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Review objective/questions: The objective of this scoping review is to map the evidence relating to the reporting and evaluation of health technologies for the prevention and detection of falls in adult hospital in-patients. The following questions will guide this scoping review: i) What falls prevention and detection health technologies have been reported in the literature? ii) What outcomes have been reported that measure falls prevention and detection health technologies in terms of clinical effectiveness, cost-effectiveness, acceptability and feasibility of use?

OBJECTIVE:To synthesize and integrate the best available evidence on the experiences and effectiveness of canine-assisted interventions (CAIs) on the health and well-being of older people residing in long-term care. INTRODUCTION:Canine-assisted interventions (CAIs) are commonly used as an adjunct therapy to enhance health and well-being and are often implemented in long-term care facilities. The number of studies undertaken in this area has increased substantially over the last five years; therefore, an update of two previous systematic reviews is warranted. INCLUSION CRITERIA:This review will consider older people who reside in long-term care facilities and who receive CAIs. For the quantitative component, CAIs will be compared to usual care, alternative therapeutic interventions or no interventions, and outcomes will be grouped under the following headings: biological, psychological and social. For the qualitative component, the experiences of older people receiving CAIs, as well as the views of people directly or indirectly involved in delivering CAIs, will be explored. Quantitative, qualitative and mixed methods studies published from 2009 to the present will be considered. METHODS:A search of 10 bibliographic databases and other various resources for published and unpublished English language studies will be undertaken. Study selection, critical appraisal, data extraction and data synthesis will be undertaken following the segregated JBI approach to mixed methods reviews.

BACKGROUND: Effective nutritional screening, nutritional care planning and nutritional support are essential in all settings, and there is no doubt that a health service seeking to increase safety and clinical effectiveness must take nutritional care seriously. Screening and early detection of malnutrition is crucial in identifying patients at nutritional risk. There is a high prevalence of malnutrition in hospitalized patients undergoing treatment for colorectal cancer.OBJECTIVES: To synthesize the best available evidence regarding the diagnostic test accuracy of nutritional tools (sensitivity and specificity) used to identify malnutrition (specifically undernutrition) in patients with colorectal cancer (such as the Malnutrition Screening Tool and Nutritional Risk Index) compared to reference tests (such as the Subjective Global Assessment or Patient Generated Subjective Global Assessment).INCLUSION CRITERIA: TYPES OF PARTICIPANTS: Patients with colorectal cancer requiring either (or all) surgery, chemotherapy and/or radiotherapy in secondary care. Focus of the review: The diagnostic test accuracy of validated assessment tools/instruments (such as the Malnutrition Screening Tool and Nutritional Risk Index) in the diagnosis of malnutrition (specifically under-nutrition) in patients with colorectal cancer, relative to reference tests (Subjective Global Assessment or Patient Generated Subjective Global Assessment). Types of studies: Diagnostic test accuracy studies regardless of study design.SEARCH STRATEGY: Studies published in English, German, Danish, Swedish and Norwegian were considered for inclusion in this review. Databases were searched from their inception to April 2014.METHODOLOGICAL QUALITY: Methodological quality was determined using the Quality Assessment of Diagnostic Accuracy Studies checklist.DATA COLLECTION: Data was collected using the data extraction form: the Standards for Reporting Studies of Diagnostic Accuracy checklist for the reporting of studies of diagnostic accuracy.DATA SYNTHESIS: The accuracy of diagnostic tests is presented in terms of sensitivity, specificity, positive and negative predictive values. In addition, the positive likelihood ratio (sensitivity/ [1 - specificity]) and negative likelihood ratio (1 - sensitivity)/ specificity), were also calculated and presented in this review to provide information about the likelihood that a given test result would be expected when the target condition is present compared with the likelihood that the same result would be expected when the condition is absent. Not all trials reported true positive, true negative, false positive and false negative rates, therefore these rates were calculated based on the data in the published papers. A two-by-two truth table was reconstructed for each study, and sensitivity, specificity, positive predictive value, negative predictive value positive likelihood ratio and negative likelihood ratio were calculated for each study. A summary receiver operator characteristics curve was constructed to determine the relationship between sensitivity and specificity, and the area under the summary receiver operator characteristics curve which measured the usefulness of a test was calculated. Meta-analysis was not considered appropriate, therefore data was synthesized in a narrative summary.RESULTS: 1. One study evaluated the Malnutrition Screening Tool against the reference standard Patient-Generated Subjective Global Assessment. The sensitivity was 56% and the specificity 84%. The positive likelihood ratio was 3.100, negative likelihood ratio was 0.59, the diagnostic odds ratio (CI 95%) was 5.20 (1.09-24.90) and the Area Under the Curve (AUC) represents only a poor to fair diagnostic test accuracy. A total of two studies evaluated the diagnostic accuracy of Malnutrition Universal Screening Tool (MUST) (index test) compared to both Subjective Global Assessment (SGA) (reference standard) and PG-SGA (reference standard) in patients with colorectal cancer. In MUST vs SGA the sensitivity of the tool was 96%, specificity was 75%, LR+ 3.826, LR- 0.058, diagnostic OR (CI 95%) 66.00 (6.61-659.24) and AUC represented excellent diagnostic accuracy. In MUST vs PG-SGA the sensitivity of the tool was 72%, specificity 48.9%, LR+ 1.382, LR- 0.579, diagnostic OR (CI 95%) 2.39 (0.87-6.58) and AUC indicated that the tool failed as a diagnostic test to identify patients with colorectal cancer at nutritional risk,. The Nutrition Risk Index (NRI) was compared to SGA representing a sensitivity of 95.2%, specificity of 62.5%, LR+ 2.521, LR- 0.087, diagnostic OR (CI 95%) 28.89 (6.93-120.40) and AUC represented good diagnostic accuracy. In regard to NRI vs PG-SGA the sensitivity of the tool was 68%, specificity 64%, LR+ 1.947, LR- 0.487, diagnostic OR (CI 95%) 4.00 (1.23-13.01) and AUC indicated poor diagnostic test accuracy.CONCLUSIONS: There are no single, specific tools used to screen or assess the nutritional status of colorectal cancer patients. All tools showed varied diagnostic accuracies when compared to the reference standards SGA and PG-SGA. Hence clinical judgment combined with perhaps the SGA or PG-SGA should play a major role.IMPLICATIONS FOR PRACTICE: The PG-SGA offers several advantages over the SGA tool: 1) the patient completes the medical history component, thereby decreasing the amount of time involved; 2) it contains more nutrition impact symptoms, which are important to the patient with cancer; and 3) it has a scoring system that allows patients to be triaged for nutritional intervention. Therefore, the PG-SGA could be used as a nutrition assessment tool as it allows quick identification and prioritization of colorectal cancer patients with malnutrition in combination with other parameters.IMPLICATIONS FOR RESEARCH: This systematic review highlights the need for the following: Further studies needs to investigate the diagnostic accuracy of already existing nutritional screening tools in the context of colorectal cancer patients. If new screenings tools are developed, they should be developed and validated in the specific clinical context within the same patient population (colorectal cancer patients).

Review questions/objectives: The objective of this scoping review is to examine and map absolute clinical skill decay in the medical, nursing and allied health professions and to map the range of approaches used to address decay of clinical skills in these professions. Review questions/objectives: Specifically, the review questions are: which clinical skills, performed by which professional groups, are reported to be most susceptible to absolute clinical skill decay, and what approaches have been reported for addressing absolute clinical skill decay in the medical, nursing and allied health professions? Review questions/objectives: In addressing the review questions, the following sub-questions will also be addressed: Review questions/objectives: It is anticipated that this scoping review will inform further systematic review/s on the topic of addressing clinical skill decay in the medical, nursing and allied health professions, as well as identify gaps in the research knowledge base that will inform further primary research.

Review question/objective The objective of this review is to synthesize the best available qualitative evidence on the perceived competencies and skills required by members of a multidisciplinary bariatric care team to provide safe, meaningful and appropriate care for severely obese patients undergoing bariatric surgery. Inclusion criteria Types of participants The review will focus on specialist surgical services for patients with severe and complex obesity (BMI ≥40), provided internationally within public, independent or private sectors. Study participants of interest are members of the MDT providing the specialist services. The review will initially concentrate on four key roles within the MDT; all identified as key contributors to the best possible provision of care for bariatric patients: a) specialist bariatric surgeon; b) specialist bariatric nurse; c) specialist bariatric dietitian; d) psychologist and/or psychiatrist. Where available, literature pertaining to other practitioners with the key roles listed below will be included: e) physiotherapists; f) specialist physicians; g) anesthetists; h) radiographers and radiologists. The particular competencies of the individual MDT members to be explored pertain to the specialist knowledge, skills, and understanding required in order to provide a high quality service. Phenomena of interest The phenomena of interest for the review are the competencies and skills required by multidisciplinary team members to provide care for severely obese patients undergoing bariatric surgery. All types of bariatric procedures are of relevance to the review.

Background Breast-feeding is considered the optimum method of infant nutrition conveying health and psychological benefits for mother and baby. Women from disadvantaged groups are less likely to initiate or successfully establish breast-feeding and with the current emphasis on addressing health inequalities there is an identified need to tailor breast-feeding strategies towards this population. Objectives To appraise and synthesize the best available evidence on effectiveness and maternal satisfaction of interventions supporting the establishment of breast-feeding in the early postnatal period, up to seven days following delivery, for women from disadvantaged groups. Inclusion criteria Types of participants Women from disadvantaged groups, defined as those from socio-economically deprived areas; low income; under 20 years or substance dependent. Types of intervention(s)/phenomena of interest Any study exploring practical, motivational, informative and/or educational interventions supporting disadvantaged women to establish breast-feeding. Types of studies Quantitative and qualitative studies. Types of outcomes The establishment of breast-feeding/lactation within the postnatal period; perceived usefulness and acceptability of the intervention to support breast-feeding establishment in the postnatal period. Search strategy Searches were conducted for any published or unpublished material, in the English language, between 1992 and March 2013. A three-step search of databases including ASSIA; Campbell Collaboration; CINAHL, Cochrane Database; EBSCO; EThOS; Journals @OVID; Medline and SAGE journals was conducted. Methodological quality Each paper was assessed by two independent reviewers for methodological quality using the appropriate critical appraisal instrument from Joanna Briggs Institute. Data collection Data was collected using standardized extraction tools developed by Joanna Briggs Institute. Data synthesis Data was synthesized according to their methodological approach using instruments from the Joanna Briggs Institute. Where this was not possible, findings are presented in a narrative form. Results A total of 10 studies were included in the review. Two were quantitative studies (prospective cohort studies) and eight were qualitative studies (qualitative components of a mixed methodology study and seven qualitative studies). Forty-five findings were extracted from the qualitative components of the studies. Findings were synthesized into 12 categories. Categories were synthesized into three findings. The quantitative review demonstrated that technical assistance and information provision resulted in greater awareness of breast-feeding physiology, increased rates and a longer duration of breast-feeding. The qualitative synthesized findings suggested that maternal satisfaction was enhanced when proactive practical assistance was given within the confines of a collaborative relationship. Professional support offering positive encouragement and delivering socio-culturally appropriate strategies were considered by mothers as helping to meet their breast-feeding objectives. Disempowering practices included inaccessible information, conflicting advice and judgmental attitudes from health care providers. Conclusions The review identified interventions aimed at enhancing technical skill and knowledge as clinically effective in establishing successful breast-feeding. Disadvantaged women considered support strategies offering culturally relevant advice and specific to their individualized needs as the most acceptable and effective in meeting their breast-feeding intentions.

Review question/objective The objective is to identify the effectiveness of peer support interventions in community-dwelling adults with chronic non-cancer pain. More specifically, the objectives are to identify: The effectiveness of peer support interventions in function, pain, quality of life, self-efficacy and health service utilization for adults with chronic non-cancer pain dwelling in the community, compared to those receiving usual care or other self-management interventions. The specific review question is therefore: Is peer support more effective than usual care or other self-management interventions in reducing pain and health service utilization, and enhancing function, self-efficacy and quality of life in community-dwelling older adults with chronic non-cancer pain? Inclusion criteria Types of participants Since chronic pain affects adults of all ages there will be no upper limit set; we will include participants aged 18 or over. Chronic pain in children is often managed differently than in adults, with specific guidelines, 11 therefore participants under 18 are outwith the scope of this review. Cancer pain is also considered outwith the scope of this review due to its specific nature and management 14 which often differs from non-cancer related causes of chronic pain. Adults who are hospitalized or living in residential care will also be excluded from this review. Peer support interventions in these settings are likely to differ greatly from those designed for community dwelling adults; the focus of this review is on interventions designed for community-dwelling adults. Types of intervention(s)/phenomena of interest The review will consider studies that evaluate any peer support intervention or any intervention that includes a defined element of peer support. Peer support interventions can be aimed at individuals or groups, therefore both will be included in this review. Interventions will include support groups or clubs, email discussion groups, telephone calls, home visits, and any other intervention that can be considered to be peer support. Peers will have knowledge of chronic pain. They may be self-selected or selected by health professionals, and will have received a moderate amount of training to deliver an intervention, in keeping with the definition presented above. 2 People with no training are considered natural lay helpers and are excluded from this review. People who have undergone extensive training are considered paraprofessionals and are likewise excluded from this review. In cases where it is not possible to determine whether the support was provided by a natural lay helper, peer or paraprofessional, studies will be included in order to minimize the risk of omitting relevant data. Types of comparator This review will consider studies that have compared peer support interventions to other self-management interventions that are not delivered by peers. These will include one-on-one or group interventions delivered by paraprofessionals or by health professionals. This review will also consider studies that have compared peer support to usual care. Since there is no one agreed definition of usual care for long term management of adults with chronic pain, any study that provides a description of usual care as their comparator will be included. There may also be studies in which the self-management intervention is the same in the experimental and comparison group, the only difference being the addition of a peer support element to the experimental group; these studies will also be considered. Types of outcomes This review will consider studies that include the following quantitative measures: function, pain, quality of life, self-efficacy and health service utilization. This is in keeping with recommendations for outcome measurement in chronic pain and self-management research, 13,16-17 therefore these measures should be available for consideration. Measures of function may be specific to the region of chronic pain, eg Roland Morris Low Back Pain Disability Questionnaire and Oswestry Low Back Pain Disability Questionnaire, or more general measures, eg Pain Disability Index. In addition to these measures of physical function, measures of emotional function will also be considered, eg scales that measure depression, anxiety and loneliness. Any measure of pain will be included, eg Visual Analogue Scale and Multidimensional Pain Inventory. Any quality of life measure will be included eg SF-36, Euroqol. Any measure of self-efficacy will be included, eg self-care of chronic pain and self-efficacy questionnaires. In addition, where self-management knowledge and skills have been measured these will likewise be considered (eg Health Education Impact Questionnaire) Any measure of health service utilization will be considered, such as emergency room and physician visits. Economic evaluation is however outwith the scope of this review. Where possible, outcomes measured with similar scales will be pooled together.

The quantitative objective is to identify the known and/or potential health effects of working in the wind power generation industry. More specifically the objectives are to identify: 1. The musculoskeletal and other physical health risks to onshore wind technicians associated with the repeated climbing of vertical ladders; 2. The musculoskeletal and other physical health risks to onshore wind technicians associated with working in confined spaces within wind turbine structures. The qualitative objective is to identify onshore wind technicians' and/or related workers' perceptions and experiences of work-related musculoskeletal and other physical health disorders. The textual objective is to identify the issues related to musculoskeletal and other physical health risks of working in the wind power generation industry. Inclusion criteria Types of participants The quantitative and qualitative components of this review will consider studies that include adult onshore wind technicians. In the absence of studies directly relating to onshore wind technicians, participants from other related sectors (i.e. occupations that involve repeated vertical ladder climbing and/or confined space working similar to turbine structures) will be considered. These participants include, but are not restricted to, telecommunications workers, offshore oil and gas workers, construction and maintenance workers and electricians. The specific environmental health effects associated with offshore wind and marine developments are not within the scope of this review. The textual component of this review will consider the same participants as the quantitative and qualitative components, but will also include occupational health and safety experts, health professionals, employers and industry bodies. Types of intervention(s)/phenomena of interest The quantitative component of the review will consider studies that evaluate the musculoskeletal and other physical health risks to onshore wind technicians and related others associated with the repeated climbing of vertical ladders and working in confined spaces. The qualitative component of this review will consider studies that investigate onshore wind technicians' and related others' perceptions and experiences of work-related musculoskeletal and other physical health disorders. The textual component of this review will consider publications that describe the issues related to musculoskeletal and other physical health risks of working in the wind power generation and TRUNCATED AT 350 WORDS

Levels of medication administration error have been reported as accounting for 38% of all adverse drug events and have been calculated as occurring in 3-8% of all administrations. The majority of these will occur as part of "routine" administration.To undertake a systematic review of roles and systems for preventing medication error during routine medication administration in hospital-based acute care settings and of perceptions of causes of error.Types of participants- Participants were nurses, pharmacists, pharmacy technicians, medical and surgical staff and adult patients in hospital-based, acute care settings.Types of intervention/Phenomena of interest- Intervention related to administration systems and related to roles of those who administer medicines were considered. The perceptions of causes of error was the phenomena of interest.Types of outcomes- 1) Number of medication administration errors, and 2) Nurses and patients' perceptions of causes of medication errorTypes of studies- Quantitative studies of medication error rates for differing medication systems and roles of those administering medications. Qualitative and descriptive studies of perceived causes of errors.The review sought studies published in English from 1990 to December 2008. 23 databases, websites and search engines were searched.Critical appraisal tools from Joanna Briggs Institute were used. Two reviewers appraised studies independently. 35 studies out of 1004 identified papers were critically appraised. 19 studies met the inclusion criteria.Data were extracted using standardised extraction forms.It was not possible to undertake meta-analysis due to lack of studies in all categories and lack of similarity between studies. Quantitative results were combined in a narrative summary. Qualitative studies were synthesised accordingly using a meta-aggregative approach.Nurses perceptions of medication administration errors suggest that ineligible prescriptions and distractions/interruptions (external factors) are perceived as key causes of error. Limited evidence on patient perceptions, suggest that their inclusion in routine medication administration may reduce errors.Studies related to routine medication administration roles and systems are small and lack power and generalisability to all acute care contexts. What evidence exists suggests routine medication that is individualised to the patient and administered close to the bedside, reduces error.There is equivocal evidence related to differing roles of nurses. The use of dedicated medication nurses and primary administration (nurse administers "own" patient medications) are inconclusive. Equivocal evidence related to three system types was identified: self administration; trolley, bay and bedside systems; individualised and unit dose medications.There is no evidence of effectiveness related to one or two nurse checking or related to the use of devices to reduce distractions, such as signs or tabards.Administration from individually labelled medication, administered close to the patient, appear to be the most significant factors in reducing errors during routine medication rounds. Nurses' perspectives on causes of medication errors, may differ from those recorded. There is no conclusive evidence that manipulating the nursing role has any impact on errors.Implication for practice- Individual or patient dose systems used with administration occurring as close to the patient as possible. Including the patient more fully in the administration process through self administration or involvement in the checking process has some potential for reducing errors.Implication for research- The review identifies the need for rigorous large scale further research.

Review question/objective The aim of the systematic review is to identify and synthesize the best available qualitative evidence regarding the needs, experiences and perspectives of people with dementia or mild cognitive impairment who are either in employment or wish to gain employment and other significant stakeholders. This is a review of qualitative evidence as qualitative studies are known to be the most effective in elucidating needs, experiences and perspectives and may permit the reviewers to address the following questions: What are the needs, experiences and perceptions of people with dementia or mild cognitive impairment who are in employment or seeking employment? What are the needs, experiences and perceptions of people who care for, partner or otherwise informally support people with dementia or mild cognitive impairment who are in employment or seeking employment? What are the needs, experiences and perceptions of employers and co-workers of people with dementia or mild cognitive impairment? What are the needs, experiences and perceptions of employees of statutory health, social care and other governmental and voluntary agencies on the employment of people with dementia or mild cognitive impairment? What are the needs, experiences and perspectives of people with dementia or mild cognitive impairment who are in employment or wish to gain employment and other significant stakeholders in regards to self and agency facilitated management strategies utilized to sustain people with dementia or mild cognitive impairment in employment? What are the needs, experiences and perspectives of people with dementia or mild cognitive impairment who are in employment or wish to gain employment and other significant stakeholders in regards to the factors that predict or facilitate the sustained employment of individuals with dementia or mild cognitive impairment? What are the needs, experiences and perspectives of people with dementia or mild cognitive impairment who are in employment or wish to gain employment and other significant stakeholders in regards to the factors that impede or preclude employment in individuals with dementia or mild cognitive impairment? Inclusion criteria Types of participants This review will consider people with dementia or mild cognitive impairment who are in employment or seeking TRUNCATED AT 350 WORDS