Joanna Thompson-Coon

Mediterranean Diet, Cognitive Function, and Dementia A Systematic Review

Background: Adherence to a Mediterranean diet has been associated with lower risk of various age-related diseases including dementia. Although narrative reviews have been published, no systematic review has synthesized studies on the association between Mediterranean diet adherence and cognitive function or dementia. Methods: We conducted a systematic review of 11 electronic databases (including Medline) of published articles up to January 2012. Reference lists, selected journal contents, and relevant websites were also searched. Study selection, data extraction, and quality assessment were performed independently by two reviewers using predefined criteria. Studies were included if they examined the association between a Mediterranean diet adherence score and cognitive function or dementia. Results: Twelve eligible papers (11 observational studies and one randomized controlled trial) were identified, describing seven unique cohorts. Despite methodological heterogeneity and limited statistical power in some studies, there was a reasonably consistent pattern of associations. Higher adherence to Mediterranean diet was associated with better cognitive function, lower rates of cognitive decline, and reduced risk of Alzheimer disease in nine out of 12 studies, whereas results for mild cognitive impairment were inconsistent. Conclusions: Published studies suggest that greater adherence to Mediterranean diet is associated with slower cognitive decline and lower risk of developing Alzheimer disease. Further studies would be useful to clarify the association with mild cognitive impairment and vascular dementia. Long-term randomized controlled trials promoting a Mediterranean diet may help establish whether improved adherence helps to prevent or delay the onset of Alzheimer disease and dementia.

Sleep positioning for children with cerebral palsy

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The overall aim of this systematic review is to determine whether commercially available night-time postural management systems, compared with usual care, reduce hip migration in children with cerebral palsy. Secondary objectives include: to determine the effect of sleep positioning systems on sleep patterns and quality. to determine the effect of sleep positioning systems on the quality of life of the child. to determine the effect of sleep positioning systems on the quality of life of the family. to determine the effect of sleep positioning systems on pain. to determine the effect of sleep positioning systems on physical functioning to determine any adverse effects of sleep positioning systems.

OP27 Dissemination and implementation in dementia care practice: a systematic scoping review

Background There is a gap between the dementia care that is provided and that which research evidence suggests should be provided and this hinders efforts to improve the quality of care for people with dementia. A systematic scoping review was conducted to identify and synthesise the strategies of disseminating and implementing practices that have been shown to improve dementia care, and describe barriers and facilitators to the process. Methods Twelve databases were searched from inception to October 2015. Backward and forward citation searching was performed and websites of relevant organisations were searched to identify unpublished material. Studies with a comparative research design (quantitative) or recognised methods of data collection (qualitative) were included if they addressed dissemination and implementation strategies or enablers and barriers to best practice across dementia stages and care settings. Titles, abstracts and full texts were screened independently by two reviewers with discrepancies resolved by a third where necessary. Data extraction was performed by one reviewer and checked by a second. The EPOC taxonomy was used to classify the implementation approaches (professional, organisational, regulatory, financial) and specific strategies used (e.g. educational meetings). A mixed-methods approach was employed to synthesise the evidence. Results Of the 2,609 citations retrieved, 104 met the inclusion criteria (27 quantitative, 49 qualitative and 28 mixed-methods studies). A small proportion of studies address dissemination of knowledge. Approximately 40% of studies focus on implementation strategies to improve practice in areas of dementia care ranging from use of restraints and antipsychotics to nonpharmacological behaviour management to wider culture change approaches. Most of these studies employ strategies targeting professionals (educational meetings and materials) followed by a few organisational approaches; regulatory and financial strategies are rare. Over 50% of studies address barriers, and to a lesser extent, facilitators of dementia care practices in residential care settings. Organisational factors including time constraints and increased workload are recurrent barriers, whereas leadership and managerial support are often reported to promote implementation. Ongoing analysis will provide further insight into the type and effectiveness of implementation strategies used and allow mapping of evidence gaps in this area. Discussion The review describes the breadth of available research on dissemination and implementation strategies in dementia care and factors that may affect the translation of evidence-based research into practice. These findings will inform the development of successful implementation strategies and highlight opportunities for future research.