weak and limited. Mixed and inconclusive evidence was observed on the impacts of socio‐demographic variables, health condition, habit and privacy/security. Given the reported low level of HIT adoption among seniors, we call for more rigorous research in this area using a 'senior‐centred' approach, which takes into account the discourse/interaction between seniors and their collective environment to better understand the factors that affect their technology adoption and address their needs. [ABSTRACT FROM AUTHOR]