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The Development, Implementation and/or Sustainability of Age‐Friendly Cities and Communities Programmes: Findings From an Umbrella Review

ABSTRACT

Aim

To examine the evidence from systematic reviews on the development, implementation, and/or sustainability of age-friendly cities and communities programmes.

Design

This review was informed by the Joanna Briggs Institute umbrella review methodology.

Methods

Critical appraisal, data extraction, and synthesis were carried out according to the Joanna Briggs protocol for undertaking umbrella reviews.

Data Sources

An extensive CINAHL, MEDLINE, PsychINFO, PubMed and Scopus search was conducted for literature published from January 2007 to July 2024. Finalised search terms included ‘age-friendly’, ‘age-friendly cities and communities’ ‘systematic review’, meta-analysis', ‘integrative review’, ‘narrative review’, ‘scoping review’, ‘rapid review’ and ‘scientometric review’ in combination with index terms were utilised to locate relevant literature.

Results

Ten reviews were included comprising 4 scoping reviews, 1 interpretive review, 1 integrative review, 2 systematic reviews, 1 rapid review and 1 structured literature review. Synthesised findings were presented under the categories of ‘Development’; ‘Implementation’; and ‘Sustainability’.

Conclusion

The findings are relevant to policy, practice and research. Longitudinal and evaluation research is needed to determine the long-term sustainability of AFCC programmes. More evidence is required on the success of programmes in marginalised communities and low to middle-income countries. Designing appropriate environments for ageing in place has far-reaching implications for the health and well-being of communities, especially our oldest citizens. This is particularly salient in this time of unprecedented population ageing. Nurses must have an in-depth understanding of the broader determinants of health, including ensuring environments are fit for purpose and meet the needs of older communities.

Implications for the Profession and/or Patient Care

Understanding the importance of ensuring our cities and communities are age-friendly will positively influence the health and social care provided by nurses to older adults.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyse checklist were used to report the screening process.

Patient or Public Contribution

There was no patient or public contribution to this umbrella review.

Trial Registration

The PROSPERO registration number: CRD42023413096 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=413096)

Psychometric properties of early childhood development assessment tools in low- and middle-income countries: a systematic review

Por: Bliznashka · L. · Hentschel · E. · Ali · N. B. · Hunt · X. · Neville · S. E. · Olney · D. · Pitchik · H. O. · Roy · A. · Seiden · J. · Solis-Cordero · K. · Thapa · A. · Jeong · J.
Objective

Valid and reliable measurement of early childhood development (ECD) is critical for monitoring and evaluating ECD-related policies and programmes. Although ECD tools developed in high-income countries may be applicable to low- and middle-income countries (LMICs), directly applying them in LMICs can be problematic without psychometric evidence for new cultures and contexts. Our objective was to systematically appraise available evidence on the psychometric properties of tools used to measure ECD in LMIC.

Design

A systematic review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

Data sources

MEDLINE, Embase, PubMed, PsycInfo, SciELO and BVS were searched from inception to February 2025.

Eligibility criteria

We included studies that examined the reliability, validity, and measurement invariance of tools assessing ECD in children 0–6 years of age living in LMICs.

Data extraction and synthesis

Each study was independently screened by two researchers and data extracted by one randomly assigned researcher. Risk of bias was assessed using a checklist developed by the study team assessing bias due to training/administration, selective reporting and missing data. Results were synthesised narratively by country, location, age group at assessment and developmental domain.

Results

A total of 160 articles covering 117 tools met inclusion criteria. Most reported psychometric properties were internal consistency reliability (n=117, 64%), concurrent validity (n=81, 45%), convergent validity (n=74, 41%), test–retest reliability (n=73, 40%) and structural validity (n=72, 40%). Measurement invariance was least commonly reported (n=16, 9%). Most articles came from Brazil, China, India and South Africa. Most psychometric evidence was from urban (n=92, 51%) or urban–rural (n=41, 23%) contexts. Study samples focused on children aged 6–17.9 or 48–59.9 months. The most assessed developmental domains were language (n=111, 61%), motor (n=104, 57%) and cognitive (n=82, 45%). Bias due to missing data was most common.

Conclusions

Psychometric evidence is fragmented, limited and heterogeneous. More rigorous psychometric analyses, especially on measurement invariance, are needed to establish the quality and accuracy of ECD tools for use in LMICs.

PROSPERO registration number

CRD42022372305.

Nurses Must Improve Delirium Care: A Call to Action

Journal of Clinical Nursing, Volume 34, Issue 6, Page 1979-1981, June 2025.

A systematic review of reasons and risks for acute service use by older adult residents of long‐term care

Abstract

Aims and Objectives

To identify the reasons and/or risk factors for hospital admission and/or emergency department attendance for older (≥60 years) residents of long-term care facilities.

Background

Older adults' use of acute services is associated with significant financial and social costs. A global understanding of the reasons for the use of acute services may allow for early identification and intervention, avoid clinical deterioration, reduce the demand for health services and improve quality of life.

Design

Systematic review registered in PROSPERO (CRD42022326964) and reported following PRISMA guidelines.

Methods

The search strategy was developed in consultation with an academic librarian. The strategy used MeSH terms and relevant keywords. Articles published since 2017 in English were eligible for inclusion. CINAHL, MEDLINE, Scopus and Web of Science Core Collection were searched (11/08/22). Title, abstract, and full texts were screened against the inclusion/exclusion criteria; data extraction was performed two blinded reviewers. Quality of evidence was assessed using the NewCastle Ottawa Scale (NOS).

Results

Thirty-nine articles were eligible and included in this review; included research was assessed as high-quality with a low risk of bias. Hospital admission was reported as most likely to occur during the first year of residence in long-term care. Respiratory and cardiovascular diagnoses were frequently associated with acute services use. Frailty, hypotensive medications, falls and inadequate nutrition were associated with unplanned service use.

Conclusions

Modifiable risks have been identified that may act as a trigger for assessment and be amenable to early intervention. Coordinated intervention may have significant individual, social and economic benefits.

Relevance to clinical practice

This review has identified several modifiable reasons for acute service use by older adults. Early and coordinated intervention may reduce the risk of hospital admission and/or emergency department.

Reporting method

This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

Patient or public contribution

No patient or public contribution.

Ageism directed at older nurses in their workplace: A systematic review

Abstract

Aims

To identify and synthesise evidence related to ageism in older regulated nurses' practice settings.

Design

A systematic review following Joanna Briggs Institute methodology.

Methods

The review included empirical studies that involved older nurses as the primary study population and studies that focused on ageism in older nurses' work environments, including strategies or interventions to address ageism within the workplace. Following the initial screening, all relevant studies were critically appraised by two reviewers to ensure they were appropriate to include in the review. A synthesis without meta-analysis reporting (SWiM) guideline was employed in the review.

Data Sources

Medical Literature Analysis and Retrieval Systems Online, Scopus, Psychological Information Database and Cumulative Index to Nursing and Allied Health Literature and Google Scholar were searched to identify empirical studies and a range of academic institutional websites were accessed for master's and doctoral dissertations and theses. The search covered the period from January 2022 to May 2022, and only publications in English from 2000 onwards were considered.

Results

Nineteen studies were included, ten qualitative studies, seven quantitative studies and two mixed methods secondary analyses. Our results revealed that negative perceptions and beliefs about older nurses' competencies and skills prevail in their practice settings, which influences older nurses' health and well-being as well as their continuation of practice. Further, older nurses' continuation of practice can be facilitated by having a positive personal outlook on ageing, meaningful relationships in their practice settings and working in an environment that is age-inclusive.

Conclusion

To combat ageism in older nurses' practice settings and support their continuation of practice, effective interventions should be organisational-led. The interventions should focus on fostering meaningful relationships between older nurses and their colleagues and managers. Further, healthcare institutions should implement initiatives to promote an age-inclusive work environment that supports an age-diverse nursing workforce.

Implications for the profession and/or patient care

The review findings offer insights for healthcare managers, policymakers and researchers, emphasising the need for anti-ageism policies in healthcare organisations. According to WHO (2021), educational activities such as role-playing and simulation during in-service training may also be effective interventions. Additionally, incorporating anti-ageism initiatives into staff meetings and mandating anti-ageism training could support the continuation of practice for older nurses while fostering a more age-diverse nursing workforce.

Impact

We found evidence on the presence of ageism in older nurses' workplace and the detrimental effects of ageism on older nurses' well-being and continuation of practice. Importantly, we identified a lack of organisational initiatives to address ageism and support older nurses. These findings should encourage healthcare organisations to address ageism in older nurses' practice settings and prompt policymakers to develop age-inclusive policies that support older nurses' continuation of practice.

Reporting method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis Without Meta-analysis checklists were used to report the screening process.

Trial and Protocol Registration

The PROSPERO registration number for the review was CRD42022320214 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320214).

No Patient or Public Contribution.

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