BackgroundWhile 80% of critically ill patients treated in an intensive care unit (ICU) will survive, survivors often suffer a constellation of new or worsening physical, cognitive, and psychiatric complications, termed post-intensive care syndrome. Emerging evidence paints a challenging picture of complex, long-term complications that are often untreated and culminate in substantial dependence on acute care services. Clinicians and decision-makers in the Fraser Health Authority of British Columbia are working to develop evidence-based community healthcare solutions that will be successful in the context of existing healthcare services. The objective of the proposed review is to provide the theoretical scaffolding to transform the care of survivors of critical illness by a synthesis of relevant clinical and healthcare service programs.MethodsRealist review will be used to develop and refine a theoretical understanding of why, how, for whom, and in what circumstances post-ICU program impact ICU survivors’ outcomes. This review will follow the recommended five steps of realist review which include (1) clarifying the scope of the review and articulating a preliminary program theory, (2) searching for evidence, (3) appraising primary studies and extracting data, (4) synthesizing evidence and sharing conclusions, and (5) disseminating and implementing recommendations.DiscussionThis realist review will provide a program theory, encompassing the contexts, mechanisms, and outcomes, to explain how clinical and health service interventions to improve ICU survivor outcomes operate in different contexts for different survivors, and with what effect. This review will be an evidentiary pillar for health service development and implementation by our knowledge user team members as well as advance scholarly knowledge relevant nationally and internationally.Systematic review registrationPROSPERO CRD42018087795Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0939-7) contains supplementary material, which is available to authorized users.

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Background Organizational supports are thought to help address wide-ranging barriers to evidence-informed health care (EIHC) and knowledge translation (KT). However, little is known about the nature of the resources and services that exist within paediatric health care and research settings across Canada to facilitate evidence use in health care delivery. This survey examined existing supports for EIHC/KT within these organizations to inform the design of similar EIHC/KT support programmes. Methods A national environmental scan was conducted using a bilingual online survey distributed to leaders at Canadian paediatric academic health science centres and their affiliated research institutes. Participants were invited through email, social media and webinar invitations and snowball sampling. Supports of interest included personnel, resources, services, organizational structures or processes, and partnerships or collaborations; barriers and successes were also probed. Data were compiled by site, reported using descriptive statistics, or grouped thematically. Supports were described using the AIMD (Aims, Ingredients, Mechanism, Delivery) framework. Results Thirty-one respondents from 17 sites across seven provinces represented a 49% site response rate. Eleven (65%) sites reported an on-site library with variable staffing and services. Ten (59%) sites reported a dedicated KT support unit or staff person. Supports ranged from education, resource development and consultation to protocol development, funded initiatives and collaborations. Organizations leveraged internal and external supports, with the majority also employing supports for clinical research integration. Supports perceived as most effective included personnel, targeted initiatives, leadership, interdepartmental expertise, external drivers and logistical support. Barriers included operational constraints, individual-level factors and lack of infrastructure. Conclusions This first survey of organizational supports for EIHC/KT identified the range of supports in place in paediatric research and health care organizations across Canada. The diversity of supports reported across sites may reflect differences in resource capacity and objectives. Similarities in EIHC/KT and research integration supports suggest common infrastructure may be feasible. Moreover, stakeholder engagement in research was common, but not pervasive. Tailored support programmes can target multi-faceted barriers. Findings can inform the development, refinement and evaluation of EIHC/KT support programmes and guide the study of the effectiveness and sustainability of these strategies.

This review paper aimed to undertake an extensive exploration of the extent, range, and nature of research activities regarding the effect and emerging evidence in the field of physical activity interventions on cognitive development among children and youth (0–17.99 years) with neurodevelopmental disorders (NDD), and to help identify key gaps in research and determine precise research questions for future investigations. To carry out this scoping review, five electronic databases were searched. A total of 12,097 articles were retrieved via search efforts with an additional 93 articles identified from the identified review papers. Sixty articles were eligible for inclusion. The results of this scoping review revealed many positive key cognitive outcomes related to physical activity including, but not limited to: focus, attention, self-control, cognitive process, and alertness. No studies reported a negative association between physical activity and cognitive outcomes. Based on the findings from this scoping review, physical activity appears to have a favorable impact on the cognitive outcomes of children and youth with NDD.