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Peer reviewed: True, Objectives: To assess the risk of new-onset or worsening hyperglycaemia, hypertension, weight gain and hyperlipidaemia with systemic corticosteroid therapy (CST) as reported in published randomised control trial (RCT) studies. Data sources: Literature search using MEDLINE, EMBASE, Cochrane library, Web of Science and Scopus Study eligibility criteria: Published articles on results of RCT with a systemic CST arm with numerical data presented on adverse effect (AE). Participants and interventions: Reports of hyperglycaemia, hypertension, weight gain and hyperlipidaemia associated with systemic CST in patients or healthy volunteer’s ≥17 years of age. Study appraisal methods: Risk of bias tool, assessment at the level of AE and key study characteristics. Results: A total of 5446 articles were screened to include 118 studies with 152 systemic CST arms (total participants=17 113 among which 8569 participants treated with CST). Pooled prevalence of hyperglycaemia in the CST arms within the studies was 10% (95% CI 7% to 14%), with the highest prevalence in respiratory illnesses at 22% (95% CI 9% to 35%). Pooled prevalence of severe hyperglycaemia, hypertension, weight gain and hyperlipidaemia within the corticosteroid arms was 5% (95% CI 2% to 9%), 6% (95% CI 4% to 8%), 13% (95% CI 8% to 18%), 8% (95% CI 4% to 17%), respectively. CST was significantly associated hyperglycaemia, hypertension and weight gain as noted in double-blinded placebo-controlled parallel-arms studies: OR of 2.13 (95% CI 1.66 to 2.72), 1.68 (95% CI 0.96 to 2.95) and 5.20 (95% CI 2.10 to 12.90), respectively. Intravenous therapy posed higher risk than oral therapy: OR of 2.39 (95% CI 1.16 to 4.91). Limitations: There was significant heterogeneity in the AE definitions and quality of AE reporting in the primary studies and patient populations in the studies. The impact of cumulative dose effect on incidental AE could not be calculated. Conclusions and implications of key findings: Systemic CST use is associated with increased risk of metabolic AEs, which differs for each disease group and route of administration. PROSPERO registration number: CRD42020161270.

Identifying and monitoring of health inequalities requires good-quality data. The aim of this work is to systematically review the evidence base on approaches taken within the healthcare context to improve the quality of data for the identification and monitoring of health inequalities and describe the evidence base on the effectiveness of such approaches or recommendations. Peer-reviewed scientific journal publications, as well as grey literature, were included in this review if they described approaches and/or made recommendations to improve data quality relating to the identification and monitoring of health inequalities. A thematic analysis was undertaken of included papers to identify themes, and a narrative synthesis approach was used to summarise findings. Fifty-seven papers were included describing a variety of approaches. These approaches were grouped under four themes: policy and legislation, wider actions that enable implementation of policies, data collection instruments and systems, and methodological approaches. Our findings indicate that a variety of mechanisms can be used to improve the quality of data on health inequalities at different stages (prior to, during, and after data collection). These findings can inform us of actions that can be taken by those working in local health and care services on approaches to improving the quality of data on health inequalities.

This article aims to provide an overview of the form, structure and content of conference posters for researchers who intend to submit an academic poster to a conference. It focuses in particular on the design and layout of academic conference posters, making some suggestions for possible poster layouts. It also provides information about factors influencing conference selection. Finally, it summarises some top tips to be considered when creating a conference poster such as font selection and use of images.

This article aims to provide an overview of the structure, form and content of systematic reviews. It focuses in particular on the literature searching component, and covers systematic database searching techniques, searching for grey literature and the importance of librarian involvement in the search. It also covers systematic review reporting standards such as PRISMA-P and PRISMA, critical appraisal and tools and resources to support the review and ensure it is conducted efficiently and effectively. Finally, it summarizes the requirements when screening search results for inclusion in the review, and the statistical synthesis of included studies’ findings.

BACKGROUND: Speech development requires intact and adequately functioning oral anatomy and cognitive 'speech processing' skills. There is evidence that speech input processing skills are associated with speech output problems in children not born with a cleft. Children born with cleft palate ± lip (CP±L) are at high risk of developing disordered speech output. Less is known about their speech input processing skills and whether they are associated with cleft-related speech sound disorder (SSD). AIMS: (1) To collate and evaluate studies reporting evidence regarding the speech input processing skills of children born with cleft palate in comparison with data from typically developing children or other comparison groups; and (2) to identify any available evidence regarding relationships between speech input processing skills and speech output in children born with CP±L. METHODS & PROCEDURES: Potentially relevant studies published up to November 2019 were identified from the following databases: Medline via Ovid, Embase via Ovid, Cinahl via Ebscohost, PsycInfo via Ebscohost, BNI via ProQuest, AMED via Ovid, Cochrane Library and Scopus. Inclusion criteria were: peer-reviewed articles published in scientific journals, any design, published in English, participants born with a CP±L aged up to age 18 years who completed speech input processing assessments compared with normative data and/or a control or other comparison group. Critical Appraisal Skills Programme (CASP) checklists were used to quality appraise included studies. OUTCOMES & RESULTS: Six studies were retained in the final review. There is some evidence that children born with CP±L perform less well than non-cleft controls on some speech input processing tasks and that specific input processing skills may be related to errors in the children's speech. Heterogeneity in relation to study groups and assessments used, as well as small sample sizes, limits generalization of findings. CONCLUSION & IMPLICATIONS: There is limited evidence regarding the speech input processing skills of children born with CP±L. There are indications that children born with CP+/L may have difficulty in some aspects of speech input processing in comparison with children not born with a cleft, and that difficulties with some speech input processing tasks may be specific to errors in children's speech output. Further research is required to develop our understanding of these skills in this population and any associations with speech output. WHAT THIS PAPER ADDS: What is already known on the subject Few studies have been published that examine aspects of speech input processing in children born with CP±L. Theoretical models of speech processing, and published studies, propose that speech input processing skills are associated with SSD in children who were not born with a cleft. However, it is less clear whether there is any association between speech input processing and cleft-related SSD. What this paper adds to existing knowledge This review systematically collates and evaluates the published, peer-reviewed evidence regarding speech input processing skills in children born with CP±L. The collated evidence indicates that some speech input processing skills differ between children with and without CP±L. There is some evidence, from a single study, that speech input processing of specific cleft speech characteristics (CSCs) may be associated with the presence of these CSCs in the speech output of some children born with CP±L. What are the potential or actual clinical implications of this work? While the evidence is currently limited, increasing our knowledge of speech input processing skills in children born with CP±L contributes to our clinical understanding of the nature of cleft-related SSD. The current evidence suggests that speech and language therapists should consider speech input processing skills when assessing children with cleft-related SSD to support intervention planning. Considering these skills in relation to literacy development in these children may also be important.

This article provides an overview of writing for publication in peer-reviewed journals. While the main focus is on writing a research article, it also provides guidance on factors influencing journal selection, including journal scope, intended audience for the findings, open access requirements, and journal citation metrics. Finally, it covers the standard content of a scientific journal article, providing general advice and guidance regarding the information researchers would typically include in their published papers.

Academic librarians with teaching responsibility have traditionally delivered training in discovering and organising information. However, in recent years, there has been an increased emphasis on supporting researchers through all stages of the research lifecycle. While librarians are ideally placed to provide training in writing for publication and presentation of research, very few in the United Kingdom appear to be doing so. However, there are clear benefits to teaching these subjects. Based on feedback from faculty on user needs, the University of Cambridge Medical Library's training programme was expanded to include training and support in the publication and presentation of research outputs. This article recounts the process by which the new courses were developed, and the techniques used by the library's teaching staff to gain understanding of conventions and requirements of forms of written communication with which they were unfamiliar. It also evaluates the impact of the new courses, discusses next steps and provides advice for other librarians wishing to develop similar courses. D.I.

Introduction Frail older people are known to have low rates of advance care planning (ACP). Many frail patients prefer less aggressive treatment, but these preferences are often not known or respected. Frail patients often have multiple hospital admissions, potentially providing opportunities for ACP. Objective To systematically review the literature concerning ACP with frail older people in the acute hospital, with particular reference to: (1) Does ACP improve outcomes? (2) What are the views of patients, relatives, and healthcare professionals regarding ACP? (3) Does ACP currently occur? (4) What are the facilitators and barriers to ACP? Design Systematic literature review and narrative synthesis. Electronic search of MEDLINE, CINAHL, ASSIA, PsycINFO, and Embase databases from January 1990 to May 2019 inclusive. Studies in the acute setting of populations with a mean age >75 years not focussed on a disease-specific terminal condition were included. Results 16,133 articles were retrieved, 14 met inclusion criteria. No studies used an objective measure of frailty. One RCT found that ACP improves outcomes for older patients. Although 74-84% of capacitous older inpatients are receptive to ACP, rates of ACP are 0-5%; the reasons for this discrepancy have been little studied. The nature of ACP in clinical practice is unknown thus the extent to which it reflects the RCT intervention cannot be assessed. The outcomes that are important to patients are poorly understood and family and physician experiences have not been explored. Conclusions A better understanding of this area could help to improve end-of-life care for frail older people.

BackgroundThe rising prevalence of childhood obesity is a global public health concern. Evidence suggests that exposure to non-parental childcare before age six years is associated with increased risk of obesity, diet, and activity behaviours (physical activity, sedentary behaviour, and sleep). However, findings are inconsistent and mostly from cross-sectional studies, making it difficult to identify the direction of causation in associations. This review identified and synthesised the published research on longitudinal associations between non-parental childcare during early childhood, diet, and activity behaviours.MethodsSeven databases were searched using a predefined search strategy. Results were independently double-screened through title/abstract and full-text stages according to predefined criteria. Included studies were tabulated, and evaluated for risk of bias using the Nutrition Evidence Library Bias Assessment Tool.ResultsOf 18793 references screened, 13 studies met eligibility criteria and were included in the review. Eight studies reported on diet and seven studies reported on activity behaviour outcomes (three on physical activity, three on sedentary behaviour, and one on sleep). These studies included results on 89 tested childcare:outcome associations. Of 63 associations testing diet outcomes, 37 (59%) were null, and the remainder showed inconsistent patterns. There was an indication of a potential benefit of Head Start providers (vs other care, including parental) on dietary behaviours. Of 26 associations testing activity behaviour outcomes, 22 (85%) were null, and the remainder were inconsistent. Most studies (92%) did not use (or did not report using) valid and reliable outcome measures, and outcome assessors were not blinded (or it was unclear if they were blinded) to children’s exposure status (77%).ConclusionsThe scarce available literature indicates little and mixed evidence of a longitudinal association between exposure to non-parental childcare before age six years and diet or activity behaviours. This reflects a paucity of research, rather than clear evidence of no effect. There is an urgent need for studies investigating the longitudinal associations of non-parental childcare on diet and activity behaviours to assess potential lasting effects and mechanisms. Studies should assess whether and how associations vary by provider and child sub-groups, as well as differences by intensity and duration of care.

Background: Frail older people have multiple hospital admissions in the last year of life and account for 40% of UK deaths. Advance care planning (ACP) has been shown to improve outcomes for patients and families. Most frail older people have not participated in ACP but would like to do so. We sought to understand whether an acute hospital admission represents an opportunity for frail older patients to engage in and benefit from ACP through a systematic review and narrative synthesis. Method: Electronic literature search of MEDLINE, CINAHL, ASSIA, PsycINFO, and Embase databases from 1 January 1990 to 1 September 2017. Population: Patients aged 60 years or older with multiple co-morbidities or frailty or need for help with personal care. Setting: Acute hospital wards in any healthcare system. Review questions: Does ACP occur and is it of benefit? What are the views of patients and clinicians? What are the barriers and facilitators? Results: The search returned 8076 unique articles, 16 of which met inclusion criteria. One further study was identified from reference searching. Rates of ACP with hospitalised frail older patients are very low (0-3%) but most patients would welcome the opportunity to participate in ACP, which was found to improve outcomes, including respecting patient wishes and reduced relatives’ depression after death. Patients and families perceive the most important facilitator is access to doctors willing to discuss ACP, whereas clinicians believe the biggest barrier is patient and family members’ difficultly at accepting a poor prognosis. ACP uptake is increased by trained facilitators and patient ACP information packs. Conclusions: Hospital admission is a missed trigger opportunity for ACP with frail older patients, with a wide gap between evidence and clinical practice. Review findings are limited by variable study quality and scarcity of research in some areas.

Background The rising prevalence of obesity, particularly in childhood, is a global public health emergency. There is some evidence that exposure to non-parental childcare before age 6 years is associated with subsequent development of obesity and obesity-related behaviours such as physical activity, sedentary behaviour, sleep, diet and stress, although these findings are inconsistent. It is possible that the relationship between early childcare and later obesity and obesity-related behaviours depends on characteristics of childcare exposure such as type (i.e. informal versus formal care), duration (i.e. number of years spent in childcare), intensity (e.g. number of hours per week) and timing (i.e. age of onset of childcare) of care received. The relationship may also be moderated by socio-demographic characteristics of children and their families. We will conduct a systematic review exploring longitudinal associations between childcare (type, duration, intensity and timing) and measures of adiposity and body mass, physical activity, sedentary behaviour, sleep, diet and stress. We will also assess whether these relationships vary by socio-demographic factors. Methods We will include studies that explore longitudinal associations between childcare attendance in children aged