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BackgroundDespite the potential of technology-based mental health interventions for young people, limited uptake and/or adherence is a significant challenge. It is thought that involving young people in the development and delivery of services designed for them leads to better engagement. Further research is required to understand the role of participatory approaches in design of technology-based mental health and well-being interventions for youth. ObjectiveTo investigate consumer involvement processes and associated outcomes from studies using participatory methods in development of technology-based mental health and well-being interventions for youth. MethodsFifteen electronic databases, using both resource-specific subject headings and text words, were searched describing 2 broad concepts-participatory research and mental health/illness. Grey literature was accessed via Google Advanced search, and relevant conference Web sites and reference lists were also searched. A first screening of titles/abstracts eliminated irrelevant citations and documents. The remaining citations were screened by a second reviewer. Full text articles were double screened. All projects employing participatory research processes in development and/or design of (ICT/digital) technology-based youth mental health and well-being interventions were included. No date restrictions were applied; English language only. Data on consumer involvement, research and design process, and outcomes were extracted via framework analysis. ResultsA total of 6210 studies were reviewed, 38 full articles retrieved, and 17 included in this study. It was found that consumer participation was predominantly consultative and consumerist in nature and involved design specification and intervention development, and usability/pilot testing. Sustainable participation was difficult to achieve. Projects reported clear dichotomies around designer/researcher and consumer assumptions of effective and acceptable interventions. It was not possible to determine the impact of participatory research on intervention effectiveness due to lack of outcome data. Planning for or having pre-existing implementation sites assisted implementation. The review also revealed a lack of theory-based design and process evaluation. ConclusionsConsumer consultations helped shape intervention design. However, with little evidence of outcomes and a lack of implementation following piloting, the value of participatory research remains unclear.

Background: Cardiovascular disease (CVD) is the leading cause of non‐cancer death in cancer survivors, but the risk of CVD varies between cancers. Objectives: To synthesise available evidence on patterns and magnitude of CVD mortality risk. Methods: A systematic search of Medline (OVID), CINAHL and Scopus databases from 01‐January‐2000 to 16‐July‐2023 of studies of people with cancer, reporting CVD mortality in cancer population compared with a reference population (e.g. general population) as standardised mortality ratios (SMR). Meta‐analysis of SMRs across cancer and CVD types were pooled using a random‐effects model to allow for heterogeneity of the true effect size across studies. Results: We identified 136 studies from 16 countries. Sample sizes ranged from 157 to 7,529,481. The majority (n = 98; 72%) were conducted in the United States, followed by Europe (n = 22; 16%). The most common cancers studied were gastrointestinal (n = 34 studies), haematological (n = 31) and breast (n = 29). A total of 876 CVD SMRs were extracted across diverse CVD conditions. Of those, the majority (535; 61%) indicated an increased risk of CVD death (SMR >1), 109 (12%) a lower risk of CVD death (SMR <1) and 232 (27%) an equivalent risk (95% CI of SMR included 1) compared to the general population. The meta‐analysis of all reported SMRs showed an increased risk of CVD death (SMR = 1.55, 95% CI = 1.40–1.72) in cancer survivors compared with the general population. The SMR varied between CVD conditions and ranged from 1.36 (95% CI = 1.29–1.44) for heart diseases to 1.56 (95% CI = 1.39–1.76) for cerebrovascular diseases. SMR varied across cancer types, ranging from 1.14 (95% CI = 1.04–1.25) for testicular/germ cell tumours to 2.82 (95% CI = 2.20–3.63) for brain/central nervous system tumours. Conclusions: Cancer survivors are at increased risk of premature CVD mortality compared to the general population, but the risk varies by cancer type and CVD. Future research should focus on understanding mechanisms behind the increased CVD risk to develop appropriate interventions. [ABSTRACT FROM AUTHOR]

Recognition of the importance of end-of-life care will enable improvements in the quality of care delivered to patients and their families. Australia is experiencing an increasing number of deaths, (many expected), with an aging population who are living longer, often with multimorbidity. This makes end of life care a priority. The last year of someone's life takes place in a complex healthcare system, with increasing pressures on care delivery, placing the spotlight on health service providers to ensure that teams and individuals are supported and enabled to provide such care. Two rapid literature reviews identified best practice principles and processes for delivering safe and high-quality end-of-life care in acute care, aged care and community settings. The reviews identified that end-of-life care is experienced within the whole health and social care system, including hospital admissions interspersed with care in the community, outpatient and emergency department visits and potentially admission to a hospice. Much of this last year of life is spent at home, which may be a personal residence, an aged care facility, prison, supported accommodation or even on the streets. Transitions across settings requires seamless care, as well as organisational readiness to deliver safe and culturally appropriate care. This is more important now with end-of-life care subject to quality assurance mechanisms within the National Safety and Quality Health Service Standards (2nd edn): Comprehensive care. This requires all sectors to work collaboratively when caring for someone at the end of their life in order to see positive changes in care outcomes. [ABSTRACT FROM AUTHOR]

Background Multimorbidity is prevalent in general practice and general practitioners internationally report challenges in its management. Understanding the perspectives of general practitioners at the frontline of care is important for system sustainability and accessibility as populations age. Objective To explore Australian general practitioner perspectives on managing multimorbidity, the factors supporting their work, and those impeding their ability to meet their own standards of care provision. Method A qualitative study conducted with Australian general practitioners using semistructured, in-depth interviews and inductive thematic data analysis. Results Twelve interviews with general practitioners were conducted. Three main themes were constructed from the data: Multimorbidity as an encounter with complexity and contingency; Evidence constraints in multimorbidity care; and Concerns for patient safety. System structure and the Australian general practice model restrict general practitioners' ability to provide care to their level of satisfaction by linking short consultation times to practice remuneration. Attitudes toward the applicability of guideline evidence were mixed despite most general practitioners questioning its generalizability. Patient safety concerns pervaded most interviews and largely centered on system fragmentation and insufficient intersectoral communication. General practitioners rely on multiple sources of information to provide patient-centered care but chiefly the accumulated knowledge of their patients. Conclusions Australian general practitioners share many multimorbidity concerns with international colleagues. While multimorbidity-specific evidence may be unrealistic to expect in the immediate term, system investment and adaptation is needed to support general practice sustainability and clinician ability to provide adequate multimorbidity care, suitably remunerated, into the future. [ABSTRACT FROM AUTHOR]

This study assessed Australian clinical practice guidelines for life-limiting index conditions for the extent to which they acknowledged comorbidities and framed management recommendations within the context of older age and reduced life expectancy. A comprehensive search identified current, evidence-based Australian guidelines for chronic life-limiting conditions directed at general practitioners. Guideline content was analysed qualitatively before comorbidity acknowledgements were quantified using a 17-item checklist. Full guidelines were quality appraised using AGREE-II. Ten documents covering chronic obstructive pulmonary disease, heart failure, cancer pain, dementia and palliative care in aged care were identified. Most guidelines addressed one 'comorbid' condition and prompted clinicians to consider patient quality of life and personal preferences. Fewer addressed burden of treatment and half suggested modifying treatments to account for limited life expectancy, age or time horizon to benefit. Half warned of potential adverse drug interactions. Guidelines were of moderate to very high quality. Guidelines naturally prioritised their index condition, directing attention to only the most common comorbidities. However, there may be scope to include more condition-agnostic guidance on multimorbidity management. This might be modelled on the 'guiding principles' approach now emerging internationally from organisations such as the American Geriatrics Society in response to increasing multimorbidity prevalence and evidence limitations. [ABSTRACT FROM AUTHOR]

Objectives: To investigate causes of death of people with cancer alive five years after diagnosis, and to compare mortality rates for this group with those of the general population. Design, setting, participants: Retrospective cohort study; analysis of South Australian Cancer Registry data for all people diagnosed with cancer during 1990–1999 and alive five years after diagnosis, with follow‐up to 31 December 2016. Main outcome measures: All‐cause and cancer cause‐specific mortality, by cancer diagnosis; standardised mortality ratios (study group v SA general population) by sex, age at diagnosis, follow‐up period, and index cancer. Results: Of 32 646 people with cancer alive five years after diagnosis, 30 309 were of European background (93%) and 16 400 were males (50%); the mean age at diagnosis was 60.3 years (SD, 15.7 years). The median follow‐up time was 17 years (IQR, 11–21 years); 17 268 deaths were recorded (53% of patients; mean age, 80.6 years; SD, 11.4 years): 7845 attributed to cancer (45% of deaths) and 9423 attributed to non‐cancer causes (55%). Ischaemic heart disease was the leading cause of death (2393 deaths), followed by prostate cancer (1424), cerebrovascular disease (1175), and breast cancer (1118). The overall standardised mortality ratio (adjusted for age, sex, and year of diagnosis) was 1.24 (95% CI, 1.22–1.25). The cumulative number of cardiovascular deaths exceeded that of cancer cause‐specific deaths from 13 years after cancer diagnosis. Conclusions: Mortality among people with cancer who are alive at least five years after diagnosis was higher than for the general population, particularly cardiovascular disease‐related mortality. Survivorship care should include early recognition and management of risk factors for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Abstract Background Heart failure is a highly debilitating syndrome with a poor prognosis primarily affecting the elderly. Clinicians wanting timely access to heart failure evidence to provide optimal patient care can face many challenges in locating this evidence. This study developed and validated a search filter of high clinical utility for the retrieval of heart failure articles in OvidSP Medline. Methods A Clinical Advisory Group was established to advise study investigators. The study set of 876 relevant articles from four heart failure clinical practice guidelines was divided into three datasets: a Term Identification Set, a Filter Development Set, and a Filter Validation Set. A further validation set (the Cochrane Validation Set) was formed using studies included in Cochrane heart failure systematic reviews. Candidate search terms were identified via word frequency analysis. The filter was developed by creating combinations of terms and recording their performance in retrieving items from the Filter Development Set. The filter's recall was then validated in both the Filter Validation Set and the Cochrane Validation Set. A precision estimate was obtained post-hoc by running the filter in Medline and screening the first 200 retrievals for relevance to heart failure. Results The four-term filter achieved a recall of 96.9% in the Filter Development Set; 98.2% in the Filter Validation Set; and 97.8% in the Cochrane Validation Set. Of the first 200 references retrieved by the filter when run in Medline, 150 were deemed relevant and 50 irrelevant. The post-hoc precision estimate was therefore 75%. Conclusions This study describes an objective method for developing a validated heart failure filter of high recall performance and then testing its precision post-hoc. Clinical practice guidelines were found to be a feasible alternative to hand searching in creating a gold standard for filter development. Guidelines may be especially appropriate given their clinical utility. A validated heart failure filter is now available to support health professionals seeking reliable and efficient access to the heart failure literature.

Chronic lower-limb lymphoedema disrupts physical and mental health and requires labour-intensive therapies. This review synthesised evidence on the impact of exercise therapy on sufferer quality of life and symptom experience, concluding that exercise may improve strength, fitness, function, and decrease fatigue. It might also improve quality of life and subjective symptom scores, or at least have no negative impact. Existing studies are heterogenous in terms of size and exercise type, intensity, and frequency. Larger, more coordinated trials of longer duration are required in the future. [ABSTRACT FROM AUTHOR]

One approach to manage people with behaviours of concern including agitated or aggressive behaviours in health care settings is through the use of fast‐acting medication, called chemical restraint. Such management often needs to be delivered in crisis situations to patients who are at risk of harm to themselves or others. This paper summarizes the available evidence on the effectiveness and safety of chemical restraint from 21 randomized controlled trials (RCTs) involving 3788 patients. The RCTs were of moderate to high quality and were conducted in pre‐hospital, hospital emergency department, or ward settings. Drugs used in chemical restraint included olanzapine, haloperidol, droperidol, risperidol, flunitrazepam, midazolam, promethazine, ziprasidone, sodium valproate, or lorazepam. There was limited comparability between studies in drug choice, combination, dose, method of administration (oral, intramuscular, or intravenous drip), or timing of repeat administrations. There were 31 outcome measures, which were inconsistently reported. They included subjective measures of behaviours, direct measures of treatment effect (time to calm; time to sleep), indirect measures of agitation (staff or patient injuries, duration of agitative or aggressive episodes, subsequent violent episodes), and adverse events. The most common were time to calm and adverse events. There was little clarity about the superiority of any chemical method of managing behaviours of concern exhibited by patients in Emergency Departments or acute mental health settings. Not only is more targeted research essential, but best practice recommendations for such situations requires integrating expert input into the current evidence base. [ABSTRACT FROM AUTHOR]

Context: The use of peer support as a faculty development technique to improve clinical teaching is uncommon in medical education, despite the benefits of situating learning in the workplace. The authors therefore conducted a broad search seeking theoretical and empirical literature describing peer support strategies for clinical teachers in health care workplaces. This included descriptive and non‐experimental studies that are often excluded from reviews. The review aimed to identify and assess existing initiatives and to synthesise key challenges and benefits. Methods: An integrative literature review was undertaken (2004–2017), based on searches of eight international electronic databases and targeted manual searches. Key concepts, elements and models were mapped using an iterative, constant comparative method. An evaluative framework, drawing on previous research, informed conclusions regarding the quality of evidence. Results: From a pool of 5735 papers, 34 met the inclusion criteria. The majority referred to studies conducted in the USA (59%) and in the medical profession (71%). Analysis revealed a trend towards using a collaborative model (56%), voluntary participation (59%), and direct workplace observation by a peer clinician (68%). Design features of the peer support strategy were commonly reported (65%), with half providing outcome measures (56%). Few papers reported on process evaluation (15%) or evidence of programme sustainability (15%). Despite logistical and time‐associated challenges, benefits accrued to individuals and the workplace, and included improved teaching practices. Embedding the peer support strategy into routine organisational practice proved effective. Conclusions: The results indicated that a workplace‐based peer support model is an acceptable and effective faculty development strategy for health care clinical teachers. Conceptualising workplace‐based peer support via a sociocultural model that acknowledges the significance of educational design, peers as collaborators and the importance of workplace context and culture is emphasised. Future research should focus on clarification studies informed by contemporary models of faculty development, in which factors impacting the health care workplace are considered. By reviewing the literature, Campbell et al. highlight how collaborative relationships and workplace connections with peers offer an under‐utilized resource for effectively improving teaching expertise. [ABSTRACT FROM AUTHOR]

Background: Searching for topics within large biomedical databases can be challenging, especially when topics are complex, diffuse, emerging or lack definitional clarity. Experimentally derived topic search filters offer a reliable solution to effective retrieval; however, their number and range of subject foci remain unknown. Objectives: This systematic scoping review aims to identify and describe available experimentally developed topic search filters. Methods: Reports on topic search filter development (1990‐) were sought using grey literature sources and 15 databases. Reports describing the conception and prospective development of a database‐specific topic search and including an objectively measured estimate of its performance ('sensitivity') were included. Results: Fifty‐four reports met inclusion criteria. Data were extracted and thematically synthesised to describe the characteristics of 58 topic search filters. Discussion: Topic search filters are proliferating and cover a wide range of subjects. Filter reports, however, often lack clear definitions of concepts and topic scope to guide users. Without standardised terminology, filters are challenging to find. Information specialists may benefit from a centralised topic filter repository and appraisal checklists to facilitate quality assessment. Conclusion: Findings will help information specialists identify existing topic search filters and assist filter developers to build on current knowledge in the field. [ABSTRACT FROM AUTHOR]

The vision for Australia's national electronic health record system included empowering consumers to become active participants in their own health care. This paper aims to critically review the literature on consumer perspectives of Australia's My Health Record (formerly PCEHR). The review is based on a subset of articles (n=12) identified in the Australian EHR Repository (N=143), a repository of metadata of Australian Research on EHR located at Flinders University. Results show low levels of awareness and concerns about sharing records and equity of access for all Australians, which in view of the change from opt in to opt out raises concerns about explicit consent. Improved promotion and support, along with different models of access might lead to higher consumer engagement with, and use, of My Health Record, especially for populations at risk of digital exclusion. [ABSTRACT FROM AUTHOR]

Background: Reports from patients on seeing or hearing a dead relative or dreaming a highly significant dream at the end of life can be perplexing for health professionals who may wonder how best to respond. Aim: The aim of this study was to systematically review the literature on deathbed phenomena (DBP), and provide suggestions for a clinical response to dying patients’ recounts of these hard-to-explain phenomena. Methods: The authors searched for relevant studies which reported on DBP within a palliative care context. Eligibility criteria were established, a review process was employed and a narrative synthesis approach was used to interpret the data. Results: In total, eight papers met the inclusion criteria. Reported prevalence of DBP ranged from 24–51% with common themes described. Distinguishing between DBP and hallucinations was discussed, requiring very different clinical responses. Phenomena were timed most often in the last hours or days before death. Experiencing a DBP was, in most cases, deeply meaningful, bringing comfort, peace and reassurance. Health professionals were not surprised to hear of a DBP, but were not always well prepared to respond appropriately. Conclusions: Rather than simply dismissing DBP as medication related or the physiological effects of dying, the significance of these events and the comfort afforded by them to patients and carers should be recognised. Disclosure of DBP may enable health professionals to discuss more spiritual and existential concerns, which have the potential to offer hope, meaning and connection. We propose strategies and approaches for strengthening compassionate clinical practice in this area. [ABSTRACT FROM AUTHOR]

Objective. To develop and validate a PubMed search filter, LIt.search, that automatically retrieves Aboriginal and Torres Strait Islander health literature and to make it publicly accessible through the Lowitja Institute website. Methods. Search filter development phases included: (1) scoping of the publication characteristics of Aboriginal and Torres Start Islander literature; (2) advisory group input and review; (3) systematic identification and testing of MeSH and text word terms; (4) relevance assessment of the search filter's retrieved items; and (5) translation for use in PubMed through the web. Results. Scoping study analyses demonstrated complexity in the nature and use of possible search terms and publication characteristics. The search filter achieved a recall rate of 84.8% in the full gold standard test set. To determine real-world performance, post-hoc assessment of items retrieved by the search filter in PubMed was undertaken with 87.2% of articles deemed as relevant. The search filter was constructed as a series of URL hyperlinks to enable one-click searching. Conclusion. LIt.search is a search tool that facilitates research into practice for improving outcomes in Aboriginal and Torres Strait Islander health and is publicly available on the Lowitja Institute website. [ABSTRACT FROM AUTHOR]

Background: PubMed translations of OvidSP Medline search filters offer searchers improved ease of access. They may also facilitate access to PubMed's unique content, including citations for the most recently published biomedical evidence. Retrieving this content requires a search strategy comprising natural language terms ('textwords'), rather than Medical Subject Headings (MeSH). We describe a reproducible methodology that uses a validated PubMed search filter translation to create a textword-only strategy to extend retrieval to PubMed's unique heart failure literature. Methods: We translated an OvidSP Medline heart failure search filter for PubMed and established version equivalence in terms of indexed literature retrieval. The PubMed version was then run within PubMed to identify citations retrieved by the filter's MeSH terms (Heart failure, Left ventricular dysfunction, and Cardiomyopathy). It was then rerun with the same MeSH terms restricted to searching on title and abstract fields (i.e. as 'textwords'). Citations retrieved by the MeSH search but not the textword search were isolated. Frequency analysis of their titles/ abstracts identified natural language alternatives for those MeSH terms that performed less effectively as textwords. These terms were tested in combination to determine the best performing search string for reclaiming this 'lost set'. This string, restricted to searching on PubMed's unique content, was then combined with the validated PubMed translation to extend the filter's performance in this database. Results: The PubMed heart failure filter retrieved 6829 citations. Of these, 834 (12%) failed to be retrieved when MeSH terms were converted to textwords. Frequency analysis of the 834 citations identified five high frequency natural language alternatives that could improve retrieval of this set (cardiac failure, cardiac resynchronization, left ventricular systolic dysfunction, left ventricular diastolic dysfunction, and LV dysfunction). Together these terms reclaimed 157/834 (18.8%) of lost citations. Conclusions: MeSH terms facilitate precise searching in PubMed's indexed subset. They may, however, work less effectively as search terms prior to subject indexing. A validated PubMed search filter can be used to develop a supplementary textword-only search strategy to extend retrieval to PubMed's unique content. A PubMed heart failure search filter is available on the CareSearch website (www.caresearch.com.au) providing access to both indexed and non-indexed heart failure evidence. [ABSTRACT FROM AUTHOR]

Background: Heart failure is a highly debilitating syndrome with a poor prognosis primarily affecting the elderly. Clinicians wanting timely access to heart failure evidence to provide optimal patient care can face many challenges in locating this evidence. This study developed and validated a search filter of high clinical utility for the retrieval of heart failure articles in OvidSP Medline. Methods: A Clinical Advisory Group was established to advise study investigators. The study set of 876 relevant articles from four heart failure clinical practice guidelines was divided into three datasets: a Term Identification Set, a Filter Development Set, and a Filter Validation Set. A further validation set (the Cochrane Validation Set) was formed using studies included in Cochrane heart failure systematic reviews. Candidate search terms were identified via word frequency analysis. The filter was developed by creating combinations of terms and recording their performance in retrieving items from the Filter Development Set. The filter's recall was then validated in both the Filter Validation Set and the Cochrane Validation Set. A precision estimate was obtained post-hoc by running the filter in Medline and screening the first 200 retrievals for relevance to heart failure. Results: The four-term filter achieved a recall of 96.9% in the Filter Development Set; 98.2% in the Filter Validation Set; and 97.8% in the Cochrane Validation Set. Of the first 200 references retrieved by the filter when run in Medline, 150 were deemed relevant and 50 irrelevant. The post-hoc precision estimate was therefore 75%. Conclusions: This study describes an objective method for developing a validated heart failure filter of high recall performance and then testing its precision post-hoc. Clinical practice guidelines were found to be a feasible alternative to hand searching in creating a gold standard for filter development. Guidelines may be especially appropriate given their clinical utility. A validated heart failure filter is now available to support health professionals seeking reliable and efficient access to the heart failure literature. [ABSTRACT FROM AUTHOR]

Introduction: Integrated care IC is a multifaceted concept, with a vast range of overlapping terminologies. Bibliometric analyses have demonstrated the evidence base for IC is diffuse. Peer-reviewed research is published in a range of journals which are indexed in bibliographic databases with subject coverage extending beyond health. A significant amount of relevant IC literature is found outside conventional publishing channels in the grey literature. Thus, practitioners and researchers face significant challenges to finding relevant IC literature. To address the issues associated with retrieving integrated care literature, an IC search filter, badged as Integrated Care Search ICS, was developed. A search filter is an evidence-based search strategy with a known level of retrieval effectiveness. Various "value adding" products were also developed to enhance the effectiveness and usability of the search filter. Methods: Following a well-established experimental methodology [1], and informed by bibliometric analyses and consultation with an established Expert Advisory Group EAG, ICS was developed and validated for use in PubMed. Additionally, a research librarian translated the validated search filter for use in other databases, and developed a guide for searching the grey literature for content relevant to IC. Finally, input from the EAG was solicited via survey to guide the development of relevant topic searches to be combined with the search filter to further refine results. Results: Given the challenges associated with IC literature retrieval, two versions of the validated search filter were developed. ICS Narrow enables more precise searching, whereas ICS Broad enables more sensitive searching. Supplementary topic searches covering care settings, populations, geographic regions and facets of IC are provided, to enable more focused searching by end-users. Both search filters were translated for use in other databases including: Medline Ovid, Embase Ovid, PsycINFO Ovid, CINAHL EBSCOhost, Cochrane Library Wiley, Scopus, Web of Science, and ProQuest. Finally, step-by-step instructions for searching for relevant IC grey literature were developed. These products are available on an interim site https://www.caresearch.com.au/caresearch/tabid/4757/Default.aspx, and it is planned that they will be moved to the IFIC website in time for launch at ICIC18. Discussion: ICS and its associated value-adding products provide end users with the ability to locate difficult-to-retrieve published and unpublished IC literature. Conclusions: A flexible approach to database searching using a combination of keyword and subject headings is required for optimal retrieval of the published IC literature across a range of databases. Lessons learned: The polymophous nature of IC necessitated the development of not one but two validated search filters, and an additional suite of products, including guidance for IC grey literature retrieval. Limitations: The envisioned functionality of the search filters has not been fully achieved, as they are currently hosted on an interim site. Suggestions for future research: Further research studies could include an evaluation of the impact of Integrated Care Search on end-user satisfaction with retrievals and search confidence. [ABSTRACT FROM AUTHOR]

Introduction: Evidence from quality research is vital for demonstrating the effectiveness of integrated care in reducing health care fragmentation. Locating that evidence should be a crucial precursor to its use in informed policy making and organisational reform. Finding integrated care research may, however, present challenges due to a multiplicity of definitions and frameworks, and relevance across a range of sectors, organisations, and professional groups. Understanding difficulties in finding integrated care evidence could aid in the development of practical measures to make it more visible. This might include customised repositories, search tools, or strategies for improving dissemination. Bibliometric analysis is one method for examining published literature relevant to a field of research or practice. It is particularly useful for mapping complex, fluid and diffuse fields such as integrated care. This study builds on and extends a previous bibliometric analysis by Sun[1] by investigating: the growth of the integrated care literature; the core journals in which it is published; the combination of bibliographic databases required to find the majority of the literature; and the value of the PubMed standardized term Medical Subject Heading for retrieving it. Methods: The broad term 'Integrated care' was searched across the title, abstract, and subject heading fields within PubMed, CINAHL, EMBASE Ovid, PsycINFO Ovid, EconLit Ovid and Cochrane Central Register of Controlled Trials. The citations retrieved were analysed for frequency by year and country of publication, author, journal name, natural language terms, and subject headings. In addition, the performance of the Medical Subject Heading MeSH term 'Delivery of Health Care, Integrated' was tested by asking an advisory group of integrated care experts n=8 to each screen a set of 100 citations retrieved by this heading and indicating relevance of each. Results: A wide range of terms and journal titles contribute to the integrated care body of evidence and multiple databases provide access to a significant number of unique citations beyond PubMed. Furthermore, Interrater agreement was low on the relevance of citations retrieved by PubMed's main integrated care MeSH term. Discussion: This study confirms the diffuse nature of the integrated care research literature and highlights factors that may make it inherently difficult to find via search mechanisms. This includes a lack of consensus between experts as to the relevance of literature retrieved by its main indexing term in PubMed. Conclusions: Our findings suggest a need for search solutions to enhance the identification and, by extension, utilisation, of the integrated care literature. Limitations: The use of the single broad term 'integrated care' to find citations across databases was a pragmatic approach to finding a core set of literature for analysis. We acknowledge that integrated care is described by a variety of terms and this approach would not find a substantial subset of relevant citations. Suggestions for future research: Following this study, an integrated care search filter was developed for finding the literature in PubMed. Other practical tools for finding integrated care literature are advocated. [ABSTRACT FROM AUTHOR]

General practitioners (GPs) are increasingly expected to provide palliative care as ageing populations put pressure on specialist services. Some GPs, however, cite barriers to providing this care including prognostication challenges and lack of confidence. Palliative care content within clinical practice guidelines might serve as an opportunistic source of informational support to GPs. This review analysed palliative care content within Australian guidelines for life-limiting conditions to determine the extent to which it might satisfy GPs' stated information needs and support them to provide quality end-of-life care. Six databases and guideline repositories were searched (2011–2018). Eligible guidelines were those for a GP audience and explicitly based on an appraisal of all available evidence. Content was mapped against an established palliative care domain framework (PEPSI-COLA) and quality was assessed using AGREE-II. The nine guidelines meeting inclusion criteria were heterogenous in scope and depth of palliative care domain coverage. The 'communication' needs domain was best addressed while patient physical and emotional needs were variably covered. Spiritual, out-of-hours, terminal care and aftercare content was scant. Few guidelines addressed areas GPs are known to find challenging or acknowledged useful decision-support tools. A template covering important domains might reduce content variability across guidelines. [ABSTRACT FROM AUTHOR]

Introduction: This workshop is an interactive demonstration of a validated search filter which has been developed to assist clinicians and managers in locating published research on integrated care. The presenters will give a brief overview of the project and the methodology used. They will demonstrate the beta version of the search filter and invite comment and feedback from the audience. Attendees are encouraged to share their experiences in locating the peer-reviewed literature on IC, including specific questions on aspects of IC for which evidence is sought. Integrated care (IC) is a prime driver of healthcare policy and practice reform internationally as governments and healthcare organisations endeavour to enhance efficiencies and patientcentred care. It is, however, a multifaceted concept, with a vast range of overlapping terminologies, and arguably lacks a unifying definition [1]. Search filters represent one innovative solution to this problem, by enabling brokered access to the underlying evidence base for rapid utilisation. Methods: The International Foundation for Integrated Care (IFIC), Central Coast Local Health District (NSW), The University of Newcastle (NSW), and Flinders Filters, Flinders University (SA)[2] collaborated to create an IC search filter (or "search strategy") with known retrieval effectiveness in the PubMed Database, using a well-established experimental methodology[3]. Results: An IC search filter with a known level of sensitivity has been developed and validated for PubMed. This filter will be combined with a range of topics of interest to the IC community for more focused retrieval. These topics will include patient-centred care; health and social care integration; and chronic disease management. The search filter, badged as Integrated Care Search, will be made available on the IFIC website at https://integratedcarefoundation.org/. Discussions: IC is a polymorphous topic with contextually different meanings. Despite inherent complexities, under the guidance of international experts, it was possible to develop and validate a search filter which is capable of retrieving PubMed indexed IC literature at multiple levels of granularity through simple, one-click links. In tegrated Care Search will improve the ease, speed, and accuracy by which IC evidence is found. End-users can rely on the fact that it comprises a range of core IC concept terms, comprehensively identified and tested in a set of literature deemed of importance by IC experts. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis synthesised the post-1990 literature examining the effect of human milk on morbidity, specifically necrotising enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and neurodevelopment in infants born ≤28 weeks’ gestation and/or publications with reported infant mean birth weight of ≤1500 g. Online databases including Medline, PubMed, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched, and comparisons were grouped as follows: exclusive human milk (EHM) versus exclusive preterm formula (EPTF), any human milk (HM) versus EPTF, higher versus lower dose HM, and unpasteurised versus pasteurised HM. Experimental and observational studies were pooled separately in meta-analyses. Risk of bias was assessed for each individual study and the GRADE system used to judge the certainty of the findings. Forty-nine studies (with 56 reports) were included, of which 44 could be included in meta-analyses. HM provided a clear protective effect against NEC, with an approximate 4% reduction in incidence. HM also provided a possible reduction in LOS, severe ROP and severe NEC. Particularly for NEC, any volume of HM is better than EPTF, and the higher the dose the greater the protection. Evidence regarding pasteurisation is inconclusive, but it appears to have no effect on some outcomes. Improving the intake of mother’s own milk (MOM) and/or donor HM results in small improvements in morbidity in this population. [ABSTRACT FROM AUTHOR]

This study assessed Australian clinical practice guidelines for life-limiting index conditions for the extent to which they acknowledged comorbidities and framed management recommendations within the context of older age and reduced life expectancy. A comprehensive search identified current, evidence-based Australian guidelines for chronic life-limiting conditions directed at general practitioners. Guideline content was analysed qualitatively before comorbidity acknowledgements were quantified using a 17-item checklist. Full guidelines were quality appraised using AGREE-II. Ten documents covering chronic obstructive pulmonary disease, heart failure, cancer pain, dementia and palliative care in aged care were identified. Most guidelines addressed one 'comorbid' condition and prompted clinicians to consider patient quality of life and personal preferences. Fewer addressed burden of treatment and half suggested modifying treatments to account for limited life expectancy, age or time horizon to benefit. Half warned of potential adverse drug interactions. Guidelines were of moderate to very high quality. Guidelines naturally prioritised their index condition, directing attention to only the most common comorbidities. However, there may be scope to include more condition-agnostic guidance on multimorbidity management. This might be modelled on the 'guiding principles' approach now emerging internationally from organisations such as the American Geriatrics Society in response to increasing multimorbidity prevalence and evidence limitations.

Introduction: Integrated care research evidence should be optimally visible and accessible to stakeholders. This study examines the contribution of specific databases to the discovery of integrated care evidence, and tests the usefulness of Medical Subject Heading (MeSH) indexing of this literature within PubMed., Methods: We used bibliometric methods to analyse the integrated care literature indexed within six databases between 2007 and 2016. An international expert advisory group assessed the relevance of citations randomly retrieved from PubMed using MeSH term 'Delivery of Health Care, Integrated'., Results: Integrated care evidence is diffuse, spread across many journals. Between 2007 and 2016, integrated care citations grew substantially, with the rate of increase highest in Embase. PubMed contributes the largest proportion of unique citations (citations not included in any of the other databases analysed), followed by Embase, PsycINFO and CINAHL. On average, expert reviewers rated 42.5% of citations retrieved by MeSH term 'Delivery of Health Care, Integrated' as relevant to integrated care. When these citations were dual reviewed, inter-rater agreement was low., Conclusion: MeSH terms alone are insufficient to retrieve integrated care content from PubMed. Embase and CINAHL contain unique content not found in PubMed that should not be overlooked. A validated search filter is proposed to simplify the process of finding integrated care research for clinicians, managers and decision-makers.

This systematic review and meta-analysis synthesised the post-1990 literature examining the effect of human milk on morbidity, specifically necrotising enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and neurodevelopment in infants born ≤28 weeks' gestation and/or publications with reported infant mean birth weight of ≤1500 g. Online databases including Medline, PubMed, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched, and comparisons were grouped as follows: exclusive human milk (EHM) versus exclusive preterm formula (EPTF), any human milk (HM) versus EPTF, higher versus lower dose HM, and unpasteurised versus pasteurised HM. Experimental and observational studies were pooled separately in meta-analyses. Risk of bias was assessed for each individual study and the GRADE system used to judge the certainty of the findings. Forty-nine studies (with 56 reports) were included, of which 44 could be included in meta-analyses. HM provided a clear protective effect against NEC, with an approximate 4% reduction in incidence. HM also provided a possible reduction in LOS, severe ROP and severe NEC. Particularly for NEC, any volume of HM is better than EPTF, and the higher the dose the greater the protection. Evidence regarding pasteurisation is inconclusive, but it appears to have no effect on some outcomes. Improving the intake of mother's own milk (MOM) and/or donor HM results in small improvements in morbidity in this population.

Background: Clinicians are important stakeholders in the translation of well-designed research evidence into clinical practice for optimal patient care. However, the application of knowledge translation (KT) theories and processes may present conceptual and practical challenges for clinicians. Online learning platforms are an effective means of delivering KT education, providing an interactive, time-efficient, and affordable alternative to face-to-face education programs., Objective: This study investigates the availability and accessibility of online KT learning opportunities for health professionals. It also provides an analysis of the types of resources and associated disciplines retrieved by a range of KT synonyms., Methods: We searched a range of bibliographic databases and the Internet (Google advanced option) using 9 KT terms to identify online KT learning resources. To be eligible, resources had to be free, aimed at clinicians, educational in intent, and interactive in design. Each term was searched using two different search engines. The details of the first 100 websites captured per browser (ie, n=200 results per term) were entered into EndNote. Each site was subsequently visited to determine its status as a learning resource. Eligible websites were appraised for quality using the AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) tool., Results: We identified 971 unique websites via our multiple search strategies. Of these, 43 were health-related and educational in intent. Once these sites were evaluated for interactivity, a single website matched our inclusion criteria (Dementia Knowledge Translation Learning Centre)., Conclusions: KT is an important but complex system of processes. These processes overlap with knowledge, practice, and improvement processes that go by a range of different names. For clinicians to be informed and competent in KT, they require better access to free learning opportunities. These resources should be designed from the viewpoint of the clinician, presenting KT's multifaceted theories and processes in an engaging, interactive way. This learning should empower clinicians to contextualize and apply KT strategies within their own care settings., (©Raechel A Damarell, Jennifer J Tieman. Originally published in JMIR Medical Education (http://mededu.jmir.org), 13.07.2017.)