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Donor human milk (DHM) from a milk bank is the recommended feeding method for preterm infants when the mother's own milk (MOM) is not available. Despite this recommendation, information on the possible contamination of donor human milk and its impact on infant health outcomes is poorly characterised. The aim of this systematic review is to assess contaminants present in DHM samples that preterm and critically ill infants consume. The data sources used include PubMed, EMBASE, CINAHL and Web of Science. A search of the data sources targeting DHM and its potential contaminants yielded 426 publications. Two reviewers (S. T. and D. L.) conducted title/abstract screening through Covidence software, and predetermined inclusion/exclusion criteria yielded 26 manuscripts. Contaminant types (bacterial, chemical, fungal, viral) and study details (e.g., type of bacteria identified, study setting) were extracted from each included study during full‐text review. Primary contaminants in donor human milk included bacterial species and environmental pollutants. We found that bacterial contaminants were identified in 100% of the papers in which bacterial contamination was sought (16 papers) and 61.5% of the full data set (26 papers), with the most frequently identified genera being Staphylococcus (e.g., Staphylococcus aureus and coagulase‐negative Staphylococcus) and Bacillus (e.g., Bacillus cereus). Chemical pollutants were discovered in 100% of the papers in which chemical contamination was sought (eight papers) and 30.8% of the full data set (26 papers). The most frequently identified chemical pollutants included perfluoroalkyl substances (six papers), toxic metal (one paper) and caffeine (one paper). Viral and fungal contamination were identified in one paper each. Our results highlight the importance of establishing standardisation in assessing DHM contamination and future studies are needed to clarify the impact of DHM contaminants on health outcomes. Key messages: Research regarding chemical contamination in donor human milk (DHM) is limited and needs to be studied further to draw appropriate conclusions on reducing potential risks for infants.Parents/guardians should be educated on the availability of DHM as a supplemental feeding option and made aware of the current research in the field.DHM use requires further standardisation both within the United States and abroad. This standardisation should ensure that risks are not overemphasised and DHM is a cost‐effective, accessible resource as a short‐term intervention when used appropriately as part of optimal lactation and breastfeeding support. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness can have a negative impact on people's physical and psychological well‐being; building social capital is a potential means of addressing this connection. Community initiatives (e.g. groups, clubs, neighbourhood activities) may be a route that enables people to build social capital to tackle loneliness. Understanding what is known, and where gaps in knowledge exist, is important for advancing research on this topic. Methods: A scoping review was undertaken to explore the question – What community initiatives, with a focus on well‐being, have been evaluated in the United Kingdom that include information about social capital and loneliness? Four databases (Medline, CINAHL, ASSIA and Embase) were searched for relevant research papers. References were screened by two researchers to identify if they met the review's inclusion criteria. Data were summarised as a narrative and in tables. Results: Five papers met the review's inclusion criteria. They all used qualitative methods. Findings suggested that social capital could be developed through creating a sense of trust, group cohesion and reciprocity among participants in the community initiatives. This connection enabled people to experience a sense of belonging and to feel they had a meaningful relationship with others, which appeared to alleviate feelings of loneliness. Conclusion: More research is warranted on the review topic, including studies that have employed quantitative or mixed methods. Clarity around definitions of social capital and loneliness in future research is required. Engagement with community initiatives can provide a formalised route to help people develop connections and counteract limitations in their social networks. However, individuals may be wary about attending community initiatives, needing support and encouragement to do so. Social prescribing link workers are one means of motivating people to access groups, events or organisations that could improve their well‐being. [ABSTRACT FROM AUTHOR]

Introduction: To contribute to addressing diagnostic health inequalities in the United Kingdom, this review aimed to investigate determinants of diagnostic service use amongst people experiencing high deprivation in the United Kingdom. Methods: A systematic review was conducted using three databases (EBSCO, Web of Science and SCOPUS) to search studies pertaining to diagnostic service use amongst people experiencing high deprivation. Search terms related to diagnostics, barriers and facilitators to access and deprivation. Articles were included if they discussed facilitators and/or barriers to diagnostic service access, contained participants' direct perspectives and focussed on individuals experiencing high deprivation in the United Kingdom. Articles were excluded if the full text was unretrievable, only abstracts were available, the research did not focus on adults experiencing high deprivation in the United Kingdom, those not including participants' direct perspectives (e.g., quantitative studies) and papers unavailable in English. Results: Of 14,717 initial papers, 18 were included in the final review. Determinants were grouped into three themes (Beliefs and Behaviours, Emotional and Psychological Factors and Practical Factors), made up of 15 sub‐themes. These were mapped to a conceptual model, which illustrates that Beliefs and Behaviours interact with Emotional and Psychological Factors to influence Motivation to access diagnostic services. Motivation then influences and is influenced by Practical Factors, resulting in a Decision to Access or Not. This decision influences Beliefs and Behaviours and/or Emotional and Psychological Factors such that the cycle begins again. Conclusion: Decision‐making regarding diagnostic service use for people experiencing high deprivation in the United Kingdom is complex. The conceptual model illustrates this complexity, as well as the mediative, interactive and iterative nature of the process. The model should be applied in policy and practice to enable understanding of the factors influencing access to diagnostic services and to design interventions that address identified determinants. Patient or Public Contribution: Consulting lived experience experts was imperative in understanding whether and how the existing literature captures the lived experience of those experiencing high deprivation in South England. The model was presented to lived experience experts, who corroborated findings, highlighted significant factors for them and introduced issues that were not identified in the review. [ABSTRACT FROM AUTHOR]

Aim: To explore and summarise published literature with regards to secondments to clinical research and to identify the gaps in research to inform further work. Design: Systematic scoping review. Method: A scoping review was undertaken in accordance with the Patterns, Advances, Gaps, Evidence and Research framework. Databases searched included CINAHL, PubMed, Medline and Embase. Inclusion/exclusion criteria were applied by two independent reviewers. Two reviewers independently retrieved full‐text studies for inclusion and applied the framework as a tool for synthesising Patterns, Advances, Gaps, Evidence and Research recommendations. Results: Six papers and one abstract published between 2003 and 2018 were included. All secondees (n = 34) were released from NHS posts, with secondments (where specified) ranging in duration from 0.25 to 2 years and for 40%–100% of their working hours. All seven papers reported benefits for personal and professional development, predominantly in the form of personal reflections. Few described involvement with research delivery teams. Conclusion: Published initiatives vary in nature and lack standardised reporting and measurement of impact. Further research is required to identify benefits at a departmental or organisational level, the facilitators for setting up secondments and the application of knowledge gained from secondment opportunities. Implications for the Profession: Undertaking a research secondment is reported to offer professional and personal benefit for clinical staff. Research secondments are one way in which a research culture can practically be embedded within clinical settings. Impact: This scoping review identified a lack of published empirical research seeking to understand research secondments as a tool to enhance research and evidence engagement. Although there is a suggestion that secondments could positively impact staff retention, there is limited evidence about the benefit for the organisation or for patient care. These findings have implications for staff, managers and their organisations. Reporting Method: The PRISMA‐ScR guidelines were used to guide reporting. No Patient or Public Contribution: This was not relevant to the research design. [ABSTRACT FROM AUTHOR]

Older adults are at increased risk of pressure injuries (PIs) due to age‐related changes. Traditionally, PI knowledge and education have been delivered in hospitals and residential aged care facilities, however, there remains a critical gap in understanding how PI knowledge on prevention and management is shared with older adults and their carers living in the community. We aimed to describe the nature and characteristics of structured and unstructured PI education programs available to community‐dwelling older adults and their carers. As coping review was undertaken. We searched five databases: CINAHL, Medline, Scopus, Cochrane Library and ProQuest from 2009 to August 2023. The review was guided by Arksey and O'Malley's six‐step framework and adhered to the PRISMA‐ScR guidelines. It included primary peer‐reviewed papers published in English, which focus on PI education for older adults and/or their carers living in community settings. Data extraction was organised in a table, and findings presented as a narrative summary. One‐hundred and thirty‐six papers were screened and four included in the review. Results indicate that consideration was placed on literacy levels and cognitive status of older adults and their carers when designing PI education materials. Educational materials such as leaflets/brochures, in‐person training sessions or a combination of both were used. However, duration of these interventions varied, lasting for 1–4 weeks while others were completed over 12 months. Some improvements in PI knowledge such as how to treat PI, dietary requirements and importance of mobility were noted. However, information retention and its translation into effective long‐term behaviour change remained unclear. In conclusion, adopting a multifaceted educational approach increases the effectiveness of PI knowledge translation. Continuous education, support and reinforcement on PIs over time are necessary when interacting with older adults and caregivers to ensure long‐term management and prevention success. Conversations on PIs should start at the primary care levels when older adults and carers are visiting their GP clinics and accessing support services for other healthcare needs. Understanding older adults' and carers' literacy levels, cognitive status and cultural background can assist clinicians in designing and delivering fit‐for‐purpose PI educational interventions that are accessible, relatable and effective in promoting knowledge transfer and behaviour change. Carers are vital conduits in the care continuum. These factors will lead to a more informed, collaborative and person‐centred approaches to PI management and prevention. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of occupational therapy (OT) on the self‐management of function, pain, fatigue, and lived experience for people living with rheumatoid arthritis (RA). Methods: Five databases and gray literature were searched up to June 30, 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE‐ Confidence in Evidence from Reviews of Qualitative research (qualitative) were used to assess the quality of evidence for each intervention type. Results: Of 39 eligible papers, 29 were quantitative (n = 2,029), 4 qualitative (n = 50), and 6 mixed methods (n = 896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long‐term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self‐management for fatigue. Conclusion: Although patient education is promising for self‐managing RA, no strong evidence was found to support OT programs for self‐managing fatigue or patient experience and long‐term effectiveness. More research is required on lived experience, and the long‐term efficacy of self‐management approaches incorporating OT, particularly timing programs to meet the individual's conditional needs (i.e., early or established RA) to build on the few studies to date. [ABSTRACT FROM AUTHOR]

Background: Youth engagement in research, wherein youth are involved in the research beyond mere participation as human subjects, is growing and becoming more popular as an approach to research. However, systematic and deliberate theory‐building has been limited. We conducted a systematic review to identify and synthesize theories, models and frameworks that have been applied in the engagement of youth in health research, including mental health. Methods: Six academic databases (MEDLINE, PsycINFO, Embase, PubMed, Scopus, CINAHL) and the grey literature were searched for relevant studies. Citation tracking was conducted through ancestry and descendancy searches. The final search was completed on 7 February 2023. Findings were summarized in a narrative synthesis informed by principles of hermeneutic analysis and interpretation. Reporting of results is in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta‐Analyses) 2020 Statement. Results: Of the 1156 records identified, 16 papers were included, from which we extracted named theories (n = 6), implicit theories (n = 5) and models and frameworks (n = 20) used for youth engagement in health research. We identified theories that were explicitly stated and surfaced theories that were more implicitly suggested. Models and frameworks were organized into four categories based on their principal features: power‐focused (n = 8), process‐focused (n = 7), impact‐focused (n = 3) and equity‐focused (n = 2). Few frameworks (n = 5) were empirically tested in health‐related research. Conclusions: The state of theoretical development in youth engagement in research is still evolving. In this systematic review, we identified theories, models and frameworks used for youth engagement in health research. Findings from this systematic review offer a range of resources to those who seek to develop and strengthen youth engagement in their own research. Patient or Public Contribution: Youth engaged as patients in the research were not involved in planning or conducting the systematic review. However, youth researchers in their early to mid‐20s led the planning, implementation and interpretation of the review. As part of subsequent work, we formed a youth advisory board to develop a youth‐led knowledge mobilization intended for an audience of youth with lived experience of being engaged as patients in research. [ABSTRACT FROM AUTHOR]

Background: Implementation of shared decision‐making in antenatal care has had limited exploration. Objective: To assess what is known about shared decision‐making in antenatal care. Search Strategy: Five databases were searched (1997–2022) limited to English language studies from OECD countries. Data Collection and Analysis: A data collection table was constructed with findings from 32 papers. A narrative synthesis was conducted with subsequent thematic analysis of included papers. Main Results: Four areas of decision‐making were identified with six themes revealing enablers and barriers to shared decision‐making in antenatal care. Conclusion: Implementation of shared decision‐making requires continuity, time and personalisation of care. [ABSTRACT FROM AUTHOR]

Aims: Advances in type 1 diabetes management are enabling more to reach older ages. Frailty is known to complicate type 2 diabetes. However, frailty in people with type 1 diabetes has not been extensively researched. This review summarises the available evidence on frailty in those with type 1 diabetes. Methods: A systematic search strategy was applied to multiple databases (Medline, Embase, CINAHL and Cochrane) including grey literature (Scopus, OAIster, OpenGrey, dissertation and thesis database). All evidence types were considered. English articles published after 2001 were eligible. For inclusion, participants must have been over 55 with type 1 diabetes. Frailty must have been clearly defined or assessed. The results were synthesised into a descriptive format to identify key themes. Results: Of 233 papers subject to full‐text review, 23 were included. Older adult diabetes research frequently does not specify the type of diabetes; 100 articles were excluded for this reason. No articles were found specifically researching frailty in older adults with type 1 diabetes. Fourteen different definitions and nine assessments of frailty were outlined. Generally, the papers supported relaxation of glucose targets and greater adoption of diabetes technology. Conclusions: This review highlights the paucity of evidence in older adults with type 1 diabetes and frailty. Consensus on standardised definitions and assessments of frailty would aid future research, which is urgently needed as more people with type 1 diabetes reach older ages. Identifying and addressing the key issues in this population is vital to support individuals through the challenges of ageing. [ABSTRACT FROM AUTHOR]

Introduction: As the world's population ages, there has been increasing attention to developing health policies to support older adults. Engaging older adults in policy‐making is one way to ensure that policy decisions align with their needs and priorities. However, ageist stereotypes often underestimate older adults' ability to participate in such initiatives. This scoping review aims to describe the characteristics and impacts of public engagement initiatives designed to help inform health policy‐making for older adults. Methods: A systematic search of peer‐reviewed and grey literature (English only) describing public engagement initiatives in health policy‐making for older adults was conducted using six electronic databases, Google and the Participedia website. No geographical, methodological or time restrictions were applied to the search. Eligibility criteria were purposefully broad to capture a wide array of relevant engagement initiatives. The outcomes of interest included participants, engagement methods and reported impacts. Results: This review included 38 papers. The majority of public engagement initiatives were funded or initiated by governments or government agencies as a formal activity to address policy issues, compared to initiatives without a clear link to a specific policy‐making process (e.g., research projects). While most initiatives engaged older adults as target participants, there was limited reporting on efforts to achieve participant diversity. Consultation‐type engagement activities were most prevalent, compared to deliberative and collaborative approaches. Impacts of public engagement were frequently reported without formal evaluations. Notably, a few articles reported negative impacts of such initiatives. Conclusion: This review describes how public engagement practices have been conducted to help inform health policy‐making for older adults and the documented impacts. The findings can assist policymakers, government staff, researchers and seniors' advocates in supporting the design and execution of public engagement initiatives in this policy sector. Patient or Public Contribution: Older adult partners from the McMaster University Collaborative for Health and Aging provided strategic advice throughout the key phases of this review, including developing a review protocol, data charting and synthesis and interpreting and presenting the review findings. This collaborative partnership was an essential aspect of this review, enhancing its relevance and meaningfulness for older adults. [ABSTRACT FROM AUTHOR]

Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]

Introduction: In order to be prepared for professional practice in a globalised world, health professions students need to be equipped with a new set of knowledge, skills and attitudes. Experiential learning gained during an international placement has been considered as a powerful strategy for facilitating the acquisition of global health competencies. The aim of this review was to synthesise the diverse body of empirical research examining the process and outcomes of international short‐term placements in health professions education. Methods: A systematic review was conducted using a meta‐narrative methodology. Six electronic databases were searched between September 2016 and June 2022: Medline, Embase, CINAHL, PsycINFO, Education Research Complete and Web of Knowledge. Studies were included if they reported on international placements undertaken by undergraduate health professions students in socio‐economically contrasting settings. Included studies were first considered within their research tradition before comparing and contrasting findings between different research traditions. Results: This review included 243 papers from 12 research traditions, which were distinguished by health profession and paradigmatic approach. Empirical findings were considered in four broad themes: learner, educational intervention, institutional context and wider context. Most studies provided evidence on the learner, with findings indicating a positive impact of international placements on personal and professional development. The development of cultural competency has been more focus in research in nursing and allied health than in medicine. Whereas earlier research has focussed on the experience and outcomes for the learner, more recent studies have become more concerned with relationships between various stakeholder groups. Only few studies have looked at strategies to enhance the educational process. Conclusion: The consideration of empirical work from different perspectives provides novel understandings of what research has achieved and what needs further investigation. Future studies should pay more attention to the complex nature of the educational process in international placements. This review of 243 papers highlights positive impacts of international placements on personal & professional development, suggesting more focus is needed on educational processes surrounding cultural competence [ABSTRACT FROM AUTHOR]

Introduction: Children living in rural, regional and remote locations experience challenges to receiving services for mental illness and challenging behaviours. Additionally, there is a lack of clarity about the workforce characteristics to address the needs of this population. Objective: To scope the literature on the rural, regional and remote child mental health and behavioural workforce and identify barriers and enabling mechanisms to mental health service provision. Design: A scoping review utilising the Joanna Briggs Institute methodology. A database search was undertaken using Medline, CINAHL, PsycINFO, ProQuest and Scopus to identify papers published 2010–2023. Research articles reporting data on mental health workforce characteristics for children aged under 12 years, in rural, regional or remote locations were reviewed for inclusion. Findings: Seven hundred and fifty‐four papers were imported into Covidence with 22 studies being retained. Retained studies confirmed that providing services to meet the needs of children's mental health is an international challenge. Discussion: The thematic analysis of the review findings highlighted four workforce strategies to potentially mitigate some of these challenges. These were: (1) The use of telehealth for clinical services and workforce upskilling; (2) Role shifting where non mental health professionals assumed mental health workforce roles; (3) Service structure strategies, and (4) Indigenous and rural cultural factors. Conclusion: A range of potential strategies exists to better meet the needs of children with mental health and behavioural issues. Adapting these to specific community contexts through co‐design and production may enhance their efficacy. [ABSTRACT FROM AUTHOR]

To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub‐epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design that report the impact that assessment using SEM assessments have on healthcare practitioners' delivery of PI/PU care pathways in adults at risk of developing PI/PUs. The review protocol was registered on PROSPERO (CRD42023416975). A literature search was conducted in May 2023, using PubMed, CINAHL, Scopus, Cochrane, EMBASE, Web of Science and Science Direct databases. Data were extracted using a data extraction tool including elements such as country, setting, sample size, intervention, control and quality appraisal was undertaken using the Evidence‐based Librarianship. We identified nine papers published between 2017 and 2022. The majority of these studies were conducted in England (n = 6; 67%). The systematic review included studies conducted across multiple care settings including acute care, medical‐surgical units, and palliative care, highlighting the importance of PI/PU prevention and management across diverse patient populations. The PI/PU care pathways implemented in the studies varied, but commonly included elements such as the application or increased use of pressure‐redistributing mattresses/cushions, implementation of repositioning plans, management of incontinence and moisture, regular skin inspection, and assessment of patient mobility. Out of the nine studies identified, seven reported PI/PU incidence. A meta‐analysis of seven studies (N = 18 451) demonstrated a statistically significant reduction in visual PI/PU development in favour of SEM‐guided care pathways compared to usual care (the odds ratio = 0.36 [95% confidence interval: 0.24–0.53, p < 0.00001]). This systematic review provides evidence that implementing SEM assessments in patients at risk of developing PI/PUs prompts anatomy‐specific clinical actions. The subsequent implementation of enhanced and targeted skin care interventions leads to consistent and sustained reductions in hospital‐acquired PU incidence. The findings emphasise the importance of incorporating SEM assessments as part of comprehensive PI/PU prevention strategies in all care settings and patient populations. This systematic review is limited by the predominance of observational studies and variable study quality. Future research should focus on randomised trials in different care settings that monitor the efficacy of preventive interventions and their impact in reducing PI/PU incidence when implemented based on SEM assessments. [ABSTRACT FROM AUTHOR]

Background: Scaling in health and social services (HSS) aims to increase the intended impact of proven effective interventions. Patient and public involvement (PPI) is critical for ensuring that scaling beneficiaries' interests are served. We aimed to identify PPI strategies and their characteristics in the science and practice of scaling in HSS. Methods: In this scoping review, we included any scaling initiative in HSS that used PPI strategies and reported PPI methods and outcomes. We searched electronic databases (e.g., Medline) from inception to 5 February 2024, and grey literature (e.g., Google). Paired reviewers independently selected and extracted eligible reports. A narrative synthesis was performed and we used the PRISMA for Scoping Reviews and the Guidance for Reporting Involvement of Patients and the Public (GRIPP2). Findings: We included 110 unique reports out of 24,579 records. In the past 5 years, the evidence on PPI in scaling has increased faster than in any previous period. We found 236 mutually nonexclusive PPI strategies among 120 scaling initiatives. Twenty‐four initiatives did not target a specific country; but most of those that did so (n = 96) occurred in higher‐income countries (n = 51). Community‐based primary health care was the most frequent level of care (n = 103). Mostly, patients and the public were involved throughout all scaling phases (n = 46) and throughout the continuum of collaboration (n = 45); the most frequently reported ethical lens regarding the rationale for PPI was consequentialist‐utilitarian (n = 96). Few papers reported PPI recruitment processes (n = 31) or incentives used (n = 18). PPI strategies occurred mostly in direct care (n = 88). Patient and public education was the PPI strategy most reported (n = 31), followed by population consultations (n = 30). Conclusions: PPI in scaling is increasing in HSS. Further investigation is needed to better document the PPI experience in scaling and ensure that it occurs in a meaningful and equitable way. Patient and Public Contribution: Two patients were involved in this review. They shared decisions on review questions, data collection instruments, protocol design, and findings dissemination. Review Registration: Open Science Framework on 19 August 2020 (https://osf.io/zqpx7/). [ABSTRACT FROM AUTHOR]

Background: The number of people living with diabetes is rising worldwide and a higher prevalence of diabetes has been linked to those experiencing socioeconomic deprivation. Self‐management strategies are vital and known to reduce the risks of long‐term complications amongst people living with diabetes. Lack of knowledge about self‐care activity required to manage diabetes is a key barrier to successful self‐management. Self‐management interventions can be less effective in socioeconomically deprived populations which can increase the risk of exacerbating health inequalities. The purpose of this review is to identify and synthesise qualitative evidence on the barriers and facilitators of self‐management of diabetes amongst people who are socioeconomically disadvantaged. Methods: MEDLINE, EMBASE, AMED, PsycINFO and CINAHL Plus were searched for qualitative studies concerning self‐management of multiple long‐term conditions amongst socioeconomically disadvantaged populations. Relevant papers which focused on diabetes were identified. Data were coded and thematically synthesised using NVivo. Findings: From the search results, 79 qualitative studies were identified after full‐text screening and 26 studies were included in the final thematic analysis. Two overarching analytical themes were identified alongside a set of subthemes: (1) Socioeconomic barriers to diabetes self‐management; healthcare costs, financial costs of healthy eating, cultural influences, living in areas of deprivation, competing priorities and time constraints, health literacy, (2) facilitators of diabetes self‐management; lifestyle and having goals, support from healthcare providers, informal support. Discussion: Self‐management of diabetes is challenging for people experiencing socioeconomic deprivation due to barriers associated with living in areas of deprivation and financial barriers surrounding healthcare, medication and healthy food. Support from healthcare providers can facilitate self‐management, and it is important that people with diabetes have access to interventions that are designed to be inclusive from a cultural perspective as well as affordable. Patient or Public Contribution: A patient advisory group contributed to the research questions and interpretation of the qualitative findings by reflecting on the themes developed. [ABSTRACT FROM AUTHOR]

Background: Meaningful involvement of adolescents in health research is their fundamental human right and has many benefits. A lack of awareness among researchers on how to meaningfully involve adolescents in health research has been linked to adolescent under involvement in health research. To address this barrier, studies have reported the need for more guidance. To inform the development of better guidelines on adolescent involvement, there is a need to first consolidate the currently available guidance on adolescent involvement in health research and to identify the gaps in these guidelines. This review aims to systematically identify all the currently available guidelines on adolescent involvement in health research and evaluate their scope, content, context, and quality. Methods: This rapid review was pre‐registered with PROSPERO #CRD42021293586. It included documents that incorporated tangible recommendations on the involvement of adolescents in health research. We searched six databases for peer‐reviewed literature: MEDLINE, CINAHL, Embase, Scopus, Web of Science, and ERIC. We conducted a grey literature search in Google Scholar, Google, websites of 472 relevant organisations and sought expert input. The quality of the guidelines was assessed using the Appraisal of Guidelines for REsearch & Evaluation (AGREE‐II) Instrument. Data was analysed using descriptive analyses and narrative synthesis. Results: We found that the current guidelines on adolescent involvement in health research are often narrow in scope, targeting specific users and populations while focusing on limited research areas. The guidelines individually fail to provide comprehensive coverage of recommendations across all topics related to adolescent research involvement, that are collectively addressed across all included guidelines. Furthermore, these guidelines tend to be context‐specific and are generally of low quality, often due to inadequate stakeholder involvement and a lack of rigorous development methods. Conclusion: This review provides a consolidated list of guidelines on adolescent involvement in health research along with their quality scores as a resource for researchers to select the guidelines suitable for their research topic, context, and scope for adolescent involvement. There is a need to develop a set of guidelines on adolescent involvement in research, which are comprehensive in scope, cover all key aspects of adolescent involvement in health research, can be adapted for different contexts, and which are based on rigorous and systematic methods. Patient and Public Involvement: Adolescent co‐researchers D. B. and C. W. were involved at different stages of the review process. D. B. screened 25% of the peer‐reviewed articles at the title and abstract screening stage and 10% at full‐text screening stage. C. W. extracted data from 10% of the included guidelines. Both co‐researchers reviewed and shared their feedback on the article and are co‐authors on this paper. They will also be invited to contribute to further dissemination of the findings from this review. [ABSTRACT FROM AUTHOR]

Objectives: To map the current evidence about the health concerns and the potential solutions related to the Islamic pilgrimage to Mecca. Design: A scoping review was applied. Papers published in English between 2012 and 2023 were included but non‐human research and sources without any related data were excluded. Data charting and extraction were used to map the current evidence. Results: The total of 36 papers were included with the total number of pilgrims of 17,075,887. The majority of studies were published in the Asia Pacific region (36.11%) as original articles (88.89%). The health concerns were grouped into five main aspects. There were 7603 deaths recorded or about 44 incidences of deaths per 100,000 pilgrims during the pilgrimage. There were recorded 11,018; 6178; 3393; and 17,810 cases for communicable diseases; non‐communicable diseases; injuries and trauma; and health services (i.e., cardiac catheterization) and vaccination, respectively. Conclusion: Relating to the five health concerns, this study identified the top seven issues in each category (i.e., hypertension, influenza vaccination), except for the death record. Moreover, there were three solutions (for general health, non‐ and communicable‐diseases) presented. Stakeholders could use this evidence to improve healthcare quality particularly related to the annual Islamic pilgrimage to Mecca. [ABSTRACT FROM AUTHOR]

Background: Increasing research capacity and capability for the speech and language therapy (SLT) profession is a key national strategic driver, with many speech and language therapists (SLTs) aspiring to a clinical academic (CA) career. There are known benefits but also acknowledged challenges with this career path, including limited funding opportunities and a poorly established career trajectory. Aims: To present models, frameworks and support structures that can be used by aspiring SLT CAs to chart research knowledge and skills, and plan career development. Organisational models are also presented to facilitate SLT CA career development and research capacity‐building. Methods & Procedures: A narrative review was conducted using a literature search of published peer‐reviewed journals across four electronic databases: Medline, CINAHL, AMED and Embase, with additional search for grey literature through internet searches. Search results were screened against eligibility criteria by two researchers, with full‐text articles retrieved and reviewed by four researchers independently. Results & Discussion: The database search and grey literature search combined identified 610 records. Full‐text screening of 66 records resulted in 19 articles or grey literature sources being included within the narrative review. Main Contribution: This paper details models, frameworks and support structures pertinent to SLTs that can be used at an individual and organizational level to assist CA skill development and career paths. Conclusion & Implications: The national climate is looking positive for aspiring SLT CAs. The time is now to take the initiative and use the support structures available to show our CA value and develop the necessary skills outlined within these resources to fulfil our ambitions. WHAT THIS PAPER ADDS: What is already known on the subject: Interest in CA careers within the SLT profession is increasing. Whilst there are known benefits to embedding research within clinical practice, barriers exist including the strategic and operational steps individuals can take to make the career path a reality. What this study adds: This narrative review has searched the literature for CA models, frameworks and support structures created for nurses, midwives and allied health professionals. These tools are presented and discussed, with special consideration and focus to the SLT profession. What are the clinical implications of this work?: This paper will provide SLTs with the tools to support their personal CA career development as well as advocate for CA roles within their teams and organisations. Organisational models are also presented to support SLT managers to foster a CA path for workforce development. [ABSTRACT FROM AUTHOR]

Objective: This article addresses the persistent challenge of Delayed Hospital Discharge (DHD) and aims to provide a comprehensive overview, synthesis, and actionable, sustainable plan based on the synthesis of the systematic review articles spanning the past 24 years. Our research aims to comprehensively examine DHD, identifying its primary causes and emphasizing the significance of effective communication and management in healthcare settings. Methods: We conducted the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) method for synthesizing findings from 23 review papers published over the last two decades, encompassing over 700 studies. In addition, we employed a practical and comprehensive framework to tackle DHD. Rooted in Linderman's model, our approach focused on continuous process improvement (CPI), which highlights senior management commitment, technical/administrative support, and social/transitional care. Our proposed CPI method comprised several stages: planning, implementation, data analysis, and adaptation, all contributing to continuous improvement in healthcare delivery. This method provided valuable insights and recommendations for addressing DHD challenges. Findings: Our DHD analysis revealed crucial insights across multiple dimensions. Firstly, examining causes and interventions uncovered issues such as limited discharge destinations, signaling unsustainable solutions, and inefficient care coordination. The second aspect explored the patient and caregiver experience, emphasizing challenges linked to staff uncertainty and negative physical environments, with notable attention to the underexplored area of caregiver experience. The third theme explored organizational and individual factors, including cognitive impairment and socioeconomic influences. The findings emphasized the importance of incorporating patients' data, recognizing its complexity and current avoidance. Finally, the role of transitional and social care and financial strategies was scrutinized, emphasizing the need for multicomponent, context‐specific interventions to address DHD effectively. Conclusion: This study addresses gaps in the literature, challenges prevailing solutions, and offers practical pathways for reducing DHD, contributing significantly to healthcare quality and patient outcomes. The synthesis introduces the vital CPI stage, enhancing Linderman's work and providing a pragmatic framework to eradicate delayed discharge. Future efforts will address practitioner consultations to enhance perspectives and further enrich the study. Patient or Public Contribution: Our scoping review synthesizes and analyzes existing systematic review articles and emphasizes offering practical, actionable solutions. While our approach does not directly engage patients, it strategically focuses on extracting insights from the literature to create a CPI framework. This unique aspect is intentionally designed to yield tangible benefits for patients, service users, caregivers, and the public. Our actionable recommendations aim to improve hospital discharge processes for better healthcare outcomes and experiences. This detailed analysis goes beyond theoretical considerations and provides a practical guide to improve healthcare practices and policies. [ABSTRACT FROM AUTHOR]

Objective: To review the evidence on using family resilience as a concept in interventions by public health nurses/health visitors with families with children and young people as part of an evaluation of the evidence base for the Family Resilience Assessment Instrument and Tool (FRAIT). FRAIT was developed by University faculty with Health Visitors and a Community of Practice in Wales, and is used by Health Visitors in Wales with families with children under 5 years to assess family resilience. Method: A standard Cochrane Systematic Review methodology was used to review published literature. A protocol (crd.york.ac.uk/PROSPERO/display_record.php?RecordID = 230845) was submitted to Prospero in September 2021, and reviewing began in January 2022. Title and abstract searching were undertaken 12 databases and results were captured using PRISMA and Excel spreadsheet. Second reviewers reviewed title and abstract screening, and full‐text extraction. Results: Initial title screening brought back 1350 papers across 12 databases. Titles and abstract screening reduced these to 106, 44 papers were considered for full‐text extraction, with 25 papers included for review. Discussion: Results demonstrated a focus on specific demographics, and use of family resilience with families living with specific health problems. Existing family resilience scales showed improved results in selected specific demographic groups, albeit in a reactive way. FRAIT has originality within the literature as it is used in a universal, preventative way with all families regardless of demographic or health issues. There is evidence to show that using a family resilience program in this way has originality and implications for the physical and mental health of children and young people. No patient or public contribution: This was a systematic review of existing literature so public or patient contribution would not have been appropriate. [ABSTRACT FROM AUTHOR]

Background: Wellness is a holistic, multidimensional, and process‐oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well‐being without an in‐depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer‐reviewed papers in English; papers published in scientific journals using the surrogate terms 'wellness', 'health', 'health care', and 'health care and wellness'; and papers discussing and/or defining the concept of wellness. Twenty‐six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: 'a holistic and multidimensional concept represented on a continuum of being well that goes beyond health'. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well‐being without an in‐depth clarification of its theoretical foundation. [ABSTRACT FROM AUTHOR]

Background: Meaningful, varied, joyful conversation is an important therapy target for adults with language or cognitive–communication disorders following acquired brain injury (ABI). However, the complexity of daily communication is often reduced to component parts within intervention programmes, with mixed evidence of generalization to everyday conversation. Interventions targeting co‐construction of communication within a dyad offer a structured way in which to retain and treat elements of everyday conversation for individuals and their communication partner (CP). Such interventions exist but they are variably labelled, target different ABI populations and have not been synthesized. Aims: To identify the nature, scope and effects of intervention studies targeting co‐constructed communication in adults with ABI. Method: This systematic review was completed using PRISMA Guidelines. Six databases (MEDLINE, Embase, CINAHL, Scopus, LLBA, PsychInfo) were searched and 1210 studies were screened. Data were extracted and studies were rated for methodological quality and completeness of reporting. Outcome measures and effects of treatment were collated through descriptive synthesis. Main Contribution: This review highlights an emerging evidence base in relation to an intervention approach that targets everyday communication. Co‐constructed communication interventions have been reported by 13 studies, from a total of 206 participants with post‐stroke aphasia, traumatic brain injury and progressive language impairments. These interventions take a range of formats, including referential communication tasks, retell/recount therapies and communication training programmes. Methodological quality evaluation indicated mostly low‐level study designs. Heterogeneity was identified in primary outcome measures, with 28 unique primary outcome measures reported across studies. Most studies demonstrated change in task‐specific or broad communication outcome measures. Conclusions: Co‐constructed communication interventions may offer clinicians a systematic, protocolized, replicable way to target everyday communication for adults with ABI. More high‐quality, experimental designs with complete reporting and psychometrically sound outcome measures are needed to strengthen the evidence base. What This Paper Adds: What is already known on this subject: Everyday conversation is an important therapy target for adults with ABI, but there is mixed evidence of therapy gains generalizing to everyday life. Many interventions reduce conversation to component parts such as naming or sentence construction. A different approach is needed to capture the social, dyadic, interactive and multifaceted nature of conversation. We propose the term 'co‐constructed communication interventions' as a therapy genre targeting semi‐structured dialogue. These interventions retain elements of everyday conversation (such as multimodal communication and situating tasks within dyads), combined with experimental elements (where stimuli prompt interactions and responses can be scored against normative data). What this paper adds to existing knowledge: This review proposes and describes a distinct genre of discourse intervention within the current evidence base with a novel operational definition of 'co‐constructed communication'. What are the potential or actual clinical implications of this work?: Co‐constructed communication interventions directly target elements of everyday communication by situating the therapy goals within a dyadic, interactive, multimodal task. A range of intervention tasks have been identified, including collaborative storytelling and problem‐solving. This review will be of interest to clinicians working with adults with ABI; co‐constructed communication interventions may offer a useful, replicable way to target aspects of everyday communication. This synthesis of the current evidence base encourages clinicians' informed, evidence‐based decisions around these interventions. [ABSTRACT FROM AUTHOR]

Patients with neurological diseases often suffer from overactive bladder. Posterior tibial nerve stimulation is mentioned in guidelines as a treatment when antimuscarinics fail or cannot be tolerated by patients, but the evidence is scant. This article summarizes the evidence on the practical aspects of tibial nerve stimulation for neurogenic overactive bladder (NOAB), such as electrical parameters and treatment duration, and identifies areas requiring further investigation. Scoping review. Literature search on PubMed, CINAHL, and Cochrane Library, including studies from 2010 to 2024 regarding tibial nerve stimulation for NOAB. Sixteen papers were considered: seven on transcutaneous tibial nerve stimulation (TTNS), seven on percutaneous tibial nerve stimulation (PTNS) and two protocols. Most studies enrolled neurological and non‐neurological patients or studied non‐randomized samples of a few patients. Clinical outcomes, treatment duration, number of sessions, and follow‐up times showed considerable heterogeneity, but some practical recommendations could be drawn. For PTNS, most authors suggest using 20 Hz and 200 μs, but the amplitude is highly variable among studies. For TTNS, 10 Hz and 200 μs are suggested, with considerable variability in the number of sessions and overall treatment duration. Most papers propose similar criteria regarding the frequency and duration of the stimulation, and all of them support the efficacy of tibial nerve stimulation, except for one. The areas requiring research include long‐term results, allowing for shaping adequate maintenance programmes to avoid losing the results achieved. [ABSTRACT FROM AUTHOR]

Effective exudate management is key for optimal ulcer healing. Superabsorbent dressings are designed to have high fluid handling capacity, reduced risk of exudate leakage, fluid retention under compression, and to sequester harmful exudate components. This study aimed to systematically identify existing evidence for the clinical efficacy and cost‐effectiveness of superabsorbent dressings for the treatment of moderate‐to‐highly exudating chronic ulcers of various etiologies. The aim is focused on examining the 'class' effect of all superabsorbers, not any particular dressing. Clinical and cost effectiveness systematic reviews were conducted, searching Embase, MEDLINE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. The Cost Effectiveness Analysis Registry and Econ papers were also searched for the economic review. Outcomes of interest included ulcer closure, dressing properties, hospital‐ and infection‐related outcomes, safety, and economic outcomes. Fourteen studies were included in the clinical systematic review. Eleven were case series, with one randomised controlled trial, one retrospective matched observational study, and one retrospective cohort study. The studies investigated eight superabsorbent dressings and were heterogeneous in their patient population and outcomes. Superabsorbent dressings may result in favourable outcomes, including reductions in frequency of dressing change and pain scores. As most studies were case series, drawing firm conclusions was difficult due to absence of a comparator arm. The economic systematic review identified seven studies, five of which were cost‐utility analyses. These suggested superabsorbent dressings are a more cost‐effective option for the treatment of chronic ulcers compared with standard dressings. However, the small number and low quality of studies identified in both reviews highlights the need for future research. [ABSTRACT FROM AUTHOR]

Introduction: Participation in work and employment is a milestone of adulthood. People returning to work after burn injury may have physical, psychological, social, and environmental barriers to overcome in order to resume their pre‐injury employment. The aim of this paper is to evaluate qualitative findings regarding return‐to‐employment after burn injury. Methods: A qualitative synthesis was conducted based on the qualitative findings of an earlier mixed methods review. A pre‐determined scoping review protocol was used in the earlier review to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT, and CDSR databases between 2000 and Aug 2021. Any papers presenting qualitative data from previously employed adults with cutaneous burn injuries were included. Findings: A total of 20 papers with qualitative data on return‐to‐employment after burn injury were found. Only six included studies focused on return‐to‐employment outcomes and the remaining studies reporting on quality of life and life experiences after burn injury. Common themes included impairments that develop and change over time; occupational identity and meaning; temporal aspects of burn recovery; burn rehabilitation services and interventions; attitudes, knowledge and support of service providers; workplace environments supporting work re‐engagement after burn injury; usefulness of work accommodations; family and social supports, individuals attributes that influence re‐engaging in employment; and accepting and rebuilding. Conclusion: Resumption of work after burn injury is regarded as a key marker of recovery for working‐aged adults by burn survivors and burn care professionals. Support at transition points during the burn recovery process and peer‐led programmes were important. However, limited information currently exists regarding clinical practices, service gaps, and understanding of return‐to‐employment outcomes after burn injury. [ABSTRACT FROM AUTHOR]

Background: Mentorship is a mutually beneficial voluntary relationship between mentor and mentee. In principle, the mentee trusts in the mentor for guiding career development and acquiring new knowledge and skills while the mentor finds giving back to the profession rewarding. Mentorship is beneficial at every career stage, but little is known about current programs and processes. Objective: To review the literature about mentorship in allied health to inform programs and practices in occupational therapy. Scoping focused on barriers, facilitators and reported outcomes of programs and attributes of mentors and mentees. Data Sources: A search was applied to six databases on 8 February 2022 in Ovid MEDLINE, Ovid Embase, Scopus, PUBMED and CINAHL Complete. Search terms were developed in consultation with an academic librarian and using the population, concept and context mnemonic. Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) and the JBI Manual for Evidence Synthesis. Data extraction forms were piloted with two reviewers and dual extraction occurred with a portion of papers. Where conflicts arose, discussion occurred until a consensus was reached. Findings: Sixty‐two papers were included from eleven countries. The papers arose from ten allied health disciplines, with five in occupational therapy. One‐on‐one mentoring was most common followed by groups and the use of online platforms. Structured approaches were often used, with the support of professional associations. Trust and willingness to share expertise were required attributes of mentors. Mentees appreciate self‐selecting their mentor and having protected time for mentorship. Conclusion and Significance: This synthesis provides a description of the available literature on mentorship in allied health. Benefits of mentorship were recorded with the acquisition of skills and knowledge being the most prominent. This synthesis provides ideas for future development and refinement of mentorship in occupational therapy. [ABSTRACT FROM AUTHOR]

Objective: Therapeutic boundaries are limits to appropriate behaviours within a therapist–client relationship (e.g. related to accepting gifts, self‐disclosures, therapist neutrality and advocacy). Therapeutic boundary considerations are fundamental in the care of refugees and asylum seekers. Research on the experiences of therapists navigating such boundaries is sparse and warrants further exploration. The aim of this qualitative systematic review was to thematically synthesise literature regarding therapists' (psychologists, psychotherapists, counsellors) experiences of implementing flexible therapeutic boundaries with refugee and asylum seeker clients and determine how such applications have been helpful for therapeutic interventions. Method: Six databases were searched. Following full‐text screening, 21 papers were included in the analysis. Boundary theory underpinned the analysis. Results: Three major themes were developed: (i) Changes to Therapeutic Practice & Therapeutic Intervention, (ii) Re‐Conceptualisation of Therapy as 'Clinical Political' and Re‐Conceptualisation of Therapist Identity and (iii) Careful Monitoring of Personal Boundaries—Not becoming 'Hardened' or 'Haunted'. Papers described how, when used in a reflective, considerate way, flexible therapeutic boundaries can strengthen the therapist–client alliance and positively impact therapeutic interventions. Many therapists acknowledged making conscious efforts to re‐conceptualise therapeutic work with refugee and asylum seeker clients from advocacy standpoints. However, systemic constraints, and lack of guidance, made this difficult to navigate and contributed to therapist burn‐out. Conclusions: Boundary considerations manifested as interpersonal, structural and cultural changes to practice. These have implications for clinical practice and developing guidelines on boundary practices with refugees and asylum seekers. Future research should explore promoting therapist well‐being and training needs for therapists supporting this population. [ABSTRACT FROM AUTHOR]

Background: Blended feeding has become increasingly prevalent in recent years with its practice gaining some momentum. With anecdotal reports of benefits and little evidence of harm in the literature regarding blended feeding, this scoping review was deemed important. The aim of this scoping review was to summarise the published evidence about blended feeding in gastrostomy‐fed children. Method: The scoping review methodology used included searches in specific online databases: PUBMED, PsychINFO, CINAHL, SCOPUS, AMED and EMBASE for articles that addressed issues pertaining to blended feeds in gastrostomy‐fed children. Grey literature was also considered. Inclusion criteria included papers that pertained to information and research on blended feeding in gastrostomy‐fed children. Studies published in English over the past 11 years (2011–2022) were included. This resulted in 59 papers being included in this scoping review. Results: Thematic analysis of the literature identified eight overall themes. It was clear that parents found blended feeding promoted the normalising of feeding, their own involvement in decision‐making around foods and promotion of a socially inclusive mealtime. The need for dietician and health professional input and support is key, whereas a lack of guidelines acts as a barrier to blended feeding. Furthermore, risks associated with blended feeding are identified but also the benefits to the physical well‐being of the child are considered. Conclusion: The review was comprehensive in that it identified a broad range of literature, exploring the extent, range and nature of research activity related to the use of blended feeds. The lack of original research is a concern. However, it is expected this review will provide direction for researchers, and in particular inform policy and practitioners working in the field where blended feeds may be an option for gastrostomy‐fed children. [ABSTRACT FROM AUTHOR]

Background: Children with Tourette syndrome (TS) have historically experienced problems in academic and social settings, yet their language and communication abilities have not been extensively researched. Aims: This scoping review maps the literature on the oral language and social communication abilities of children with TS in order to describe the nature of the current literature, present a summary of major findings and identify where gaps exist. Methods: A scoping review was completed to identify studies measuring the oral language or social communication abilities of children with TS. A systematic search of six electronic databases was conducted to obtain published and unpublished literature. All English studies measuring the oral language or social communication abilities of children with TS were included. Information was extracted from records and knowledge was synthesised in a narrative summary. Main Contribution: We identified 56 records for inclusion. Almost all records were located in journals within the fields of psychology and psychiatry. Skills most often studied were verbal IQ and verbal fluency. The literature suggests an increased prevalence of language disorders and social communication problems in children with TS; however, literature comprehensively detailing these challenges was scarce. Language strengths were identified in verbal intelligence, story/sentence recall, categorisation and performance on tasks at the single‐word level. Conclusions: Oral language and social communication skills are important for academic and social success. This review brings scattered literature together to provide up‐to‐date information about language in children with TS and highlights that there are considerable gaps in our knowledge about language and communication in this population. This scoping review can inform future research and support speech language pathologists in the assessment of young people with TS. WHAT THIS PAPER ADDS: What is already known on the subject: Speech‐language pathologists (SLPs) working in various contexts (e.g., schools, mental health teams) are likely to encounter children with Tourette syndrome (TS); however, the description of this population and potential communication characteristics is not well represented in the SLP literature. Previous literature reviews have reported strengths in verbal fluency and morphological processing. Challenges in expressive language, higher order language, social cognition and a propensity towards autistic traits have also been identified. What this paper adds to existing knowledge: This review differs from previous narrative reviews by employing a systematic approach to searching for literature. As a result, we identified 25 additional studies that had not been cited in previous reviews and additional relevant findings in 23 previously reviewed studies. This review confirms several previous conclusions about language in children with TS and extends or clarifies several others, thereby providing the most current information on oral language and social communication abilities. The use of current taxonomies of language and social communication helps to organise this literature for clinicians and researchers in speech‐language pathology and identifies a need for further research from the SLP perspective. What are the potential or actual clinical implications of this work?: These results imply that SLPs should screen children with TS for language disorders and investigate social communication and social interaction development. Clinicians can expect greater challenges in language and communication development for children with complex forms of TS (i.e., those who exhibit co‐occurring conditions such as attention‐deficit/hyperactivity disorder). The multidisciplinary nature of the current literature implies that clinical collaboration with other disciplines will be of particular benefit to serving this group of children. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that speech substantially changes in ageing. As a complex neurophysiological process, it can accurately reflect changes in the motor and cognitive systems underpinning human speech. Since healthy ageing is not always easily discriminable from early stages of dementia based on cognitive and behavioural hallmarks, speech is explored as a preclinical biomarker of pathological itineraries in old age. A greater and more specific impairment of neuromuscular activation, as well as a specific cognitive and linguistic impairment in dementia, unchain discriminating changes in speech. Yet, there is no consensus on such discriminatory speech parameters, neither on how they should be elicited and assessed. Aims: To provide a state‐of‐the‐art on speech parameters that allow for early discrimination between healthy and pathological ageing; the aetiology of these parameters; the effect of the type of experimental stimuli on speech elicitation and the predictive power of different speech parameters; and the most promising methods for speech analysis and their clinical implications. Methods & Procedures: A scoping review methodology is used in accordance with the PRISMA model. Following a systematic search of PubMed, PsycINFO and CINAHL, 24 studies are included and analysed in the review. Main Contribution: The results of this review yield three key questions for the clinical assessment of speech in ageing. First, acoustic and temporal parameters are more sensitive to changes in pathological ageing and, of these two, temporal variables are more affected by cognitive impairment. Second, different types of stimuli can trigger speech parameters with different degree of accuracy for the discrimination of clinical groups. Tasks with higher cognitive load are more precise in eliciting higher levels of accuracy. Finally, automatic speech analysis for the discrimination of healthy and pathological ageing should be improved for both research and clinical practice. Conclusions & Implications: Speech analysis is a promising non‐invasive tool for the preclinical screening of healthy and pathological ageing. The main current challenges of speech analysis in ageing are the automatization of its clinical assessment and the consideration of the speaker's cognitive background during evaluation. WHAT THIS PAPER ADDS: What is already known on the subject: Societal aging goes hand in hand with the rising incidence of ageing‐related neurodegenerations, mainly Alzheimer's disease (AD). This is particularly noteworthy in countries with longer life expectancies. Healthy ageing and early stages of AD share a set of cognitive and behavioural characteristics. Since there is no cure for dementias, developing methods for accurate discrimination of healthy ageing and early AD is currently a priority. Speech has been described as one of the most significantly impaired features in AD. Neuropathological alterations in motor and cognitive systems would underlie specific speech impairment in dementia. Since speech can be evaluated quickly, non‐invasively and inexpensively, its value for the clinical assessment of ageing itineraries may be particularly high. What this paper adds to existing knowledge: Theoretical and experimental advances in the assessment of speech as a marker of AD have developed rapidly over the last decade. Yet, they are not always known to clinicians. Furthermore, there is a need to provide an updated state‐of‐the‐art on which speech features are discriminatory to AD, how they can be assessed, what kind of results they can yield, and how such results should be interpreted. This article provides an updated overview of speech profiling, methods of speech measurement and analysis, and the clinical power of speech assessment for early discrimination of AD as the most common cause of dementia. What are the potential or actual clinical implications of this work?: This article provides an overview of the predictive potential of different speech parameters in relation to AD cognitive impairment. In addition, it discusses the effect that the cognitive state, the type of elicitation task and the type of assessment method may have on the results of the speech‐based analysis in ageing. [ABSTRACT FROM AUTHOR]

Background: Preceptorship has been found to be effective in supporting Newly Qualified Nurses (NQNs) during their transition into challenging environments, particularly in addressing issues related to confidence and anxiety. Effective preceptorship is an element of best practice and essential to support NQNs' transition into the critical care setting. However, the impact of preceptorship on NQNs and their preceptors in critical care units is yet to be completely understood. Aim: To review the impact of preceptorship on NQNs and preceptors working in a critical care environment. Study Design: An integrative literature review of the literature. The review employed Whittemore and Knafl's (2005) five‐stage integrative review approach. Methods: Three databases (MEDLINE, CINAHL and PsycINFO) were searched for papers published between January 2010 and May 2022. The PRISMA framework was used to guide the search and screening. Thematic analysis was used to extract, organize and analyse the data. Results: Nine studies were included in this review. Reflective thematic analysis revealed three themes, with four related subthemes. Preceptorship has an impact on the development of the NQNs and preceptors' 'nurturing' relationship. NQNs develop their knowledge, competence and confidence when experiencing supportive preceptorship. Meanwhile, preceptors experience a combination of increased workload and opportunities for learning and professional development as a result of preceptorship. Conclusion: There is evidence of the impact of preceptorship on learning and professional development for both NQNs and preceptors, but this is a complex phenomenon and further research is required to understand this area more fully. Relevance to Clinical Practice: In nursing practice, it is well‐established that Newly Qualified Nurses (NQNs) often face heightened levels of anxiety and a lack of confidence when embarking on their careers, particularly in the demanding and stressful environment of critical care units. This review holds particular significance in the realm of clinical practice as it delves into the pivotal role of preceptorship in nurturing the professional growth and development of NQNs within the challenging domain of critical care. Effective preceptorship, as an essential component of best practice, plays a pivotal role in aiding NQNs' transition into critical care settings. [ABSTRACT FROM AUTHOR]

Background: Breathing practices are increasingly being utilised in therapeutic interventions for mental health problems, including depression. One of the challenges of evaluating the impact of breathing exercises on the treatment of depression is the variability in the type of exercises used. Aims: To bring greater clarity in this area, this scoping review aimed to identify, categorise and synthesise breathing interventions that have been evaluated for depression, in order to inform further research and reviews. Method: A thematic synthesis approach was used to analyse the descriptions of breathing interventions in order to categorise these via their common features. Results: Thirty papers were included in the final synthesis. Main themes developed from thematic synthesis were related to procedural aspects of breathing interventions, namely: attention and awareness, using the body and senses, and paced breathing. Clinical implications and suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]

Aims: In tackling rising diabetes‐related emergencies, the need to understand and address emergency service usage by people with type 1 diabetes is vital. This review aimed to quantify current trends in presentations for type 1 diabetes‐related emergencies and identify public health strategies that reduce the frequency of diabetes‐related emergencies and improve glycaemic management. Methods: Medline (OVID), Cochrane and CINAHL were searched for studies published between 2000 and 2023, focusing on people with type 1 diabetes, severe hypoglycaemia and/or diabetic ketoacidosis, and ambulance and/or emergency department usage. There were 1313 papers identified, with 37 publications meeting review criteria. Results: The incidence of type 1 diabetes‐related emergencies varied from 2.4 to 14.6% over one year for hypoglycaemic episodes, and between 0.07 and 11.8 events per 100 person‐years for hyperglycaemic episodes. Notably, our findings revealed that ongoing diabetes education and the integration of diabetes technology, such as continuous glucose monitoring and insulin pump therapy, significantly reduced the incidence of these emergencies. However, socio‐economic disparities posed barriers to accessing these technologies, subsequently shifting the cost to emergency healthcare and highlighting the need for governments to consider subsidising these technologies as part of preventative measures. Conclusions: Improving access to continuous glucose monitoring and insulin pump therapy, in combination with ongoing diabetes education focusing on symptom recognition and early management, will reduce the incidence of diabetes‐related emergencies. Concurrent research assessing emergency healthcare usage patterns during the implementation of such measures is essential to ensure these are cost‐effective. [ABSTRACT FROM AUTHOR]

Nursing staff engage readily with patients and associates in mental health/forensic inpatient settings. These settings are known to have instances of workplace violence directed towards staff and such violence includes racism. Racism is a form of workplace violence that must be better understood and supported within this complex setting. Completing a systematic review to coalesce preexisting research and suggested interventions can be beneficial to supporting nurses. Systematic review following PRISMA guidelines. CINAHL, PsycInfo, Medline, British Nursing Database and Web of Science databases were searched. Reviewers screened the papers for inclusion (29 articles out of 7146 were selected for inclusion) and completed the quality appraisal using the Mixed Methods Appraisal Tool. Subsequently, data extraction was completed, and findings were summarised through narrative synthesis. The way racism was conceptualised impacted how data was collected, reported and interpreted; racism was silenced or exposed depending on how studies were undertaken. If exposed, evidence indicates racism is a problem but is not always acknowledged or acted upon. Some evidence determined racism led to negative work‐related outcomes. The literature provided limited examples of interventions. These included changing education/orientation for staff, openly discussing racist events and better planning for patients among colleagues and management. Increasing diversity within the workforce requires more research exploring and addressing issues related to racism towards nurses. Narratives of racism being normalised and embedded in mental health/forensic settings need to be challenged. [ABSTRACT FROM AUTHOR]

This systematic review aimed to provide an overview of test protocols used to measure peak oxygen uptake (VO2peak) in adults with Down syndrome (DS) and to determine how generalisable the outcomes are for the entire population of adults with DS by describing the sample characteristics of these studies and their impact on VO2peak. A literature search (PROSPERO CRD42022309560) was performed (18 July 2023) using the following databases: PubMed, CINAHL, APA PsycINFO, Web of Science, Embase and SPORTDiscus. For articles to be included, they had to be peer‐reviewed pubications, reporting VO2peak or VO2max for individuals with DS separately, with a sample of n ≥ 5 and a mean age ≥18 years. Systematic reviews and meta‐analyses were excluded but their reference lists were searched for additional papers to include. Studies were evaluated for risk of bias following the guidelines of Kmet et al. The results were summarised with frequency statistics. Forty‐three studies were included in this systematic review. Sample sizes of included adults with DS ranged from n = 4–226, with a total of n = 1498 adults with DS being included. Most studies (29/43) used the same standardised maximal exercise treadmill protocol to measure VO2peak in adults with DS, and 33 out of 43 studies used at least one objective criterion to determine a valid maximal effort. Participants were predominantly male, under 40 years old, and overweight or obese. Additionally, the diversity of study samples was lacking or not reported. The most widely used, standardised, maximal exercise test treadmill protocol is recommended for future use in research and practice, including objective criteria to determine valid maximal effort. The current study samples are not representative of the population of adults with DS in terms of sex, age and diverse backgrounds and therefore likely overestimate VO2peak of this population. [ABSTRACT FROM AUTHOR]

Aims: To identify barriers and enablers that influence engagement in and acceptability of diabetes prevention programmes for people with pre‐diabetes. The results will provide insights for developing strategies and recommendations to improve design and delivery of diabetes prevention programmes with enhanced engagement and acceptability for people with pre‐diabetes. Methods: This review used a critical realist approach to examine context and mechanisms of diabetes prevention programmes. Medline, Embase, PsycInfo, Cinahl, Web of Science, Scopus and Pre‐Medline were searched for English language studies published between 2000 and 2023. A quality assessment was conducted using Joanna Briggs Institute critical appraisal tools. Results: A total of 90 papers met inclusion criteria. The included studies used a variety of quantitative and qualitative methodologies. Data extracted focused on barriers and enablers to engagement in and acceptability of diabetes prevention programmes, with seven key mechanisms identified. These included financial, environmental, personal, healthcare, social and cultural, demographic and programme mechanisms. Findings highlighted diverse factors that influenced engagement in preventive programmes and the importance of considering these factors when planning, developing and implementing future diabetes prevention programmes. Conclusions: Mechanisms identified in this review can inform design and development of diabetes prevention programmes for people with pre‐diabetes and provide guidance for healthcare professionals and policymakers. This will facilitate increased participation and engagement in preventive programmes, potentially reducing progression and/or incidence of pre‐diabetes to type 2 diabetes and improving health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To synthesise qualitative research on individuals diagnosed with (or reportedly showing traits of) borderline pattern personality disorder who underwent dialectical behaviour therapy, aiming to comprehend their perceptions of change processes and the therapy's effects. Method: A comprehensive literature search was conducted across multiple online databases and grey literature sources. Papers were quality appraised using an adapted version of the Critical Appraisal Skills Programme tool. A metaethnographic approach was employed during the synthesis. Results: Eleven studies met criteria for inclusion in the review. The main themes identified through the synthesis process were the impact of DBT, the supportive structure and the 1:1 therapy component. Conclusions: The synthesis uncovered the importance of various processes within DBT that patients perceived as active ingredients for their change. Many of these processes aligned with proposed theoretical processes of change and quantitative research on DBT's effectiveness. [ABSTRACT FROM AUTHOR]

Background: Older adults with hearing loss struggle to communicate with care providers and experience higher mortality rates when hospitalized (Genther et al., 2015), even after controlling for age and comorbidities. Personal hearing amplifiers (PHAs), (e.g., Pocketalkers™), can improve communication with older patients. Methods: We conducted a scoping review to identify research gaps and summarize findings on the clinical use of PHAs with patients with hearing loss. After refining search terms relating to hearing loss and PHAs, we searched MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL Complete, Web of Science Core Collection, ERIC (Proquest), PubMed, ClinicalTrials.gov, International Clinical Trials Registry Platform, and the International Standard Randomised Controlled Trial Number Registry. We identified articles published in English between 1980 and 2022 that reported empirical outcomes relating to PHA use in clinical settings. Two reviewers independently extracted data from articles. We then organized data into an evidence map, and a narrative review summarizing outcomes. Results: From 4234 initially identified titles and abstracts, 12 met our criteria as full texts. These included three surveys on clinicians' awareness and use of PHAs, one evaluation of the acoustic output of a PHA, and eight interventions wherein PHAs were provided to patients with hearing loss. These papers used 10 different terms for PHAs and largely did not cite one another. Results showed high levels of satisfaction with PHAs, and consistently improved speech understanding. Despite this, care providers used devices inconsistently, with challenges around provider awareness, and device maintenance and location tracking. Conclusions: PHAs have a consistent positive effect on patients' ability to understand their care providers despite hearing loss. Barriers and facilitators to their use in clinical settings should be further explored. [ABSTRACT FROM AUTHOR]

Inconsistent engagement in pelvic floor muscle exercise (PFME) among patients with prostate cancer (PC) following radical prostatectomy may have contributed to varying effectiveness in improving urinary incontinence across studies. Identifying factors influencing engagement can help develop effective interventions to maximize participation, enhance urinary function and improve quality of life (QoL). This scoping review aims to systematically search for factors influencing PFME engagement among post radical prostatectomy patients managing urinary incontinence. Eligible publications in English were identified from various databases, including PubMed, CINAHL, ProQuest, PsycINFO and Scopus. A health science librarian was consulted to assist in formulating search terms, encompassing PC, PFME terms and influencing factors terms. We employed Colandrapp™ for data extraction, focusing on key themes such as study characteristics, PFME education and training, recommended sessions, engagement rates and factors influencing PFME engagement following radical prostatectomy. Results were presented in tables and supplemented by a narrative discussion addressing gaps in research knowledge. The synthesis drew from a diverse body of literature, blending quantitative and qualitative approaches, to contribute to a comprehensive understanding of PFME engagement factors. Twelve papers, based on 10 studies published between 2011 and 2018, met our inclusion criteria. The reviewed studies primarily employed longitudinal quantitative designs, except for one study that utilized a mixed‐method design. Only three studies incorporated theories to guide the selection of potential factors influencing PFME engagement. The factors examined across the reviewed studies encompassed aspects related to the patient–partner relationship, patient's action control, planning (dyadic or individual), self‐efficacy, perceived urinary incontinence and the patient–provider relationship. We observed conflicting findings regarding the factors influencing PFME engagement across studies. Our review underscores the importance of theory‐informed studies using rigorous methodology and precise theoretical and operational definitions of potential factors. Such studies can help pinpoint the most influential factors to enhance PFME engagement and, ultimately, improve symptoms and QoL for PC patients. The scoping review also showed critical implications for nursing practice. Nurses should develop individualized and culturally sensitive interventions, integrate health behaviour change theories, assess patient–partner relationships and action control and consider intention's mediating role in the enhancement of PFME engagement following radical prostatectomy. [ABSTRACT FROM AUTHOR]

Aim: Identify and map international evidence regarding innovations led by or involving advanced practice nurses in response to COVID‐19. Background: COVID‐19 necessitated unprecedented innovation in the organization and delivery of healthcare. Although advanced practice nurses have played a pivotal role during the pandemic, evidence of their contributions to innovations has not been synthesized. Evidence is needed to inform policies, practices, and research about the optimal use of advanced practice nurses. Methods: A scoping review was conducted and reported using the PRISMA‐ScR checklist. Electronic databases were searched for peer‐reviewed articles published between January 2020 and December 2021. Papers were included that focused on innovations emerging in response to COVID‐19 and involved advanced practice nurses. Results: Fifty‐one articles were included. Four themes were identified including telehealth, supporting and transforming care, multifaceted approaches, and provider education. Half of the articles used brief and mostly noncomparative approaches to evaluate innovations. Conclusion: This is the first synthesis of international evidence examining the contributions of advanced practice nurses during the pandemic. Advanced practice nurses provided leadership for the innovation needed to rapidly respond to healthcare needs resulting from COVID‐19. Innovations challenged legislative restrictions on practice, enabled implementation of telehealth and new models of care, and promoted evidence‐informed and patient‐centered care. Implications for practice: Advanced practice nurses led, designed, implemented, and evaluated innovations in response to COVID‐19. They facilitated the use of telehealth, supported or transformed models of care, and enabled health providers through education, mentorship, and mental health support. Implication for policy: Advanced practice nurses are a critical resource for innovation and health system improvement. Permanent removal of legislative and regulatory barriers to their full scope of practice is needed. [ABSTRACT FROM AUTHOR]

The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence is not well understood. To address this we conducted a systematic review and meta‐synthesis of qualitative studies. Our search strategy included electronic searches of 18 databases and grey literature, citation tracking and reference list screening. Studies were eligible if they presented qualitative data from racially and/or ethnically minoritised women or girls, who had experienced sexual violence at any age and described their experiences of receiving treatment from statutory mental health and/or substance use services. Studies were analysed using meta‐ethnography. Fourteen papers based on 12 individual studies were included. Analysis developed three main themes: (1) understanding minoritised women holistically, (2) processing the trauma and beginning the healing and (3) the need for social connectedness and empowering relationships. For minoritised women to benefit from treatment, mental health and substance use services need to challenge the dynamics of the multiple traumas minoritised women experience. Knowledge and understanding of the racial trauma minoritised women experience is limited and many are subjected to further harm from racist practices occurring in some treatment services. Offering culturally safe, trauma‐informed care which promotes anti‐racist practices may help improve mental health and substance use service responses to minoritised women who have experienced sexual violence. [ABSTRACT FROM AUTHOR]

Background: We now have sufficient evidence demonstrating inequalities in specific avoidable causes of death for adults with intellectual disability compared to their peers without intellectual disability. Apart from covid‐19, the largest differentials that disadvantage people with intellectual disability are in relation to pneumonia, aspiration pneumonia, epilepsy, cerebrovascular disease, ischaemic heart disease, deep vein thrombosis, diabetes and sepsis. The aim of this systematic review is to report on strategies at the individual, population or policy levels aimed at preventing these conditions that are applicable to adults with intellectual disability and that have been based on or recommended by research. Methods: Systematic review of PUBMED, EMBASE, CINAHL, PsychInfo, Social Care Online, International Bibliography of the Social Sciences (IBSS), Web of Science, Scopus, Overton, the Cochrane Library and Google Scholar databases was carried out. Searches were completed on 30 June 2023. Quantitative, qualitative and mixed‐methods research; systematic, scoping or evidence‐based reviews; and audit and reports of mortality reviews were included. Publications included in the review were about preventing the eight potentially avoidable causes of death. Findings: Ninety‐four papers were included in the review (9 in relation to pneumonia; 11 for aspiration pneumonia; 18 for sudden unexpected death in epilepsy; 7 for cerebrovascular disease; 8 for ischaemic heart disease; 4 for deep vein thrombosis; 31 for diabetes; 6 for sepsis). The eight most frequently occurring potentially avoidable causes of death in people with intellectual disability are very different medical conditions, but they shared striking similarities in how they could be prevented. The literature overwhelmingly implicated the need to make lifestyle changes to address obesity, lack of exercise and poor nutrition, and to have regular medical reviews. In addition, 'whole‐population' approaches are required that look beyond the individual to the social determinants of health. Conclusions: We found little peer‐reviewed evidence specifically about preventing these conditions in people with intellectual disability. However, most of the literature about preventative strategies pertaining to the general population was applicable to people with intellectual disability, albeit that some 'reasonable adjustments' would be required. Accessible Summaries: People with intellectual disability die from some illnesses that could be avoided. This is a bigger problem in people with intellectual disability than in people without intellectual disability.We searched for evidence about what we could do to prevent these illnesses.We found that although the most common illnesses are very different, there are things we can do that will prevent them. Some things will prevent a few illnesses.The best things that we can do are to eat a healthy diet with lots of fruit and vegetables, to do lots of exercise and to lose weight if we are overweight. Changing our lifestyle like this can make a big difference to how long we live.The government also needs to do things, like making sure that healthy food is easy to get and that there are safe places to exercise. [ABSTRACT FROM AUTHOR]

Background: Supplementary search methods, including citation searching, are essential if systematic reviews are to avoid producing biased conclusions. Little evidence exists on how to prioritise databases for citation searching or to establish whether using multiple sources is beneficial. Objectives: A systematic review examining urgent and emergency care reconfiguration was used to investigate the utility of citation searching on Web of Science (WOS) and/or Google Scholar (GS). Methods: This case study investigated numbers of studies, additional studies and unique studies retrieved from both sources. In addition, the time to search, the ease of adding references to reference management software and obtaining abstracts of studies for screening are briefly considered. Results: WOS retrieved 62 references after deduplication of the results, 52 being additional references not retrieved during the database searching. GS retrieved 134 unique references with 63 additional references. WOS and GS retrieved the same three additional included studies. WOS was less time intensive to search given the facility to restrict to English language papers and availability of abstracts. Conclusions: In a single systematic review case study, citation searching was required to identify all included studies. Citation searching on WOS is more efficient, where a subscription is available. Both databases identified the same studies but GS required additional time to remove non‐English language studies and locate abstracts. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Background: The complexity of communication presents challenges for clinical assessment, outcome measurement and intervention for people with acquired brain injury. For the purposes of assessment or treatment, this complexity is usually managed by isolating specific linguistic functions or speech acts from the interactional context. Separating linguistic functions from their interactional context can lead to discourse being viewed as a static entity comprised of discrete features, rather than as a dynamic process of co‐constructing meaning. The ecological validity of discourse assessments which rely on the deconstruction of linguistic functions is unclear. Previous studies have reported assessment tasks that preserve some of the dialogic features of communication, but as yet, these tasks have not been identified as a distinct genre of assessment. We suggest the term 'co‐constructed communication' to describe tasks which are specifically designed to capture the dynamic, jointly produced nature of communication within a replicable assessment task. Aims: To identify and summarize how co‐constructed communication has been assessed with individuals with non‐progressive acquired communication disability regarding task design, measures and psychometric robustness. Methods: A scoping review methodology was used to identity relevant studies. Systematic database searches were conducted on studies published before July 2021. Studies in the yield were assessed against eligibility criteria, with 37 studies identified as eligible for inclusion. Main contribution: This is the first time that co‐constructed communication has been defined as a genre of discourse assessment for stroke and traumatic brain injury populations. Co‐constructed communication has been assessed for 144 individuals with aphasia and 111 with cognitive–communication disability. Five categories of co‐constructed communication tasks were identified, ranging in complexity. Variability exists in how these assessment tasks are labelled and measured. Assessment measures require further psychometric profiling, specifically regarding test–retest reliability and validity. Conclusions: Co‐constructed communication is a discourse genre which offers researchers and clinicians a replicable method to assess language and communication in an experimentally rigorous way, within an ecologically valid context, bridging the gap between experimental and ecological assessment approaches. What this paper adds: What is already known on this subject: Standardized assessments of language skills and monologue offer reliable, replicable ways to measure language. However, isolating language from an interactional context fundamentally changes the behaviour under study. This raises questions about the ecological validity of the measures we routinely use to determine diagnoses, guide treatment planning and measure the success of treatment. What this study adds to the existing knowledge: This review highlights studies that conceptualize, and often quantify, interaction by combining experimental rigour and aspects of everyday dialogue. This is the first time this genre of discourse assessment has been identified. We propose the term 'co‐constructed communication' to describe this genre and provide an operational definition for the term. What are the practical and clinical implications of this study?: Co‐constructed communication assessment tasks require refinement, particularly regarding aspects of psychometric robustness. In the future, these tasks offer pragmatic, meaningful ways to capture the effect and impact of aphasia and cognitive–communication disability within interaction. [ABSTRACT FROM AUTHOR]

Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi‐component intervention to be more effective than single‐component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi‐component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi‐component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi‐component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi‐component intervention. [ABSTRACT FROM AUTHOR]

Aims: To systematically review the literature investigating the links between stigma and the management of type 1 diabetes. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines. Both quantitative and qualitative data were considered. Included papers were subject to quality assessment using the Mixed Methods Appraisal Tool (MMAT), and a narrative synthesis of results was reported. Results: Nineteen articles met the inclusion criteria and were included in the final analysis. Amongst these, one study used mixed methods, nine were qualitative, and nine were quantitative. All studies found a negative relationship between stigma and type 1 diabetes management. Qualitative studies provided a further understanding of the effects observed in the quantitative studies and found that stigma can affect self‐care activities, disclosure of diabetes, and the uptake of diabetes technology. Systemic causes of stigma and intersectional stigma were also observed. Conclusions: This review highlights that people with type 1 diabetes are negatively affected by stigma, irrespective of their age, gender, culture, or use of diabetes technology. Quantitative studies were limited, in that all studies were cross‐sectional, and there was a lack of standardisation across outcome measures. There is a need for interventions to target stigma on both an individual and a systemic level, particularly where people experience multiple intersecting stigmas. [ABSTRACT FROM AUTHOR]

Background: A paucity of qualitative research on sensitive topics that focuses on participants with intellectual disabilities leaves their views unexplored. This scoping review mainly aimed to provide an overview of qualitative data collection methods used in research involving participants with intellectual disabilities to explore death and dying. Method: A scoping review of primary research and methodological papers published between January 2008 and March 2022 was conducted. The PRISMA‐ScR checklist was followed. Results: We identified 25 articles utilising four data collection methods: interviews, focus groups, the Nominal Group Technique, and participant observation. Data collection trends were identified, including accommodations for participants with intellectual disabilities, visual media used as a facilitator, and reporting of distress protocols. Most participants had mild to moderate intellectual disabilities. Conclusions: The included studies demonstrate a flexible approach that relies on the use of multiple methods. Future research must adequately report study characteristics to ensure transparency and reliability. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long‐term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood. Aim: Describe how health and care workers contribute to the prevention of emerging infectious diseases in long‐term care facilities. Design: A scoping review. Methods: A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long‐term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross‐checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings. Results: A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: "The roles of health and care workers evolve with the times", "The core competencies of health and care workers are essential for preventing emerging infectious diseases in long‐term care facilities" and "The key to successful prevention of emerging infectious diseases in long‐term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels". Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes. Conclusions: The roles of health and care workers are evolving, and effective infection prevention within long‐term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers. Clinical Relevance: Infection prevention efforts within long‐term care facilities must take into account the evolving roles of health and care workers, with a focus on guaranteeing access to resources, training and support that will help them gain the core competencies necessary for juggling those roles. In addition, there is an urgent need for research instruments that will help assess those competencies and identify areas of improvement. [ABSTRACT FROM AUTHOR]