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Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions. [ABSTRACT FROM AUTHOR]

The increasing number of self-report surveys being collected using computers has led to a body of literature examining the response rates for computerized surveys compared with the more traditional paper-and-pencil method. However, results from individual studies have been inconsistent, and the meta-analyses available on this topic have included studies from a restricted range of years and did not use proper statistical procedures for examining comparability. Consequently, we conducted a meta-analysis with 96 independent effect sizes spanning over two decades of studies; we also assessed potential moderators. Comparability was determined using confidence interval equivalence testing procedures. The meta-analysis indicated nonequivalence, with those in the paper-and-pencil condition being almost twice as likely to return surveys as those in the computer condition. There was large heterogeneity of variance, and 11 of the 18 potential moderators were significant. Two meta-regressions yielded only two significant unique moderators: population and type of measure. Results highlighted issues within the response rate literature that can be addressed in future studies, as well as provided an example of using equivalence testing in meta-analyses. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this systematic review was to compare the effectiveness of electronic recording with paper-based recording of clinical skills assessments for entry-level health professional students. Methods: A comprehensive database search was undertaken using AMED, CINAHL, CENTRAL, EMBASE, Medline, PsycINFO, Scopus, and Web of Science on 12–16 June 2017, and updated 9 April 2018. Studies investigating electronic and paper-based recordings of clinical skills assessments of students in entry-level health professional programs were eligible for inclusion. Two independent researchers completed screening of studies for inclusion, quality assessments, and data extraction, with discrepancies resolved by consensus. Quality assessment was performed using the Critical Appraisal Skills Program Diagnostic checklist. Results: From 2264 studies identified, five observational cohort studies were included. Published between 2006 and 2016, included studies investigated electronic and paper examinations of clinical skills assessments of students from medical, dentistry, and physical therapy programs. Electronic assessments were reported to be more time efficient than paper-based assessments with an added advantage of no missing data. Quality and quantity of quantitative and qualitative student feedback increased with electronic assessment compared to paper-based assessments. Conclusions: Electronic assessments were used successfully across a range of health professional programs, take significantly less time to complete and provide higher quality feedback to students. Future studies are needed with more robust psychometric testing and cost-effective analysis to inform the increasing uptake of electronic assessment tools in health professional training. [ABSTRACT FROM AUTHOR]

This paper presents a narrative literature review on the evidence relating to the youth worker role with young people in the hospital setting, within which the research gaps and inconsistencies within the body of knowledge available are highlighted. Medline, CINAHL, PsycINFO, AMED and British Nursing Index databases were searched and screened for papers which involved the youth worker role with young people in a hospital setting. Data relating to the youth workers who worked with young people in the hospital setting were extracted by two independent reviewers. A total of 11 papers were identified dating from 1971 to 2018, from a range of countries. In order to present the available body of knowledge, this narrative synthesis of the literature is presented under three headings: descriptive work, service evaluation and empirical research. The findings suggest that the youth worker role in the hospital setting has a positive impact upon the lives of young people and this was accomplished through the interventions the youth worker employed when working with young people. Equally, challenges were highlighted relating to the youth worker undertaking their role in the hospital setting. However, changes during this time period in attitudes towards adolescent health particularly within the United Kingdom, along with the loss of funding for youth work has had an impact on the research in this area of clinical practice. The number of descriptive papers in this review, highlights the necessity for empirical evidence in both quantitative and qualitative research in order to gain a greater understanding of what the youth worker role in the hospital provides to young people and the impact of their interventions from the perspectives of young people, parents, youth workers and members of the multi-disciplinary team. [ABSTRACT FROM AUTHOR]

BACKGROUND: Currently, surgical methods for the treatment of degenerative scoliosis include simple decompression and decompression combined with internal fixation. However, there is still controversy over the choice of fixation and fusion segment in surgery, which requires more reliable evidence-based medical evidence for reference. OBJECTIVE: To evaluate the clinical efficacy and complication of short versus long segments of internal fixation for the treatment of degenerative scoliosis using meta-analysis. METHODS: CNKI, Wanfang Database, VIP, CBM, EMBase, PubMed, Web of Science, and Cochrane Library were searched to collect the randomized and non-randomized controlled studies which compared long fusion with short fusion in the treatment of degenerative scoliosis from inception to February 2019. Relevant conference papers and authoritative journals in the field were retrieved manually. The quality of the included studies was assessed by two evaluation mem bars according to the Cochrane collaboration network standard or the Newcastle-Ottawa Scale. The included studies were analyzed by using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) A total of 20 articles were included, involving a sample of 1329 individuals. Long segment group consisted of 601 cases, and short segment group consisted of 728 cases. (2) The meta-analysis results showed that long-segment internal fixation surgery had better improvement of coronal Cobb angle (P=0.000 4 ), coronal balance (P=0.000 2), Oswestry disability index (P=0.003) and visual analogue scale score (P < 0.000 01 ). However, the incidence of implant failure (P=0.01) and dural tear (P=0.01) in short segment group was lower than that in long segment group. The short segment group had small trauma and shorter hospital stays after surgery (P < 0.000 1 ). (3) There was no statistical difference in other therapeutic indicators and complications between the two groups (P > 0.05). (4) These findings verify that long-segment internal fixation is superior to short-segment internal fixation in the correction of scoliosis, but the recovery is slow and the incidence of some complications after operation is high. It should be considered comprehensively when selecting specific surgical procedures. [ABSTRACT FROM AUTHOR]

This work aims to review the state of the art of the most important circuit synthesis techniques of rational approximation of electromagnetic multiport systems in order to incorporate them into a circuit simulator. In particular, equivalent circuits for the state‐space or for the pole/residue representation of impedances, admittances, and scattering parameters are reviewed in details. Furthermore, a novel contribution is given to show how it is possible to migrate from a state‐space (S,Y,Z) representation to another one by applying different matrix transformations. The resulting equivalent circuits can then be connected to linear/nonlinear devices or lumped elements in a Spice‐like framework allowing to analyze mixed electromagnetic/circuit problems. The validity of all the presented equivalent circuits and state‐space transformation is tested through two pertinent numerical examples. Pseudocodes are provided in order to make the reader able to easily implement the revised synthesis techniques. [ABSTRACT FROM AUTHOR]

Background Obesity is the greatest health issue for this generation; schools have improved food offered within their grounds. The built environment surrounding schools and pupils' journeys home have not received the same level of attention. This review identified papers on impacts of hot food takeaways surrounding schools in the UK. Methods Methods were informed by the PRISMA (QUORUM) guidelines for systematic reviews. Searches were completed in 12 databases. Results A total of 14 papers were included and quality assured before data extraction. Three descriptive themes were found; descriptions of hot food takeaway's geography and impacts concerning schools, strategic food policy and pupils reported food behaviour. Conclusions Most included studies compared anthropometric measures with geographical location of hot food takeaways to find correlations between environment and childhood obesity. There was good evidence of more hot food takeaways in deprived areas and children who spend time in deprived neighbourhoods tend to eat more fast food and have higher BMIs. Few studies were able to quantify the correlation between school's environment and obesity amongst pupils. This lack of evidence is likely a factor of the studies' ability to identify the correlation rather than lack of a correlation between the two variables. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the synthesis was to develop a new understanding about the influences on communication in interprofessional teams from therapist and nurse perspectives. Methods: Six electronic databases were searched, combined with citation tracking and hand searching, yielded 3994 papers. Three researchers were involved in screening and quality appraisal, resulting in 18 papers for synthesis, using the process of meta-ethnography. Concepts were identified, compared and translated under five category headings. Two researchers mapped interpretative summaries and a line of argument was created. Results: The line of argument is that four inter-related contingences underpin effective communication between therapists and nurses. Effective communication depends on there being a genuine need to give and receive information for patient care, the capacity to attend to, hold, and use information, and opportunities to share space to enable communication to occur. The fourth contingency is good quality relationships and this is the glue that holds the contingencies together. Conclusion: This synthesis has provided an opportunity to illuminate how therapists and nurses accomplish interprofessional work through communication. The contingencies of need, capacity, opportunity, and quality of relationships create a new structure for understanding what underpins communication between these two groups. Need, capacity and opportunity should be understood as contingencies that underpin effective communication about patients, strongly centered on the fourth contingency, quality of relationships between professionals. Therapists and nurses should examine what information they genuinely need from each other to effectively conduct integrated care, from the perspective of both giving and receiving information. Consideration should be given to whether a culture of reciprocity might expand the capacity of professionals to attend to, hold and use the information they share about patients. Therapists and nurses should examine how the way they share space on the ward creates or limits their opportunities to communicate about patients and develop relationships. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to map the use of implementation science frameworks, models, and theories in intervention research targeting learning needs in the classroom. Method: A scoping review was conducted. Electronic database and manual searches were conducted. Two reviewers independently completed screening, data extraction, and quality appraisal. Qualitative content analysis was undertaken using Nilsen's taxonomy and the domains of the Consolidated Framework for Implementation Research (CFIR). The data were further analyzed using the CFIR valence and strength rating scales. Results: Included papers (n = 22) used a diverse sample of implementation science frameworks and models. Most studies used determinant frameworks to guide data collection and analysis. Few studies used implementation science theory. Most studies were mixed methods (n = 11), published since 2019 (n = 20), and conducted in North America (n = 15). Over half of the interventions targeted social, emotional, and mental health (n = 13). A complex interplay of inner setting factors was identified as having a strong influence on implementation. Teachers' knowledge and beliefs, adaptability, and complexity of interventions were also identified as important considerations when conducting research in this context. Conclusions: Early engagement with stakeholders in education is recommended when designing universal level speech, language, and communication interventions for use in the ordinary classroom. Adaptive, hybrid designs that test both implementation strategies and effectiveness of interventions may be warranted given the influence of inner setting factors on implementation outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To identify and describe international practice in incontinence management after radical cystectomy and orthotopic neobladder. Materials and Methods: A systematic scoping review following the methodology of the Joanne Briggs Institute was conducted in which the application searched 15 data sources to identify papers published in English, from 1979 to 2022. Results: Of the 16 papers that met the eligibility criteria, articles in Eastern countries mainly focus on the effect of conservative treatment, while in Western countries, more attention is paid to the effect of surgical treatment. Clinical characteristics of patients included conservative treatment failure, duration of post‐operative intervention and unique differential treatment of male and female patients. Reported factors influencing the achievement of urinary incontinence (UI) include lack of evidence to guide management practice, limited value of conservative treatment, high risk of surgical treatment and uncertainty of efficacy; currently, early behavioural research and multimodal rehabilitation training have good results. Conclusions: UI in neobladder patients is a distressing condition that is difficult to treat and often requires high‐quality rehabilitation guidance and surgical intervention. Further research to address current knowledge gaps is important to inform practice. [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]

This scoping review aims to (1) synthesise the research findings on the experiences of individuals with acquired brain injuries, and their families, when interacting with, or accessing, community-based services and (2) identify where gaps in service provision may exist and their cause. A systematic search strategy was employed across multiple databases to identify all studies relating to the experiences of individuals with acquired brain injuries and their families when interacting with, or accessing, community-based services. Inclusion was assessed by at least two reviewers at each stage and data extraction was completed by one researcher and validity checked by another. A narrative synthesis was employed. A total of 101 papers met the inclusion criteria with the narrative synthesis identifying three main themes of (1) unmet needs, (2) types of access, and (3) barriers to access. The results identify that those with acquired brain injuries, and their families, experience significant difficulties interacting with community-based services and often do not receive appropriate access. Many barriers to access were identified including a lack of knowledge of the long-term effects of acquired brain injury amongst professionals working in health and social care services. Brain injury is a leading cause of disability worldwide with a range of physical, cognitive, emotional, and behavioural difficulties. It is important that service users and families are given appropriate information about the long-term difficulties associated with ABI so they are better informed about the types of support they may need upon discharge from hospital. Rehabilitation professionals need to ensure they have good level of knowledge of the difficulties associated with ABI to ensure appropriate access to services for individuals and their families. Understanding more about unmet needs allows community rehabilitation services to be tailored and person-centred. [ABSTRACT FROM AUTHOR]

Aim: To review the evidence of how nurse and pharmacist roles have been incorporated into the management of patients undergoing systemic anti‐cancer therapy (SACT) services and their impact on patient experience and care provision. Design: Systematic Review. Data Sources: Seven databases were searched on 10 April 2022. Review Methods: Research studies that met defined inclusion criteria were included. Quantitative findings were converted into textual descriptions and combined with qualitative results for thematic analysis. Data were categorized and aggregated into themes. Heterogeneity of studies meant meta‐analysis was not possible. Results: Fifteen papers were included. Three main themes were identified: advanced clinical practice (ACP) SACT service development; ACP skills and qualifications; and the impact of ACP SACT services on patient care and outcomes. There is a variation in tasks undertaken by nurses and pharmacists and role integration is restricted by limited physician engagement. Role titles used and skills and qualifications acquired differ and professional autonomy is variable. Qualitative studies were limited. Conclusion: Evidence of how nursing and pharmacist ACP roles are implemented, what skills are essential and how roles are impacting patient experience and outcomes is limited. More research is required to explore patient and physician experience of, and satisfaction with multi‐professional care, alongside further evaluation of clinical delivery models. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal pain affecting children is common. Rehabilitation and treatment effectiveness can be influenced by multiple individual and contextual factors. The need for more rigorous evaluation of physiotherapy treatment for children's pain, identification of the role of specific techniques, and exploration of the influence of the therapeutic alliance is needed. This scoping review of research aimed to examine: (1) What are the perceptions of children, parents, and physiotherapists about the importance of therapeutic alliance during musculoskeletal pain treatment? (2) What are the key characteristics of therapeutic alliance during a child's musculoskeletal pain treatment from the perspectives of children, parents, and physiotherapists? and (3) What are the perceived impacts of therapeutic alliance (positive and negative) during a child's physiotherapy treatment for musculoskeletal pain? Methods: The scoping review, based on Arksey and O'Malley's framework and reporting was guided by PRISMA-ScR. The search strategy was based on three concept blocks: (1) Study population: Children (<18 years); (2) Medical condition: Any musculoskeletal pain (acute, chronic primary, chronic secondary); (3) Intervention: Qualitative exploration of experience of physiotherapy treatment delivered by a physiotherapist from the perspective of a child, parent, or physiotherapist. The search (no date limit) was conducted in February 2024 across Medline, AMED and CINAHL. Results: Following duplicate removal and assessment of eligibility of the initial 236 articles, nine articles were included; of these, only one specifically aimed to explore therapeutic alliance and it was the only paper to directly mention therapeutic alliance. All nine articles presented the child's experience. One overarching theme "Finding resilience within me through therapeutic alliance" and three main themes: "A trusted guide through the ups and the downs of rehabilitation"; "Having a route map"; and "Take me seriously but make it fun" were identified. Discussion: Therapeutic alliance was considered important by children, parents and physiotherapist and it influenced child and parent perceptions of physiotherapy and overall treatment outcomes. Physiotherapists can foster the children's resilience when experiencing musculoskeletal pain by providing disciplinary expertise, connecting and collaborating with the child by becoming their trusted guide, and co-creating a route map for rehabilitation by helping them to learn about their body, pain and recovery timeline. [ABSTRACT FROM AUTHOR]

This integrative review aims to evaluate the experiences of health and social care practitioners with regard to how they exercise professional curiosity in child protection practice. Professional curiosity gained significant currency following the Munro Review of Child Protection (2010) in England, as a means of seeking clarity on what is happening within a family. However, a recurrent finding from child safeguarding practice reviews is that practitioners continue to struggle to exercise curiosity. This is evident within both the United Kingdom and international literature, although descriptors for the concept may differ. This study attempted to identify facilitators and barriers to applying professional curiosity to provide a greater understanding of this theoretical concept. Title and abstract review of 1428 articles identified from databases and 11 from other sources resulted in 52 papers for full‐text review. The quality of each article was appraised using the Critical Appraisal Skills Programme tool for qualitative studies, the Mixed Methods Appraisal Tool (MMAT) for quantitative/mixed method studies and the Joanna Briggs framework for theoretical/opinion papers. Key findings were recorded in the Summary Table of Literature Reviewed. Data extracts were thematically analysed. Twenty‐four papers predominantly from the UK, but also from Australia, Italy, Sweden and USA formed the data set. Overarching themes that emerged from the thematic analysis included: noticing dissonance, emitting curiosity, constructing meaning, facilitators, individual professional challenges, organisational and macro‐level influences and conceptual development. This review demonstrated that professional curiosity is multifaceted and involves a whole system approach, from empowered, knowledgeable and competent frontline practitioners to creative, innovative and empathic organisations, that value staff contributions and place the child's best interests at the forefront of service development. Recommendations are made for practice and further research. [ABSTRACT FROM AUTHOR]

Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

Introduction: Allotment gardening is a popular pastime which anecdotally contributes to health and wellbeing, although the extent of supportive research evidence is unclear. This systematic review investigates the question: Does allotment gardening contribute to health and wellbeing? Method: A systematic search was conducted, including the terms 'allotment', 'garden', 'health' and 'wellbeing'. Abstracts of identified papers were compared with inclusion criteria, and 10 papers were finally selected. Critical appraisal and data extraction were conducted simultaneously. Qualitative research papers predominated and were analysed thematically. Resultant themes were compared and integrated with the findings of quantitative research papers. Findings: Thematic analysis of the qualitative and quantitative papers' findings revealed five distinct health and wellbeing themes. Allotment gardening provides a stress-relieving refuge, contributes to a healthier lifestyle, creates social opportunities, provides valued contact with nature, and enables self-development. Conclusion: This review suggests that allotment gardening does indeed impact health and wellbeing. It is therefore recommended as occupational therapy for people with health problems, and as a health promoting occupation for the general population. Research particularly focused on the impact of group and therapeutic allotment gardening, so further investigations are recommended to explore the health promoting influences of everyday allotment gardening for individuals. [ABSTRACT FROM AUTHOR]

Living with a chronic or mental health condition can be challenging and requires considerable adjustment. As ways of coping are culturally influenced, it is important to understand how minority ethnic populations cope, to inform appropriate services. This review aimed to explore the coping strategies used by UK residents from an African Caribbean or Irish background between 1960 and 2020. A systematic literature search on strategies used to cope with chronic health conditions in both populations living in the United Kingdom identified 26 relevant studies. Data were extracted, quality of papers was appraised and critical interpretive synthesis was applied. Two major foci of the studies were coping strategies and barriers to coping. The main coping strategies were denial/scepticism, self‐management, spirituality and religion. Within each population, there was variation in ways of coping. The review highlights the complex role of religion in influencing coping strategies. It demonstrates how personal and minority ethnic populations' experiences of service use are connected with stigma, fear and mistrust, which also act as barriers to seeking help and to coping. Coping with a chronic or mental health condition in the Irish and African Caribbean populations is under‐researched. Stigma, fear and mistrust in services act as key barriers to help‐seeking and religion is a prominent coping strategy. However, few detailed examples were given on how it was used to assist individuals when managing a chronic or mental health condition. Also due to a lack of research, firm conclusions cannot be drawn for the Irish population. [ABSTRACT FROM AUTHOR]

To identify the definitions of a fall, faller classifications and outcomes used in prospectively-recorded falls research among people with Multiple Sclerosis (MS). A systematic review of peer-reviewed journal articles was conducted using electronic databases. Relevant data were extracted by one reviewer and verified by a second independent reviewer. Twenty-six papers met the inclusion criteria. A relative degree of heterogeneity existed amongst studies for the outcomes of interest to this review. Thirteen different fall definitions were identified. Fourteen different falls outcomes were used across the included studies, with six of these reported by only one study each. Data regarding injurious falls were presented by only eight papers. The majority (n = 17) of papers classified individuals as a faller if they fell at least once. This review highlights the large variation in fall definitions, faller classifications and outcomes used in this research field. This hinders cross-comparison and pooling of data, thereby preventing researchers and clinicians from drawing conclusive findings from existing literature. The creation of an international standard for the definition of a fall, faller classification and falls outcomes would allow for transparent and coordinated falls research for people with MS, facilitating progression in this research field. Falls are a common occurrence among people with Multiple Sclerosis (MS) resulting in numerous negative consequences. There is large heterogeneity in the definitions, methods and outcomes used in falls research for people with MS. This lack of standardisation prevents the accurate cross-comparison and pooling of data, impeding the identification of falls risk factors and effective falls prevention interventions for people with MS. Consequently, clinicians should interpret the outcomes of falls research for people with MS with caution, particularly when comparing studies regarding falls risk assessments and falls prevention interventions for use in clinical practice. [ABSTRACT FROM AUTHOR]

Aims: To describe what is known from existing scientific literature on children's and parents' experiences of hospital‐based home care and to identify future research areas. Design: The scoping review design used adheres to the methodological framework of Arksey and O'Malley, and to the PRISMA‐ScR checklist. Review Methods: A systematic search was conducted, and peer‐reviewed scientific papers were screened through the application of Rayyan software. Data were extracted and presented in table and synthesised thematically as narrative text. Data Sources: Searches were carried out November 2021 and updated November 2022 in the CINAHL, MEDLINE, Embase, Cochrane, Scopus, Web of Science, Academic Search Elite, and Amed databases and Google Scholar. Results: A total of 1950 studies were screened and assessed for eligibility. Eight studies met the inclusion criteria by reporting on parents' experiences, whereas five out of these eight studies also reported on the experiences of children. Parents of children with cancer and preterm children reported feeling more in control, being empowered, and being more connected to their children's care team when their children were receiving hospital‐based home care. The family's own resources were activated, and they felt more involved in their children's care compared to being in an inpatient setting. Children with cancer, acute infection, chronic disease, and/or a syndrome reported feeling safer and more comfortable in their home environment and experienced better interaction with their care providers. Some aspects of the children's health‐related quality of life (HRQOL) were improved. Conclusion: The identified studies indicate that hospital‐based home care is a valued alternative to traditional inpatient care by both parents and children. The mode of care has no crucial negative effects. Future studies should encompass the experiences of children with different diagnoses and syndromes and compare patients treated in a traditional hospital setting with those in a hospital‐based home‐care programme. Relevance to Clinical Practice: Children's and parents' experiences of HBHC indicate that it offers a good solution if parents are well prepared and feel in control. In addition, certain structural conditions must be in place before this type of care can be established: there must be a certain number of patients and the hospital must not be too far away. In the field of neonatal home care, professionals should be more responsive to fathers' needs and tailor support by focusing on their individual experiences and needs. Our findings may guide and inform best practice for present and future providers of HBHC. Implications for the Profession and/or Patient Care: Hospital‐based home care can offer families a greater degree of autonomy, more flexible care options, improved family functioning, improved communication with care providers, and more control over the child's care. When certain structural conditions are met, such as a certain number of patients, the hospital not being too far away, and parents being well prepared and feeling in control, then hospital‐based home care is valued as an alternative to traditional inpatient care. Specific aspects of children's HRQOL may improve, and the psychosocial burden on the family does not increase. Impact: HBHC provides a valued alternative to traditional inpatient care and allows families to receive care in the comfort of their own home. Our findings may guide and inform best practice for present and future providers of hospital‐based home care. Reporting Method: In this scoping review, we have adhered to the Preferred Reporting Items for Systematic reviews and Meta Analyses Extension for Scoping Reviews checklist. Patient or Public Contribution: There has been no direct patient or public contribution to the review. Trial and Protocol Registration: Not required. [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]

Introduction: This reviews aim was to explore the evidence base for the use of antipsychotic medications in the management of acute symptoms in patients with emotionally unstable personality disorder. Methods: Relevant databases and grey literature were searched for relevant papers. Inclusion/exclusion criteria were applied which resulted in the retrieval of eight papers pertinent to the literature review. The papers were critically appraised, and a thematic analysis was undertaken to collate relevant data. Findings: Five themes emerged from this literature review: different outcome measures, symptom domains (anger, impulsivity, mood instability, pseudopsychotic symptoms, self-harm and suicidal behaviours, adverse effects, the quality of the evidence and bias). Conclusions: The evidence base is not robust enough to allow conclusions to be drawn. Any positive results must be weighed up against the potential for adverse events. This review lays the foundations for further research, which is needed to explore antipsychotic treatment. [ABSTRACT FROM AUTHOR]

Sick leave due to long-term stress is increasing in Finland and other Western countries. Occupational therapists might contribute to the prevention of and/or recovery from stress-related exhaustion. To describe what is known about occupational therapy for stress-related exhaustion. A five-step scoping review included papers published in six databases from 2000 to 2022. Extracted data was summarized to show the occupational therapy contribution within the literature. There were 29 papers meeting the inclusion criteria, of which a limited number described preventive interventions. Most articles described recovery-oriented occupational therapy with group interventions. The occupational therapists contributed with prevention measures, mostly targeting recovery in multi-professional interventions in terms of stress reduction or return-to-work. Occupational therapy involving stress management both prevents stress and supports recovery from stress-related exhaustion. Occupational therapists internationally use craft, nature activities or gardening as stress management measures. Occupational therapy appears to be a potential treatment option for stress-related exhaustion internationally in conditions that could also work in Finland, for example in occupational healthcare. [ABSTRACT FROM AUTHOR]

Background: People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief. Traditional approaches to address psychological concerns aim to modify dysfunctional thinking; however, this is limited in palliative care, as often concerns area valid and thought modification is unrealistic. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at promoting acceptance and valued living even in difficult circumstances. Evidence on its value in palliative care is emerging. Aims: To scope the evidence regarding Acceptance and Commitment Therapy for people with advanced progressive illness, their caregivers and staff involved in their care. Design: Systematic scoping review using four databases (Medline, PsychInfo, CINAHL and AMED), with relevant MeSH terms and keywords from January 1999 to May 2023. Results: 1,373 papers were identified and 26 were eligible for inclusion. These involved people with advanced progressive illness (n = 14), informal caregivers (n = 4), palliative care staff (n = 3), bereaved carers (n = 3), and mixed groups (n = 2). Intervention studies (n = 15) showed that Acceptance and Commitment Therapy is acceptable and may have positive effects on anxiety, depression, distress, and sleep in palliative care populations. Observational studies (n = 11) revealed positive relationships between acceptance and adjustment to loss and physical function. Conclusion: Acceptance and Commitment Therapy is acceptable and feasible in palliative care, and may improve anxiety, depression, and distress. Full scale mixed-method evaluation studies are now needed to demonstrate effectiveness and cost-effectiveness amongst patients; while further intervention development and feasibility studies are warranted to explore its value for bereaved carers and staff. [ABSTRACT FROM AUTHOR]

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Background: This review examined the impact of participation in an intentional physical activity or sport program on community participation and inclusion for people with intellectual disability. Method: Five electronic databases (PsychINFO, PubMed, Medline, CINAHL, AMED) were systematically searched for papers relating to intellectual disability, intentional physical activity, and community inclusion. Results: There were nine eligible papers reporting on seven unique studies conducted in North America, Europe and Australia. Interventions ranged from Special Olympics to an exercise and health education program. Peers without intellectual disability were involved in several programs, and the development of friendships was common among participants with and without disability: these were rarely transferred to the wider community. Conclusions: The identified programs involved substantial commitment of people and infrastructure to support people with intellectual disability in intentional physical activity programs. There was little evidence these programs improved community participation and inclusion for people with intellectual disability. [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]

Purpose: It is increasingly acknowledged that understanding of the process and impact of psychotherapy is enhanced by awareness of the experience of service users. Cognitive analytic therapy (CAT) was developed as a time‐limited and integrative psychotherapeutic approach. Although reviews have been published on CAT outcome studies, no reviews are currently available on service users' experience of CAT. This paper aims to systematically review and synthesize what is known about service users' experience of CAT. Methods: A systematic search of HDAS, Cochrane, and Ethos databases was conducted. Following this, fourteen papers were selected for review, appraised using CASP tools, and then thematically synthesized. Results: CAT therapy enabled service users to acquire useful knowledge and skills. Most service users found CAT tools helpful in gaining insight into their reciprocal roles and patterns. However, CAT was experienced by some service users as a painful, frightening, and upsetting process, particularly in relation to the sequential diagrammatical reformulation (SDR) and reformulation letter. The importance of the therapeutic relationship was highlighted, as well as difficulties some service users had with trusting their therapist. Conclusions: CAT is helpful in supporting service users to understand their patterns and to identify useful coping skills. However, some service users can experience strong emotions in therapy and struggle to trust their therapist. Greater attention to working within the service users' zone of proximal development (ZPD) and engendering hope during the reformulation stage may attenuate some of these risks. Recommendations are made for future research directions. Practitioner points: CAT therapy enables users to develop insight to their reciprocal roles and patterns and helpful coping skills.The service user's ZPD should be worked with when delivering CAT to manage risk of distress and reciprocal role enactments and enhance the working alliance.CAT therapists should explore ways to engender hope by attending to any helpful reciprocal roles, patterns, and exits. [ABSTRACT FROM AUTHOR]

Background: Inter‐professional collaboration (IPC) has been recommended for many years as a means by which the needs of children with developmental language disorders (DLD) can be met at school. However, effective IPC remains difficult to achieve and our knowledge of how to support it is limited. A shared understanding between those involved has been identified as critical to IPC. Aims: To examine the literature, as one source of data, for evidence of a shared understanding between the fields of speech and language therapy (SLT) and education about children with DLD and how such needs can best be met at school. Methods & Procedures: An integrative review of the literature was undertaken. A systematic search of the published, peer‐reviewed literature (between 2006 and 2016) was conducted for empirical and theoretical papers and a manual search was undertaken to obtain a representative sample of policy/professional guidelines. A total of 81 papers across SLT and education were included in the review. The papers were scrutinized using a qualitative content analysis. Main Contribution: Although some commonality between perspectives in the literature was identified, differences between the fields dominated. These differences related to how DLD is conceptualized; how children's needs are assessed; which outcomes are prioritized and how best these outcomes can be achieved. We also found differences about what constitutes useful knowledge to guide practice. We suggest that the nature of the differences we identified in the literature may have negative implications for practitioners wishing to collaborate to meet the needs of children with DLD in school. The perspectives of practising SLTs and teachers need to be sought to determine whether the findings from the literature reflect dilemmas in practice. Conclusions: Effective IPC is essential to meet the needs of children with DLD in school; yet, it remains difficult to achieve. Our review of the literature across SLT and education indicates evidence of a lack of shared understanding about DLD. If these differences are also evident in practice, then a conceptual model to support IPC may be warranted. [ABSTRACT FROM AUTHOR]

Qualitative evidence syntheses (QES) have increased in prominence and profile over the last decade as a discrete set of methodologies to undertake systematic reviews of primary qualitative research in health and social care and in education. The findings from a qualitative evidence synthesis can enable a richer interpretation of a particular phenomenon, set of circumstances, or experiences than single primary qualitative research studies can achieve. Qualitative evidence synthesis methods were developed in response to an increasing demand from health and social professionals, policy makers, guideline developers and educationalists for review evidence that goes beyond "what works" afforded by systematic reviews of effectiveness. The increasing interest in the synthesis of qualitative research has led to methodological developments documented across a plethora of texts and journal articles. This "State of the Method" paper aims to bring together these methodological developments in one place, contextualizing advances in methods with exemplars to support readers in making choices in approach to a synthesis and aid understanding. The paper clarifies what a "qualitative evidence synthesis" is and explores its role, purpose and development. It details the kind of questions a QES can explore, the processes associated with a QES, including the methods for synthesis. The rational and methods for integrating a QES with systematic reviews of effectiveness are also detailed. Finally approaches reporting and recognition of what a "good" or rigorous QES look like are provided. [ABSTRACT FROM AUTHOR]

Introduction There is a growing need for health professions to demonstrate cost-effectiveness in an increasingly financially constrained climate. High quality health economic evaluations are recommended by the National Institute for Health and Care Excellence. This systematic review examines the quality of health economic evaluations of occupational therapy interventions. Method A systematic search was conducted, and 262 potential review papers were screened, with nine being selected for review. The consolidated health economic evaluation reporting standards statement alongside a devised scoring frame was used to appraise the quality of the review papers. Results The nine papers appraised varied considerably in quality. The main concerns were: quality of the original clinical study; statement of cost-perspective and time horizon, choice of outcome units; presentation of included costs; use and reporting of uncertainty analyses. Conclusion The current low number and variable quality of health economic evaluations are largely insufficient to inform resource allocation decisions. If occupational therapy as a profession is to flourish, as financial challenges continue to increase, it must engage more strongly with health economic evaluations and produce good quality research that incorporates health economic evaluations at a much higher quality and volume than currently. We are part of a fast evolving healthcare world, and we need to evolve with it. [ABSTRACT FROM AUTHOR]

High prevalence of mental illness and the need for effective mental health care, combined with recent advances in AI, has led to an increase in explorations of how the field of machine learning (ML) can assist in the detection, diagnosis and treatment of mental health problems. ML techniques can potentially offer new routes for learning patterns of human behavior; identifying mental health symptoms and risk factors; developing predictions about disease progression; and personalizing and optimizing therapies. Despite the potential opportunities for using ML within mental health, this is an emerging research area, and the development of effective ML-enabled applications that are implementable in practice is bound up with an array of complex, interwoven challenges. Aiming to guide future research and identify new directions for advancing development in this important domain, this article presents an introduction to, and a systematic review of, current ML work regarding psycho-socially based mental health conditions from the computing and HCI literature. A quantitative synthesis and qualitative narrative review of 54 papers that were included in the analysis surfaced common trends, gaps, and challenges in this space. Discussing our findings, we (i) reflect on the current state-of-the-art of ML work for mental health, (ii) provide concrete suggestions for a stronger integration of human-centered and multi-disciplinary approaches in research and development, and (iii) invite more consideration of the potentially far-reaching personal, social, and ethical implications that ML models and interventions can have, if they are to find widespread, successful adoption in real-world mental health contexts. [ABSTRACT FROM AUTHOR]

Background: Nutrition informatics has become a novel approach for registered dietitians to practice in this field and make a profit for health care. Recommendation systems considered as an effective technology into aid users to adjust their eating behavior and achieve the goal of healthier food and diet. The purpose of this study is to review nutrition recommendation systems (NRS) and their characteristics for the first time. Material and Methods: The systematic review was conducted using a comprehensive selection of scientific databases as reference sources, allowing access to diverse publications in the field. The process of articles selection was based on the PRISMA strategy. We identified keywords from our initial research, MeSH database and expert's opinion. Databases of PubMed, Web of Sciences, Scopus, Embase, and IEEE were searched. After evaluating, they obtained records from databases by two independent reviewers and inclusion and exclusion criteria were applied to each retrieved work to select those of interest. Finally, 25 studies were included. Results: Hybrid recommender systems and knowledge-based recommender systems with 40% and 32%, respectively, were the mostly recommender types used in NRS. In NRS, rule-based and ontology techniques were used frequently. The frequented platform that applied in NRS was a mobile application with 28%. Conclusion: If NRS was properly designed, implemented and finally evaluated, it could be used as an effective tool to improve nutrition and promote a healthy lifestyle. This study can help to inform specialists in the nutrition informatics domain, which was necessary to design and develop NRS. [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]

The most common type of arthritis that alters a joint's mechanical and structural properties is osteoarthritis (OA). A new and promising non-pharmacological strategy for treating OA that has received recent attention is a combination of resistance training with blood flow restriction training (BFRT). This paper aims to identify the outcomes and outcome measures used for studying BFRT in knee OA, and to evaluate the cuff parameters and BFRT intervention used. The scoping review was based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. The review was based on material from the Cochrane Central Register of Controlled Trials, the Physiotherapy Evidence Database and PubMed. Eight studies were included. The range of outcomes used in the study were knee pain, function, strength, quadriceps cross-sectional area, quality of life, disease severity, growth hormone level, and range of motion. The included studies used interventions ranging from four to five sets of 10 to 15 repetitions at 20% to 30% of 1 repetition maximum load; progressive blood restriction ranged from 30%-80% of arterial occlusion pressure when the cuff was placed at the most proximal part of the thigh. When used with appropriate parameters, low-intensity exercise training combined with blood flow restriction (BFR) is a viable alternative to traditional strategies for improving pain, strength, muscle mass, hormone levels, functionality, range of motion, and overall quality of life among patients with knee OA. [ABSTRACT FROM AUTHOR]

Research examining the prevalence and impacts of stalking on mental health professionals (MHPs) has grown over the last two decades. Yet only one previous review has been undertaken examining impacts on staff and focusing on clients as stalkers, with prevalence estimated between 10% and 13%. This systematic review sought to assess prevalence of stalking, and associated impacts and methods of coping reported by MHPs, irrespective of perpetrator type. The search included all healthcare professional groups working in a mental health setting, reported in English or with available translation. Secondary searches were conducted through references cited in primary papers. Of the 7,060 papers identified in five databases, 11 peer-reviewed papers met rigorous inclusion criteria and were quality appraised. Reviewed studies reported prevalence rates between 10.2% and 50%, with higher quality papers reporting a narrower band, 13.9% and 14.3%. However, substantial variability in stalking definitions, and quality of methodology precluded precise prevalence estimation. Participants within the included studies disclosed significant adverse impacts on confidence and competence at work as a consequence of their experiences. Staff invoked substantial workplace and lifestyle changes to mitigate impacts of stalking. However, studies revealed staff disclosed stalking by perpetrators other than clients, notably colleagues and intimate partners, as often or more frequently than by clients. Limitations of the included research and future directions are discussed. [ABSTRACT FROM AUTHOR]

Background: Patellar tendinopathy is a very common and debilitating condition that affects the anterior aspect of the knee. This review aimed to determine the effectiveness of shockwave therapy on pain and symptom severity for all types of patients with chronic patellar tendinopathy. Methods: A search for quantitative primary studies was conducted, using the Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro) and the Cochrane Database of Systematic Reviews (CDSR) databases. Investigation of grey literature sources, Google Scholar and manual citation searching also took place. All searches were completed between 1 and 8 January 2022. Papers were included if the patients' symptoms were chronic (lasting 12+ weeks); any dose, method and type of shockwave therapy were also accepted. Results: A total of six articles were accepted following screening, all published after 2010. This review included a total of 270 patients, of which 145 received shockwave therapy. Overall, the methodological quality of the six papers was moderate to low. Despite this, and the variation in application of shockwave therapy, the results demonstrated improvements in both pain and symptom severity outcome measures. Conclusions: Shockwave therapy was effective in improving patients' pain and symptom severity, although more high-quality research trials are needed to investigate the effects of this therapy. The clinician's first line of treatment for patellar tendinopathy should be education and exercise; however, if this fails, shockwave therapy should then be considered. [ABSTRACT FROM AUTHOR]

Objective: To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. Data sources: A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. Review methods: Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. Results: A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). Conclusion: The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review. [ABSTRACT FROM AUTHOR]

Aims To understand how decisions are made to transfer dying patients home from critical care units. Background Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Design Integrative review. Data sources Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. Review methods An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. Results The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. Conclusion The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. [ABSTRACT FROM AUTHOR]

This systematic review investigated the effectiveness of Acceptance and Commitment Therapy (ACT) for managing grief experienced by bereaved spouses or partners of adults who had received palliative care. Systematic searches were undertaken on seven bibliographic databases and grey literature was also searched. The review was informed by the use of the PICO framework and PRISMA-P guidelines. Initially 30 relevant papers were identified, but only two international studies met the criteria for inclusion. One was a qualitative, doctoral study using Interpretative Phenomenological Analysis; the other, a randomized controlled trial comparing ACT with usual psychosocial support. These studies showed some evidence of benefit for bereaved individuals, particularly by promoting the acceptance of troubling emotions. However, this type of therapy may be more effective in reducing psychological distress rather than grief. Further research is needed into the value of ACT in addressing grief following bereavement. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Engagement is regarded as important and beneficial for service users and mental health servicesA universal definition of engagement is not yet fully agreed upon. What this paper adds to existing knowledge?: Based upon their experience, mental health staff use varied engagement approaches to fit with the changeable and unique needs of people who use services (service users).Mental health staff demonstrate qualities such as persistence and adaptability to successfully engage with service users. What are the implications for practice?: Irrespective of professional background, the role of community mental health staff is not restricted to any single approach. Practical help and social support are as seen as important as clinical treatment to establish successful engagement.Little is known about the engagement experiences of mental health staff working in early intervention settings as most studies in this review focused on the perspectives of staff based in assertive outreach or community mental health teams. There is a need to further understand staff experiences of engagement with service users in early intervention settings.Role descriptions and expectations of community mental health workers should account for the wide‐ranging flexible approach required in order to deliver appropriate interventions. This may involve a focus on engagement in training programmes. Introduction: Effective mental health care is dependent on engaging service users, but some individuals do not actively attend appointments, and may stop engaging with mental health services. Quantitative studies reveal some salient factors that seem to predict engagement, but these studies miss the nuances of good clinical practice in this area. A number of qualitative studies of health professionals' experiences and understanding of effective engagement have been published. Aim: This review aimed to systematically identify, evaluate and synthesize results from these studies with a view to informing effective practice in this area. Methods: Electronic databases MEDLINE, EMBASE, CINAHL, PsychINFO and AMED were searched (PROSPERO systematic review protocol registry (www.crd.york.ac.uk/prospero/; ID CRD42017083976). Of 799 records, ten papers met the inclusion criteria. All papers were subjected to quality appraisal based on the CASP checklist and data systematically extracted. A thematic synthesis of included studies examining mental health practitioners' experiences of engagement in community mental health settings was conducted. Results: Mental health practitioners see engaging service users as depending upon complex, multi‐dimensional phenomena which should include individualized person‐centred approaches as well as practical, social and clinical support. Mental health practitioners demonstrate qualities such as determination and adaptability to establish and maintain engagement with service users. Implications for practice: As a core aspect of nurse education, registered mental health nurses and other professionals would benefit from systematic guidance regarding engagement strategies. Most studies in this review focused on assertive outreach or community mental health teams, more clarification is needed of practitioner's engagement experiences in early intervention settings. [ABSTRACT FROM AUTHOR]

Featured Application: This systematic review summarizes the available literature about integration of CBCT scans, digital casts, and facial scans. Background: This systematic review summarizes the current knowledge on the superimposition of three-dimensional (3D) diagnostic records to realize an orthodontic virtual patient. The aim of this study is to analyze the accuracy of the state-of-the-art digital workflow. Methods: The research was carried out by an electronic and manual query effectuated from ISS (Istituto Superiore di Sanità in Rome) on three different databases (MEDLINE, Cochrane Library and ISI WEB OF SCIENCE) up to 31st January 2020. The search focused on studies that superimposed at least two different 3D records to build up a 3D virtual patient—information about the devices used to acquire 3D data, the software used to match data and the superimposition method applied have been summarized. Results: 1374 titles were retrieved from the electronic search. After title-abstract screening, 65 studies were selected. After full-text analysis, 21 studies were included in the review. Different 3D datasets were used: facial skeleton (FS), extraoral soft tissues (ST) and dentition (DENT). The information provided by the 3D data was superimposed in four different combinations: FS + DENT (13 papers), FS + ST (5 papers), ST + DENT (2 papers) and all the types (FS + ST + DENT) (1 paper). Conclusions: The surface-based method was most frequently used for 3D objects superimposition (11 papers), followed by the point-based method (6 papers), with or without fiducial markers, and the voxel-based method (1 paper). Most of the papers analyzed the accuracy of the superimposition procedure (15 papers), while the remaining were proof-of-principles (10 papers) or compared different methods (3 papers). Further studies should focus on the definition of a gold standard. The patient is going to have a huge advantage from complete digital planning when more information about the spatial relationship of anatomical structures are needed: ectopic, impacted and supernumerary teeth, root resorption and angulations, cleft lip and palate (CL/P), alveolar boundary conditions, periodontally compromised patients, temporary anchorage devices (TADs), maxillary transverse deficiency, airway analyses, obstructive sleep apnea (OSAS), TMJ disorders and orthognathic and cranio-facial surgery. [ABSTRACT FROM AUTHOR]

Aims: Lay opinions and published papers alike suggest mood varies with the seasons, commonly framed as higher rates of depression mood in winter. Memory and confirmation bias may have influenced previous studies. We therefore systematically searched for and reviewed studies on the topic, but excluded study designs where explicit referrals to seasonality were included in questions, interviews or data collection. Methods: Systematic literature search in Cochrane database, DARE, Medline, Embase, PsychINFO and CINAHL, reporting according to the PRISMA framework, and study quality assessment using the Newcastle-Ottawa scale. Two authors independently assessed each study for inclusion and quality assessment. Due to large heterogeneity, we used a descriptive review of the studies. Results: Among the 41 included studies, there was great heterogeneity in regards to included symptoms and disorder definitions, operationalisation and measurement. We also observed important heterogeneity in how definitions of 'seasons' as well as study design, reporting and quality. This heterogeneity precluded meta-analysis and publication bias analysis. Thirteen of the studies suggested more depression in winter. The remaining studies suggested no seasonal pattern, seasonality outside winter, or inconclusive results. Conclusions: The results of this review suggest that the research field of seasonal variations in mood disorders is fragmented, and important questions remain unanswered. There is some support for seasonal variation in clinical depression, but our results contest a general population shift towards lower mood and more sub-threshold symptoms at regular intervals throughout the year. We suggest future research on this issue should be aware of potential bias by design and take into account other biological and behavioural seasonal changes that may nullify or exacerbate any impact on mood. [ABSTRACT FROM AUTHOR]

This paper summarizes the main theoretical points within the scientific discussion on the issue of digitalization in Mass Customization concept and online Mass Customization frameworks. Origins of a stand-alone Mass Customization concept drawback to the second half of the 1990s, but major theoretical content changes and development have been identified in the last 2 decades. An intensive application of combined technology and management solutions, digital society and business transformations in the past decade has shifted the orientation of the concept to intangible products management, customer involvement and mutual value creation via frameworks in the online environment. The main purpose of the research is to reveal and present the role and impact of the digitalization sub-domain to the Mass Customization concept, its transition to the e-concept version and modelling of new combined online customization frameworks. The decision relevance of this scientific problem is multiple issues in transitions of practical organizations to the modern and mixed technological-management approach-based Mass Customization version as well as application limitations of existing online customization frameworks. The analysis of the research topic is carried out in the logical sequence. Firstly, the author presented the influence of the digitalization sub-domain to theoretical transformations of traditional Mass Customization concept. Then, a case study of the organizational transition to electronic Mass Customization and Personalization and online customization frameworks was conducted. Methodological tools and research methods used in the paper have been integrative literature review and narrative synthesis of qualitative findings of 53 articles, and a simplified Robinson conceptual modelling framework together with a c-tuple method for the simulation of new combined online customization frameworks. The research empirically confirms and theoretically proves that within last decade both practical and academic attention to sustainable and agile development of new, fully digital customized products and personalized services as well as flexible online customization frameworks and solutions significantly have increased. Furthermore, here the extent by 6 new online customization frameworks is offered next to 3 standard theoretical online customization frameworks, which became difficult to apply in the environment and preferences of modern e-business organizations and digital end-users. The results of the research can be useful for continuous scientific researches to test and validate 6 new online customization frameworks in a feedback loop part and evaluate the influence of these frameworks to a digital end-user behaviour, their role in frameworks and attitude aspects. [ABSTRACT FROM AUTHOR]

Background: Supported asthma self-management improves health outcomes. However, people with limited health literacy, especially in lower-middle-income countries (LMICs), may need tailored interventions to enable them to realise the benefits. We aimed to assess the clinical effectiveness of asthma self-management interventions targeted at people with limited health literacy and to identify strategies associated with effective programmes.Methods: Following Cochrane methodology, we searched ten databases (January 1990 - June 2018; updated October 2019), without language restriction. We included controlled experimental studies whose interventions targeted health literacy to improve asthma self-management. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. The primary outcomes were clinical (asthma control) and implementation (adoption/adherence to intervention). Analysis was narrative.Results: We screened 4318 titles and abstracts, reviewed 52 full-texts and included five trials. One trial was conducted in a LMIC. Risk of bias was low in one trial and high in the other four studies. Clinical outcomes were reported in two trials, both at high risk of bias: one of which reported a reduction in unscheduled care (number of visits in 6-month (SD); Intervention:0.9 (1.2) vs Control:1.8 (2.4), P = 0.001); the other showed no effect. None reported uptake or adherence to the intervention. Behavioural change strategies typically focused on improving an individual's psychological and physical capacity to enact behaviour (eg, targeting asthma-related knowledge or comprehension). Only two interventions also targeted motivation; none sought to improve opportunity. Less than half of the interventions used specific self-management strategies (eg, written asthma action plan) with tailoring to limited health literacy status. Different approaches (eg, video-based and pictorial action plans) were used to provide education.Conclusions: The paucity of studies and diversity of the interventions to support people with limited health literacy to self-manage their asthma meant that the impact on health outcomes remains unclear. Given the proportion of the global population who have limited health literacy skills, this is a research priority.Protocol Registration: PROSPERO CRD 42018118974. [ABSTRACT FROM AUTHOR]

Background: We have undertaken a systematically searched literature review using a realist logic of analysis to help synthesise the diverse range of literature available on hospice at home services. Aim: To find out in the existing literature what features of hospice at home models work best, for whom and under what circumstances. Design: A realist logic of analysis was applied to synthesise the evidence focusing on mechanisms by which an intervention worked (or did not work). An initial programme theory was developed using the National Association for Hospice at Home standards, Normalisation Process Theory and through refinement using stakeholder engagement. Data sources: PubMed, Science Direct, AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsychINFO, SCOPUS, Web of Science, DARE, Google Scholar, NHS Evidence, NIHR CRN portfolio database, NIHR journal library of funded studies, including searches on websites of relevant professional bodies (August 2014, June 2017, June 2019). Results: Forty-nine papers were reviewed, of which 34 contributed evidence to at least one of the eight theory areas: marketing and referral, sustainable funding model, service responsiveness and availability, criteria for service admission, knowledge and skills of care providers, integration and coordination, anticipatory care, support directed at carers. Conclusions: Our literature review showed how it was possible to develop a coherent framework and test it against 34 published papers and abstracts. Central to this review was theory building, and as further evidence emerges, our programme theories can be refined and tested against any new empirical evidence. [ABSTRACT FROM AUTHOR]

Purpose: A large number of systematic reviews (SRs) studies have been performed in the cloud computing field, demonstrating miscellaneous outcomes and utilizing different approaches. Accordingly, a meta-review of cloud SRs is needed to appraise the results of such studies and create an integrated understanding. The paper aims to discuss these issues. Design/methodology/approach: A tertiary study was conducted using a systematic method to analyze SRs including two stages: searching and screening the SRs and thematic synthesis of results. As a qualitative data management tool, Nvivo software was used to support the research process, for data coding and synthesis. Findings: First, by searching electronic sources between the year of 2011–2016, out of a total of 142 identified articles, 94 articles were included according to pre-determined criteria, of which 76 articles were approved after qualitative evaluation. In the second stage, identifying the research themes, a map of the concepts and issues related to each theme was drawn up. The analysis shows that the quality of articles has improved but can be further enhanced using methodological guidelines as well as supporting tools. The research has focused more on the technical aspect, although there is an equal demand for synthesizing of cloud governance concepts. Originality/value: This is the first tertiary study which presents the main research themes and concepts of cloud SRs in form of thematic maps by using the thematic synthesis and SR methods. This paper also provides some recommendations to improve reviews after evaluating the quality of papers. This study can support reviewers for future SRs in the field and also helps practitioners and managers to have a better understanding of different aspects of cloud computing. [ABSTRACT FROM AUTHOR]

Background Intentional rounding (IR) is a structured process whereby nurses conduct one to two hourly checks with every patient using a standardised protocol. Objective A realist synthesis of the evidence on IR was undertaken to develop IR programme theories of what works, for whom, in what circumstances and why. Methods A three-stage literature search and a stakeholder consultation event was completed. A variety of sources were searched, including AMED, CINAHL, MEDLINE, PsycINFO, HMIC, Google and Google Scholar, for published and unpublished literature. In line with realist synthesis methodology, each study's 'fltness for purpose' was assessed by considering its relevance and rigour. Results A total of 44 papers met the inclusion criteria. To make the programme theories underpinning IR explicit, we identified eight a priori propositions: (1) when implemented in a comprehensive and consistent way, IR improves healthcare quality and satisfaction, and reduces potential harms; (2) embedding IR into daily routine practice gives nurses 'allocated time to care'; (3) documenting IR checks increases accountability and raises fundamental standards of care; (4) when workload and staffing levels permit, more frequent nurse-patient contact improves relationships and increases awareness of patient comfort and safety needs; (5) increasing time when nurses are in the direct vicinity of patients promotes vigilance, provides reassurance and reduces potential harms; (6) more frequent nurse-patient contact enables nurses to anticipate patient needs and take pre-emptive action; (7) IR documentation facilitates teamwork and communication; and (8) IR empowers patients to ask for what they need to maintain their comfort and well-being. Given the limited evidence base, further research is needed to test and further refine these propositions. Conclusions Despite widespread use of IR, this paper highlights the paradox that there is ambiguity surrounding its purpose and limited evidence of how it works in practice. [ABSTRACT FROM AUTHOR]

Background Patient and public involvement ( PPI) is increasingly recognized as bringing a range of benefits to clinical and health services research. Recent systematic reviews have identified and synthesized many benefits (eg higher recruitment rates) and some costs (eg extra time need). Much of the literature focuses on PPI in long-term conditions rather than more acute health care in which the majority of microbiological research is undertaken. Objectives The aim was to identify the extent, quality and impact of PPI in antimicrobial drug development research. Objectives were to identify any relevant reporting of PPI in antimicrobial research; appraise the quality of reporting on PPI using recognized PPI reporting and critical appraisal tools; and extract and synthesize data on the impact of PPI. Search strategy A systematic review was undertaken with a search strategy based on four word groups ( PPI, patients, antimicrobial drug development and outcomes). Eight online databases were searched. Inclusion criteria English language publication, publication between 1996 and 2016 and studies describing PPI in antimicrobial drug development research. Main results No studies were found through online searching that met the search strategy and inclusion criteria. One relevant protocol paper with a brief mention of PPI was identified through expert recommendation. Commentary papers recommending PPI were identified through website searching and expert opinion. Discussion and conclusions Despite strong policy guidance encouraging PPI at the international and national levels, and anecdotal accounts of PPI taking place, evidence for the extent, quality and impact of PPI in antimicrobial drug development research has not yet appeared in the peer-reviewed literature. [ABSTRACT FROM AUTHOR]

Purpose: The use of anti-dementia medication in people with intellectual disabilities has been controversial and requires additional research to assess the efficacy of such medications. An essential part of this treatment (both in terms of research and clinical practice) is having robust outcome measures to assess the efficacy of these medications for individuals. Currently there is no consensus in the UK regarding which outcome measures, in conjunction with clinical judgement, are effective in informing clinicians' decision-making regarding anti-dementia medication management and this paper aims to present useful outcome measures. Design/methodology/approach: A comprehensive literature search was conducted to identify relevant outcome measures. Outcome measures focused on aspects of patients' presentation such as cognition, activities of daily living, neuropsychiatric presentation or the impact of their presentation (either on themselves, or on others). These outcome measures were critically appraised to ascertain their suitability in informing clinician's decisions regarding management of anti-dementia medication. The focus of this appraisal was on good quality measures that are practical and accessible and can be easily used within clinical NHS services. Findings: This paper provides advice for clinicians on using appropriate outcome measures, depending on patients' presentations and the symptoms of dementia being targeted, that can be used alongside their clinical assessment to enhance their anti-dementia medication management. Two case studies are presented to illustrate the use of such outcome measures. Originality/value: The case for using a range of assessments that are both broad in focus, and those specifically selected to measure the areas of functioning targeted by the anti-dementia medication, is presented. [ABSTRACT FROM AUTHOR]